Podcast on Internet Only type of patient.
After examining a patient one day (PSA and rectal exam) he asked if that was all I was planning to do to him to check for prostate cancer. I said that what I had done was enough for now, the prostate felt fine and the PSA would be back in a couple of days.
He said he had read about a digital exam and he wanted that also…he had read about it on the internet. His tone was that of someone who thought he knew something I didn’t and that I was remiss in offering the “newest technology.”
I said that I did not understand. “We do ultrasound evaluations of the prostate but I am not familiar with anything that is digital.”
“Well, I read it on the internet and I want it. It said it must be done with the PSA.”
Then it dawned on me…a digital exam was the old-fashioned rectal exam, finger wave, or exam with your digit…a digital exam.
When I say the internet lacks context, texture and depth, this is what I mean. It is good, don’t get me wrong, but run it all through the prism of your caregiver and certainly don’t make a decision solely on what you have read. Examples being the rush to Proton therapy or Robotic prostatectomy because of the marketing hype and footprint on the internet.
Prostate Diaries 
Too much information is a dangerous thing. Do not overload
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C’mon, get real, doc!
For treating most prostate cancer and doing so effectively, don’t pooh-pooh proton therapy, a procedure that’s proved itself all over the world–15,000+ successful treatments at Loma Linda University Medical Center alone.
I’m at Loma Linda now, 9 treatments down and 33 to go. The talk here about proton treatment, as you might imagine, is all positive–nobody complains about side effects, incontinence, impotence, fatigue, or depression because for the most part they just don’t happen with proton therapy. What patients here DO complain about is medical bias, about how almost without exception their diagnosing urologists recommended radical prostatectomy for garden-variety adenocarcinoma with T1-stage PCa with Gleason 6 scores and below–so many say their diagnosing urologists told them they were perfect candidates for RP, as mine did.
Patients here didn’t take that first recommendation, and from my admittedly unscientific sample they seem 100% certain that proton therapy for their prostate cancer is the right treatment. They didn’t come here because they did all their research on the Internet; they came mostly because they learned about proton treatment from those who had been through it before–PCa survivors who are leading full, happy post-PCa lives without diapers and without ED and without depression.
After reading eight books (including yours) on prostate cancer, talking with dozens of PCa survivors, and getting a second opinion at Mayo Clinic, my own conclusion was that surviving a prostatectomy with an excellent prognosis and no side effects or collateral damage takes a lot of luck, but surviving proton therapy with an excellent prognosis and zero side effects or collateral damage is ho-hum routine–to be expected. Nothing I’ve seen or heard since that time has changed my mind.
One guy’s opinion but probably shared by proton patients and alumni around the world.
–Milt (age 70) at Loma Linda
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Thanks for the note…you did the process the right way and did what you felt best for you based on all the research you could do. No complaints here from me and I hope you do well. Ps…all the treatments have side effects “zero side effects, excellent prognosis with proton therapy”…who can argue with that? I wish you the best and I enjoyed your comments. jm
Pss…take a look at the link about “adverse gu side effects with proton therapy” in the above post.
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