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New data from Hopkins on Active Survelience

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Posted 10/24/2009 1:31 AM (GMT 0)
John Hopkins just released data on 470 Active Survelience patients of which 11% underwent radical surgery within 3 years of diagnosis. Findings:

Most disease progresses within 1-2 years, if it progresses.

This suggests under sampling of agressive tumors in the original biopsy.

Even with progresson most tumors had favorable pathology with 27% being insignificant.

A small % of men had significant disease.

Conclusion: The study indicates a strong potential of AS as a treatment strategy.

http://prostatecancerinfolink.net/2009/10/22/pathology-of-prostate-cancer-in-patients-after-active-surveillance/

I would strongly recommend that anyone considering AS get a color doppler ultrasound or a 3D mapping of the prostate to identify any agressive tumors that may have been undersampled. This would significantly reduce the number of men on AS ever needing treatment.

JohnT

Posted 10/24/2009 3:28 AM (GMT 0)
Interesting data there on AS, John. Thanks for sharing.
Posted 10/25/2009 1:48 AM (GMT 0)
I did AS for 4 years after Dx before facing the Da Vinci. While these types of studies  sometimes naturally make me 2nd guess my Da Vinci encounter, I am reassured that, if my tumor could be insignificant as the study suggests, then it gives me hope that taking it out means cure for me!

Posted 10/25/2009 2:15 AM (GMT 0)
Thank you, John, for another interesting article.

(When I was first diagnosed with PC, I started scanning for information all over the Internet. Thankfully, I found this site and more thankfully I found some pertinent posts that were written by John T. He set me on the path of looking into color doppler testing and other forms of testing which resulted in me vying for AS.)
Posted 10/26/2009 2:07 AM (GMT 0)
Hi John,

you are totally right. Everyone should know what type of PC he has, so he can make a decision he can live with.

When I asked the doctors ( 6 ) I consulted with about doing those tests they all advised in my case it won't make a difference.

My biopsy which included several refined tests showed I have tumors on the left, middle and right of the gland. 3 cores all 5% T1C G6. AS for me would be a long shot 50/50, but still, I would liked to know how aggressive my PC is.

Thanks, John.
I included the following in case some one would like to know about the tests you mentioned.

You might need to copy and paste.

What is 3D Mapping Biopsy?
http://www.hopeforprostatecancer.com/3d.asp

What is Doppler Ultrasound?
http://www.webmd.com/a-to-z-guides/doppler-ultrasound
Posted 10/26/2009 2:33 AM (GMT 0)
GTA
http://www.prostate-cancer.org/pcricms/sites/default/files/PDFs/Is10-1.pdf

On page 3 there is an article "Monitoring AS through High Resolution Color Doppler Ultrasound"
by Dr Duke Bahn. It has a number of examples of how CDU made a difference in a patient's decision on treatment. This is must reading if you are in the research stage.
The two best CDU doctors are Fred Lee in Rochester Mi and Duke Bahn in Ventura Ca. I have also heard good results from Dr Dattoli in Sarasota Fla and Dr Sconti in NYC.
Dr Bahn's website is PIOA.org (Prostate Instutitute of America)
The skill of the doctor is paramount and Lee and Bahn are the best of the best.
My doctor's said the same thing and they were dead wrong. I would have been looking at a failed surgery if I had not had a CDU.
JT
Posted 10/27/2009 3:18 AM (GMT 0)
JOHN,

thanks for the info. It is a very educational article and a must read for everyone as you advised.

If someone wants to look up the article and could not do it with the links you provided, they can try the following link and look for February 2007 vol 10, No. 1

http://www.prostate-cancer.org/pcricms/node/59

I will be meeting again with 2 doctors to discuss my options. I will not go with any procedure without first do the Color-Doppler.

the following link tells you what recommendations the first group of doctors advised.

https://www.healingwell.com/community/default.aspx?f=35&p=1&m=1614725

Thanks
GTA
Posted 10/27/2009 4:01 AM (GMT 0)
Below is a link from where I had my saturation 3 D mapping in a .pdf file


http://alprostate.com/Documents/TFTMAPPING.pdf
Posted 10/27/2009 2:59 PM (GMT 0)

JT:

I finally got around to reading your links and they are terrific.  The info from Dr. Bahn continues to make a compelling case for color doppler.  As I have stated before, I had no info on color doppler before coming to this site and my one regret re my treatment is that I did not have CDU prior to my BT.

On another subject, as you brought up HDR BT in another thread, do you have any thoughts or specific advice re the use of HDR as a primary treatment for early stage PCa?  I have a friend who has recently received the "news".  He is 69 years old with G6, and a very small nodule identified via DRE...I don't know his percentages...  He refuses to consider AS but has been encouraged by the URO group he goes to to choose between surgery and HDR.  Anyway, any thoughts on HDR as a primary treatment would be appreciated.

Tudpock

Posted 10/27/2009 4:35 PM (GMT 0)
Tud,
I Don't really know a lot about HD Brachy. There isn't as much data as there is for regular Brachy.
The procedure is somewhat longer and the radiation implants are temporary not permenant, like we have. Sorry I couldn't be of much help.
JT
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