John, thank you for the comments.
I will follow up with the clinic information you provided.
I am in the St. Louis area. We have the Barnes-Jewish medical center here. The Urology clinic here is rated number 9 in the country, and they are on my provider list from my medical insurance company.
I have an appointment Monday to see one of their primary professors in surgery. This one teaches laparoscopic surgery for the prostate. I am usually good at pronunciation, but I can spell "laparoscopic" better than I can pronounce it.
One of the studies I found on-line found that disappointing patient outcomes, and subsequent infections, varied inversely with the frequency of prostate surgeries performed. The guys who do it all the time are best at getting it right and not killing you with infections.
A few more details - I was quite brief in beginning.
I share your suspicions about my first Urologist. I have substantial distrust of physicians, just as a matter of course. Two things put me off of him. First was being blind-sided by the biopsy, then him bragging that he knew it from the beginning.
The other was that he lied to me. The funny part is that I do not know what his lie was. What I do know is that his face and body language fairly screamed "I AM LYING". The majority of people are honest. They are not practiced liars. When unprepared, they have obvious "tells" that broadcast their state of mind. I think he nearly sprained something when he executed that "tell".
After that, I would not let him neuter my dog, much less allow him to touch me with a scalpel. Indeed, he
John Sheraton (imported) wrote: Thu Jun 26, 2008 10:54 am
may want to put his daughter through college, get that Mercedes, and keep his surgical team warmed up
He very briefly described four options - essentially castration, chemical or physical, external radiation, implanted seed radiation, and radical retropubic prostatectomy. Had he used the word "laparoscopic", I would now be able to pronounce it.
Moving on - my Gleason score is 6, according to him.
I am prepared to believe that number. The combination of a palpable deformation of my prostate, a ridiculous Free PSA count, and observable cancer cells constituting 75% of one of my 12 biopsy samples (medium growth rate) convince me that his estimate is about as close as anyone is going to get without more serious cutting.
My PSA level is 3.4, and has been so for at least two years. It was an out of range PSA level that had my GP send me to this guy in the first place. A second blood test came back with the same level I had before. That was when they measured my free PSA.
My free PSA needed to be above 15%, to be comfortable. It is below 3%. The sources I have found online suggest that if the free PSA is well below 15, like 8 or 9, a biopsy should be performed. If the biopsy is performed and nothing is found, but the free PSA is below 5 or 6, another biopsy is needed. Reading between the lines - "the cancer is there, you just have not found it yet."
If my Gleason score were lower - less than 4, I would be finding a way to get the seeds implanted. If the growth rate were low, instead of medium, and the Gleason score was 4, I would still use the seeds.
A Gleason score above 6 is considered high risk. A 6 is not comforting, to me.
I found two references on-line that suggested that some prostate cancers interfere with sex drive.
I am in my second marriage. We have been seeing each other for five years, ecstatically married for four, except for the sex. My sex drive has plunged in that time. My wonderful wife will work it out with me, but she misses the sex.
Again, thank you for the information.