John McHugh M.D.:

Radiation messes up things in the process of killing cancer.

Originally posted on Prostate diaries:


i wish i did not know now what i did not know then

Review of “Salvage” options if prostate cancer comes back after radiation.

One of the most common reasons I am given by patients choosing to have their prostate removed is the argument that one can do radiation after surgery but you can’t (easily) do surgery after radiation. It is a valid argument and I think something to consider in the decision-making process.  The concept is, however, not that cut and dried. Here are some caveats.

  • If you have your prostate removed and at some point your PSA goes up then that means there is residual disease. In most cases the disease is microscopic and local (near the bed from which the prostate was removed). In this case where there may be a very small amount of disease then external beam radiation can “clean up” the residual disease for a curative intent. An example would be may be a very…

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John McHugh M.D.:

Free PSA? No…you pay for it!

Originally posted on Prostate diaries:

three types of lies....lies, damned lies, and ...statistics....

The below is helpful but not a stand alone type statistic or characteristic of your PSA.

  • I have a friend whose free PSA was very high indicating a low probability of prostate cancer and ….all of his twelve cores showed cancer, however all the cores were Gleason’s 6.
  • The free PSA (being very low) was what prompted me to “get off the fence” and do a biopsy..so in that regard it sometimes is that extra shove in the reluctant patient.
  • I have  had patients with a low free PSA and no cancer.

In general the chart below indicates that you have a higher chance of having prostate cancer on a biopsy if your free PSA is low, and vice versa if it is high, but again this is not fool-proof and should only be “one of the arrows in your prostate decision-making quiver.”


PSA Scale/ Partin table

PSA Scale…

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John McHugh M.D.:

Did you know that pink used to be more associated with men in the early 1900’s? Had to do with blood and war.

Originally posted on Prostate diaries:

Rush Limbaugh weighs in on the Breast vs. Prostate debate

the prostate and prostate cancer….the rodney dangerfield of cancers and organs

June 26, 2010 by John McHugh M.D. | Edit

budding urologist with incontinence-author circa 1959

Five reasons the prostate is the “Rodney Dangerfield” of organs…it gets no respect.

“I’m not a sexy guy. I went to a hooker. I dropped my pants. She dropped her price.”- R.D.

The reason why the prostate doesn’t get any respect has a little to do with the very nature of the organ and its disease and a little to do with the mindset of the male.  The perfect storm which is a gland that the male can’t see or feel and a cancer that doesn’t cause symptoms until it is too late is the reason for the tragedy of over 25,000 deaths a year in the United States a year…

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Minimally Invasive Robotic Surgery/Microscopic Vas Reversals at N.G.U.A..

My biopsy experience


Home page / Archives 26,127
the dreaded prostate biopsy revealed 10,367
holy bloody mess batman!….the bleeding scrotum capo…i mean caper…tmi? 10,152
When is a prostate nodule a nodule and do nodules always mean prostate cancer? 9,017
My bladder spasm experience 3,630
Five men-Five stories-Five deicisions about what to do about one’s prostate cancer 3,527
“But I had radiation for my prostate cancer over 5 years ago!” Blood and clots in the urine after radiation for prostate cancer. 3,250
Can you get cancer from having sex with a man who has prostate cancer?…Part Two-response to a comment. 2,920
Reed’s prostate cancer journey process 2,558
If an elevated PSA goes down after antibiotics does that mean you don’t have prostate cancer? 2,537
high psa and normal prostate biopsy-what does that mean? well that you don’t have prostate cancer…maybe. 2,253
Wives/partners 2,070
Incontinence after prostate cancer surgery-It will probably be the wife buying the diapers 1,796
Flooding around my catheter, blood around my catheter after a radical prostatectomy for prostate cancer 1,583
How I as a urologist made my “Decision.” 1,546
Prostate Diaries 1,529
Question: Urine leaks around catheter after prostatectomy. Is this normal? 1,479
Prostate cartoons 1,436
“Decision” Process 1,231
My letter to the New York Times in regards to Richard Albin discoverer of PSA-(Not accepted) 1,131
McHugh Decision Worksheet 1,020

John McHugh M.D.:

Better to cure at the beginning than at the end💃

Originally posted on Prostate diaries:

This is good and makes the point, but really you need to be aware before ” wee-wee” issues.

Love your prostate- Doug Gray’s site



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John McHugh M.D.:

That was 400,000 views ago.

Originally posted on Prostate diaries:

chloe's corner

When we go to the lake the first order of business is to divide a can of chunky Alpo between Chloe and Penelope. Penelope first and Chloe sweet as she is then walks around behind me and waits for the second portion after Penelope begins. The the two dog begin their routine. For Penelope it is run as fast as she can over the whole property to “russel up” either a squirrel or a deer. Chloe slowly ambles to the cove in the left hand corner facing out to her spot.

Chest deep in the water and then begins to bite at the water and drinking at the same time. Wades around dipping and biting but never going completely under or swimming. Then out and up into the grass to shake and then to wriggle on her back for a nice back rub. Then to the top of the grassy area to…

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