Sunday, December 18, 2011

PSA Tests, Gleason Scores, Biopsies, and Prostate Cancer

In a recent conversation with a client, he explains his family physician is certain he has Prostate Cancer.

"My family doctor just told me he is quite certain - his words - that I have Prostate Cancer, and he is referring me to a Urologist for a prostate biopsy to confirm it. He explained that at my age of 65, my PSA score wouldn't jump from 4.4 to 5.3 in a three months unless it was likely Prostate Cancer," says my Client.

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While his doctor's advice in referring him to a Urologist is a good next step, I thought it unnecessarily dramatic to cause him such concern before the proper tests were performed by the chosen specialist for the issue - in this case a Urologist.

The physician is understandably concerned, but his dramatic response can cause unwarranted fear and anxiety. So, I encouraged my client to take it one step at a time.

The first step I suggest is conduct due diligence by asking friends, colleagues, and family if they know of a Urologist they can recommend. This will help raise the chances of consulting with a trusted specialist. After scheduling a consultation with the specialist (Urologist), consider asking an objective advisor, such as a Patient Advocate or a level-headed friend to go along for the appointment. When individuals are dealing with such a high-stress situation as a possible cancer scare, it's nearly impossible to remain calm, remember everything that is being said, and to ask all the questions. Having another individual who is focused, calm, objective, and knowledgeable about Prostate Cancer will help in more ways than mere moral support. Also, I strongly recommend that during the consultation, patients ask the physician if they can record the conversation to ensure the patient fully comprehends his/her advice once they are there. Once the patient arrives at the appointment with the Urologist, I suggest asking - at least - the following questions: What is your impression of my PSA results? What, if anything, would you advise me to do about these results?

If he/she suggests a sonogram and/or a biopsy, ask:

Please explain this procedure to me. What is the preparation needed for this procedure? What can I expect to experience post-procedure and what arrangements do you suggest I make? (a ride, rest, medication, protocol, etc.) What are the potential complications of this procedure? What do you plan to learn from this procedure? Is there an alternate plan of action to determine the elevated PSA tests? When can we go over the results?

NOTE: In some cases, the Urologist may schedule both the sonogram and biopsy for the same visit. In this instance, I suggest patients ask what percentage of patients do they move forward on the biopsy and what are the determining factors for doing so?

Sometimes patients undergo tests that are more precautionary than necessary. So, I encourage my clients to ask questions that help determine which procedures they're agreeing to, i.e., precautionary or necessary.

In closing, it is essential to the individual's overall well-being that they remain as calm as possible every step of the way. Take each step without thinking too far ahead. It's natural to imagine things going awry or running into the worst case scenario. At this diagnostic stage, especially, I urge my clients to remain in the moment rather than jumping to assumptions and conclusions that may never come to fruition.

Patients may contact me so I may provide more detailed services, such as additional questions and research, accompanying them on appointments, remaining on the phone long-distance, or prepping them future phases with this - or any - health situation.

PSA Tests, Gleason Scores, Biopsies, and Prostate Cancer

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