TV Anchor, Kurt Ludlow, goes public with his diagnosis

Have any of you been following this? It's interesting, and he's being pretty forthcoming about it.

Here's a link to one story. You can find many with simple searches:
newsroom.ohiohealth.com/abc6fox28-anchor-kurt-ludlow-diagnosed-with-prostate-cancer

Watching one of the videos, his doctor said it's Gleason 6 and Stage 1. Then eventually they cut back to the studio, have a little banter about PSA screening, and then Kurt says something like "Of course I'm in favor of it!". They all laugh in obvious "Of course!" agreement and fade to commercial.

We've discussed PSA screening here ad nauseum, but I wonder about his case. Is he possibly the type of case doctors are actually trying not to find? I wonder how many cores, how much Gleason 6 there is? I haven't seen any follow up yet about what they're thinking of doing. Hopefully, if it's a low volume G6 they'll explore Active Surveillance. He could possibly do a great public service by not selecting treatment.

I'm obviously in favor of PSA screening. I'm a little concerned with the tone of this item, that finding a Stage 1 G6 is life-saving. Maybe, but those would typically take a long time to become a true threat. If he opts for treatment, I hope they do a good job of explaining why.

[Edit: I just learned that he is in surgery, apparently today, Monday 9/19. Here's to a successful surgery!]

And I'm afraid I had to wince a little when I heard that surgeon, who should know better, say that one in six men will GET prostate cancer, when it's one in six men will be DIAGNOSED with it.

Just a slip, I'm sure, but still ...

I don't like how you seem to think you know what is best for him. If he wants to do RP then let him. It's a very well accepted recommendation.

I thought that this forum required us to respect people's choices.

Tud,

I think you should reread alephnulls post.

If I made similar statements about AS or Radiation I am sure you would find it disrespectful.

Post Edited (RCS) : 9/20/2016 7:02:03 AM (GMT-6)

RCS, I see your point and if alephnull had stated to one of our members, "your doc didn't educate you very well" the post probably would have been subject to edit. However, he was speaking about a public figure who has chosen to publicize his choice. With the info provided, I thought his questioning was within bounds.

The truth is that I would rather err on the side of avoiding over treatment rather than worrying about hurting some public figure's feelings -- especially since there is no evidence that said public figure is present on HW. Our focus needs to be on support for members that need it and, very importantly, making sure new members get info that helps them become empowered patients.

Jim

Yeah, I listened to the video link; so there is quite a bit of info about his case there. 3+3, 3 cores, <5%, PSA was just over 4ng/mL, negative DRE.

Had surgery yesterday.

He made this comment in the video (comment made last week, within a month of his diagnosis) about the PSA test: "Hopefully it saved my life."

An empowered, educated patient would have realized that his longevity was not at risk with those case metrics.

So in summary, it seems the moderator feels it is ok to disrespect this guys choice because he is a public figure; others believe it is ok to disrespect this guys choice because they feel it is the right thing to do; and another that it is disrespects the doctor and not the guy.

My original statement was only a reminder that the forum requires that we respect guys choices ..... then for whatever reason the moderator and others chose to defend why it was ok not to respect this guys choice. I do not make the rules, or interpret them, but somehow this feels highly skewed.

With that I'll shut up.

Post Edited (RCS) : 9/21/2016 6:26:19 AM (GMT-6)

Hi,

I watched the video and two points stood out.

1. The Gleason score was given as going from a low of 1 to a high of 10. Clearly the lowest is 1+1.

2. More significantly, the urologist either ignored or was not aware of the 2005 ISUP consensus conference which essentially made the Gleason score 6 the lowest score: the urologist declared the scores 5, 6, 7 to be be middle scores. With such advice, no wonder the patient opted to avoid Active Surveillance.

halbert said...
This brings up, yet again in my mind, the abject failure of the professional medical community to consistently provide good, solid, science based information to their patients and the public at large. The unwillingness to call the bad actors to account IS a big deal.

I agree. I think your comment is very much on-point. There IS an extra-ordinary amount of "physician variation" in the management of favorable-risk prostate cancer...much more variation than there should be.

So, halbert, how should we accomplish what you are calling for...to "call the bad actors to account?"

I have some ideas; I'd like to hear yours (or the ideas of other people).

alephnull, I also won't "blame" patients. Rather, I will encourage patients to participate in the process, educate and empower themselves to become knowledgeable and involved. Multiple studies have been shown that those patients who are most involved end up having the highest satisfaction with their outcomes, and those who are involved/educated the least tend to have the highest regret.

It sounds like your viewpoint is solidly aligned with halbert's comment to blame the doctors for failing to educate patients, which seems to result in the wide variation for the treatment of favorable-risk cases. halbert wants to "call them to account." Any ideas/suggestions on how to do that?

Have certain standards of practice that are NOT set by the physician class.

But along with that give the physicians a break by not allowing them to be sued for every last little thing.

Should they be sued for not fully educating patients? Heck no. But they should be required to do so.
Punishment by their Medical Boards should be enough.

On the subject of 'calling to account'....I don't have a good idea of how to go about it. Unfortunately, the best way would be if the medical community itself would do it...but they likely won't. Whether we like it or not, reality is that the vast majority of prostate patients go from a GP to a urologist to biopsy to treatment in pretty short order, and never ask any questions beyond "what do I do about it?"

At my most cynical, I'd propose a remedy found in this chilling sci-fi short story, "The Public Hating" (sorry, I couldn't find a link).