Month: February 2015

From the ASC Website

Finding and treating all prostate cancers early may seem like a no-brainer. But some prostate cancers grow so slowly that they would likely never cause problems. Because of an elevated PSA level, some men may be diagnosed with a prostate cancer that they would have never even known about at all — it would never have lead to their death or even caused any symptoms. But they may still be treated for these cancers, either because the doctor can’t be sure how aggressive (fast growing and fast spreading) the cancer might be, or because the men are uncomfortable not having any treatment.

What is the internal sphincter in regards to the male bladder, post prostatectomy incontinence and the external sphincter?” Hmmmmmmmmmm? If the internal sphincter is so important to continence then why don’t men leak after a TURP?

Dr. Catalon’s explanation of post prostatectomy anatomy and continence.

There  was  a comment about the internal sphincter and a patient being disappointed that the urologist did not tell him that it would be removed at the time of a prostatectomy. The patient has incontinence and is concerned that if the internal sphincter had not been removed he would not be leaking urine.  Here are my thoughts and my understanding of continence after the prostate is removed..

But first….Walsh’s take on this matter…on in which I am in full agreement.

• The external sphincter is a defined muscle that one can contract and stop and start the urinary stream.
• It is the primary sphincter for the control…

Question:

I am 63 years old and in good health.  I was recently diagnosed with prostate cancer (Gleason 6; low volume; TIC Stage 2).  My urologist–a surgeon–went through the options with me and my wife.  He also stated that he felt I was a prime candidate for using the new trueBeam radiation method (45 treatments).  He set me up to meet with radiology oncologist.  I also have an appointment with a surgeon he recommended that performs the daVinici Robotic surgery.  After reading your book and the Johns Hopkins book, I was leaning towards the surgery — the “gold standard.”  Now after meeting with the radiologist, many of my fears and concerns relative to radiation were “debunked.”  Do you have any insight or could you direct me to any studies relative to the trueBeam radiation therapy?  Treatments would be done less than six miles from my home — a real plus.

From the…

I know you’ve read the poem, ” the road not taken” my mother referred to it as the road “less traveled” and that is the problem with the common interpretation. It is more complicated than you would think and may have a different meaning than you thought. It also has a prostate cancer decision implication. This is the tease. Read the poem a couple of times and then see what you really think it’s about,  then apply to prostate cancer and the decisions related to that. And then of course we find that Frost had prostate cancer and died of complications of  it, albeit at an old age. More later… I have a little story to tell about the poem that I’ll share tomorrow. Enjoy this classic, it has so many turns. Research what Frost himself said about it. Hint: the road less traveled is not necessarily the  better one.

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