<p>^^Who needs Nurse Ratchett??</p>
<p>MOWC…cyber hugs to you form across the oceans. I am sure you and DH, clever folks, made the best choices for your health. God speed.</p>
<p>MOWC – here is a link to a book by Dr. Patrick Walsh. A while back, I read something about prostate cancer, and his name was given as the best MD in the field. <a href=“http://www.amazon.com/Patrick-Walshs-Surviving-Prostate-Cancer/dp/0446679143/ref=pd_bxgy_b_text_b/102-7124440-4949705[/url]”>http://www.amazon.com/Patrick-Walshs-Surviving-Prostate-Cancer/dp/0446679143/ref=pd_bxgy_b_text_b/102-7124440-4949705</a>
Here is another link to his bio <a href=“Patrick C Walsh, M.D., Professor Emeritus of Urology | Johns Hopkins Medicine”>Patrick C Walsh, M.D., Professor Emeritus of Urology | Johns Hopkins Medicine;
<p>I’m sure you’ve had your fill of advice, but sometimes another resource is worth looking at. If you’ve had enough, feel free to ignore this! :)</p>
<p>Best wishes for a speedy recovery.</p>
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<p>What kind of knee surgery on the big dog? Our St. Bernard had ACL surgery on one of his knees two years ago. The Elizabethan collar was NOT big enough and he tore his staples out several times. We finally had a friend who makes orthopedics graft another 8 inches of plastic on the collar and that finally did the trick. And yeah, not covered by insurance to the tune of $4,500, with all of the complications included. He’s doing great now, though.</p>
<p>I hope your husband’s surgery is a success! And that your son feels better soon. Our son called last week from Urgent Care, with bronchitis and an asthma attack (his first asthma attack since about age 12 or 13!). I felt so helpless but he’s recovered now. Hugs to you!</p>
<p>MoWC- I’m sorry about your husband’s illness! As with all treatments, there will be disenting opinions about what is best. Go with your gut - I’m sure you will do what is right for you. Good luck!</p>
<p>Would that you could pinpoint the exact moment in time that would give you the latest possible diagnosis with absolute survivability…but you can’t. Early detection maximizes the chance for a complete recovery. In my mom’s case, scintimammography detected cancer before a palpable lump had even formed. Biopsy confirmed the scintimammogram diagnosis…and she may walk away from this with lumpectomy, radiation and possibly no chemotherapy. Two years from now, who knows?</p>
<p>I believe in early detection and there is plenty of current medical thought to support the benefits of early detection. All of the deaths from prostate cancer that I have learned of were cases where symptoms were ignored and there was no early diagnosis. We’ll take our chances with early detection and treatment, thanks.</p>
<p>The dog is a large Golden Retriever and had a torn ACL. I can’t imagine how big the E collar had to be for your St. Bernard! It probably didn’t fit through doorways. As the surgeon said, “big friends” seem to have these ACL problems more frequently than “little friends”.</p>
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<p>And that is the problem. How do we know? If we aren’t going to disturb someone’s peace of mind by checking PSAs or, worse, biopsying their prostates, then we are treating everyone as if they have slow growing disease that that won’t die from and that simply isn’t true. Although the number of prostate cancer deaths/year has been decreasing since the late 90’s, it still amounts to 30,000 deaths/year.</p>
<p>PSA rate of change, age adjusted PSA, PSA density, % free PSA all may help identify patient’s at greater risk for the disease. As for treatment once diagnosed you then have to take into consideration age and health. A 61 year old should be treated very differently (more agressively) than an 81 year old (careful monitoring).</p>
<p>Pat Walsh (N.B. - strong advocate of screening and surgical treatment), writing in the J. Urol., 169:4, p.1588-1598 (April 2003) about two studies out of Sweden where their socialized, centralized medical care system seems to allow them to do these types of long term, randomized studies of cancer:</p>
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<p>2dsdad -(Disclosure: urologist, that is, a “cutter” and advocate of da Vinci robotic prostatectomy)</p>
<p>MOWC, Good luck to you and your H with the treatment and recovery!</p>
<p>MomofWC…so sorry your adjustment to my former home town has begun with your husband’s diagnosis and treatment. Thank God he has been staying on top of his check ups all these years and also that there is such a great medical community in your new home city. Great news that he is going to be on top of this! good karma for you and yours this first holiday season in a town that I am sure you will come to love.</p>
<p>MOWC, sending prayers and good wishes to you and yours for a speedy recovery.</p>
<p>Faline2- we love our new town already. We are thrilled with almost every aspect of it. It is beautiful, friendly and fun. All the kids (D, S and D’s boyfriend) will be hear for Thanksgiving (post-surgery for H) and will only have to maneuver around a few unpacked boxes. I am starting to “get” the whole SEC football thing!</p>
<p>Far be it that I would tell a cutter how to practice his medicine. I will quote, however, from the American Cancer website which summarizes the recommendations various professional associations:
BTW, neither the NCI nor the American Cancer Society recommend routine screening either.</p>
<p>Some groups DO recommend screening for those with additional risk factors, such as relatives with disease, race etc. </p>
<p>BTW, it is interesting that even the uro’s own quote of Walsh’s editorial is pretty equivoval - hardly the strong endorsement one would expect of a true advocate of surgery.</p>
<p>I realize that this kind of screening advice is counterintuitive to many folks, including some physicians. But that’s the reason conventional medical wisdom needs to be investigated and challenged. Anecdotal evidence, which is all a single medical professional can get, is not enough on which to make decisions.</p>
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I don’t feel that you are telling me how to practice medicine. In the interest of full disclosure, I just wanted to be clear where I was coming from so that the OP, whose husband is already diagnosed with prostate cancer, or other readers of the thread can evaluate the source of information. Could I have a bias? Of course!</p>
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The public can be understandbly confused at this point when you can also find on the ACS website the following under Guidelines for Early Detection of Cancer (Prostate):
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<p>Although I don’t know all the details of his situation, I would support the original poster’s husband’s decision to seek treatment based on his age alone and the choice of robotic surgery, for reasons we don’t have to get into here, is a good one. In general once a patient makes whatever decision he feels is right for him he should be supported in that decision. I wish him the best.</p>
<p>Thanks, 2dsdad. We researched and networked quite a bit, and it seemed that most (all, in our universe) of the men in a situation comparable to my husband’s opted for the robotic surgery. We haven’t spent a minute doubting this choice- it seems like the clear right thing to do. I’m not sure people realize that if the radiation treatment doesn’t work, the later surgical options are almost non-existent.</p>
<p>2dsdad, </p>
<p>You should know there is a big difference between “offering” and “recommending”. </p>
<p>If you had read the quoted material I posted, you would see that it says the same thing as what you posted. And, it is for reasons like this that the public must depend on health care professionals being up to date with the latest clinical research and recommendations. Too many are not, and recommend practices or treatments that are ineffective or worse. </p>
<p>BTW, I neither concur nor disagree with the OP’s decisions, particularly since we don’t have access to much of the critical information needed to make a decision. That’s why I find “drive by” decisions, such as yu made in post 34, to be so curious. Perhaps you feel you gained enough information in a PM, though I wish medical decision making were always so simple.</p>
<p>2dsdad, </p>
<p>You should know there is a big difference between “offering” and “recommending”. </p>
<p>If you had read the quoted material I posted, you would see that it says the same thing as what you posted. And, it is for reasons like this that the public must depend on health care professionals being up to date with the latest clinical research and recommendations. Too many are not, and recommend practices or treatments that are ineffective or worse. </p>
<p>BTW, I neither concur nor disagree with the OP’s decisions, particularly since we don’t have access to much of the critical information needed to make a decision. That’s why I find “drive by” decisions, such as yu made in post 34, to be so curious. Perhaps you feel you gained enough information in a PM, though I wish medical decision making were always so simple.</p>
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<p>AMEN!!!</p>
<p>Newmassdad, what “drive by” decision did 2dsdad make? I just see a professional offering a general opinion, and trying to support the decision that someone has already made. I, for one, really appreciate it when someone with expertise in a particular field offers some general opinion – I’d never rely on such an opinion to make a decision, but I’m a big believer in gathering all possible information.</p>
<p>I appreciate the input from 2dsdad. He is in a better position than any of the rest of us to understand the options and the risks.</p>