Ultrasound Images At Last

prostatedoppler$950 later, I finally got a whopping five ultrasound images.  This was from my prostate ultrasound test in New York City last month by Dr. Robert Bard.  The lure of the “3-D/4-D” power doppler sonogram was the promise of hundreds or thousands of color enhanced images that could be turned into a three dimensional view that would also show motion in real time.  What I actually received after my appointment was a single, 1990s fetal-ultrasound-quality, black and white polaroid-sized image.

Prior to the appointment, I specifically asked if the images would be available to me in some format for a second opinion, if necessary.  In reviewing the cryptic response from the Dr. Bard, it seems it might have even been intentionally vague or even dodged the question altogether.  I guess that should have been a red flag.  Nonetheless, after the ultrasound, he said a partial set of images would be available and referred me to his staff.  I was sent a single black and white digital image, though it was at least more detailed than the polaroid.  I repeated my request and got no reply.  After a couple weeks, with my next consultation looming for the MRI, I sent another request.  A few more exchanges resulted in five images being sent to me, as the previous email with the first image must have been corrupted.  Apparently, five images were all they kept!  For all the promise of this technology, they claim to have kept only five 2-dimensional images out of thousands, with zero benefit of 3D or 4D available to me for future reference or a second opinion!

At least a few of the five had color enhancement, supposedly showing areas of increased blood flow.  I’m quite skeptical now, but perhaps the MRI I have in a couple weeks will confirm the findings.  Even the results are suspect to me at this point.  Though I was told a couple times that the findings indicated a “moderately aggressive cancer”, I found it a little unusual that the report does not mention the word cancer anywhere.  In addition, I note that the bill also didn’t use any of the standard diagnosis codes for prostate cancer.  Instead, it listed, “Unspecified Disorder of Prostate” and, “Other Specified Inflammatory Diseases of Prostate.”  I sincerely hope that mentioning cancer wasn’t simply a fear tactic to sell me on the MRI, the book , his two dietary supplements and the followup $950 ultrasound visits every 4-6 months that were all recommended to me.

I was disappointed enough in the ultrasound that I sent my images to an expert on prostate ultrasound imaging.  As I expected, this radiologist was unable to comment on the images, saying he didn’t believe any physician could make a definitive diagnosis from them.  I can’t fault the ultrasound technology directly, as there appears to be a reasonable amount of evidence that it can be useful in some situations.  In comparing my images to power dopper images of proven aggressive/advanced prostate cancers, they appear nothing alike to the untrained eye.  In fact, one of suspect areas he identified appears strikingly similar in some ways to the effect of having the ultrasound taken while you are on your side (which I was), rather than on your back.

At the very least, I hope if there was an obvious cancer that required immediate treatment, this physician would have suggested I have a biopsy done right away.  Suffice to say I won’t be buying any books or supplements at this time.  I’m glad I already had an advanced 3T MRI scan and biopsy scheduled and didn’t fall prey to paying even more money for a standard MRI.  Another positive?  I had a good chuckle about the whole experience with a friend of mine who accompanied me to the office visit (who also thought it was a bit unorthodox).  That’s a pretty expensive chuckle, though.  Live and learn, as they say.

4 thoughts on “Ultrasound Images At Last”

  1. It’s simeple as far as I am concerned. Urologist by definition have a lousy self image, like sociopaths. They are greedy and unethical. The look at medicine as a money maker. Now see how the emphasis in diagnosis has shifted frm immediate bioposy to new high tech methods….expensive ones, the total costs to the patient exceeding a good old fashined proatate cancer surgery. Hey, money to be made. That’s the new wave. Briefly, I am 74 and have had enough false positive biopsies for a lifetime. Bitter, yes but I hope that my comments here and elsewhere awaken other “candidates”. Urology yoursmology you *&&^%%$s

  2. Very helpful that you have actualy gone ahead and tried with what others of us trying to find more intermediate and less invasive alternative evaluations steps than biopsy have only considered. I too was attracted to considering power doppler sonogram – found through Ronald Wheeler site in Sarasota, though I learned of Bard in NYC along the way also.
    Urologists dismissed sonogram and said biopsy was only sure way to know; but it seemed worth checking thoroughly and independently regardless. Bard sounds like a scam though, largely, and probably the rest of the power doppler sonogram option is also. MRI was the other option, except that I was told (if I understood correctly) it only picks up larger cancers…much later than cellular level found by biopsy, so is too late/not sensitive enough to pick up early evidence – when one wants to find it – and is used more for later check of spread.

    1. The advantage of the 3T MRI is that it has better resolution for finding smaller cancers. Of course, it will still miss cancers in the earliest stage. Consider also that any cancers so small to be missed by MRI are also less likely to be found by biopsy, too. The biopsy can see the cells, but only if a sample is taken at the right spot. Biopsies only sample a very small percentage of the prostate volume, so it would be a lucky shot to find a very early, localized cancer. I’ve also seen the question posed that if a cancer is so small that it is missed by a high resolution MRI, at what point would you even consider it significant enough to recommend surgery? I don’t have the answer to that, but it is a consideration.

  3. Love your blog, its a very interesting perspective on your approach. Its great to see different views and procedures so everyone can read and gather information that will help them make a decision. I have enjoyed reading your blog and continue to wish you the best of luck! Darren Ritch

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