Question for Lorenzo Squarf and Terry Herbert of Yananow about prostate cancer-Let’s play doctor!

it's not the size of the dog in the's the size of the fight in the dog....

So I am out at the lake where the above picture was taken and I have DSL and a laptop I recently purchased to leave out here and I was assured by the computer guy that it  was fully loaded with Microsoft Word. So I do the blog stuff, walk my dogs to the steps in front of our dock, throw some sticks, was some sheets, gather trash and then sit down to begin my “Best Christmas Ever” book for this Christmas to give out to patients and friends. I mean, I have the story in my head and I worked on the beginning of it in my head on the “Jessie Jewel” steps at the lake and was excited about sitting down and starting the story. About me, of course, and in first person. John Irwin, author of “The Prayer for Owen Meany” said that first person gave the author more emotion and feeling. I need that for this story.

Anyway, the damn laptop has a starter version of Word 2010 and won’t let me open the damn thing. I’ll have to take the laptop to the computer guy that comes by my office and have him install or for him to condescending say to me, ” Oh, you just push this button,” or ” press this key, the program you need is right here. You could have used it all along.” I don’t know the button and now can’t do what I wanted to do this afternoon. Then I got Mr. Huberts comment: I have a question for him and the Squarf’s of the world. It is a very simple question and I am sure there will be a simple answer.

Missures….Squarf and Herbert:

You two are urologists ” informed and enlightened as you are” and I am your younger brother. For better or worse my family doctor has been getting PSAs on me and this is what’s going on. (This is my true story)

Your little brother is married, employed, has three children, healthy and has serial PSAs that have gone from low threes to 5.4. Your little brother (for better or worse ) had a biopsy and it showed 4 of 16 positive and there were elements of Gleason’s 7. You know your little brother to be a bit anxious about things and not only that his wife particularly is. You detect it in your conversations with him. His children are all in high school save one, who has finished college, married and pregnant.

Here’s the question: What would be your advice to me? A word of caution…if you list or ramble on about numbers an percentages remember I am your little brother and I am counting on you. Also remember one in a hundred is 100% if it’s you. I am not a number, a statistic, a public health funding issue, I am young, vibrant and want what is best for me and my family.

Now you are the doctor….what do you two recommend?….not for the masses but your little brother.

I appreciate you both…this fun to me…ya’ll “add flavor to the soup” that must be considered by the newly diagnosed prostate cancer patient in making “his” decision.  Pssssssssss—–when you use emotional words like “dug out prostate tissue” or “Dr. Doom” you betray the origins of your opinions.

Nostradamus? You both referenced him. Predictions that came true but because of laxity of interpretation and the “watered down” clarity of time influenced by those hoping to prove his assertions correct.

You are correct you cannot know will happen to your little brother if he does nothing (remember his age) or if he does something. On which side of erring (making the wrong decision) do you two want to be on? Let me be clear…I am not saying you are wrong, but what do you tell your little brother to do?  Will you tell him what to do or will you give him options? If you give him options are you being true to your beliefs?   Have fun with it…no emotion here. I lay out the facts and my patients make the decision they feel is best for them…just as you two did.

7 Replies to “Question for Lorenzo Squarf and Terry Herbert of Yananow about prostate cancer-Let’s play doctor!”

  1. Seems McHugh has lost interest in informing men about prostate cancer and it also seems a bit late to respond to this feeble attack on my integrity – including but not limited to the deliberate or careless misspelling of my name. BUT….this foolish post is still high on the Google responses so, in case anyone else stumbles across it, here is my (Terry Herbert) response to the question that McHugh poses: “….what do you tell your little brother to do?”

    I would suggest that he visits the website that I started in 1998 and continue to run, having not stopped in my efforts to help men understand some of the complexities of the disease. The site is at

    If he follows the sequential pages he will gain an understanding of what he needs to do to help him make the best decision for him and his family, based on his particular circumstances. In particular before he gets to the page which sets out the many treatment options available he will, hopefully, understand that it is vitally important to assess status before deciding on strategy.


  2. In defense of my friend Terry Herbert, look before you leap before making remarks appearing to be disparaging of the good intentions of Terry and the years of work put into developing his website so that men diagnosed with prostate cancer – as well as their caregivers – would have a website they could go to in order to review the vast number of remarks made by men earlier diagnosed with this insidious men’s disease who were treated with the variety of options available to men. That being said, there are several online prostate cancer support lists where newly diagnosed can go to learn from those who have been there, done that (,, to name a couple and on my website on the “Observations” webpage is alphabetically listed “Newly Diagnosed” that explains treatment options and my availability to help any-and-everyone travel their prostate cancer journey. See: as well as questions to ask the Urologist, or Radiation Oncologist, or Medical Oncologist. See:
    Questions to ask your Urologist*
    Questions to ask your Radiation Oncologist*
    Questions to ask your Medical Oncologist*
    …Now…regarding your comments “elements of Gleason 7” and 4 tissue samples identified with prostate cancer presence: If there are “elements of Gleason 7, then little brother’s Gleason Score is “7.” But important at this point, was the Gleason 3+4/7 or 4+3/7? 4+3/7 is of much more concern than 3+4/7 because of the primary being grade 4. Little brother would NOT be a candidate for Active Surveillance because his status requires treatment in near-time rather permitting the cancer more likely to become more developed. My paper Newly Diagnosed discusses his options and he should visit with more than one Urologist and more than one Radiation Oncologist (and not in the same practice group) to discuss forms of treatment available. Little brother needs to take the important time of researching, studying, and educating himself of just what “Prostate Cancer” is all about. And, he should involved his concerned wife in all visits with physicians, with reading information he is finding important, and in exchanging the emotions both of them are experiencing in order to recognize that this damned disease has an impact on both of them….his with concern on how to eradicate the disease…hers with worry about the one she loves and is sharing her life and what she can do, and should be allowed to do, in helping him and herself take care of each other.
    Nuff said.
    If interested in my prostate cancer, advocacy, and mentoring background, (my “credentials” if you may) please visit the following where you can also click on the menu word “Observations” and access over 160 papers I have either authored, compiled, or posted from medical friends regarding prostate cancer, recurring prostate cancer, treatment options, treatment of the side effects that often accompany most all treatment options, and more.


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