The Coming Year

Your Board of Directors including Director Emeritus R.B. McGowen have continued the discussions of how to improve our organization.  R.B. recently handed me a stack of magazines and papers on the diagnosis and treatment of prostate cancer (CaP).  He observed that when his cancer was first diagnosed in the early 90's, that there was very little information available about CaP, but now there was a great deal.  Therefore there is not as much need for our meetings as in the past.  Also the physician survey indicated there is a great deal of repetition and little new information is provided.  It would appear then that our every other month format is a step in the right direction.

On the other hand, two studies-quoted below-show that attendance at support groups leads to a longer and more satisfying life.  Our one-on-one consultations on demand would seem to partly fill the between meetings function. 

Our regular meeting format's purpose is for you to talk to those who have been there, to visit personally and one-on-one with our speaker, and to help you stay informed.  Newly diagnosed can also get to know us.

Finally, Tom Nuckol's and my attendance at the recent "What to do when your therapy fails" conference would seem to help with the "nothing new" criticism.  I have written up some of the new approaches and findings in the February Newsletter.  If you want a copy, call me at 903-893-6437 or e-mail me at jerryby@cableone.net, and I will send you a copy.

And I have decided to do the meeting notice as a part of our newsletter.  It appears that this change is needed since less than a third of seniors have been reported to visit the Internet.

See you at the March meeting.  Jerry Bylander

Date:  Tuesday Evening, March 15
Time:  6:30 pm - Social & Coffee  7:00 pm - Program
Location:  Senior Center, Wilson N. Jones North Campus, South Entrance, 3305 Calais Drive,
Sherman, Texas
Title: Newly Diagnosed Prostate Cancer
Speaker:  Dr. Steven Johnson, Board Certified Urologist.  Past President, Texas Urology Society.  Texoma Urology Associates, Offices in Sherman and  Denison

Program: Dr. Johnson will discuss PSA elevation, DRE, and your biopsy's Gleason score and how your doctor will make determinations and recommendations for therapy from these simple factors.

Topic:  "Roundtable Discussion:  Life is Good; Here are Some Tips to Make It Better"

Leadoff Panel: Jerry Bylander, Tom Nuckols, Henri Plunkett, other members
 
Program:   The first half of the discussion went well and was well-received.  The last twenty minutes initially became rancorous after one member raised a question about high medical costs which led to a discussion of our dysfunctional medical system.  Shortly thereafter, a latecomer became agitated and started complaining about the failings of the leaders of the group meetings.  The discussion leader, Jerry, then raised the question as to whether we should dissolve the group.  It had earlier been pointed out that our group had seemed to have lost the support of the medical community.  However almost all the attendees were opposed to stopping our informative meetings.

The meeting adjourned about 8:15 PM.

Jerry Bylander

Material posted here is intended for educational purposes only and must not be considered a substitute for informed medical advice from your own physician.

PROSTATE CANCER BIOLOGY

When I was diagnosed with prostate cancer I really wanted to know what treatment I needed to cure my cancer condition. My doctor simply stated that my initial PSA, Gleason sum, and DRE looked good. He suggested surgery and surgery only. I asked about seed implantation and he quoted an article called Seeds of hope but seeds of doubt. As I did not want to wait longer before therapy I blindly submitted to surgery. During the recovery period I found I now had the time to do my homework on prostate cancer and, low and behold, I had done everything WRONG. I simply believed that the three factors:  PSA, Gleason, and DRE (Digital Rectal Exam), were all that is needed for a doctor to really size up and initiate therapy on prostate cancer.  WRONG AGAIN.

After much studying I realized that one's body has biological truths that are speaking to an intelligent audience. Thus I needed to ask after learning the PSA score, what was my free PSA score?  The free PSA score was not performed but however is a simple test to see how much bound or unbound PSA was available at time of the type of therapy to be the chosen decision process. In fact, one should always see more free PSA than the usual PSA for a good biological outcome. Next, consider the Gleason score and the sum of its parts. THIS measure is usually the most important biological finding to base a therapy on. But having said that, one needs to know how many biopsy cores where taken and how much cancer was found in each core, along with quantity of aggressive prostate cancer  found in each core, the percentage of cancer of each core found, and the location of each core.. Now ones starts to  get a better understanding of what's going on biologically and not just words from a spokesperson. Next consider the DRE.  If anything at all is felt to be abnormal in the prostate this is a clear biological finding the prostate is probably not normal even though this exam is subjective.

SUBJECTIVE  is the word here as in all these tests need reviewed by experts to minimize opinions and to home in on the true findings of these critical biological endpoints. Second opinions on the Gleason score by an expert are critical as this finding alone may change your therapy choice if the score is changed by an expert. Next, it is prudent to check for excessive bone resorption by an inexpensive tgf-beta 1 test to test your biology on bone resorption.  Excessive bone resorption may suggest systemic disease. ALSO an inexpensive PAP ( prostate acid phosphatase) test helps point to the biological understanding of systemic disease.  So here is the ENDPOINT: so many men run to doctors to seek the therapies they think they need to fix their prostate cancer. HOWEVER without understanding the biology whether or not your prostate cancer is ORGAN-CONFINED OR NOT, all your good intentions could and would be futile. Your doctor and you must do biological studies beyond simple PSA, Gleason, and DRE to make an informed, intellectual, and of course biologically correct decision to hopefully get it right the first time and to cure YOUR PROSTATE CANCER.  You guessed it, prostate cancer is not really as simple as many people are led to believe, with knowledge you will win........Henri Plunkett

Editor's Note:  Please recall Tom's and my findings at the "what to do when your therapy fails" conference. Henry's advice and opinions, such as given above, are completely in line with the panel of physician's recommendations at the conference--if anything, his arguments are not as strongly put as theirs.  Also you will want to remember to educate your doctor.  For example, R.B. has done this successfully with his oncologist.  Finally we heard very high failure rate numbers at the conference for all conventional therapies such as radiation and surgery.  The rates were over 60% as I recall.  Maybe, just maybe some failures could be reduced by your working more closely with your doctor???  Remember, it is your life, not your doctor's life that is at risk, and also remember, just as for safety, it's you - not the doctor (or your company for the case of safety) - that should take responsibility as recommended above.

Jerry Bylander, Editor