1. I have heard the phrase “Active Surveillance”, what is this concept? Is it a treatment plan?
This protocol, also known as “chronic disease management”, was developed by Dr. Ron Wheeler to allow men to live with their prostate cancer much the way men live with arthritis, diabetes, etc., using diet and nutrition along with PSA monitoring. This allows the disease to dictate the response, doing only what the disease requires and nothing more, rather than a “one size fits all” treatment.
2. I just had a diagnosis of prostate cancer, a Gleason score of 6. My urologist wants to take out my prostate next week. Is this a good idea? Do I need to do something so quickly?
As in any treatment decision, there is no need to rush. Do your homework and seek the counsel of other experts. A Gleason 6 cancer is the most overtreated of prostate cancers and, in many cases, can be managed with Chronic Disease Management.
3. How do you decide whether to biopsy or not in the face of a rising PSA?
A high PSA, a rising PSA over time or a suspicious rectal exam will usually trigger a biopsy recommendation from the standard urologist. At our clinic we use the MRI technology to “see” the prostate and biopsy only the suspicious area. This dramatically reduces the trauma to the prostate and potential for spreading the cancer cells, which is prevalent in “random” biopsies.
4. When should I consider testosterone supplementation if I have a rising PSA?
Only after a thorough exam and MRI scan determines that the PSA is not cancer related. Thereafter consistent PSA monitoring is recommended while on the testosterone supplementation.
5. Is the MRI a good idea after cryosurgery if my PSA comes back?
The MRI scan is an excellent way to determine the success or failure of any prior “definitive” treatment. We can see if the cancer remains and even suggest a salvage treatment using HIFU.
6. I have had a series of negative biopsies, but my PSA continues to rise……what should I do?
This is the perfect scenario for the application of the MRI technology. Not all rising PSAs are caused by cancer, but until the PSA is brought under control nutritionally, or a scan determines the precise disease state, you will continue to be chased around the urologist’s office with a biopsy needle.
7. I’m considering HIFU as a treatment option. How would MRI be a part of that decision process?
In two ways. First, it would confirm the existence of the cancer and its precise location. Secondly it would be useful in a post-HIFU confirmation of the success of the procedure.
8. My doctor has never tested me for prostatitis, why not?
The only definitive diagnosis for prostatitis is through an examination of the prostatic fluid which is obtained during the DRE. The fluid is viewed under a 400 power microscope and white blood cells are counted. If a bacterial prostatitis is suspected, a bacterial culture will be grown. This is unusual as the vast majority of cases of prostatitis is non-bacterial.
9. What is High Grade PIN? Does this diagnosis mean I have prostate cancer?
Although Prostatic Intraepithelial Neoplasia is not cancer, it is often a precursor or early indicator of cancer to come. This can be seen with the MRI scan, validated with a tissue sample, and can be monitored for any further development. It is not a condition requiring treatment other than good diet and nutrition.
10. What inspired Dr. Wheeler to explore non-surgical options to prostate care?
As you know, I am a physician and urologist (surgeon). Within my profession, we should constantly strive to give our patients the most conservative successful options to improve or eliminate their problem. We also know that surgery is not always the best option. Surgery does not come without complications and risk. I am elated to be associated with a product that I believe will be revered as the first line of therapy for men with a prostate disorder.
11. I recently had a biopsy before I knew that biopsies could spread disease, what should I do?
Contact our center, Diagnostic Center for Disease, as soon as possible and schedule a conference call with Dr. Ron Wheeler.
12. Dr. Ronald Wheeler, why don't you agree with other experts that a PSA of 0-4 ng/ml is normal?
Here is an area where we have shot ourselves in the foot as Professionals. How can O-4 ng/ml be normal when 20-30% of all prostate cancers are discovered in this range? While 0-4 ng/ml is common, it is not normal! This represents a true medical oxymoron.
13. Can a Prostate Biopsy Spread Prostate Cancer?
Absolutely! There was a study done (the reference eludes me) that demonstrated a risk of 10-20% for needle tracking of cells along the biopsy path. Patients and physicians should always consider carefully the risks and potential benefits before a prostate biopsy is performed.
14. At what age should one consider prostate nutrition?
Generally ages 35-90; with earlier usage if you are an adult male and have been on antibiotics for a urinary tract infection or Prostatitis even one time during your adult life.