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Old 01-29-2011, 05:38 AM   #1
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klains HB User
prostate cancer and acromegaly

Wondering if anyone has the both at the same time. Husband diagnosis recent PC and Acromegaly ( pituitary gland produces to much growth hormone) ? Have been to both Urologist and endocrinologist. Both docotors only handle there department. He did get his testosterone levels tested and they came back " lower than normal" . They want him to treat the PC ( surgery) before they do the head surgey for the acromegaly ( pitutary tumor in the head)

 
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Old 01-29-2011, 12:41 PM   #2
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Re: prostate cancer and acromegaly

Quote:
Originally Posted by klains View Post
Wondering if anyone has the both at the same time. Husband diagnosis recent PC and Acromegaly ( pituitary gland produces to much growth hormone) ? Have been to both Urologist and endocrinologist. Both docotors only handle there department. He did get his testosterone levels tested and they came back " lower than normal" . They want him to treat the PC ( surgery) before they do the head surgey for the acromegaly ( pitutary tumor in the head)
I am learning a lot,new to it like you.
You don't give Gleason score or staging?

Read as much as you can before making any decisions.

Good Luck.

 
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Old 01-29-2011, 01:28 PM   #3
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Re: prostate cancer and acromegaly

psa was done in 10/10 at 4.4 gleason 7. He had a PSA redone in dec after a DRI exam, that came back at 5.2, He will be getting another one

 
Old 01-29-2011, 06:54 PM   #4
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Re: prostate cancer and acromegaly

Hi klains,

Welcome to the Board! You posted the following in response to ReadingALot's question:

Quote:
Originally Posted by klains View Post
psa was done in 10/10 at 4.4 gleason 7. He had a PSA redone in dec after a DRI exam, that came back at 5.2, He will be getting another one
Here's a fundamental consideration: how serious is the pituitary tumor, and how good is your husband's overall health? The reason for asking is that prostate cancer is often a slow growing cancer, and many men can outlive it, even without treatment. In your husband's case, that Gleason 7, if assessed by an expert or later confirmed, indicates moderate aggressiveness that would probably cause your husband trouble if not death some years out if not treated; this is not a cancer you would ordinarily approach with active surveillance instead of treatment.

However, other health risks, such as the other tumor, should play an important role in deciding on treatment. Your husband's PSA level is not a high-risk characteristic because it does not exceed 10. That rise in PSA after the DRE is a concern, but it may be artificial, or it may be partly or wholly due to an infection. (Prostate infections can be very difficult to detect and pin down to a specific cause; they can cause PSA to soar upward or rise just a bit, and the PSA can bounce around as the infection waxes and wanes.) You don't mention the DRE result; was it negative? If so, that would be a second low-risk characteristic of the big three, leaving only the Gleason.

Here are two key questions about the Gleason score. Was it assessed by an expert pathologist highly familiar with prostate cancer (a substantial or dominant part of his practice) or by a general pathologist? If the latter, is is fairly likely that the Gleason has been either under or overscored. If the original was not done by an expert, a second opinion by an expert is highly advisable, per the experts I follow.

Secondly, do you know other key facts about your husband's case, including previous PSAs and dates for the past year or so, the size of his prostate (often based on the TRUS report from the biopsy, but can be based on the DRE), the grades in the Gleason (3+4, or 4+3), the number of cores that were positive for cancer and the total number of cores taken, the extent of cancer in each positive core, and the extent of Gleason grade 4 where it occured? Your husband has a right to his biopsy report, and that may cover many of these details. You could also ask the doctor who performed the biopsy for the size of the prostate and details of the DRE. He may have prepared notes, which could be useful.

These key facts can help assess whether surgery, or radiation, are warranted in your husband's case, or whether active surveillance or hormonal therapy might be the superior choices in his overall circumstances. While a Gleason of 7, if confirmed, normally rules out active surveillance (AS), AS is considered a sound course if there are other substantial helath risks. Frankly, based on the limited information so far, I'm puzzled why a doctor would think surgery should be done in the near future.

There are some lifestyle tactics you and your husband could put to work now. They involve nutrition, supplements, diet, exercise and stress reduction. They probably won't turn the tide against a true GS 7 prostate cancer, but they might slow it down.

I'm hoping your husband will be able to confidently focus just on the pituitary tumor and avoid major treatment of the prostate cancer. However, it's possible that it's important to treat the prostate first for reasons I don't understand.

Good luck in working your way through all of this!

Take care,

Jim

 
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