Thousands of men have never been heard

[Darryl]

I'm pissed off that many doctors buy into pre-disposed stereotypes and don't bother to engage in meaningful consultations with their patients. This might be particularly toxic for men appropriate for active surveillance. Am I wrong or is it time to change this. What are the stereotypes and cliches and bigoted ideas about men that boil your blood (or, that you just notice and move on from)?

For examples:

Most men love watching sports

Most men won't see a doctor

Most men don't talk about their feelings

Most men have a high tolerance of pain

Most men won't cry

Most men are married

Most men resist digital rectal exams

[Fox2018]

Hello Daryl,

I have a question for you. Over on the advanced prostate cancer site there are many stories of men who receive a diagnosis of severely advanced PCa. They are surprised and shocked by the diagnosis.

How is it that the disease can get to such advanced stages in so many men without being detected at an earlier stage via regular PSA and/or DRE tests and exams?

Mike

[Darryl Partner in reply to Fox2018]

Prostate cancer doesn't always progress at a steady rate. I've met many men who had low or lowish annual PSA results for years, and then, suddenly,their PSA elevates and their biopsy shows a Gleason 8 or 9. Also, many men in their 40's and 50's have an elevated first time PSA...should we be PSA testing in the 20's and 30's. I've met and, eventually mourned two men who, in their 40's, had first time PSA scores of around 200 and 400. Also, African American men are much more likely to have a Gleason 8 or 9 at earlier ages than white men....no one "really" knows why, yet.

[Rob100 in reply to Darryl]

You are correct. Officially the medical profession doesnt know why Africsn Americans are more likely to have advanced cases. The theory is that it is known I'm general they have significant lower levels of 25hydroxy vitamin d when they live north of equator. Out of the 12,000 people I have tested for vit d levels in my practice, several thousand have been Africa American and ONE lone man had a level over 32 ng.....80 nMol. Their average level is lower than the average Caucasian . The medical profession tends to not publicize the valid studies on vit d, thats a whole different issue.

[JimVanHorn]

I agree with Darryl. The cancer is often slow growing but can also be very deadly. Letting it go for many years may not be the best idea. I started in 2007 and since then a lot of information has been found out about this monster. I was treated and I am currently free of cancer. I wish you all luck!