Dr Trewkare may not be infallible, but I suspect he is about as good as they come. Even though we had seen him only three times over a four year period, he greeted my wife and me on a first name basis as if we were old family friends. Apparently Dr Trewkare reviewed most of the medical information I had submitted prior to our appointment. We quickly reviewed the treatment plans that I had considered and rejected including brachytherapy, cryotherapy, HIFU and surgery. It seemed evident he agreed I had not overlooked the ideal option. He visibly shook his head ever so slightly at the mention of HIFU.
At this point I asked him about the advisability of the Casodex plan. "Who recommended that" he wanted to know? "An oncologist by the name of Dr Cy Fer," I answered. "I know him," he replied, "he irritates me every time I see him at one of our meetings, and now it is all the more obvious that he DOES NOT KEEP UP WITH THE LITERATURE." It was fairly apparent that this is about as bad as it gets in the medical community in general and the oncological profession in particular.
"Your PSA remains fairly low," Dr Trewkare returned to the task at hand, " and in my opinion its rate of ascent is not particularly worrisome." ( Although this observation runs counter to my perception of my predicament, it directlly parallels Dr Gud E. Nuff's judgement precisely). "We should begin to think in terms of treatment when your PSA reaches 10," he continued. "When we do treat we should consider traditional hormone therapy on an intermittant basis. Please monitor your PSA, provide me with the results, and when you return from Texas in six months come in and see me." So goes the current plan