A perspective from Men's health

[Mark]

Being a guy approaching 50 who still thinks he's 25  , I read men's health magazine and as someone who diligently researched both treatment options and came down on the radiosurgery side, I found this article in this months issue interesting. It is not specifically AN related but I think of how many stories have occurred in this forum about people getting diagnosed and being told they had to have surgery immediately and I felt there was a relevance.

Mark

Link to the article

http://www.menshealth.com/cda/article.do?site=MensHealth&channel=health&category=doctors.hospitals&conitem=2641a348a8c62110VgnVCM10000013281eac____&page=6

The 4 take away points when faced with any surgical situation

Spot a Greedy Doctor

American medicine is, for better or worse, big business. And don't assume your physician isn't caught up in it. "Many doctors at hospitals are profiled based on how much revenue they produce," says Elliot Fisher, M.D., M.P.H., a professor of medicine at Dartmouth medical school. Guard your body--and your wallet--by watching out for these warning signs.

 

1. You need a pricey scan, for no reason.

High-tech tests, such as the 64-slice CT scan, spot anomalies that might otherwise go unnoticed. But anomaly doesn't always equal illness. "Excessive testing is like a gateway drug that leads to unnecessary treatments," says Steven Woloshin, M.D., a research associate with the VA Outcomes Group.

 

2. Surgery is the first option on the table.

We've learned to love surgeons, and not because of the hot women on Grey's Anatomy. "Surgical procedures are attractive to patients because they're easy to understand," says Floyd J. Fowler, Ph.D., president of the Foundation for Informed Medical Decision Making. "But there's almost always an alternative."

 

3. They can fit in your surgery tomorrow!

Unless you're doubled over in pain or spurting blood, all surgical procedures are elective. "Someone rushing you into a treatment is a huge red flag," Dr. Fisher says. That's because many doctors know the same thing that car salesmen know: The odds you'll buy drop dramatically once you leave.

4. Your second opinion is down the hall.

Doctors who work closely together tend to adopt similar solutions to a problem, and "it's bad politics to disagree with your colleagues," says Pamela Gallin, M.D., author of How to Survive Your Doctor's Care. When you ask your physician for a referral, say, "I'd like to see a specialist in another group."

 

-Denny Watkins

[BeJoi]

Hi Mark,

Thank you so much for this.  I walk into every doctor's office knowing that they're in business, too, and often times we don't want to acknowledge that.  The hospital/doctor connection is also something to consider when signing up for surgery or tests.  I'm going the radiotherapy route, but I'm still having doubts about whether I should wait longer or move forward now.  My hearing is the biggest consideration--I want to try to preserve what I have now if at all possible.  And I have a gut feeling that my AN will continue to grow, and I have to trust my gut.

It's interesting, my radiation oncologist wanted me to have these gold markers implanted in my skull to help with aligning the trilogy system each day.  But I suspected that he was also recommending it because it would give some business to the neurosurgeon (as outpatient surgery), since the neurosurgeon won't be involved in my FSR treatment.  Who knows--but I opted not to go through with that procedure just to save 5 minutes every day during the treatment. 

Are the MRI and CT scans both necessary for the planning of this treatment.  I don't know that answer either, but here I have to trust that the radiation oncologist is looking for as much information as possible before he starts radiating my brain. 

It's all confusing and there is a point where I have to trust that the doctors know more than I do.  But I will always ask questions and do research so that I will know as much as I can before I agree to anything.  We all need to be informed patients, and we need to speak up and ask the tough questions when it's necessary.

Thanks again,

Beverly

[Windsong]

Beverly, the first post you wrote about markers being suggested I thought right away oh now that's interesting as markers are used as guidelines for radiation therapy, but I couldn't figure out why they would be used for an An as with Gk or Novalis or whatever name the machine has, plus Ck, there already is a way of stabilizing the head for an An......ie with  a mask or a mouthpiece or a Halo as for GK.....at which point in my thinking I thought hmmmmm are they trying to do this super, super, super accurately, with less margins receiving doses, (and maybe that changes the total dose received or something),  or is this a new way where even the mask can be dispensed with, or what? I even wondered if this is part of new research we don't know about yet lol.....

I know that during the weeks of treatment the tumour can change slightly as you go along which is why image guided pics each day (some machines now have that capability at the same time as one has treatment) can help with aiming the target and add even more precision to the miniscule mm figures out there ... i figured markers would maybe do the same thing too I don't know....you are the first I have heard here who has mentioned this as a possibility with an An...

In any case, stats show the variation between different radiation machines used for Ans as far as mm accuracy isn't all that variable plus as i understand it, the dosage given each time enters into the picture too..... i dont think you can look at one aspect only really...but if he says you can go without the markers, great.

Ct scans and mris show different things sharper so when they overlay one over the other,(to help them plan the treatment) it gives them an even better picture... (it's why they are moving to the machines that give the dose each day and also take pics each day ) so having an MRI and a Ct scan pre treatment is par for the course and good.


here's a site i found after i wrote the above that is about ck  generally....http://www.cyber-knife.net/fileadmin/Menubilder/Cyberknife_radiosurgery_en01.pdf





All the best,
W.

[ppearl214]

Great post, Mark... as always, thank you for sharing


Phyl

you're pushing 50?    *faints*

[Mark]

Phyl,

Yes, in August life as a young vibrant adult ceases and I become an old curmudgeon 

Mark

[ppearl214]

not far behind you, you pre-curmudgeon.... you'll always be a youngin' in my book!

[FlyersFan68]

Good Reading...Thanks. Hey, 50 is the new 35! Anyway, I was always one to assume that doctors are always giving you a good honest answer pertaining to your situation. I would like to think that there are still some left out there. My son was sick last night I and I remembered when I was really sick around his age ( many years ago in the early seventies when doctors made house calls. I remember the doctor treating me as if I was in his office. Nowadays you get an answering service with a return call many hours later from a doctor that you've never met because your primary isn't on call.