Jim,
I had a C&P exam yesterday for prostate cancer. Just a little concerned after leaving. It seemed as if the doctor was trying to say that my cancer had disappeared.
Diagnosed in 3/2011 with a low grade adeno carcinoma 2 cores positive from biopsy. I have had three biopsies since all negative which I am happy about but I still have prostate cancer. My civilian doctors and I have chosen watchful waiting as the treatment. My first reaction was to get it out of there but I'm happy with our decision. I have been to best cancer hospital in NYC and they also agreed with our decision.
Latest PSA (taken at VA) 8.7 up from last one of 6. I have DRE every 6 months and biopsy every year now. I trust my private doctors completely but this examiner implied that my doctor could write anything and I needed backup proof, which I had with biopsy and lab records. He did look at them but kept implying that since the last three biopsies were negative I would probably get little compensation if any.
Basically I have lived the last three years with cancer and this guy tells me I don't have it. I told him that I believed my doctors and I don't think prostate cancer just disappears. I know he said that he was putting that I had PC in his report but he didn't know how disabling it was and that was up to the rater to make that decision which I already knew. Just a little concerned about the exam and attitude of doctor at VA. BY the way used DBQ with help of NYS veterans counselor and would never try this without help. Any advice?
Reply:
If you have prostate cancer, there aren't any degrees of rating it. It will be rated at 100% so long as you have the cancer. Once treated, the residual effects of treatment will be rated. If you choose watchful waiting as your course, your rating will remain at 100% although that will always be a temporary rating.
The negative biopsies are meaningless. This is because a biopsy often misses the cancerous cells. Try to imagine that you have an object the size of a plum in front of you. It's well fixed and stationary inside a shoe box.
Inside the plum are 4 areas of concern, each one is about the size of a BB or pellet that you'd use in your Daisy air rifle. Those BB's represent cancerous tumors.
Now take a needle in your hand and try to point it at the BB's so you can hit one squarely. You only get 4 tries to get it right. Oh, by the way...you must wear a blindfold so that you can't see to guess where each BB is. Now, go for it. If you don't hit a BB, the results of your "biopsy" on the plum will be negative. That doesn't mean there are no tumors, it just means you didn't hit any of them.
You can see why doctors don't only rely on a biopsy. They also rely on the PSA and the digital rectal exam (DRE) to determine if you have prostate cancer or not. Once you have a positive biopsy along with the other signs of prostate cancer, the diagnosis is made. Once the diagnosis is made, it remains until you have definitive treatment. Prostate cancer doesn't just suddenly cure itself.
The examiner who gave you that ration of nonsense is one of the many reasons that the VA Compensation & Pension (C & P) exam is mostly a waste of time and taxpayer resources. He thinks his job is to be skeptical and to try and deny you a benefit. His job should be to behave like a professional and record the truth...and tell you the truth too.
If your claim is denied, I'd like to hear about it. Please save this email and let me know the results.