My Super(?) Ultrasound

I had my ultrasound yesterday.  I flew to New York City to get it.  The only physican that I could find who was closer and used similar technology for my situation was near Detroit, but they wanted to do a biopsy at the same time.  There are a number of other places doing these sonograms across the country.  New York had the advantage that I would get to visit a few good friends on my overnight visit.

I didn’t know much about the physician, Dr. Robert L. Bard, beyond a few brief email exchanges, some Google searches, and a quick check at the New York state health department to make sure he was a currently licensed physician (he was indeed a licensed radiologist with no complaints listed).  Probably a little extreme to check this, but if I’m flying out-of-state to see someone for a medical procedure, I want to at least make sure I know they are legitimate and not just a website scam or something!

The ultrasound was as expected.  Quick and relatively easy with pretty much zero risk.   The report indicated two increased vascular regions that he usually associates with a tumor.  I watched the 2D images during the exam, but it was hard for me to tell anything about the physiology, as I could often do from past MRI images.  It was also hard to tell what was good or bad, as dark and light areas or red and blue dots appeared and disappeared.  The area of most interest to him was at the edge of the screen, where it was very difficult for the non-trained eye to discern anything beyond backgroud noise.  I’m a little skeptical, but of course I have no training in how to interpret the results.  Since it’s not widely accepted for this purpose, it’s also impossible to compare with online information, as you can do sometimes with MRI images.

I don’t necessarily doubt the results.  There may well be something suspicious there, quite possibly cancer.  I was told that it was relatively small and confined to the prostate, which was good at least.  The recommendation was to followup with an MRI later that day at a nearby clinic to confirm the results.  He also advised me to start on the his anti-oxidant supplement formula, continue with ultrasound monitoring every 4-6 months and purchase a copy of his book for a more detailed explanation.  I wasn’t ready to accept any of this immediately, right after being told I might have cancer.  I’m not one to do anything like this spur of the moment, without researching further or getting yet another opinion.

That’s just me, though, and I don’t want to sound too skeptical.  It may well be sound advice and a good plan.  It seems like it has worked for many of his other patients with similar ultrasound results.  In my case, I will reserve judgement until I have some other information and/or other expert opinions on my situation.  Unfortunately, I can’t even get a full set of images or a 3D version of the ultrasound.  I am told this would require $20,000 of software.  Apparently, we had some mis-communication about this before the ultrasound.  Now, I may not even have enough useful information to share with a surgeon or to compare to a future ultrasound unless I fly back to New York to the same radiologist:-(

I do have a polaroid sized 2D printout of the most suspicious image, much like what you’d get from an old style pre-natal ultrasound.  I am also supposed to be emailed a limited set of images, though I’m not sure how useful they will be.  For the price of $950, I can’t yet decide if it was worth the cost or not.  It also remains to be seen if my insurance will cover it.  I’ll see how it compares to a possible MRI or biopsy that I may want in the future.   Worst case, it’s still another piece of information I have that doesn’t indicate anything that requires immediate attention.  I also had a nice trip visiting friends (you know who you are, thanks!).

I had another consultation this evening from a urologist.  He was very skeptical about the sensitivity of power doppler ultrasound results used alone to detect prostate cancer.  More on that tomorrow or later this week!

5 thoughts on “My Super(?) Ultrasound”

  1. Saw him a few years ago. He gave me, on the spot a cd with a pic of the whole prostate with red ect dots showing calcium ect
    a letter of finding also.
    One guy on prostate site claimed some doctor in sarasota Fl found cancer on his cd/pic that he missed. Who knows? Remember when it hits the fan, their PAT amswer is. Sorry it is the healing ARTS. Awfull high paid Artists in my book.

    1. As one radiologist told me, the prostate IS a vascular gland. There will always be indications of blood flow and these can vary by time of day, position of the patent and even be manipulated by the person doing the ultrasound to some extent.

      My impression now is that advanced ultrasound is simply not very good at differentiating early cancer from benign ailments or variations. While it may have some utility in guiding a biopsy, used alone, it may be a waste of time for someone in my situation. For someone with large or advanced cancer or in some other situation, it may have much greater utility. In that urologists and radiologists can’t agree, who am I to say for sure. Even so, check out some of these images:

      http://books.google.com/books?id=DuDzxFcYMBoC&pg=PA51&lpg=PA51&dq=ethan+halpern+prostate+ultrasound&source=web&ots=_RtI2RYMqV&sig=PncI0ZlnQ8_LTkFC–1oWFgj8eg&hl=en&ei=7KKZSYOIFpC4MoCghIYM&sa=X&oi=book_result&resnum=1&ct=result#PPA43,M1

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