As a physician living with prostate cancer, I thought it might be of interest to share my knowledge and experience with other men and their families.
Prostate cancer is a very common disease of men; in fact, if a man lives long enough, he will likely have it and not even know it. In more than 90 percent of cases, men who have an elevated screening PSA and a prostate biopsy showing low-grade cancer (Gleason Grade 6) will have non-malignant disease that needs no treatment and certainly does not need immediate life-altering surgery, or radiation.
I used active surveillance for 10 years before having radiation treatments for my low-grade prostate cancer.
Traditional prostate biopsies involve blindly inserting 12 to 15 random biopsy needles into the prostate through the rectum. Prostate biopsy has the risks of serious infections, bleeding and even death.
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A new plan of attack for evaluating an elevated PSA is the use of 3 Tesla Multiparametric MRI of the prostate. This can determine if there is a tumor, where it is, its size and the likelihood of it being malignant. If an area is identified that looks suspicious, then a more targeted biopsy can be performed and a rational treatment plan designed.
If no tumor is identified or if a biopsy suggests low- or medium-grade tumor, then watchful waiting or active surveillance can be the best choice and will completely avoid any complications.
If high-grade tumor or cancer is detected, the more definitive treatments of external radiation and/or radioactive seeds are good options, with or without hormone treatment or chemotherapy.
Surgery is also an option. Research shows that there is no difference in outcomes comparing radiation and surgery, and radiation has fewer side effects. For low-grade disease, watchful waiting or active surveillance is often recommended and has no side effects.
A source of information I found helpful is the Prostate Cancer Research Institute, whose founder and CEO is Dr. Mark Scholz, an oncologist in the Los Angeles area specializing in prostate cancer diagnosis and treatment. His book, co-written with his patient Ralph Blum, Invasion of the Prostate Snatchers, was most informative to me.
Other resources are Keepmyprostate.com, Prostate-cancer.org, Prostateoncology.com and Ustoo.org.
Remember, a prostate cancer diagnosis is not an emergency. Take your time. Get several opinions. Study the disease. Know your options.