Prostate Cancer

[TruBlu]

I have been debating starting this thread for some time, but the time has come.

For the guys out there, please get your PSA tested. And insist on your Primary Care Doctor doing regular DRE’s, even if they or you don’t want to. Early detection is vital. A little discomfort is worth it, when you consider the alternative.

I was diagnosed in July based on my rising PSA score, and a subsequent biopsy. I had little or no symptoms. Mine was caught early, and I elected Brachytherapy and IMRT, due to the decreased chance of side effects over surgery. Unfortunately, every minor chance of a side effect (plus some really nasty unexpected side effects) from my choice decided to visit me with a vengeance. I am about half way through my IMRT now, and the side effects are going away, hopefully for good. The prognosis for me is good.

I'm not looking for sympathy. I am, and will continue to be fine. I just want my fellow Duke fans to also be fine.

[OldPhiKap]

I have been debating starting this thread for some time, but the time has come.

For the guys out there, please get your PSA tested. And insist on your Primary Care Doctor doing regular DRE’s, even if they or you don’t want to. Early detection is vital. A little discomfort is worth it, when you consider the alternative.

I was diagnosed in July based on my rising PSA score, and a subsequent biopsy. I had little or no symptoms. Mine was caught early, and I elected Brachytherapy and IMRT, due to the decreased chance of side effects over surgery. Unfortunately, every minor chance of a side effect (plus some really nasty unexpected side effects) from my choice decided to visit me with a vengeance. I am about half way through my IMRT now, and the side effects are going away, hopefully for good. The prognosis for me is good.

I'm not looking for sympathy. I am, and will continue to be fine. I just want my fellow Duke fans to also be fine.

Glad to hear that the prognosis is good, and thanks for this well-needed reminder.

[Tripping William]

I have been debating starting this thread for some time, but the time has come.

For the guys out there, please get your PSA tested. And insist on your Primary Care Doctor doing regular DRE’s, even if they or you don’t want to. Early detection is vital. A little discomfort is worth it, when you consider the alternative.

I was diagnosed in July based on my rising PSA score, and a subsequent biopsy. I had little or no symptoms. Mine was caught early, and I elected Brachytherapy and IMRT, due to the decreased chance of side effects over surgery. Unfortunately, every minor chance of a side effect (plus some really nasty unexpected side effects) from my choice decided to visit me with a vengeance. I am about half way through my IMRT now, and the side effects are going away, hopefully for good. The prognosis for me is good.

I'm not looking for sympathy. I am, and will continue to be fine. I just want my fellow Duke fans to also be fine.

Thanks for sending up the warning flare. I echo it! I was diagnosed in 2009, just shy of age 40, with a prostatectomy later that year. All is well now, but went through a pretty scary summer.

I was vigilant about it because this is what took my dad in mid 2007 (after a decade-long fight because he didn't catch his early enough). A baseline PSA that then gets monitored periodically is critical.

[elvis14]

Two questions (both of which I should know the answer to and don't):

1) How is PSA determined? Blood test?
2) What it the typical age when testing and exams should start?

[Bob Green]

Two questions (both of which I should know the answer to and don't):

1) How is PSA determined? Blood test?
2) What it the typical age when testing and exams should start?

PSA is a blood test.

[Tripping William]

Two questions (both of which I should know the answer to and don't):

1) How is PSA determined? Blood test?
2) What it the typical age when testing and exams should start?

(1) Yes, it's a blood test.

(2) This really depends. I am not a doctor (and didn't stay at a Holiday Inn Express, either), and my family history and dad's persistence is what drove my timing. I had my baseline PSA at age 37. For myself, I don't see much downside to starting earlier than that, if there's any indication, from any source, that this damn disease might be lurking around.

[elvis14]

(1) Yes, it's a blood test.

(2) This really depends. I am not a doctor (and didn't stay at a Holiday Inn Express, either), and my family history and dad's persistence is what drove my timing. I had my baseline PSA at age 37. For myself, I don't see much downside to starting earlier than that, if there's any indication, from any source, that this damn disease might be lurking around.

Thanks. I don't know if they tested my PSA with my yearly physical. Hopefully they did and I just didn't notice because they really only talk about anything worrisome. I'll make sure I discuss it with my PCP when I get my physical this year.

Now, more importantly, did this affect your short game in any way? :-)

[TruBlu]

Two questions (both of which I should know the answer to and don't):

1) How is PSA determined? Blood test?
2) What it the typical age when testing and exams should start?

I'm no Doctor, but to give you my answers (TruBlu will not be held liable for untrue information).

1) Yes, blood test. Some routine blood tests done at routine annual physicals do not automatically check PSA. Make your Doctor request it at regular intervals. You need a track record. A sudden jump in PSA score might indicate trouble, even if it is still in the "acceptable" range.

2) I have heard varying things about ages, but my urologist told me to have my son start getting PSA and DRE tests at age 40, since he now has a history of Prostate cancer in his family (you are welcome, son). I think the normal age to start with no family history is 50. Of course, if you have symptoms such as ED, urinary frequency* or hesitancy, or any other related symptoms . . . get tested now!

* Those in the "YMM, Beer" thread can probably ignore the "frequency" issue while consuming massive quantities of beer.

[Tripping William]

Thanks. I don't know if they tested my PSA with my yearly physical. Hopefully they did and I just didn't notice because they really only talk about anything worrisome. I'll make sure I discuss it with my PCP when I get my physical this year.

Now, more importantly, did this affect your short game in any way? :-)

At that time, there was nowhere for my short game to go but up (golf-wise at least) . . . . .

[TruBlu]

Thanks. I don't know if they tested my PSA with my yearly physical. Hopefully they did and I just didn't notice because they really only talk about anything worrisome. I'll make sure I discuss it with my PCP when I get my physical this year.

Now, more importantly, did this affect your short game in any way? :-)

As I stated in the above, sometimes your PCP may not request the PSA test be done on routine physical blood work. Ask.

Now, as to the second part, it can! My treatment started with temporary hormone shots to shrink the prostate prior to radiation, and to minimize testosterone, which feeds cancer cells. The hormone shot definitely reduces sex drive while on it, makes you moody, and makes you want to get your nails and hair done. As far as long term, my fingers are crossed.

[MartyClark]

Thanks for posting. This is good and heartfelt advice.

My 92 year old father has Stage IV prostate cancer. He beat the odds by living for 20+ years after a couple of years of high PSA levels, biopsies that were not diagnostic, and eventually seeking treatment through the implanting of radioactive beads.

[devildeac]

I'm no Doctor, but to give you my answers (TruBlu will not be held liable for untrue information).

1) Yes, blood test. Some routine blood tests done at routine annual physicals do not automatically check PSA. Make your Doctor request it at regular intervals. You need a track record. A sudden jump in PSA score might indicate trouble, even if it is still in the "acceptable" range.

2) I have heard varying things about ages, but my urologist told me to have my son start getting PSA and DRE tests at age 40, since he now has a history of Prostate cancer in his family (you are welcome, son). I think the normal age to start with no family history is 50. Of course, if you have symptoms such as ED, urinary frequency* or hesitancy, or any other related symptoms . . . get tested now!

* Those in the "YMM, Beer" thread can probably ignore the "frequency" issue while consuming massive quantities of beer.

Or, even if consuming mild to moderate levels of Ymm, Beer.

I echo the get your PSA checked when your PCP says so and don't complaint when s/he asks you to bend over, drop your shorts and take a deep breath. You are allowed to request that your MD removes all rings and/or watches before the digital exam...

[Indoor66]

Or, even if consuming mild to moderate levels of Ymm, Beer.

I echo the get your PSA checked when your PCP says so and don't complaint when s/he asks you to bend over, drop your shorts and take a deep breath. You are allowed to request that your MD removes all rings and/or watches before the digital exam...

And no making a fist!

[CrazyNotCrazie]

Or, even if consuming mild to moderate levels of Ymm, Beer.

I echo the get your PSA checked when your PCP says so and don't complaint when s/he asks you to bend over, drop your shorts and take a deep breath. You are allowed to request that your MD removes all rings and/or watches before the digital exam...

Moon River!

Thanks to all for sharing your knowledge on this very important topic. Best of luck to all who individually or who have family members dealing with this. I am in my 40s and due for a physical so this is a good reminder to make sure that this is on my doctor's radar - he is very thorough so I assume it would be but one never knows.

[camion]

I'm a prostate cancer veteran. I credit my urologist for vigilance and early detection.

Diagonsis was several steps
1. Steadily increasing PSA led to
2. MRI with a couple of suspicious areas in prostate which led to
3. Biopsy with 2 of 11 samples being problematic and Gleason score of 3+4=7. Interestingly neither of the problem samples came from one of the MRI flagged suspicious areas.

That result comes out as early stage prostate cancer. Not a crisis, but something that required considering options and deciding a course of action. Options were everything from watchful waiting to radiation/chemo/immuno to surgery. Each had pluses and minuses. I settled on surgery.

Now I'm 3 years post-surgery still with no measurable PSA. I'm satisfied with the result, but as my doctor said before my decision, each of the options was a reasonable course in my case.

[85devil]

I am happy to hear about the positive outcomes that people are relating abot PSA screening. As a primary care doctor, I would say that PSA testing remains controversial in terms of the balance of benefit vs. harm of the testing. This is in contrast to screening for colon, breast and cervical cancer which have clear benefits. It is a complicated subject to discuss with patients. I work for the VA and we have a very nice resource (https://www.prevention.va.gov/docs/V...teCancerBr.pdf) that expalins the pros and cons of PSA testing. Bottom line is to have an informed discusssion with your primary care doctor to allow you to make the best decision for yourself.

[budwom]

yes, as others have noted, do NOT over react (as natural as it may be) to a bad PSA test...many articles have been written about overly aggressive treatment which was unnecessary...establish a track record, be VERY cautious...may own GP will not do a PSA test routinely, too many false positives...having said that, a good friend (who, importantly, has a family history of prostate cancer, including father and two brothers) has carefully monitored his over the years, finally had a significant blip upward which persisted thru a few tests, so THEN they did the biopsy...(you don't want a biopsy the first time you get a high reading, because MANY (if not most) older men do have some cancer in the prostate which will NOT be a problem.

[TruBlu]

yes, as others have noted, do NOT over react (as natural as it may be) to a bad PSA test...many articles have been written about overly aggressive treatment which was unnecessary...establish a track record, be VERY cautious...may own GP will not do a PSA test routinely, too many false positives...having said that, a good friend (who, importantly, has a family history of prostate cancer, including father and two brothers) has carefully monitored his over the years, finally had a significant blip upward which persisted thru a few tests, so THEN they did the biopsy...(you don't want a biopsy the first time you get a high reading, because MANY (if not most) older men do have some cancer in the prostate which will NOT be a problem.

Very true. Many things can cause a blip in PSA scores, including having sex a few days before the blood work. Don't overreact, but never never under-react.

(Could not spork.)

[Acymetric]

I'm no Doctor, but to give you my answers (TruBlu will not be held liable for untrue information).

1) Yes, blood test. Some routine blood tests done at routine annual physicals do not automatically check PSA. Make your Doctor request it at regular intervals. You need a track record. A sudden jump in PSA score might indicate trouble, even if it is still in the "acceptable" range.

2) I have heard varying things about ages, but my urologist told me to have my son start getting PSA and DRE tests at age 40, since he now has a history of Prostate cancer in his family (you are welcome, son). I think the normal age to start with no family history is 50. Of course, if you have symptoms such as ED, urinary frequency* or hesitancy, or any other related symptoms . . . get tested now!

* Those in the "YMM, Beer" thread can probably ignore the "frequency" issue while consuming massive quantities of beer.

Gee, thanks

As I stated in the above, sometimes your PCP may not request the PSA test be done on routine physical blood work. Ask.

Now, as to the second part, it can! My treatment started with temporary hormone shots to shrink the prostate prior to radiation, and to minimize testosterone, which feeds cancer cells. The hormone shot definitely reduces sex drive while on it, makes you moody, and makes you want to get your nails and hair done. As far as long term, my fingers are crossed.

How exactly is this different from the last 20 years?

[budwom]

And if you get it removed, go to someone with a proven track record...it's a delicate operation. Try to avoid The Simpson's Dr. Nick Riviera ("any operation for $99.99")...my friend's went very well, still took over four hours of delicate snipping.