That Frist Visit after PC Biopsy- What Questions need to be asked?

Trew I was devastated when I got that phone call from my URO the week after my biopsy.  My URO told me come to his office the next day as he wanted to give me a copy of a book titled "Surviving Prostate Cancer" by Dr Patrick Walsh and to read it before we had our first consult about my treatment and future. This book is considered the Gold Standard in PCa education and prostate health. It has a chapter on what questions to ask the URO and the options for treatments.  It also has information on how to find the right URO to use.  I knew nothing about PCa other than  both my Grandfather and Father had PC but neither of them talked about it, all I knew was get the PSA test done yearly.  You can find this book on Amazon or even a public library. You can also find many threads in here under the search option about this subject. I read Dr Walsh's book cover to cover in 3 days and my URO couldn't believe how knowledgeable about PC I was at our consult.

BTW I have told my URO about this HW forum and how I wish I had found it before 6 weeks after my surgery. He told me that he will now refer his PCa patients to this site.

Good luck in quest to help your friend,

Terry the Water Guy

Trew,

First I'm sorry that you even have to be at this site where no one wants to be. However, I agree that this site along with Dr Patrck Walsh's Guide to Surviving Prostate Cancer are good sources of information. After my disgnosis I purchased the book as an electronic iBook and read it in a matter of days and my knowledge increased immensely. From HW and the book, I prepared a list of questions on my iPad that I took with me to my appointment. Be careful not to overload yourself with information, as it will make your head spin. After my uro gave me the diagnosis, he suggested I take 2 to 3 days before I looked at the information given or surf the Internet. This was good advice for me. PCa is characterized as a slow growing cancer, so you should have time to make an informed decision. Considering my age and biopsy results, surgery was recommended by my uro and that is the decision I went with. I'm ten days out from surgery and I do not regret my decision one bit. It's a personal decision and if you have a good uro, they should be a good resource that you should not be timid to use.

Good luck in the future.

First question is to understand the characteristics of his case. Those characteristics can then be grouped together into a “risk classification.” The D’Amico Risk Classification is the most widely one used, and the NCCN (which differs only slightly) is probably the second most widely used. Everything else follows from an understanding of the risk classification: either Low, Intermediate, or High.

When there is a conflict in the Gleason score and PSA risk group, the worse factor wins and determines the risk category assignment. For example, a patient with a low Gleason Score of 6 combined with a PSA of 25 ng/ml is considered high risk. The exception to this would be, say, if there is only one positive core out of all of the ones sampled, in which case the risk category goes down to intermediate risk.

LINK

Because more men are diagnosed as Low Risk than any other, it could be prudent to anticipate the next part of the discussion. For many Low Risk men, well-known urology surgeon/prostate specialist from Memorial Sloan-Kettering (MSK), Dr James Eastham, often advises patients “let’s see what this cancer is going to do” rather than to rush into anything and possibly over-react to an indolent PC. Would this approach be prudent in this case?

Your friend might appreciate this free online webcast of MSK specialists discussing multiple treatment modes, and hearing Eastham comment on the “let’s see” approach himself HERE

Lastly, your friend should ask where the biopsy slides were read. Was it from a pathologist who specializes in prostate biopsies? If not, he should request having the slides re-read by someone like Johns Hopkins or Bostwick. Both are set-up for easy-to-do second opinions of prostate biopsy slides.



best wishes to your friend…