RE: Bone and CT scans, was: Can the PSA go down?

[Guest guest]

Hi Alan,

You’re in good company when you say <snip>

With a PSA of 3.17, I'd be surprised if one in a thousand patients would show a

positive result on a bone or CT scan. So I question whether these scans should

be done in patients with very low PSAs. I question whether they are done in the

interest of the patient, or in the interest of the hospitals and doctors. <snip>

Dr Strum has made the same point many times over, whilst at the same time

making the very good point that there are other tests that would be more useful

in defining the disease but which are ignored by the majority of the medical

world.

I also share your view when I was diagnosed,

especially as I had n insurance and had to pay for the scans myself – and

very expensive they were even after I negotiated a discount. But…the have

proved useful over the years by providing a base to compare with subsequent

scans. Changes are easier to identify than starting from scratch each time. So maybe

there is some value in them.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net  and www.prostatecancerwatchfulwaiting.co.za 

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Alan Meyer

Sent: Thursday, 3 January 2008

5:51 AM

To:

ProstateCancerSupport

Subject:

Bone and CT scans, was: Can the PSA go down?

>

> I was diagnosed with Pca in August,2007.

>

> My numbers are:

>

> Age-60

> PSA 3.17 (Had doubled in 18 months)

> Stage T1c

> Gleason 6 (3+3)

> Bone Scan & CAT Scan-Negative

I used to think that a good doctor does all of the scans he can

to find out everything he can about a disease.

I'm now coming to think that isn't so. Bone and CT scans are

both invasive. Bone scans introduce radioactive isotopes into

the blood and CT scans use a lot of x-rays.

Each of them creates a small, but non-zero risk of damage to the

patient. Or to put it another way, each of them introduces a

small amount of damage to the patient that has a small but

non-zero risk of causing longer term harm.

In addition, these scans are very expensive, they have become a

primary way that many hospitals make money, billing insurance or

Medicare for the procedures. This raises all of our insurance

premiums and Medicare taxes.

With a PSA of 3.17, I'd be surprised if one in a thousand

patients would show a positive result on a bone or CT scan.

So I question whether these scans should be done in patients with

very low PSAs. I question whether they are done in the interest

of the patient, or in the interest of the hospitals and doctors.

I'm not a doctor or any kind of expert, and I stand ready to be

corrected by someone who knows more than I who wishes to comment

on this issue.

Alan