Post by Alan MeyerYou might even consider a test in a month and a
consultation with a radiation oncologist if the rise is faster than you
are expecting.
I suggest wearing hip boots at that consultation. The entire
interdisciplinary tumor board of a major medical institution were
adamant that I undergo full-blown salvage radiation (SRT) when my PSA
took off 10 years post-op. Their only rationale was "Just In Case" ...
*just in case* the source was in my old prostate bed.
I don't operate ... or irradiate or take 18 prescription drugs (some
with high risks of serious to crippling side effects) ... that way.
Instead, I do enough literature research to answer these two absolutely
vital questions as best as I can:
1. Does this oncologist know what the heck s/he's talking about?
The answer in my case with several oncologists of all specialties was
not only "No" but "Hell, no". Sez who? Sez the top tier radiation
oncologists who taught these "several oncologists" their trade. Sez
definitive and irrefutable scans of my abdomen, which clearly ruled out
SRT. Sez their own published studies which produced MSK's SRT nomogram*.
Sez the errors I caught and they corrected in their paper and nomogram.
And sez the ensuing scans that finally *PROVED* my recurrence was
exactly where I thought it was: Somewhere outside the prostate bed and
thus unreachable by SRT.
* I would never even consider SRT without feeding my numbers into MSK's
SRT nomogram (Google it) to get my own personal likelihood of benefit.
2. Which treatment (including observation) is best FOR ME?
Upon close examination, my (and everyone else's) priorities are
different from the next patient's and from every oncologist's.
Both of those, separately and in conjunction, have encouraged and
enabled me to make some life-altering decisions I still support after
many years of heavy duty reexamination.
It's too late for Hikerman's initial decision, but a G 3+4 prostate
cancer often needs no active treatment in the first place, because it
often behaves like a 3+3 often (usually?) does ... i.e., it's going
nowhere in our lifetime. That's a major reason why routine PSA screening
has been discouraged: too many patients and too many oncologists panic
and act for no reason just because of a cancer diagnosis, incurring
decades of side effects with no benefit.
Similarly, my present oncology clinic wants me on several drugs based on
a few carefully chosen studies showing some benefit and not even
addressing side effects unless they are very common AND
life-threatening (that shocking paradigm pervades peer-reviewed
literature). Second only to my main anti-cancer drug (testosterone), my
medical oncologist strongly urges statins for me way ahead of whatever's
in third place. It took me about one minute to find a copy of Evans'
book, "Statins Toxic Side Effects: Evidence from 500 Scientific Papers".
I'm highlighting, annotating, and sending it to him just for starters.
Next, I'll condense several books written by world-renowned
cardiologists, medical statisticians, and the like proving that statins
benefit almost no one who hasn't already had their first heart attack
... if even them. Women with the highest cholesterol live the longest,
the same goes for men past age 65, and simple dietary changes can do far
more for our lipids profile, with zero risk, than any known drug can.
It's knowledge like that which persuades and encourages me to keep
reading, keep questioning every recommendation, keep trying out or
rejecting prescribed drugs until I'm convinced their benefits outweigh
their risks TO ME, and keep ultimately making my own decisions. That's
priceless.
I.P.