I enjoyed your post, Don. You wrote:

.. You are supposed to

> tell us what is best and here we are finding out that we have to

> choose - never before to my knowledge in a medical practice has the

> patient had to do the research and choose their choice of treatment.

> You and the other docs on this list say to us - do your research,

> learn and make your decision for treatment. Something is wrong

> someplace.

Didn't you say your first doc said that he'd to four biopsies and that if

he found cancer he would cut it out. This is simple, clear, and direct. If

you want a guru, pick one and listen to his directions. You can believe

that he has TRUE KNOWLEDGE and you will be at peace, knowing that you are

in good hands.

Once you do the self-education thing in PCa, however, you are taking on the

burden that comes with finding out that very few things regarding PCa are

certain. This is not the doctor's fault. Its just the state of the science

at present.

Sure some docs are more "educated" and more open-minded, but all are

necessarily limited. You can't have it both ways. Either listen to the

advice of your doctor and turn off your computer, or continue to become

knowledgeable in PCa and risk losing respect for your doctor's opinions. If

you search long enough (both for the facts and for the right doc) you just

might find a compatible match. This is not easy. It is perhaps unfair to

ask of the patient. No easy answers here.

JR Oppenheimer

Prostate Pathologist

**********************************

From MS

> On 08/13/97 21:34:58 Charlie wrote:

> >Dr. Oppenheimer, this is one of the best statements of the situation

> >that

> >I have seen. Nothing is cut and dried in this disease. There are no

> >known

> >"right" answers, and perhaps there can't be. Perhaps there are too many

> >variables in each individual case for there ever to be a certain answer

> >for any individual. So the patient is left with the burden of making the

> >final

> >decision.

>

>

> I think this statement is over broad. I just answered a case on the p2p

> where a 46 year old with palpable gleason 9 disease with a PSA of 24 was

> treated with two lupron shots followed by Rp. When the psa did not go

down

> to zero they gave him radiation! On top of all this there was a

suspicious

> lesion on bone scan. It is totally cut and dried that this poor man was

> manhandled by bad doctoring. Everyone with stats like these has to

assume

> that there is at least micrometastatic disease. Systemic therapy is the

> only thing that represents any hope of changing the natural history of

this

> man's disease.

>

> Mark Scholz M.D.

> Healing Touch Oncology

> Los Angeles

I agree completely with your sentiment, Mark. Just because there is a time

of day called "dusk" doesn't mean that there's no such thing as night and

day. Unfortunately, the equivalent to "dusk" in PCa knowledge is much too

large and research dollars must be ear-marked to reduce its size. There is

clearly incompetent medicine out there, and I feel one of the great

benefits of PPML and P2P is to help patients avoid it.

I hope my comments are not misconstrued to suggest that becomng

self-educated about PCa is futile. The time I spend on the computer would

be the greatest show of hypocrisy if that were true. For those with the

tools, talent, and stamina to help understand and contribute to their own

diagnosis, treatment, (and hopefully) recovery, I trust this is a very

worthwhile endeavor.

Regards,

Jonathan