prostate cancer forum

[steve3b3]

PSA score was rising over time, and when it went over 4, my physician sent me to the Urologist.
I had an MRI, which directed where the biopsy needles went, and the results showed a small area where there is cancer.
The biopsy itself wasn't too traumatic, but I felt like crap for the day after.
There was so much worry, until after the biopsy, when the Urologist charted out where I was, where things could go, and options along he way.
We've elected the active monitoring approach, since there isn't much cancer.
The second MRI/biopsy showed not much has changed.
I have a PSA test every 6 month, and a follow-up visit with the Urologist.
MRI/Biopsy on a 3 year schedule.
We'll continue this as long as things remain stable.

Steve

 

[docw1]

PSA score was rising over time, and when it went over 4, my physician sent me to the Urologist.
I had an MRI, which directed where the biopsy needles went, and the results showed a small area where there is cancer.
The biopsy itself wasn't too traumatic, but I felt like crap for the day after.
There was so much worry, until after the biopsy, when the Urologist charted out where I was, where things could go, and options along he way.
We've elected the active monitoring approach, since there isn't much cancer.
The second MRI/biopsy showed not much has changed.
I have a PSA test every 6 month, and a follow-up visit with the Urologist.
MRI/Biopsy on a 3 year schedule.
We'll continue this as long as things remain stable.

Steve

And this, I suspect, will be the template for much of prostate screening. Get the PSA, if it's high, or rising, check the MRI, possibly get the biopsy, then decide which way to go. Of course, Active Surveillance has it's own problems. Some people are uncomfortable knowing they have cancer, even if small. One has to go through repeated testing, possibly more biopsies. Thank you for sharing your story.

 

[bstig60]

I just had my Oncologist appt earlier this week. I did not get the scheduled Lupron shot as the side effects were really getting to me and seemed to be cumulative. The side effects from the shot I had in August were far worse than the shots I had previous to that. He agreed to take me off the Lupron for a while and check my PSA in early January. I am going to set up having my PCP check my PSA every 6 months, hopefully, it will stay stable at the level it is now.

 

[docw1]

Good luck to you with this. Hope it works out. Don't know if you had it, but there is a test, PSMA, which is a scan specific for prostate metastases, which can show tiny mets not otherwise seen by other scanning methods. Treatment can then be directed at these areas. I'm still dealing with the incontinence, but it is only 4 weeks post-op, but I think it's going to last a while.

 

[skinl19]

This thread has been dormant for a while but I will add my own story. First, 30 years ago my father had prostate cancer when he was about my age. He had complications from the surgery and was in the hospital for a week. It took a while to fully recover but no return of the cancer. He just turned 97 last August!

I had a slightly elevated PSA in the 2-4 range during my annual checkups for a long time but a few years ago I started having problems with an enlarged prostate and started seeing a urologist who prescribed Flomax which helped. I was also getting regular PSA checks since it was a little more elevated than usual. When it reached around 8 last January, I had a biopsy (no fun at all). The results showed cancer localized to one area of the prostate with a Gleason score of 3+4. After much discussion we decided to go with a robotic prostatectomy at the end of May, knowing the possible side effects.

Surgery went well and I had a catheter for two weeks. At the catheter removal they had the oncology reports which indicated that no cancerous cells were detected outside of the removed prostate. I started out wearing heavily padded undergarments due to partial incontinence, normally when getting up, laughing or sneezing, etc. This was my main concern with the effects of the surgery. Doing the Kegel exercises on my own helped a little and I switched to a lighter weight pad. The doctor referred me to a physical therapy clinic. I was skeptical and it was a little awkward with the female PT's, but after about a month of their work plus my own I was able go back to regular undergarments.

The other main side affect had to do with sexual performance and this was not unexpected since they did have to remove the blood vessels on one side. I had a prescription of 5mg Tadalafil (Cialis) which did not do much. I then got another prescription for the 20mg pill to be taken as needed Better but still not good enough. He then suggested I try adding L-arginine on a daily basis, stating that some patients had success in using this vitamin and eventually dropped the prescription drugs. I am currently taking 2000mg a day, plus the prescription, and happy to report that things are better. I will probably up it to 3000mg when the current supply is finished.

Nine months since surgery and PSA levels continue to be non-measurable. It will be some time before we can say for certain that the cancer is gone. I have been able to mostly overcome the side effects of the surgery but it helps to have a supportive spouse. Of course the first concern is beating the cancer, but as a guy the other things were more troubling to me than I imagined. I guess I was blocking the possibility from my mind. I had a book given to me at the urologist that I highly recommend, 100 Questions About Prostate Cancer by Pamela Ellsworth, MD.

 

[docw1]

Thank you for your story. I'm almost four months out from the surgery. Incontinence is better, but not back to normal yet. My doc never mentioned going to a physical therapist, just Kegel, Kegel, Kegel. Later, a nurse gave me another exercise which I added to my workout routine. He mentioned that there is a good chance of getting back to normal. Although, if they have to take the neuro-vascular bundles (one on each side) it does take longer. I told him that while they have the prostatectomy patient in the hospital, they should have a nurse educator go over incontinence mitigation strategies. I just had my three-month PSA test which was undetectable.

 

[skinl19]

When PT was suggested I didn't understand how that could help. The one I went to was highly recommended as having good success with Pelvic Floor Therapy. They made sure I was doing the Kegels properly as well as doing them, and other exercises in a lot of different ways and positions. I did the home exercises they gave me as well. Your medical issues may be different but you might want to look into it. My PT was covered by insurance. Here is a link to the place I used for an example of what to look for. https://neilkingpt.com/pelvic-floor-therapy/

 

[Weaselinsuit]

My dad has prostate cancer that has metastasized into his spine and pelvis. Not sure how much longer he may have. The crappy thing is that he is a former gp and ignored some the early warning signs. So I would urge every guy over 50 to do regular screening/testing and if any little thing feels off or concerning, go get checked out. We'll all eventually get it but we don't have to die from it.

 

[MaxPete]

My Dad was treated for prostate cancer about 28 years ago (and 10 years prior to his death from lung cancer) - so my doc has been monitoring me for many years (I am 63 at present) starting when I was about 45 or so.

Here in Ontario they use the greasey-glove inspection and twice a year I get a PSA blood test. Neither if very much fun, but they're better than the alternative. We had a guy in our riding group who had ignored his PSA until it got up to <I think> about 15-20,000 (if that is possible) at which point, the cancer was all through his bones and he died.

My PSA was around 0.5-0.9 for a long time and then about 6 years ago it suddenly jumped up to about 2 and then 4.2 a month later - and then it dropped back to around 1.0 and has been waffling up and down between 1 and 1.4 ever since. I just got a result the other day in fact - 1.24.

The prostate doc told me that they have concluded that prostate cancer is essentially part of the aging process for most men (just as breast cancer is for many women). If you get it when you are in your 30s, its a quick killer (just like breast cancer in women) but if you get it in your 60s-70's or later, it is essentially something to treat, monitor and live with. He said that if we all lived into our 90s, we'd all eventually get it (what a happy thought....).

My own doc told me that I will likely develop a prostate tumor at some point - but I'll die of something else - so we will just keep watching it and otherwise, I'm pretty relaxed about it.

So, I'll join the chorus of guys who say....lie face-down, listen for that loud SNAP, close your eyes and relax...until the next time.

 

[skinl19]

MaxPete, you bring up a lot of good points. I also have read about aging and the likelihood of prostate cancer. I'm sure you are aware that Urologists aren't as in a big of a rush to perform surgery or chemo as they were in the past. Now most use the factors you mentioned such as age, severity, current health, etc. to determine a course of actions. In many cases patients remain in an active surveillance state for the rest of their natural lives. Even if they do have cancer there are the tests and probabilities of it spreading taken into consideration.

The number one message is still the same, get your checkups and don't ignore it. I read this on one cancer website, "Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it.

 

[MaxPete]

The number one message is still the same, get your checkups and don't ignore it. I read this on one cancer website, "Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it.

ZACKLEY!!!

 

[dwalby]

The crappy thing is that he is a former gp and ignored some the early warning signs.

what are the warning signs of prostate cancer, are you referring to PSA, or something else? I wasn't aware that there are any physical warning signs, that's why they monitor the PSA and do biopsies. Is there something I don't know about?

 

[Weaselinsuit]

what are the warning signs of prostate cancer, are you referring to PSA, or something else? I wasn't aware that there are any physical warning signs, that's why they monitor the PSA and do biopsies. Is there something I don't know about?

I'm not really sure to be honest, he was just saying he likely should have gotten checked out earlier and that he ignored some stuff. He was fairly emotional at the time so I didn't push. It may simply have been getting regular testing though he also was experiencing the odd twinge in his leg/hip which may have been the cancer spreading. If so, I suspect that it was likely too late at that point as it would have already metastasized. But there's been a life long pattern of him never been a diligent patient; "I appear to have severed a limb, I'll just get some duct tape and it will be good as new.....".

Edit: I think there may be some other signs though; blood in urine, difficulty with urination (which could just be bhp) etc.

 

[dwalby]

I think the difficult part of diagnosing any cancer is by the time there's physical symptoms its usually too late. And in the case of prostate cancer a biopsy is the only sure way to tell, the PSA number is too unreliable to be of much use. I've had an MRI done before, it can diagnose certain things, but I don't think its as good as a biopsy, of which I've had 3, all negative. Even with a biopsy they can't hit everywhere, so they like to do them multiple times to get the odds more in your favor that you're actually negative.

 

[docw1]

There aren't any early symptoms of prostate cancer. Blood in the urine is usually something else (it does need to be evaluated because it could be, like in me, evidence of bladder cancer). Trouble urinating is usually Benign Prostatic Hypertrophy. The main symptoms come from, usually, boney metastases, causing pain, or, if in the spine, neurological damage and pain. By then, you're in deep sh**. They digital rectal exam can pick up some obvious cancers, but isn't very sensitive. The PSA helps to at least give a suspicion. The MRI can give a little stronger indication, as well specific location. The biopsy is what can prove it. I had my surgery when I was 69 1/2. It was Gleason 4+3. I didn't feel comfortable with Active Surveillance, not that my urologist even suggested it.

 

[Weaselinsuit]

To your point, from the Mayo Clinic;
Symptoms
Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that's more advanced may cause signs and symptoms such as:

Trouble urinating
Decreased force in the stream of urine
Blood in the urine
Blood in the semen
Bone pain
Losing weight without trying
Erectile dysfunction

 

[docw1]

Came across this article that show that since the recommendations to reduce PSA screening went into effect, the rates of metastatic prostate cancer has significantly increased. This article call for a rethinking of this strategy, which is what I indicated earlier in this thread. Get your PSA checked.

Metastatic prostate cancer on the rise since decrease in cancer screenings

LOS ANGELES — A new study from Keck Medicine of USC finds that the incidence rate of metastatic prostate cancer has significantly increased for men 45 and older and coincides with recommendations against routine prostate cancer screenings."This study is the first to document a continued rise in...

news.keckmedicine.org