got some bad news today
MZB
I had my routine physical in August. Unfortunately, I was informed my PSA
test was 4.01.
I was put on an antibiotic for a few months and then retested. Ideally, if
it is an infection, the PSA would go down. Mine went up to 4.19. They also
did a "free PSA" test. This is more specific for cancer. Ideally, you want a
number above or equal to 25. Mine was 24. Once again, not good, but all of
the above numbers were in a grey area. But the fact that my PSA 18 months
ago was 2.97 and that the last PSA went up even after the antibiotics was
not good.
I then went to Univ. of Mich. hospital for a second opinion. They have a
brand new test, the PCA-3, that is really specific for prostate cancer. 35
is the cutoff point there. Higher than 35 is not good. I just got the bad
news today. Mine was 75.9, which is just not good at all.
None of the above is diagnostic, but it is suggestive. I have to undergo a
prostate biopsy and do it quickly. Now, this is interesting. I indicated
that I would like to get the happy juice (ie: the colonoscopy type of
sedation) for the procedure as I am feeling rather wimpy about all of this.
The doctor didn't really want to do it that way, but would. Anyway, she
talked me into not going that way. I then had to talk to scheduling I want
it done ASAP. Well, I could get it done on 12/18 or they can squeeze me in
on 12/11, OR if I want the sedation, they can do it in the OR on 11/30! That
convinced me! I'm doing it on 11/30.
Now for my questions. I usually do my own research but I am now in scared
panic mode and I am just not thinking clearly. First, is there still a
decent chance that I do NOT have PC? It appears from the research I did that
there is about a 55% chance of a positive biopsy. It seems if the PCA-3 test
is that good, there would be a much higher probability, so maybe I didn't
read it right (this was awhile and I am having problems finding the
reference again). Can someone help me out on this? Also, we know that
biopsies can certainly miss cancers, so saying there is a 55% chance of a
positive biopsy does not mean there is a 55% chance you have cancer. Am I
correct? Wouldn't it be much higher?
Finally, I am now worried about having aggressive cancer, based on that
stunning number. I recall reading that they hope to use the PCA-3 to find
aggressive cancers, but I'm not sure if they quantified any of that or maybe
they even meant subsequent to one positive biopsy?
I'd appreciate any information.
Mel
--------------------------------------------------------------------------------
safire
According to the company that developed the PCA3 test (Niovogendix),
based on a test of 529 men, of the 86 men with a PCA3 score of between
50 and 100, as much as 50% still had negative biopsies. It appears that
you've read it correctly. Further, even if you would have a positive
biopsy, the cancer found may not require immediate treatment or any
treatment ever. Do yourself a favor and don't rush into treatment as you
are now rushing into the biopsy. There is substantial overtreatment
(i.e. unnecessary treatment) of PCa in the U.S. How old are you?
Califchief
> Now for my questions. I usually do my own research but I am now in
> scared panic mode and I am just not thinking clearly. First, is
> there still a decent chance that I do NOT have PC?
There is always a chance. You quoted 55% figure for positive tests.
Thus, using your math, there is at least a 45% chance for a negative
test.
Could your PSA test results stem from BPH? Have you had ultrasound
scans of your bladder and prostate?
Has there been a change in peeing? Quantity? Weak stream?
Bladder doesn't feel empty? Multiple night trips to the bathroom?
___ Blue Wave/QWK v2.12
Andre
you have cancer. That is why they will do a biopsy. This will give you a
clearer view of the situation. It is perfectly possible that your Gleason
score is very low and that they will put you on "watchful waiting" and see
how fast you PSA is rising.
It is too soon to panic, but do spend some time on the Internet to see what
the options are if you happen to have cancer. This way, you can go informed
to your doctor and will better understand the treatment options which are
available to you. Even then, as your PSA is still fairly low, you have
plenty of time to make a decision.
Steve Kramer
news:he7l4j$nv8$1...@news.eternal-september.org...
: Now for my questions. I usually do my own research but I am now in scared
: panic mode and I am just not thinking clearly. First, is there still a
: decent chance that I do NOT have PC? It appears from the research I did
that
: there is about a 55% chance of a positive biopsy. It seems if the PCA-3
test
: is that good, there would be a much higher probability, so maybe I didn't
: read it right (this was awhile and I am having problems finding the
: reference again). Can someone help me out on this? Also, we know that
: biopsies can certainly miss cancers, so saying there is a 55% chance of a
: positive biopsy does not mean there is a 55% chance you have cancer. Am I
: correct? Wouldn't it be much higher?
First, I want you to know that I know absolutely nothing about PCA-3. I've
gleaned all my knowledge from your posts, responses to your post, and
www.pca3.org. So, if you say 35 is indicative of cancer, then I assume it
is.
If you say it is indicative of needed a biopsy, I get less enthused. When
you say that there is a 55% chance of a positive biopsy, I'm thinking 50/50
chance - a crap shoot. And you got here with odds of what? 30/70?
I don't know the percentages of missed cancer in biopsies. Based on our
peers in this NG, I'm guessing it's 1%. If so, then that would increase
your percentage to about 55.55% if I'm doing the math right. Maybe 56%. In
any case, it is too little to worry about.
Furthermore, if you want to decrease the chances of a missed diagnosis, have
them fill your prostate with needles. They used to do six as a standard.
Now they do 12, 18, 20. As I recall, your prostate is enlarged, so you'll
want as many as they'll do.
: Finally, I am now worried about having aggressive cancer, based on that
: stunning number. I recall reading that they hope to use the PCA-3 to find
: aggressive cancers, but I'm not sure if they quantified any of that or
maybe
: they even meant subsequent to one positive biopsy?
According to the video on www.PCA3.org, the guy who has everything to gain
said he is "absolutely pretty sure" that he will, from HIS studies, be able
to determine some day whether it is a "significant cancer." I am not
convinced by "absolutely pretty sure" or "significant." I give his chances
at about 50/50.
Now let me be clear, Mel. I am not shunning his method. There was a time
when some guy was trying to sell his idea of PSA as an indicator. At the
time, he may very well have sounded like a snake salesman and yet it has
become the best indicator PCA has ever known. Some day, we may be saying
the same thing about PCA-3. But, today, I would not put a lot of stock in
its results.
That said, I think YOU need a biopsy. You are convinced you have cancer and
nothing short of a biopsy will ease your mind. And, if a biopsy confirms
your fears, you'll be able to attack it at an early stage. As to
'aggressive cancer', I've had aggressive and advanced cancer since 2000 and
I'm still here with undetectable PSAs. I think you can count on a making it
to 70 years or better.
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum
Andre
PSA levels of 4.0 - 10 ng/mL and negative digital rectal examination.
Antibiotic therapy versus immediate prostate biopsy - Abstract
Friday, 20 November 2009
Department of Urology, Tel Aviv Central Consulting Clinic, Clalit
Healthcare Services, Tel Aviv, Israel.
shtric...@hotmail.com This email address is being protected from
spam bots, you need Javascript enabled to view it
The management of mildly elevated (4.0-10.0 ng/ml) prostate specific
antigen (PSA) is uncertain. Immediate prostate biopsy, antibiotic treatment,
or short term monitoring PSA level for 1-3 months is still in controversy.
We conducted a retrospective chart review of patients in a large
community practice (2003 - 2007) who had PSA levels between 4.0-10 ng/mL
without any further evidence of infection. Data was gathered regarding
patient's age, whether standard antibiotic therapy (10-14 days of ofloxacin
or ciprofloxacin) had been administered before the second PSA measurement,
results of a second PSA test performed at 1- to 2-month intervals, whether a
prostate biopsy was performed and its result.
One-hundred and thirty-five men met the study inclusion criteria with
65 (48.1%) having received antibiotics (group 1); the PSA levels decreased
in 39 (60%) of which, sixteen underwent a biopsy which demonstrated prostate
cancer in 4 (25%). Twenty-six (40%) patients of group 1 exhibited no
decrease in PSA levels; seventeen of them underwent a biopsy that
demonstrated cancer in 2 (12%). The other 70 (51.9%) patients were not
treated with antibiotics (group 2); the PSA levels decreased in 42 (60%) of
which, thirteen underwent a biopsy which demonstrated prostate cancer in 4
(31%). In the other 28 (40%) patients of group 2 there was no demonstrated
decrease in PSA, nineteen of these subjects underwent a biopsy that
demonstrated cancer in 8 (42%).
There appears to be no advantage for administration of antibacterial
therapy with initial PSA levels between 4-10 ng/mL without overt evidence of
inflammation.
ken
Step one...Don't panic. In the worst case scenario, if you have
prostate cancer there is plenty of sunshine even when advanced.
Schedule the biopsy. Early detection is the key. I had my prostate
removed on Nov 10th. Stay in touch every step of the way as the
support is important. My email is K...@maemusic.com
ken
They used numbing gel for my biopsy and althoough 'uncomfortable'. it
was not intollorable.
Alan Meyer
> By coincidence, there was the following research review in
www.urotoday.com.
>
> PSA levels of 4.0 - 10 ng/mL and negative digital rectal
> examination. Antibiotic therapy versus immediate prostate
> biopsy - Abstract
> There appears to be no advantage for administration of
> antibacterial therapy with initial PSA levels between 4-10
> ng/mL without overt evidence of inflammation.
That's fascinating. The percentage of men whose PSA went down
after antibiotic treatment was EXACTLY the same as the percentage
of men whose PSA went down without antibiotic treatment.
Most people, including most doctors, don't seem to realize that
antibiotic treatment poses risks to patients. They aren't big
risks, but they are real. We have huge colonies of beneficial
bacteria in our gastrointestinal tracts together with small
colonies of pathogenic (harmful) bacteria. It is believed by
some bacteriologists that the bacteria compete with each other
for survival and that the beneficial bacteria hold the pathogenic
bacteria in check.
If any of the pathogens are antibiogic resistant, they will grow
during the antibiotic treatment because trillions of their
competitors will die off. They may or may not make a patient
sick. At the end of treatment, the percentage of antibiotic
resistant bacteria in a patient will be higher than it was at the
beginning.
Invasive medical tests and treatments including antibiotic use
and X-rays and similar tests that expose a patient to radiation
are not neutral to a patient's health. They have short and long
term consequences.
This is not an argument against using antibiotics when we need
them, but it is an argument against using antibiotics (or X-rays
or other invasive treatments) when we don't need them. The
researchers in this study concluded that, in the absence of other
signs of infection, elevated PSA is not a reason to take
antibiotics.
Alan
Alan Meyer
I agree with what everyone else has said about dealing with this
calmly and educating yourself before rushing into treatment.
In spite of the big "C" word, your situation is not an emergency
and you run the risk of doing more harm to yourself by treating
it as one than by stepping back a bit. Be concerned, but don't
panic.
MZB wrote:
> ... Also, we know that biopsies can certainly miss cancers, so
> saying there is a 55% chance of a positive biopsy does not mean
> there is a 55% chance you have cancer. Am I correct? Wouldn't
> it be much higher?
I'd also like to add a comment on your question above.
If you have a properly conducted biopsy I would expect that if
there is a *significant* cancer, it will be found. It is true
that there may be cancer cells in your prostate that are not
found but, if so, they are relatively small in number. It may
well be that if we examined every prostate cell in every man
above the age of 50, we would find at least some cancerous cells
in almost all of them. But the great majority of those men will
never develop a cancer that grows to the point of becoming
malignant and needing treatment.
One of the natural inclinations that many of us have is to test
and test and test until we find a sliver of evidence that there
is at least one cancer cell in our bodies, and then our anxiety
turns to panic and we demand major surgery or radiation to get it
out.
It's an understandable reaction but, as we learn more about
cancer, we find that such a reaction is not in our best
interests.
Alan
I.P. Freely
> That was eleven years ago. PSA remains undetectable.
A rousing Halleluja for that! I'd declare myself cured and consider any
subsequent recurrence a whole new case.
I.P.
Alex
>
> Now for my questions. I usually do my own research but I am now in scared
> panic mode and I am just not thinking clearly. First, is there still a
> decent chance that I do NOT have PC?
Mel,
I understand your feeling of panic. We've all been there. But you do need to
put the brakes on your emotions.
Having the biopsy is of course a good idea. It's not a perfect tool (my
first 12-needle biopsy found no signs of cancer, but a second one a few
months later found a small percentage in a couple of needles), but it will
give you an additional piece of information.
Now, let's say the biopsy says you do have cancer.
Not great news,but it does NOT mean you are going to die in 24 hours, nor in
24 weeks or 24 months. You have a LOT of time to gather more information
about the nature of your cancer, the wide range of treatment options open to
you, and so on.
I was diagnosed at 62, with a PSA of about 6 and Gleason of 3+3, in < 10% of
two cores (checked by Johns Hopkins.) Reflexively I prepared to "have it cut
out" as soon as possible. Then I calmed down, did a LOT of reading, found a
good research-oriented oncologist in my city, and ultimately decided to do
active surveillance, or watchful waiting. No cutting, no radiation, just PSA
tests and DREs every 3 months, and color Doppler ultrasound every six
months. After a year or so I also started taking Proscar (finesteride) to
shrink the prostate gland (and according to some theories, also shrinking
the cancer itself.) My PSA has remained flat or declined slightly.
That was a bit over 3 years ago. This Summer I went for a follow-up biopsy,
which was guided by ultrasound to the most suspicious areas of the gland.
The doc took 8 needles. None showed signs of cancer (again, verified by a
first-tier lab, Bostwick.) I doubt that the cancer has "gone away," but
suspect it has simply remained very small, and this time the needles missed
what is there.
My case is a bit unusual. But I include it to show you that there is an
enormous range of possible outcomes of this disease. The ONLY one that you
can absolutely count on is that you do NOT have to make any sudden
decisions. Any choices you make "in scared panic mode" will probably not be
optimal. Many will be irreversible; you cannot undo surgery or radiation.
Ask you doctor, "If I have the biopsy and then do nothing at all for six
months (except maybe another PSA test in 3 months), will that delay put my
life at risk?" I believe your doctor will tell you it won't. Spend that time
learning about this disease, and the panic will abate.
Alex
MZB
could they have missed it? Someone here quoted 1% missed biopsies. I thought
it was much more. Does anyone know?
The PSA can easily be influenced by BPH and prostatitis and I have both. But
the PCA-3 is NOT impacted by that or the prostate size. It is a much more
accurate test, and that's the result that is scary.
My biopsy is scheduled for 11/30, so I'll have some answers in about 3
weeks.
Mel
"Califchief" <calif...@fidotel.com> wrote in message
news:1258784903.1...@fidotel.com...
MZB
I've been doing extensive research into assorted options since the initial
August 4.01 PSA.
If my Gleason is <=6, I will seriously investigate watchful waiting. But
anything higher and I would go the surgery route, for various reasons.
My fear is that I would have a PC that is too far advanced for surgery. The
PSA scores indicate no but the PCA-3 score indicates yes.
Mel
"safire" <saf...@tele-net.com> wrote in message
news:he81am$5g1$1...@aioe.org...
MZB
scared panic mode), I've done most of my thinking prior to this last
reading.
I am not rushing into anything, but it is totally clear that I need a biopsy
pronto and I am doing that.
I do have some plans for when I get the results.
Mel
"Alan Meyer" <ame...@yahoo.com> wrote in message
news:he92vu$l0j$1...@news.eternal-september.org...
MZB
the biopsy results.
I do have plans. I'll post it as a seperate topic
Mel
"Alex" <tuchasoffentisch@_NO_SPAM_gmail.com> wrote in message
news:he9hn...@news6.newsguy.com...
Rick Merrill
Unless your insurance requires you to be in hospital before they will
cover the biopsy, I strongly recommend you NOT use the full sedation for
the biopsy: you should get a shot of Novocaine and grit your teeth for
10 to 15 minutes. The needle biopsy is a "micro surgery."
The PCA-3 "test" is a genetic test, so you certainly should follow the
doctor's advice and get the biopsy.
Your PSA can vary quite a lot depending on recency of orgasm, bowel
movements, exercise, and DRE!
Sometimes the worry is the worse part. I had to have 2 biopsies!
Let us know what pathology says.
MZB
I was all set to do the biopsy without the sedation. But when I checked to
get scheduled, they said: 12/18 or they could overbook on 12/11 or I could
have the sedation/biopsy in the OR on 11/30. Frankly, I want to get the
biopsy done ASAP, so it was a no-brainer.
I assume my insurance would cover it. If not, so be it. I'll pay.
Mel
"Rick Merrill" <Rick0....@gmail.spamless.com> wrote in message
news:he9o3v$een$3...@news.eternal-september.org...
I.P. Freely
> In article <Y7XNm.6001$kY2....@newsfe01.iad>,
> fuhghed...@noway.nohow says...
> declaration.
>
Yes, but wouldn't it make you FEEL better, and do no harm as long as you
keep tracking the PSA? At 5 years w/G8 I'm not even close to being
"cured", but I surely feel better now that my prognosis now lies on the
other side of a coin toss. My colon and prostate oncologists/surgeons
were both pretty sure they'd see me back by now from one or the other
cancers; if I make 11 free and clear I'm going to feeling prettttty
good. I guess it's semantics anyway; if you chop down an oak tree and
dig up its roots, but another tree sprouts from a stray acorn many years
later, is that the same tree, or a whole new one?
I.P.
chasjac
Pardon me if you've already answered this question earlier, but I was
wondering how old a man you are? A PSA of 4 may mean a few
different things, depending on your age. My PSA was 5.2 and I was
50. Had I been 90, we probably wouldn't have worried much at all.
You seem to be very concerned about whether you have advanced PCa
because the PCA3 score is much higher than the cutoff of 35. I spent
a few minutes at pca3.org, and didn't see anything about tumor stage
prediction, based on the score. And since it's a test for a genetic
marker, I'm not sure that it could tell you anything about tumor size
and metastases. I doubt 75 means much more than its position beyond
the cutoff. Moreover, PCA3 is a new enough tool so that the docs are
probably still learning about how it can be used.
So, don't get ahead of yourself. The biopsy will probably answer your
questions and help you decide on your treatment, if you need any. My
biopsy hurt a little, and my semen was discolored for awhile, but it
was worth it: we hit the tumor dead-on, got a good idea of its shape,
and knew that it was probably still in the prostate and had not
spread.
All the best,
charlie
Steve Jordan
> I was all set to do the biopsy without the sedation.
What, exactly, would that have proven? Answer: nothing.
> But when I checked to
> get scheduled, they said: 12/18 or they could overbook on 12/11 or I could
> have the sedation/biopsy in the OR on 11/30. Frankly, I want to get the
> biopsy done ASAP, so it was a no-brainer.
> I assume my insurance would cover it. If not, so be it. I'll pay.
FWIW, my insurance (Medicare) did pay.
I must say that the controversy over whether to have anesthetic
for the
biopsy makes no sense. Some claim that the procedure without
anesthetic
was no problem. Others say it was agony.
In the name of reason, why would anyone with a brain gamble, when
the
bet is so cheap? Demand the anesthetic. If the uro resists, fire
him. There
are plenty of others, who care about their patients.
Regards,
Steve J
MZB
From my reading, the higher the pca-3, the higher the aggresiveness of the
PC.
Mel
"chasjac" <cha...@live.com> wrote in message
news:e652083a-1d96-4ddc...@s15g2000yqs.googlegroups.com...
Steve Kramer
news:6f9a7126-2aca-4036...@e23g2000yqd.googlegroups.com...
I had my prostate
removed on Nov 10th. Stay in touch every step of the way as the
support is important. My email is K...@maemusic.com
==> Welcome to the newsgroup, Ken. Please tell us a little about yourself
and your cancer.
Steve Kramer
news:20091121-2...@Gogarty.news.bway.net...
: In article <Y7XNm.6001$kY2....@newsfe01.iad>,
: fuhghed...@noway.nohow says...
: Those guys who die 21 years after diagnosis preclude any sort of
: declaration.
:
Maybe you can celebrate on your 89th birthday. :-)
Steve Kramer
:I feel I am in almost an untenuous situation. If the biopsy is negative,
: could they have missed it? Someone here quoted 1% missed biopsies. I
thought
: it was much more. Does anyone know?
Mel, that was me! And I didn't quote anything. That was purely my sense of
the missed cancers as reported by people on this NG. I don't know the
actual statistics, but the statistics would have to be detailed enough to
collect those with 6, 12, 18, 24, 30 needle biopsies one 20, 25, 30, 40, 60,
... cc prostates, and those done during TIRPs and rectally, and those aimed
by color dopler, etc...
But, if you get yours done with a high number of needle punctures, there
should be no reaso for you to worry after a negative finding.
Alan Meyer
> ...
> In the name of reason, why would anyone with a brain gamble, when the
> bet is so cheap? Demand the anesthetic. If the uro resists, fire him. There
> are plenty of others, who care about their patients.
As I understand it, there are small but non-zero risks associated
with at least some types of anesthetics. If it were me, I would
inquire about those risks before jumping into anesthesia.
After one of my brachytherapy procedures, done under total
anesthesia, I had a bad headache for a couple of days. The
two day headache was probably worse than the mild pain I
experienced in the biopsy.
The "sedation" planned for Mel will probably be much less
invasive than the full anesthesia for several hours that I had,
but I would still inquire about it. There isn't always a free
lunch with these things.
Alan
MZB
I understand. I have had this sedation for quite a few colonoscopies. No
problems.
Mel
"Alan Meyer" <ame...@yahoo.com> wrote in message
news:hecrtl$119$1...@news.eternal-september.org...
I.P. Freely
> Steve Jordan wrote:
>> ...
>> In the name of reason, why would anyone with a brain gamble, when the
>> bet is so cheap?
Because they are the ones with the most to lose, whether for that day --
by law where driving is concerned -- or permanently. All we avoid with
anesthesia is the very tiny chance of a dozen painful "stings"; most
hardly notice the needles. Avoiding the anesthesia DOES let us drive
legally that day, DOES leaves our heads clear for making clear decisions
(we are unaware of its lingering effects), eliminates the moderate risk
of short-term hangovers/headaches, and eliminates the tiny risk of
long-term disability.
If I didn't trust my uro's advice on a simple biopsy, I sure as HELL
wouldn't take his advice on cancer treatment.
I.P.
I.P. Freely
> I have had this sedation for quite a few colonoscopies.
Probably not for the next one. It's been discouraged in the proctology
field as unnecessary for some time now, and thus may be rejected by some
insurers before long, because the primary cause of colonoscopy pain is
clumsy doctors overaccustomed to drugged-out patients, not the nature of
the procedure. I'd prefer a procto who is more careful and thus may be
less likely to perforate to one who may get more careless with
unconscious patients.
I.P.
chasjac
actually interesting to watch the monitor as the procedure
progressed.
So my lovely wife figured that anything I could do she could do
better. When her turn came, she was in agony throughout the procedure
-- same doc -- a well-respected gastroenterologist in the area who
does nothing but colonoscopies. It turns out my very tall wife has a
long, loopy colon; that's what caused all the problems. If sedation
is not an option in the future, she'll probably do without.
--charlie
Steve Kramer
: > ...
: > In the name of reason, why would anyone with a brain gamble, when the
: > bet is so cheap? Demand the anesthetic. If the uro resists, fire him.
There
: > are plenty of others, who care about their patients.
: The "sedation" planned for Mel will probably be much less
: invasive than the full anesthesia for several hours that I had,
: but I would still inquire about it. There isn't always a free
: lunch with these things.
The sedation for Mel is probably what I commonly refer to as happy juice.
There are almost no risks, no after effects, and no physical tensions during
the exam. I have had it twice. Once for a colonoscopy and once for a
biopsy. On one occasion I woke up and saw the inside of my colon and
thought to myself, "hmmmmmmmmm" and went back to sleep. I wish I could get
that kind of sedative for the end of Bengal football games.
chasjac
> [snip] I wish I could get
> that kind of sedative for the end of Bengal football games.
Ouch! What an ending... Of course, the Bears do no better, as though
they are taking a page from the Cubs playbook! There should be a name
for the kind of pain our sports teams cause us.
--charlie
MZB
Last year was brutal and they are not much better this year.
Mel
"chasjac" <cha...@live.com> wrote in message
news:61e32102-2a20-45e5...@m13g2000vbf.googlegroups.com...
MZB
Last year was brutal and they are not much better this year.
Mel
"chasjac" <cha...@live.com> wrote in message
news:61e32102-2a20-45e5...@m13g2000vbf.googlegroups.com...
Steve Jordan
Quoting me, in small part:
>>> In the name of reason, why would anyone with a brain gamble, when the
>>> bet is so cheap?
> Because they are the ones with the most to lose, whether for that day --
> by law where driving is concerned -- or permanently. All we avoid with
> anesthesia is the very tiny chance of a dozen painful "stings"; most
> hardly notice the needles. Avoiding the anesthesia DOES let us drive
> legally that day, DOES leaves our heads clear for making clear decisions
> (we are unaware of its lingering effects), eliminates the moderate risk
> of short-term hangovers/headaches, and eliminates the tiny risk of
> long-term disability.
I think IPF and I have different ideas of what constitute
"anesthesia" in
the context of a prostate biopsy.
He seems to think I'm advocating being rendered unconscious. In
fact,
I'm advocating what might be call "pain killers" aka analgesics.
See, among many, Giannarini G, et al., "Combination of
perianal-intrarectal lidocaine-prilocaine cream and periprostatic
nerve block for pain control during transrectal ultrasound guided
prostate biopsy: a randomized, controlled trial."
Conclusion: "Our findings suggest that the combination of
perianal-intrarectal lidocaine-prilocaine cream and periprostatic
nerve block provides better pain control than the 2 modalities
alone during the sampling part of transrectal ultrasound guided
prostate biopsy with no increase in the complication rate. The
magnitude of this effect is higher in younger men, men with a
larger prostate and men with lower anorectal compliance."
Pub Med, a service of the US National Library of Medicine, at
www.pubmed.gov
Search on Pub Med ID 19084860
Regards,
Steve J
chasjac
> You are preaching to the choir: LIONS FAN HERE.
>
> Last year was brutal and they are not much better this year.
>
I saw their last couple of games ... I think they're better than their
record suggests.
--charlie
MZB
But the Lions SHOULD have tried to bolster their line. Their QB will be
lucky to survive this season. He has made them better than last year.
Mel
"chasjac" <cha...@live.com> wrote in message
news:004e1548-8d12-4748...@o13g2000vbl.googlegroups.com...
chasjac
> They have a young quarterback (#1 draft) who will probably be a star.
> But the Lions SHOULD have tried to bolster their line. Their QB will be
> lucky to survive this season. He has made them better than last year.
That's part of the story with the Bears, too. Cutler is not going to
be a star, but the off. line has some things to answer for ... if a QB
is getting sacked a lot, it can't be his fault all the time.
--charlie
Califchief
> I think IPF and I have different ideas of what constitute
> "anesthesia" in the context of a prostate biopsy.
> He seems to think I'm advocating being rendered unconscious. In fact,
> I'm advocating what might be call "pain killers" aka analgesics.
> See, among many, Giannarini G, et al., "Combination of
> perianal-intrarectal lidocaine-prilocaine cream
Thanks Steve. I was waiting for someone to mention this.
Whenever I have a Synvic injection in a knee, the rheumatoligist
first chills it, then injects lidocaine, THEN the Synvic while
following the needle with ultrasound.
And I wear lidocaine patches on both legs/thighs daily for their
pain-killing effects.
___ Blue Wave/QWK v2.12
MZB
game!!
Mel
"chasjac" <cha...@live.com> wrote in message
news:a9974b3e-7b59-4221...@e7g2000vbi.googlegroups.com...
I.P. Freely
Steve's right. I was referring to the common references to "happy
juice", to which the conversation had drifted. I don't think Lidocaine
creme is going to impair anyone's driving,
I.P.
chasjac
>
> Guess what-- Stafford got a dislocated shoulder so he is out for the next
> game!!
>
winning pass?! Pretty gutsy!
--charlie
JayTKR
>
> Step one...Don't panic. In the worst case scenario, if you have
> prostate cancer there is plenty of sunshine even when advanced.
> Schedule the biopsy. Early detection is the key. I had my prostate
> removed on Nov 10th. Stay in touch every step of the way as the
> support is important. My email is K...@maemusic.com
This is just a quick note since you said you had your surgery on Novemebr
10.
I remember reading that after the surgery it is a good idea for the patient
to start on Viagara, Cialis, or whatever almost right away. The concept is
that the damaged nerves need to heal etc. and those meds somehow can help in
that process. I don't know all of the details.
MZB
a sieve. You'll end up killing that QB!
Mel
"chasjac" <cha...@live.com> wrote in message
news:a032f756-854a-49fe...@x15g2000vbr.googlegroups.com...
Alan Meyer
> ...
> I remember reading that after the surgery it is a good idea for the patient
> to start on Viagara, Cialis, or whatever almost right away. The concept is
> that the damaged nerves need to heal etc. and those meds somehow can help in
> that process. I don't know all of the details.
My understanding of this is that lack of use of the penis and its
supporting network of blood vessels and nerves can cause atrophy.
I think the idea is to exercise one's sexual faculties in hopes
of recovering function, or at least not losing function because
of lack of use.
My urologist was a little skeptical about it. He thought there
might be some element of marketing puffery by Pfizer and the
other drug makers who sponsored the trial of this and who push
the ideas hard in their marketing to urologists.
However, except for the cost, the idea of attempting sex sounds
like a winner to me and, maybe, Viagra and the other drugs can
help with that.
Alan
JayTKR
I think it makes sense for your urologist to be a little skeptical about the
motivations of the drug companies. But, there doesn't seem to be any down
side to the approach of using Viagara, Cialis, etc. early on after the
surgery. And, who knows, maybe there will be an "up" side :-)
chasjac
> [snip]
> I think it makes sense for your urologist to be a little skeptical about the
> motivations of the drug companies. But, there doesn't seem to be any down
> side to the approach of using Viagara, Cialis, etc. early on after the
> surgery. And, who knows, maybe there will be an "up" side :-)
My surgeon was looking to see if I would be a candidate for one of the
trials for daily doses of Viagra, but since I had only one nerve
spared, I was in the excluded category.
I discussed the therapeutic dosage level version of the ED meds with
my uro a few months ago, and we agreed that it's probably unnecessary
to do this. He said he never prescribes this for any of his patients,
and thinks it's just an excuse for drug companies to make a little bit
more money.
--charlie