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Part 9: Prostate Cancer CAN Be Cured!!!<
DETECTION:
When detected in its early stages prostate cancer CAN be cured
with a minimum of adverse side effects to the patient. The key to a
proper cure is EARLY DETECTION!!!
A PSA test will detect the quantity of Prostate Specific
Antigen in the blood stream and this simple test should be used to
detect the first sign of an impending problem.It is important to
realize that the PSA test (using test methods currently employed) is
accurate to +/- 30% and that these results can vary between labs and
even within the same lab at different times. There are also other
factors which may contribute to higher than normal PSA readings and
these may have nothing to do with prostate cancer. So - the PSA test
should be considered a warning sign which indicates that ADDITIONAL
confirmatory tests are needed.
Once an initial PSA test indicates the possibility of prostate
cancer the first confirmatory test should be an ultrasound coupled
with a biopsy. Examination of the ultrasound results and the
microscopic examination of the biopsy slides is completed, a Board
Certified Urologist can then make an accurate determination regarding
both the quantitative concentration of cancer cells and their
physical nature. Once this information had been determined the
prostate cancer in question can be given its full and proper
identification. This will include P.S.A, Gleason Number, and TNM
Classification. The Urologist will now be in a position to explain
the significance of the test results and suggest possible methods of
treatment. It is important to realize that Urologists are surgeons
and may opt for a form of treatment which they are more comfortable.
PLANNING FUTURE ACTION:
With the "First Name, Middle Name, and Last Name" (PSA, Gleason,
TNM) of the cancer properly identified, the patient is now in a
position to do independent research of the literature on his own.
Suggested readings are: The Prostate - A Guide for Men and the
Women Who Love Them by Patrick C. Walsh M.D. and Janet Farrar
Worthington. Johns Hopkins University Press.
A Johns Hopkins Health Book.,Prostate Cancer: A Non-Surgical
Perspective by Kent Wallner M.D., Smart Medicine Press, Canaan, N.Y.
and Man to Man: Surviving Prostate Cancer, by Michael Korda,
Random House Press.
The latter is a first hand account written by one patient who
underwent surgery. There are many other books on this subject which
are available in a comprehensive bookstore. I found the ones I have
suggested are adequate to provide a base of knowledge to make an
informed decision.
I was comfortable enough to devote over two years to "watchful
waiting" and study of the problem. Not all men will be emotionally
able to do this. If "watchful waiting" is something you can live
with, it should be done only with periodic monitoring of the PSA as
directed by a Board Certified Urologist or Radiologist.
I spent a considerable amount of time studying the problem. I have
tried to summarize the facts and have indicated the location of
supporting literature. A reader of this book could probably make an
intelligent decision concerning a treatment procedure in less than
two months.
Having now established the parameters of the cancer and with
increased knowledge of various methods of treatment the patient would
now be well advised to consult an additional source of professional
information. The Urologist has offered his suggestions and the
opinion of a Board Certified Radiologist should now be sought out.
In my personal and nonprofessional opinion, the patient should
consider IMRT Conformal Therapy. Since there is a considerable
learning curve required by the facility using this technique, it
would seem reasonable to restrict the selection of possible
facilities to these which have performed at least 500 such
treatments.
SELECTING TREATMENT:
Armed with an accurate description of his disease, fortified with
as much technical knowledge as he can absorb, and having opinions
from practitioners of both surgery and radiation, the patient is now
in a position to make an informed and knowledgeable decision.
The treatment of each patient is individualistic and the response
of one patient may not duplicate the response, or reaction, of
another. That decision may involve "watchful waiting", surgery, or
radiation as well as one of the several other forms of treatment
which are available.
It is VITAL that the patient select the BEST POSSIBLE TREATMENT
for HIS case "UP FRONT".
Medical procedures to recover from failed attempts to cure
prostate cancer are called "salvage therapy" and may generate many
additional and unwanted problems. The success rate of salvage therapy
is usually much lower than choosing the proper treatment INITIALLY.
It is important to realize that prostate cancer is a very slow
growing cancer and there is usually no need for rash decisions -
particularly involving early detection of low order cancers.
During the period of "watchful waiting" the patient, under the
proper medical supervision, can determine the "velocity" of his
disease to see how rapidly it is progressing. In my own case I opted
for two years of "watchful waiting", two years of evaluation of
medical procedures combined with additional testing and a final
treatment fully five years after the initial cancer cells were
detected and rated at a PSA of 7.5.
Considering the rapid development of medical treatment of this
disease, my choice of response to my disease was a fortuitous one.
The IMRT method I chose was first being offered at
the time I began my "watchful waiting". During the next five years
the procedure was refined and developed further as additional test
and treatment data was developed - especially concerning the
advantages of Androgen Ablation and higher levels of radiation which
could be administered as a result of the greater wealth of experience
at the treatment facility. "watchful waiting" - if possible -
therefore offers the possibility of improved treatment at a later
time.
THE PRIME OBJECTIVE:
The PRIMARY and ONLY OBJECTIVE of treatment must be the CURE of
the cancer, or forcing it into REMISSION, WITH A MINIMUM OF ADVERSE
REACTIONS TO THE BODY. The objective is NOT to find the quickest or
most convenient medical procedure or one that will "get rid of my
cancer the quickest". Cancer CURE with MINIMUM collateral damage is
the PRIME OBJECTIVE! The patient should insist that all physicians
involved in his treatment be BOARD CERTIFIED.
DURATION OF TREATMENT is not as important as the PRIMARY
OBJECTIVE.
The quickest form of treatment may not always be the best for a
specific patient.It is true that there may be certain mitigating
circumstances such as interference with employment which enter into
this decision. However, if at all possible, the PRIMARY OBJECTIVE
should be kept in mind. Many of the forms of treatment, of shorter
initial duration, may offer the possibility of adverse side effects
which will continue for years and the treatment itself may
incapacitate the patient for some time.
CONVENIENCE of treatment is of much less importance than the
Primary Objective. The inconvenience of traveling a long distance, or
perhaps staying in a strange city during treatment will be forgotten
soon enough. The CURE will last the rest of the patient's life. He
will live with the presence or absence of negative side effects for
years and perhaps the rest of his life.
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