Welcome to Ask Roswell's Journal

Earlier this month the New England Journal of Medicine wrote about the use of the prostate specific antigen test to find prostate cancer early.

Dr. James Mohler, chairman of the department of urologic oncology at Roswell Park Cancer Institute, Buffalo, N.Y., and chair of the prostate cancer treatment panel of the National Comprehensive Cancer Network gave this quote to the Chicago Tribune:

“I think there two reports are going to cause people to question whether aggressive diagnosis of prostate cancer is the best course of action. And when cancer is found, I hope the results will cause men to give more consideration to watchful waiting instead of immediate, aggressive treatment. ... I feel very strongly that it is wrong to just give a patient a PSA test without consideration of how the results will be used. The test has to be given intelligently and shouldn’t just be a knee-jerk recommendation. ... If you’re at high risk for prostate cancer because you’re African-American or have a father or brother with [the illness], do not wait for these studies to mature and for all the results to come in. Get the test. ... If you’re low risk and have a normal PSA results, I would stop [getting the test] when my life expectancy fell to 10 years or less. Until then, I’d get the test every one or two years.”

Dear Roswell:

I have a friend who had a cancerous small breast tumor removed very early on 2 yrs. ago. she was on oral med ever since but now finds out by mri, it has returned. I'm thinking this must have been a very aggressive type of cancer. i guess her options now are mastectomy and/or????

a Y'er

Dr. Michael Wong (y:dr_wong) responded to this question. His answer is below:

I am sorry to hear of the cancer recurrence. The major task now is to define the amount of tumor present, its location, and the best approach to get rid of the cancer completely and forever. Therefore, the options will be determined by the medical workup and the imaging tests. I want to point out that the very fact that it came back does not automatically make this an "aggressive" cancer.

Many such patients are rendered free of cancer again, and so there is hope in this situation. There are so many choices, not just surgery, that a good discussion isn't possible here, but is best held with the oncologist. Good luck to your friend.

Well, we realized that the y:Dr_Mike blog was getting a lot of medical questions in addition to the support ones that Dr. Zevon can answer quickly. So, to speed up the process of helping you with medical questions, we decided to start this blog.

So, if you have medical questions, message this blog (upper left hand corner) or post a comment below. We'll send to a member of our medical team to answer.

Please note that (as per our TOS) YRoswell does not provide medical advice and it is not intended to be a substitute for professional medical advice, diagnosis and treatment. You should always seek the advice of your physician or other qualified health provider with respect to any question that you may have regarding a medical condition. Reliance on any information provided by RPCI, its employees or other visitors to this site is solely at your own risk.