This is the file that MultiGraph reads to create its graphs:

Identification:
Name:           John Fistere
Address:        11290 Lorena Lane
Line2:
City:           El Cajon
State:          CA
ZIP/PostCode:   92020
Country:        USA
DayPhone:       (619) 447-1907
EvePhone:       (619) 447-1907
FAX:            (619) 447-1414
EMail:          JFistere@cox.net
BirthDate:      5/22/35
DiagnosisDate:  8/21/95
Other:          Pager: (619) 896-1820

Medical:
ProstateVolume:
Gleason:        5+4=9
ClinicalStage:  T3cN0MX
Ploidy:         diploid
Partin:
Narayan:

Options:
Graph: Med PSA
Graph: Linear PSA  Linear
Graph: LinRecent PSA  Linear  01-Jan-1998
Graph: Recent PSA  01-Jan-1996
Graph: RP PSA  01-Jan-1996  01-Jan-1998
USADates:
NoDoublingLine:
DefaultVar:    PSA

21-Sep-90 Proc: Vas   Vasectomy
9-Sep-91:  PSA 2.0
16-Jan-92 Diag: AbUS neg Details:
   Abdominal ultrasound. Reason: Chronic high liver function, averages: GGTP=132, Alk Phos=132  Impression: Caliectasis, left lower pole of the kidney with possible 2cm peripelvic cyst. Otherwise normal abdominal ultrasound.
 
1-May-1992: Diag: TrusBx neg
 
26-Feb-93  PSA 3.3
24-Feb-94 PSA = 3.1
16-Jun-95 Diag: AbUS  Details:
   Abdominal ultrasound for liver. Negative
 
21-Aug-95: PSA 5.4  Diag: DRE pos Details:
   palpable, left side.
 
28-Feb-96: PSA 18.8
 
7-May-96: -Dx age 61:  Diag: TRUSBx pos Details:
    Section A, Right prostate: Five tan to white needle cores of benign prostatic tissue. No malignant cells are identified.  Section B, Left prostate: Four needle cores of benign prostate glands and stroma with tiny separate fragment containing a sheet of fused glands of adenocarcinoma consistent with Gleason grade 4,4.  There is no stroma in this tiny fragment of cancer.  Section C, Left seminal vesicle: Five friable cores of poorly differentiated adenocarcinoma largely arranged in sheets of fused glands similar to that described for the left prostate biopsy.  The residual fragments of stroma contain an occasional malignant gland, as well, althogh there is no seminal vesicle identified.
 
17-May-96: Diag: BScan neg Details:
   Bone Scan: No areas of uptake are present to suggest metastatic disease.  Mild degenerative uptake is present in the left hip.
 
28-May-96: PSA 39.2  RT-PCR-PSA neg
29-May-96: Proc: RP, Details:
    SURGERY: It was noted that the left seminal vesicle was adherent along its lateral margin and there was difficulty in reflecting the seminal vesicle off of the rectal wall.
    PATHOLOGY: 5 samples. 1. Right obturator region. lymph node dissection: Four lymph nodes and associate soft tissue.  Negative for tumor.  2. Left obturator region, lymph node dissection: Five lymph nodes and associated soft tissue, negative for tumor.  3. Region of left seminal vesicle, excisional biopsy: Multiple fragments of high grade adenocarcinoma of prostate, Gleason 4+5=9. 4. Prostate gland and seminal vesicle, radical retropubic prostatectomy: Extensive adenocarcinoma of prostate, poorly differentiated (Gleason grade 4+4=8), involving right and left prostatic lobes and both seminal vesicles.  5. Distal left seminal vesicle, excisional biopsy: Portions of benign seminal vesicle.
    Prostate, prostatectomy: Adenocarcinoma
    Grade (Gleason): 4+4=8
    Size: 1.5 cm in both right and left lobes.
    Extent of involvement: Extensive, greater than 50% of prostate
    Capsular penetration: Absent
    Peripheral margin involvement: Absent
    Proximal and distal margins: Negative
    Seminal vesicle involvement: Bilateral and extensive
    Lymph node involvement: Absent
    Pathologic staging (TNM): T3cN0Mx
 
  Clinical Stage: T3cN0MX Ploidy: diploid
 
25-Jun-96:  PSA=30.2  (4-week post-RP) :-(
  Liver: SSGPT/ALT 54 (vs 0-40)  GGT 260 (vs 11-65)  Alk Phos 314 (vs 39-117)
8-Jul-96: PSA=28.6
8-Jul-96 Diag: Ploidy Details:
   Flow cytometry from paraffin block.  DNA index/ploidy: 1.0/diploid  S-phase fraction: 8.0%
 
11-Jul-96: Diag: MRI-S pos Details:
   There are minimal foci of increased signal on T1 weighted sequences in the prostate bed which may represent residual hemorrage.  There is no evidence of bony lesions or adenopathy.  Amorphous tissue is seen in the prostate bed, likely representing granulation tissue or residual tumor.  No mass is identifed.  Foci of increased signal are seen in the region of the seminal vesicles, which have a cystic appearance, likely representing some residual seminal vesicle.
    On spectroscopy, slightly elevated choline-to-citrate ratios are identified in a few voxels representing a small amount of residual tumor. 7-9cc of tissue.
 
19-Jul-96: PSA=37.8  :-(     PAP=6.8
  Liver: ALT 43 (vs 0-40)  GGT 246 (vs 11-65)  Alk Phos 230 (vs 39-117)
19-Jul-96: Started Casodex 50 mg/day
19-Jul-96: Started Proscar 5 mg/day
22-Jul-96: Diag: AbCT neg Details:
   Abdominal CT scan: Reason: Abnormal LFT.  Computed axial tomography is performed of the abdomen prior to and following 125cc of Optiray-320 as well as following oral contrast material.  Examination of the liver fails to demonstrate a definite abnormality.  The pancreas is not enlarged at this time.  The periaortic area shows no evidence of any lymphadenopathy.  The renal margins show some lipomatous changes in the region of the left kidney.  There is a density closely related to the dorsal surface of the left kidney, although it appears to be separate from it, and probably represents some averaging from the spleen.  IMPRESSION: No abnormalities detected on computed axial tomography of the abdomen.
 
25-Jul-96: Started Lupron
30-Jul-96: PSA=19.2    RT-PCR-PSA  negative
6-Aug-96: Started MCP modified citrus pectin, 5-15 grams per day
22-Aug-96: Diag: BS neg Bone scan negative
26-Aug-96: PSA=1.2   PAP=2.
  Liver: ALT 69 (vs 0-40)  GGT 292 (vs 11-65)  Alk Phos 214 (vs 39-117)  :-(
12-Sep-96: Stopped Casodex because of high liver function
20-Sep-96: PSA=0.2   PAP=1.7   Added soy and stewed tomatoes to low fat diet.
22-Oct-96: Switched to Quest Corning Ultrasensitive, Test Code 60492"
22-Oct-96: PSA=0.1    PAP=1.
21-Nov-96: PSA=0.09
25-Nov-96: Diag: ProstSc neg ProstaScint Negative
23-Dec-96: PSA=0.07
27-Jan-97: PSA=0.02 :-)   SSGPT/ALT=100 :-(
26-Feb-97: PSA=0.03  SSGPT/Alt=66
22-Mar-97: Diag: MRI-S neg Details:
   MRI with Spectroscopy at UCSF
    1. No evidence of recurrent disease
    2. Spectrosopy demonstrates no metabolically active tissue.
 
24-Mar-97: PSA=0.01
28-Mar-97: Proc: Implant Details:
   Mentor Mark II inflatable implant installed
 
28-Apr-97: PSA=<0.007
2-Jun-97: PSA=<0.007
26-Aug-97: PSA=<0.007
26-Aug-97: PSA=0.007 Note: < missing.
26-Aug-97: Stopped Lupron, continuing Proscar.
7-Oct-97: PSA=<0.007 :-)  Liver functions up a little.  :-(
31-Oct-97: PSA=0.1 :-(  Liver functions heading down, most OK  :-)
3 Nov 97 Diag: BDens neg Details:
   The bone mineral density of the femoral neck is 0.925 gm/cm2.  This represents 1.2 standard deviations below the young normal population control (T-score), and 0.3 standard deviations below the age/sex matched reference in the patient's ethnic group (Z-score).
    The bone mineral density of the A-P spine from L2 to L4 is 1.224 gm/cm2. This represents 0.1 standard deviations below the young normal population control (T-score), and 0.1 standard deviations above the age/sex matched reference in the patient's ethnic group (Z-score).
    This study shows bone mass that is less than the adult normal, but considered normal for the patient's age.
 
17-Nov-97: PSA=0.02 :-)
17-Dec-97  PSA 0.01
9-Feb-98   PSA 0.007
25-Mar-98  PSA 0.1
20-Apr-98  PSA 0.01
 
20-Apr-98  PSA 0.01
17-Jun-98  PSA 0.02
11-Aug-98  PSA 0.02
19-Aug-98 Stopped Proscar
15-Sep-98  <0.007
23-Nov-98 0.07
5-Jan-99 0.02
27-May-99 0.04
12-Nov-99 0.11
19-Jan-00 0.17
13-Jun-00 0.03
 
Notes:

  Low-fat, low red meat diet includes daily soy milk/tofu/modified citrus pectin shakes, stewed tomatoes with a little olive oil, multivitamins, extra A, C, E,  calcium, selenium, Ginko Biloba, Coenzyme Q-10, and green tea extract.
 
End: