If we operate on only part of the information the advise given could be dangerous to the patients health. For this reason I have included this information as advise to new patients as to how important it is to give your history to get the best help. Of course you may not have it all - but try and submit what you have. If it is incomplete it may not be submitted to the Group or the Group Members will ask for more. Be sure to let us know and tell your doctor if there is any prostate cancer or breast cancer in the family.
One of the first things a doctor in training is taught is how to take a case history. Oftentimes when they get into practice it is relegated to a nurse or some one else in the office. Sometimes I think that the doctor never looks at the file - perhaps more so the first time but less so from there on out. The result is that we get prescriptions that may conflict with other prescriptions, things that he was going to do next time and forgotten when next time is here, etc., etc., etc. All treatment recommendations and all treatment decisions have to start with a complete case history.
The same thing applies to these groups. A member joins and presents his data and ask a question. We look at the data and answer the question. Frequently the data supplied is really not enough to answer the question. In another week he comes back and asks another question but this time supplies perhaps a little new data. We look at the post and try to answer the question without looking back at his previous post to see the history. In both cases we probably give out wrong information.
I noticed this some years ago and have made a concentrated effort to get the newly diagnosed to give us a history via Step 6. Then often times they sill do not answer the questions we need. I have revamped this form, rewritten the introduction, added and subtracted information requested - all at various times through the years to make it clear that we need this history. Recently because of the studies I have added weight, weight gain and Diabetes questions on the form. Yet no matter what I do frequently the patient does not understand the importance of the data.
I think the form has been a huge success and those that submit their complete data get a lot of information from the members of the PHML group. I believe the data is necessary to make a proper suggestion for treatment or whatever they are asking. The newly diagnosed may not understand the importance of the information and frequently the members may not review the history. This is like going to the doctor and the doctor not reviewing your history before he suggests what you need. There is nothing like it anywhere for the newly diagnosed and it is a place where every man needs to start when he gets those words "you have cancer".
The items on the form are items that every doctor should know and have in the records for review but I am afraid that many, if not most, do not understand the consequences of the interplay of the various data - and neither, oftentimes, do we - although there are some who probably surpass the understanding of most doctors about our disease who are just members of these groups. The beauty of what we do is the differing opinions - however hopefully these would be based on facts and not suppositions or dreams.
There is an old saying that the three most important things in real estate is location, location, location. I believe in prostate cancer it is, case history, case history, case history. The diagnosis is a significant part of the case history but it is not the as important as the complete case history.
Lets revive the art of reading a case history and use our knowledge and the information provided to give the best advise we can based on ALL available knowledge. If the information is not there ask for it and when it comes you will have to review the original post along with the new material to answer.
This is where information becomes so important and why it is important for you to include all of the original post after where you have answered the questions at the top of the reply e-mail. Please do not bury your answers at the end of the posts and do not erase the older portions of the post when we are dealing with this kind of information and attempting to help. I know those who take the Digest form of the posts will not like it as they have to wade through all the post - but they can always change to individual posts.
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Information You Should Read
Stanford Univ. video on PCa
The Prostate - What, Where
The Prostate Biopsy
How To Tell a "Physician Artist"
The Doctors Appointment
Insignificant Cancer
Vocabulary, Glossary, etc.
Tables, Tests, Markers etc.
Gleason Info and Partin Tables
PSA - What it is and means
Locally Advanced Cancer
BPH
Prostatitis
Other Diagnostic Tools
Veterans Information
