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Old 11-13-2012, 06:38 PM   #13
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Join Date: Jul 2010
Posts: 39
RBK1111 HB User
Re: Rising PSA, need guidance on next move

I cannot say this strongly enough. Surgery is the LAST option that should be considered, and yes you are way ahead of science and a need to systematically make a determination. Who does your biopsies is not as important as how many and where take from, i.e. 12-14 from both capsules, and secondly, the correct "specialized" laboratory to analyze the samples. If cancer is found, then it requires an understanding of Gleason Scores, a rediological bone and lymphatic assessment. It is also important to know where the "suspicious" finding was located and then to begin the process of knowing as much as oncologists before consulting with one. Each oncologist has their personal philosophy and approach so you need to be able to discuss issues as a "colleague" not a subordinate. All treatment carry some risk of impotence and/or incontinence, and surgery in my view is the most dangerous and often unnecessary. Finally, with a Gleason of 3/3 which is often the most common, no treatment is the best course of action with careful and routine psa, dre, dopplar monitoring.
Originally Posted by Pratoman View Post
Thanks Chris. Thats what i am thinking. Unless the doc at Columbia tells me tomorrow that there is a good reason to wait on the biopsy, i''ll just get it done. The only question will be do i do it near home at my "long time" Urologist (who does have 30 years in practice), or do i do it at Columbia. Because if it went any further, i.e. if it was positive, i would go to Columbia, or Johns Hopkins, to get the surgery done (i know, i am getting way ahead of myself, thats how i am).
So we'll see tomorrow.
I pickedup a copy of my records from my doc today to bring with me. It was like 50 pages. WTH? What could be in 50 pages when i haven't even been sick yet. I told the secretary to seal the envelope so i am not tempted to open it and read thru it.