Let's back up for a moment and review the findings of Will's biopsies:
After numbing Will with a local anesthetic, Dr. B withdrew twenty four tissue samples throughout the prostate thus allowing him to surmise if and where the gland was diseased. Then, depending upon how many tissue samples proved positive, Will's lab report would offer Dr. B an accurate accounting of whether or not the cancer was widespread or, hopefully, contained within a specific area of the gland.
Sixteen of the twenty-four biopsies were diseased, and these sixteen were widespread throughout Will's prostate, so Dr. B. surmised that the cancer, known to be a slow growing rather than aggressive, had been invasive for several years. As this slice of information sunk into our minds, we felt like a lead weight had been dropped on our heads.
After pausing to take in this unwelcome news, Will and Dr. B. began to discuss the significant fact that Will's PSA level had not been tested for five years. When I asked what a normal PSA level would be, Dr. B responded: Normal is below 4.0. Will's recent PSA was 5.4. Upon placing those two numbers in the forefront of my mind, I listened to my husband express how it came to be that five years had passed between tests …
Will began with: Several years ago, I had an EKG that proved irregular. As I began to see my cardiologist on a regular basis, it didn't seem necessary to see my internist, as well. Thankfully, my heart continues to check out as healthy as a horse.
Two years ago, I had a serious bout of pneumonia, which saw me hospitalized and in need of oxygen and IV antibiotics for a week. Upon returning home, I'd felt exceptionally weakened for several months, so, in addition to seeing my cardiologist, I was followed by a pulmonary specialist, as well.
In retrospect, I'd no conscious concerns about my prostate, and professionally speaking, the PSA test is known for inaccuracy. Since the real value of this test is to gauge whether the number is climbing, and as my last PSA test had registered at 2.8, I just didn't think about it until I decided to see my internist, Dr. A, this June.
After my physical, Dr. A called and said that he'd felt somewhat concerned but not alarmed to see my PSA rise from 2.8 to 5.4, over a five years period. In order to assuage his concern, he asked me to return to his office, and though no nodules were felt during his examination, he suggested that I meet with you.
When I asked why he'd recommended you, Dr. A's response was two fold: He said your reputation was sterling to the point that when doctors face this problem, you are the urologist of choice. (At this, a humble smile stole across Dr. B.'s face.) Then, Dr. A went on to explain that you'd experienced your own bout with this disease, a decade ago, and how, ever since then, your practice has specialized exclusively in prostate, suggesting that over the past ten years, your surgical expertise has focused solely upon resolving problems like mine, every day. Being a surgeon, myself, that fact said a lot, and here we are.
At this, Dr. B glanced over Will's chart, because he'd run a PSA test, as well. Within the few short weeks between Will's last PSA and this one, the number had—decreased from 5.4 to 4.4—exemplifying that which Will had stated about the inconsistencies of the test. On the other hand, both Will and I strongly suggest that every man be tested every year for this reason: Whether the test proves inconsistent or not, Will's situation indicates sound reason for noting how much the PSA level may be rising from one year to the next if one hopes to detect the presence of cancer, so common within the population of men, at an early stage… I mean, who wants to hear that cancer has been invading healthy tissue for years …
As our appointment with Dr. B lasted an hour and a half … this summary of twenty questions will pause for now and resume tomorrow …
After numbing Will with a local anesthetic, Dr. B withdrew twenty four tissue samples throughout the prostate thus allowing him to surmise if and where the gland was diseased. Then, depending upon how many tissue samples proved positive, Will's lab report would offer Dr. B an accurate accounting of whether or not the cancer was widespread or, hopefully, contained within a specific area of the gland.
Sixteen of the twenty-four biopsies were diseased, and these sixteen were widespread throughout Will's prostate, so Dr. B. surmised that the cancer, known to be a slow growing rather than aggressive, had been invasive for several years. As this slice of information sunk into our minds, we felt like a lead weight had been dropped on our heads.
After pausing to take in this unwelcome news, Will and Dr. B. began to discuss the significant fact that Will's PSA level had not been tested for five years. When I asked what a normal PSA level would be, Dr. B responded: Normal is below 4.0. Will's recent PSA was 5.4. Upon placing those two numbers in the forefront of my mind, I listened to my husband express how it came to be that five years had passed between tests …
Will began with: Several years ago, I had an EKG that proved irregular. As I began to see my cardiologist on a regular basis, it didn't seem necessary to see my internist, as well. Thankfully, my heart continues to check out as healthy as a horse.
Two years ago, I had a serious bout of pneumonia, which saw me hospitalized and in need of oxygen and IV antibiotics for a week. Upon returning home, I'd felt exceptionally weakened for several months, so, in addition to seeing my cardiologist, I was followed by a pulmonary specialist, as well.
In retrospect, I'd no conscious concerns about my prostate, and professionally speaking, the PSA test is known for inaccuracy. Since the real value of this test is to gauge whether the number is climbing, and as my last PSA test had registered at 2.8, I just didn't think about it until I decided to see my internist, Dr. A, this June.
After my physical, Dr. A called and said that he'd felt somewhat concerned but not alarmed to see my PSA rise from 2.8 to 5.4, over a five years period. In order to assuage his concern, he asked me to return to his office, and though no nodules were felt during his examination, he suggested that I meet with you.
When I asked why he'd recommended you, Dr. A's response was two fold: He said your reputation was sterling to the point that when doctors face this problem, you are the urologist of choice. (At this, a humble smile stole across Dr. B.'s face.) Then, Dr. A went on to explain that you'd experienced your own bout with this disease, a decade ago, and how, ever since then, your practice has specialized exclusively in prostate, suggesting that over the past ten years, your surgical expertise has focused solely upon resolving problems like mine, every day. Being a surgeon, myself, that fact said a lot, and here we are.
At this, Dr. B glanced over Will's chart, because he'd run a PSA test, as well. Within the few short weeks between Will's last PSA and this one, the number had—decreased from 5.4 to 4.4—exemplifying that which Will had stated about the inconsistencies of the test. On the other hand, both Will and I strongly suggest that every man be tested every year for this reason: Whether the test proves inconsistent or not, Will's situation indicates sound reason for noting how much the PSA level may be rising from one year to the next if one hopes to detect the presence of cancer, so common within the population of men, at an early stage… I mean, who wants to hear that cancer has been invading healthy tissue for years …
As our appointment with Dr. B lasted an hour and a half … this summary of twenty questions will pause for now and resume tomorrow …
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