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MSK Experience - RO vs Surgeon
Came to NYC to have a consult with Dr. Nagar (RO) and Dr Edhaie (Surgeon w/heavy AS lean). Also met with Dr Choi (RO) at MDA a few weeks ago.
I’m 59……3 (3+4) spots. All on the right side with all small pattern 4 (10%, 10%, 5%). Last PSA was 3.5, PSAD .065, Artera came back at 2% risk of future spread and now waiting on Deciper results.
Heavily prefer radiation option over surgery (and at this point probably over AS if that is even an option).
Really liked Dr Nagar (reminded me of Sanjay Gupta on CNN) but he almost felt overconfident in some ways —- like I was in for a dermatology appt for a skin cancer. Strongly feels we can knock this out (one and done) with radiation with small (less 10% recurrence chance). With any recurrence most likely would be localized so retreatable and stated “who knows what options would be available 10 - 15 years from now if you ever needed them”. Don’t get me wrong….I like his confidence but it also scared me a bit as well!
Dr Ehdaie was much more measured….pending a few more tests thinks AS would very much be an option. If it moves to treatment would recommend surgery which again is not my preference.
Is this typical…….RO vs Surgeon general approach. Just so hard when two Doctors are recommending different things.
Really not even sure what I’m even asking…..would love any feedback on the decision, thoughts on MSK vs MDA, Dr Nagar and Edhaie, radiation vs surgery, etc?
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@cadaddy
It would be an interesting comparison between an Mri based Machine, and a machine like the Ethos that you are describing. As I understand it, the Ethos Machine is using AI to improve the Imaging, Both in terms of what the doctor sees size wise and the clarity.
Fiducials were not required for the Mridian but my oncologist inserted them anyway and I had no problem with that since she did it at the time that I was also getting space oar. A side discussion I had with one of the technicians indicated to me that sometimes the fiducials were added in case there was a breakdown of The Mri based Machine and that patient could be moved over to another non mri one, which didn’t happen very often at all, but still, I was OK with it.
It will be very interesting to watch real time CT and real time Mri Imaging, and how it gets used for prostate cancer and other cancer as well , as AI progresses.
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1 Reaction@bens1 That’s really interesting, Ben; I assumed fiducials would be a big No No since MRI was being used.
Isn’t MRI contraindicated for people with metal implanted?
Thanks,
Phil
@heavyphil
I believe my fiducials are made of gold so they are OK but they could be made out of other materials that also do not interfere with Radiation. I am hoping for Gold because I want to be cremated and when that time comes given the price of gold , my children will have a back up savings plan.
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2 Reactions@bens1 Yes, dumbass me just remembered that they are pure 24 k gold, so no alloys to be a problem…
…and yes, if things keeps going on current trend, you will be worth much more dead than alive !😂