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Old 07-08-2008, 02:09 PM   #3
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Join Date: Jul 2007
Location: North Carolina
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Re: Diagnostic bone and CT scans: worthwhile?

Originally Posted by IADT3since2000 View Post
.. just ran across a statement by another doctor along the same line.... that ... MRI and endorectal MRI, are not necessary for low-risk patients.

Jim- another viewpoint:

When I asked my urologist about getting an MRI, since I initially was headed for robotic surgery, I was told it's not necessary for low-risk patients. Then I ended up getting the test as part of the workup for my proton radiation- my ultimate choice of treatment. That test was somewhat inconclusive, although there were possible signs that the cancer had gone beyond the edge of the capsule. I had some waiting time of not knowing, but then got a more accurate spectroscopic (endorectal) MRI, and the reading of that concluded that I was ok, with no extracapsular penetration.

But my question is this: how does one conclude it's truly low risk when the chances of something like this are ever-present. And if one did have penetration beyond the edge of the capsule, and had surgery, there would have been a high liklihood of positive margins, so radiation might then be the logical step afterwards. So the middleman, surgery, could have been avoided under those conditions. I don't think surgery would have been the choice under those circumstances, but no one would have known until it was too late.

As it was, based on the findings in my tests, coupled with my physical exam, they chose to radiate a little deeper into the margins where the suspicious activity was going on.

So yes, overtesting is not good in itself, but how does one really judge what's necessary? I was a Gleason 7, by the way, when I was told by the urologist I was low risk. (I would have ranked me as intermediate.)