ABSTRACT
The message was clear and unambiguous, the urologist had given his unmistakable dictum: “You have prostate cancer.” “How is that possible,” replied the immediately concerned 61-year-old senior trans plant surgeon, “especially when there were no signs of a tumor with digital rectal examination and the ultrasound was completely nega tive?” The prostate specialist reorganized his thoughts before answer ing and said, “I never thought you had a good chance of having a positive biopsy either. The odds were in your favor.” Without paus ing, the urological surgeon added, “It is hard to understand these results, but now you need to remember these figures. Write them in some secure place. You are Tic, Gleason 6\ PSA 4.1. Never forget these figures, they will give you a prognostic indicator for the future. You need to become fully aware of their meaning.” The patient did not know what the urologist meant. Even though he was a surgeon, a transplant surgeon, his knowledge of the prostate gland was primi tive at best. He needed to go back to the library to learn the funda mentals of this disease.1'7 It was clear that the burden of inquiry was on his side. A decision was required as to the optimal individual mode of treatment, the best that could fit his way of life and think ing, not an easy task at this early stage of diagnosis.
