prostatediaries

Patients often times choose chance of risk/complications over what they feel is the best treatment for cure.

Prostate cancer is funny that way.

If the prostate cancer is confined to prostate the single most important factor to consider in one's decision making is the Gleason's score.

Just as a vasectomy involves removal of a segment of the vas and destroying both ends and a prostatectomy involves removing the prostate and reconnecting the urethra to the bladder, not much has changed in the "concept" of these procedures.

However as it pertains to the prostate there are several advantages to the robotic removal of the prostate and I outline these in this podcast.

I feel that one now may now comfortably state that if done in the right hands and for the right reasons, that the robotic removal has finally become the "gold standard" for the surgical management of prostate cancer.

Patients will often choose to have their prostate removed for prostate cancer because, " I can always have radiation after having the prostate removed but not vice versa." True...but does it matter. In this podcast some of the caveats of this very nuanced disease as it pertains to this line of reasoning and whether it matters or not is discussed by Dr. John McHugh a prostate cancer survivor and author of "The Decision" which is in the top five for paperback and Kindle on Amazon.com for the subject of prostate cancer. He was also chosen as the number one Online Influencer for Prostate Cancer by Sharecare Now for 2012.

That the psa goes down after a course of antibiotics is encouraging...but not definitive. A better messure of things is the trending of the value of the psa over period of time. Your urologist will know how to advise you on this and the timing and necessity of a prostate biopsy.

Since the needle that takes the prostate speciment at the time of a biopsy goes through the rectal mucosa first the possibility of an infections exists. This historically has been a low risk issue but recently and nationally it is becoming more prevalent. There is not a good answer as yet to this other than a heightened sense of awareness on the part of the patient to recognize that something is not right and to contact the urologist at the earlies sign of fever or difficulty voiding. In addition, it is making the point that a patient should thoroughly evaluate the need for the biopsy in the first place, i.e. if cancer were found would you treat it. If the answer is no and there are risks associated with the biopsy then maybe don't consent to it.

The most common questions that arise at a pre-vasectomy consultation with a urologist.