When I was recommended to see a urologist due to PSA numbers up, I went and he wanted to do a full biopsy. I wasn’t ready for that and convinced him that an MRI was better. The results showed no cancer. Fast forward one year. I get another MRI, urologist tells me there’s a spot. I get a fusion biopsy. Gleason 6. The urologist makes an appointment with a radiologist who told my wife and I all about the wonders of radiation. I am thinking active surveillance all the time. After the radiologist I go back to the urologist and he asks me if I want hormone shots today? I told him no and we left. I started looking for second opinions and settled on Memorial Sloan Kettering with a urologist attending pro AS. Since I started here, I’ve had one telemedicine appointment last Fall and another coming in March, 2024. Preceding it, I went to my GP to get blood work. The PSA results: 5.5. These results went to Sloan and will see the next steps in March.
To those who comment here and those who read the comments but choose not leave personal insights, analogy of the bully aptly described by Howard and his success taking "one step forward" implies-at least for me-each of us has an obligation to challenge "the party line" and no better place to start than meetings of patient-centered hospital affiliated PCa support groups. If one is to believe the Hippocratic Oath bears influence in the practice of contemporary medicine in America, the oath revised in 1964 states in part, "I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist drug." Dr. Louis Lasagna, Academic Dean at Tufts University School of Medicine
Once diagnosed, self advocacy, research and second (third, fourth opinions) to me seem absolutely necessary. Yes it requires work and resilience on the part of the patient. However, this ultimately gives you the knowledge to make the best decision for yourself and to not let one doctor force you into a corner and make a choice you may possibly regret. Great article!
Thanks, Howard. I have indeed explored all the current options, and in fact had a Urolift in 2019 that improved nothing. But at least it sent me to the hospital for three days of CBI until everything cleared up. Unfortunately the medical insurance situation I have doesn't offer Rezum, Aquablation or Tulsa-Pro. So a ride in the back of dad's car it is. (not a Batmobile) I'll certainly put June 1st on my calendar.
Good piece, Howard. I'm glad John followed your advice. In my case, after my 2018 targeted biopsy showed 2 low-volume G6 cores (soon after confirmed by Dr. Epstein), my first urologist insisted on treatment. To his credit, at least he didn't specify a modality.
I then sought 5 other opinions (I wanted to be sure), including some heavy hitters here in the major city where I live. None of the others agreed with him, and I liked the last guy especially - so he's my urologist now and I've been content on AS since then, coming up on 4 years in August.
Now the BPH... another issue, and I'm headed for a TURP in June. Oy vey.
Tom,
Good to see a proactive patient in action.
Stay on top of it.
Howard
When I was recommended to see a urologist due to PSA numbers up, I went and he wanted to do a full biopsy. I wasn’t ready for that and convinced him that an MRI was better. The results showed no cancer. Fast forward one year. I get another MRI, urologist tells me there’s a spot. I get a fusion biopsy. Gleason 6. The urologist makes an appointment with a radiologist who told my wife and I all about the wonders of radiation. I am thinking active surveillance all the time. After the radiologist I go back to the urologist and he asks me if I want hormone shots today? I told him no and we left. I started looking for second opinions and settled on Memorial Sloan Kettering with a urologist attending pro AS. Since I started here, I’ve had one telemedicine appointment last Fall and another coming in March, 2024. Preceding it, I went to my GP to get blood work. The PSA results: 5.5. These results went to Sloan and will see the next steps in March.
To those who comment here and those who read the comments but choose not leave personal insights, analogy of the bully aptly described by Howard and his success taking "one step forward" implies-at least for me-each of us has an obligation to challenge "the party line" and no better place to start than meetings of patient-centered hospital affiliated PCa support groups. If one is to believe the Hippocratic Oath bears influence in the practice of contemporary medicine in America, the oath revised in 1964 states in part, "I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist drug." Dr. Louis Lasagna, Academic Dean at Tufts University School of Medicine
Once diagnosed, self advocacy, research and second (third, fourth opinions) to me seem absolutely necessary. Yes it requires work and resilience on the part of the patient. However, this ultimately gives you the knowledge to make the best decision for yourself and to not let one doctor force you into a corner and make a choice you may possibly regret. Great article!
Thanks, Howard. I have indeed explored all the current options, and in fact had a Urolift in 2019 that improved nothing. But at least it sent me to the hospital for three days of CBI until everything cleared up. Unfortunately the medical insurance situation I have doesn't offer Rezum, Aquablation or Tulsa-Pro. So a ride in the back of dad's car it is. (not a Batmobile) I'll certainly put June 1st on my calendar.
Good piece, Howard. I'm glad John followed your advice. In my case, after my 2018 targeted biopsy showed 2 low-volume G6 cores (soon after confirmed by Dr. Epstein), my first urologist insisted on treatment. To his credit, at least he didn't specify a modality.
I then sought 5 other opinions (I wanted to be sure), including some heavy hitters here in the major city where I live. None of the others agreed with him, and I liked the last guy especially - so he's my urologist now and I've been content on AS since then, coming up on 4 years in August.
Now the BPH... another issue, and I'm headed for a TURP in June. Oy vey.
(are you sure YOU'RE Batman though?)