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EVALUATION:
In consideration of the knowledge of the patient, the knowledge, capability
and experience of the attending physician, and the availability and use
of the most up-to-date equipment a complete evaluation should be undertaken,
with a written report be furnished to the patient outlining ALL treatment
options available, not those that serve only the vested interests of the
physician.
Recent improvements in ultrasound equipment, namely Doppler Color Enhancement,
permits a more definable hypoechoic echogenicity that makes it possible
to provide a needle guided biopsy rather than multiple randomized biopsies
which may miss the tumors entirely especially when they are small.
Imaging enhancement with the use of CT scans and MRI can authenticate the
presence of extra-capsular tumors and confirm metastases.
Other evaluation procedures should be taken to provide additional data such
as the PH values and a ploidy analysis that indicates the aggressiveness
of the disease. Diploid designating non aggressive disease with Aneuploid
or Tetraploid characteristics indicating more aggres-sive disease.
Comparing the PSA value with the Partin tables can give a clue to whether
the disease is localized or systemic. |
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