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Old 02-11-2011, 04:34 PM   #1
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I need moral support --- PLEASE!

Yesterday my 50 yo son told me he just found out he has prostate cancer. Needless to say I was devastated! His PSA was 4 when he had his yearly physical in Dec/2010. The year before it was 3.8. His internist sent him to a urologist for a biopsy. The dr. called him yesterday with the positive results. The dr is trying to schedule him for a CAT scan and bone scan soon as possible. I need to be moral support for him but this news has made it difficult to do right now. I asked my son if he had any unusual symptoms and he said the only thing he had noticed was difficulty totally emptying his bladder and lower back ache. He attributed his back ache to the 120 miles he drives each day to work and back. NO other symptoms. Is this normal? What is he facing now?

ANY suggestions you have will be sincerely welcomed.

Thanks for listening.

 
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Old 02-11-2011, 05:47 PM   #2
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Re: I need moral support --- PLEASE!

Quote:
Originally Posted by jellybean3009 View Post
Yesterday my 50 yo son told me he just found out he has prostate cancer. Needless to say I was devastated! His PSA was 4 when he had his yearly physical in Dec/2010. The year before it was 3.8. His internist sent him to a urologist for a biopsy. The dr. called him yesterday with the positive results. The dr is trying to schedule him for a CAT scan and bone scan soon as possible. I need to be moral support for him but this news has made it difficult to do right now. I asked my son if he had any unusual symptoms and he said the only thing he had noticed was difficulty totally emptying his bladder and lower back ache. He attributed his back ache to the 120 miles he drives each day to work and back. NO other symptoms. Is this normal? What is he facing now?

ANY suggestions you have will be sincerely welcomed.

Thanks for listening.
Hi Jellybean

I am sorry for your son’s diagnosis. I was also 50 years old when I was told that I had prostate cancer. That happened eleven years ago (2000) and I am a living example to your son’s case that he can and will also fight the disease.
Do not be anxious; many here will help you in understanding the problem.

You should post other information so that fellows here can give you better advice, such as; the pathological stage, Gleason score, number of biopsy cores, number of positive, percentage of core cancer, prostate volume (if any), extra-capsular extension, etc.
The image studies recommended by his doctor will provide more information, but it may be negative to metastasis
It will be good to start reading about treatment choices and their side effects. There are several sites in the net explaining in detail each one of them. Just google “prostate cancer treatments”. You may need to get a second opinion on his doctor’s diagnosis so it will be good to gather a list of urologists and oncologists closed to your place.

I wish you both the best.
Baptista

 
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Old 02-11-2011, 07:14 PM   #3
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Re: I need moral support --- PLEASE!

Hi jellybean, and welcome to the Board!

Baptista already suggested that you provide key information about the degree of seriousness of your son's case. Prostate cancer can range in seriousness from a case of dandruff to aggressive pancreatic cancer, but many cases are toward the milder side. The few clues you have so far are consistent with a milder case.


Quote:
Originally Posted by jellybean3009 View Post
Yesterday my 50 yo son told me he just found out he has prostate cancer. Needless to say I was devastated!
So many of us feel the same way when we get the news. However, prostate cancer is almost unique among cancers in its typical slow growth. In fact, virtually 100% of men with low-risk and intermediate-risk cancer are alive not only at the ten year point but live many years beyond that, often free of serious interference from the cancer for the rest of their lives. Researchers have now figured out pretty well how to tell who needs treatment and how aggressive that treatment should be, though there are open questions yet to be answered.

Quote:
His PSA was 4 when he had his yearly physical in Dec/2010. The year before it was 3.8.
Both the score of 4 and the rise of only .2 in a year are clues that the cancer could be low-risk.

Quote:
... The dr is trying to schedule him for a CAT scan and bone scan soon as possible.
That's too bad - the doctor trying to set up the scans, I mean. In 2009 the American Urological Association came out with guidelines discouraging CT and bone scans unless cases had certain high risk characteristics. They gave those guidelines because both scans are almost always useless unless certain higher risk features are present. Perhaps that's the case - discussed below. However, if your son does not mind pressing the point, he might tactfully ask if getting the scans, in his case, is consistent with the AUA's "Prostate Specific Antigen Best Practices Statement" of 2009. That guideline is available to us patients.

One of the problems is that neither scan rules out cancer. For instance, a bone scan does not pick up the cancer until 10% or more of a spot on the bone is involved. What that means is that, with low-risk characteristics, it's very likely that little if any of the bone is involved, and the difference between that amount and 10% is almost always very small. In other words, say that around 15% cancer metastasized to bone is the practical upper limit for any patient with a PSA of below 10. (I'm using 15% as an example, I'm not sure what the real value would be, but it is low.) If the patient has the rare bad luck to have a cancer with 9% bone involvement, it is unlikely to show up. That means the real value of the scan would be for a metastasis affecting 10% to 15% of the bone. It's extremely unlikely for that to occur. (My PSA was 113.6, with a Gleason score of 7, a rock-hard prostate, a stage III assessment, but my CT and bone scans were still negative. That's common even for higher risk cases, though in those cases the scans are worth doing.)


Quote:
I need to be moral support for him but this news has made it difficult to do right now. I asked my son if he had any unusual symptoms and he said the only thing he had noticed was difficulty totally emptying his bladder and lower back ache. He attributed his back ache to the 120 miles he drives each day to work and back. NO other symptoms. Is this normal? What is he facing now?
The lower back ache could be what triggered the urologist's decision to get the scans. However, your son's explanation is certainly plausible, and it is extremely unlikely that the ache would be due to metastasis with such a low PSA, unless the Gleason were high, in the 8-10 range, as I see it as a now fairly savvy layman but with no medical education.

Quote:
ANY suggestions you have will be sincerely welcomed.

Thanks for listening.
There are a couple of books that are wonderful aids for orienting a new patient and family. One is "A Primer on Prostate Cancer - The Empowered Patient's Guide, by Dr. Stephen B. Strum, MD, and Donna Pogliano (2005, 2nd edition). The other is "Invasion of the Prostate Snatchers," by Ralph Blum and Dr. Mark Scholz, MD, 2010. There are some other books that are very simple and also useful, such as "100 Questions And Answers About Prostate Cancer", or something like that. If you have a good library system, it is likely to have these. However, the Primer has many forms for recording key information and places to take notes, so it might be best to purchase a copy. It's a great location to centralize notes about the disease. I recommend you steer clear of "Prostate & Cancer," by Dr. Sheldon Marks, MD. The version I read way back in early 2000 was helpful, but his edition of a couple of years ago was obsolete - he had made little effort to update his knowledge, especially regarding treatments other than surgery, and the book has a strong bias toward surgery that has been undermined by research over the past decade.

I'm sorry your life and your son's have been upset with the diagnosis, but trust that the situation is much better than you now think!

Take care and keep your spirits up,

Jim

 
Old 02-12-2011, 10:19 AM   #4
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Re: I need moral support --- PLEASE!

Baptista and Jim, thank you very much for your replies!

I am wondering WHY the urologist was so quick to order a CAT scan and bone scan. I don't know if the dr. considers him a "high risk" case or what. I doubt my son has told me the whole story yet. He tells as little as possible saying he doesn't want to worry me needlessly. He's always been that way. Like he didn't tell me he had a biopsy until after the cancer diagnosis. I have worked in the medical field (psychiatry) for many years but know very little about cancer. However, I hope I can help him find the best specialist in our area. I plan to have a long, honest talk with my son and try to learn more...like what is his Gleason score or did the urologist even mention it to him. Do either of you happen to know any specialists in the Atlanta, GA area you could recommend? I know many drs. want to do surgery at the first sign of ANYTHING and I hope he can avoid that type.

Did either of you have a special diet plan you followed after your diagnosis?

 
Old 02-12-2011, 12:56 PM   #5
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Re: I need moral support --- PLEASE!

There are some varieties of PC that demonstrate very little increase in PSA. They usually only do a bone scan if there's some evidence of higher grade disease or extra-capsular spread, or it may be that your son was complaining of back pain, so they checked just to be safe. He should see a Urologist and a Radiation Oncologist - does he live in the Atlanta area?

I certainly understand the need for a feeling of taking back control, especially when we feel so helpless and out of control. Anxiety over the disease caused me to seek out information, almost obsessively, and to take some supplements that might be of at least some small benefit. It certainly made me feel better to think that I was doing something to effect the outcome, in spite of my doctor's assurances that my treatment was definitive and no further action on my part was necessary.

While it is not a substitute for definitive treatment, low dose statins and NSAIDs may help slow down disease progression while he's waiting for treatment.

As for diet, there are lots of fads, but little definitive research showing major effects, other than that high intake of polyunsaturated fat and dietary calcium from dairy seem to be bad. Broccoli, and especially broccoli sprouts seem to be good -- there is a clinical trial now of its active ingredient, sulforaphane -- available from health food stores. Pomegranate juice demonstrated an ability to slow down PSA doubling time in one study. Other food supplements that have had some effect in lab studies include garlic (diallyl trisulfide), turmeric (curcumin), and green tea extract (EGCG). There is very little research but possibly some effect from quercetin, resveratrol, and Vitamin B6. There have been equivocal or negative findings for: lycopene, selenium, vitamins A, C, D, E, B12, Folate, Omega 3s (although the ratio of Omega 3s to Omega 6s may have an effect) and soy.

There have been two major studies of food supplements and prostate cancer that you can read about here:
http://www.ncbi.nlm.nih.gov/pubmed/20693267
http://www.ncbi.nlm.nih.gov/pubmed/20843485

If he decides to go with radiation as treatment, there are several anti-oxidant supplements he should avoid, as they may interfere.

Hoping for the best for your son,
Allen

Last edited by Tall Allen; 02-12-2011 at 01:01 PM. Reason: correct spelling

 
Old 02-12-2011, 11:10 PM   #6
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Re: I need moral support --- PLEASE!

Allen , thanks very much for your reply!

Yes, my son lives in Atlanta. Do you know any specialists there?

 
Old 02-13-2011, 12:27 AM   #7
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Re: I need moral support --- PLEASE!

I only know of the Prostrcision treatment based in Atlanta - a combination of seeds and radiation, but he ought to be able to get all popular treatments, except protons, locally.

 
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Old 02-13-2011, 02:58 AM   #8
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Re: I need moral support --- PLEASE!

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Originally Posted by jellybean3009 View Post
Allen , thanks very much for your reply!

Yes, my son lives in Atlanta. Do you know any specialists there?
I believe that the medical oncologists at the big institutions in Atlanta; the Saint Joseph’s Hospital or the Northside Hospital, could professionally answer about your son’s case, however they may suggest treatments based on robotic surgery as their specialty. You should then get second opinions from specialists in other areas once you get details of his prognosis.

Wishing you the best.
Baptista

Last edited by Administrator; 02-14-2011 at 05:45 AM.

 
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Old 02-18-2011, 08:41 PM   #9
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Re: I need moral support --- UPDATE

My son went for his bone scan and CAT scan Wednesday. He is to see his dr. next Tuesday for the results. I will post his results. In the meantime, he is researching drs. at Northside Hospital and ST. Joseph's Hospital for a second opinion. I'm trying to maintain a positive attitude but I am still sick to my stomach for him to be going through this! Mother love?

 
Old 02-19-2011, 05:12 AM   #10
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Re: I need moral support --- UPDATE

Hi jellybean,

This waiting part is really hard to bear!


Quote:
Originally Posted by jellybean3009 View Post
.... I'm trying to maintain a positive attitude but I am still sick to my stomach for him to be going through this! Mother love?
Please know that there has been enormous progress in dealing with prostate cancer. As an example, just this week we got important confirmation that quality pomegranate extract substantially slows down the PSA doubling time in recurring patients. That's a very strong indication that it slows the cancer. We were waiting for that confirmation of a highly impressive earlier study done by experts at UCLA, and now we have it! The confirming study was led by highly regarded researchers at Johns Hopkins. I posted about it a few days ago.

Tall Allen addressed some of the nutritional tactics we can use, and also reflected the confusion that many of us feel with these tactics. Nutrition and prostate cancer is certainly an evolving area, and at least so far it is a support for therapy (or active surveillance) and not a substitute for it. However, if your son is interested in foods and nutrition to combat the disease (I hope that he will become interested.), the best source in my opinion is "Beating Prostate Cancer: Hormonal Therapy & Diet" by Dr. Charles "Snuffy" Myers, MD. As a medical oncologist currently specializing in prostate cancer, but also as a former leading pharmacologist at NIH, his expertise has enabled him to weave through the maze of confusing information about foods and supplements. That book, and an earlier book he wrote with his wife (a PhD) and sister-in-law, I think it is "Healthy Eating for Prostate Cancer" or something like that, lay out the rationale and key research behind the recommendations. I'm following this approach, but I'm also keeping up with current research announcements, such as the one about pomegranates. Already Dr. Myers has changed his view toward curcumin that he expressed in the original edition of "Beating," now recommending consumption of curcumin if it is formulated with an agent that will allow absorption. There are other books addressing this area, such as at least one by Dr. Mark Moyad, MD. In my view several are good and worthwhile, but they lack the special pharmacological insight found in Dr. Myers work.

I'm hoping those results will be favorable.

Take care and try to keep your spirits up!

Jim


 
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Old 02-21-2011, 06:35 PM   #11
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Re: I need moral support --- PLEASE!

Hi Guys,

It's me AGAIN! I have one more question before the date with the dr. tomorrow. Can you think of ANY specific questions my son should ask the dr after he gets the results of his tests?

I am trying to stay upbeat but it's SO difficult! I know you all can identify with these emotions.

Thank you!

 
Old 02-21-2011, 08:13 PM   #12
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Re: I need moral support --- PLEASE!

Most questions will depend upon results, and can wait. The best question I asked was "May I email you with questions as they come up?" I've found that I get better responses via email than playing phone tag with a busy doctor. Writing my questions helps me formulate what it is I really want to know, and doctors really appreciate clear questions.

I never found that trying to stay upbeat when I was really feeling anxious was anything but emotionally exhausting. But so is anxiety over imagined future outcomes that may or may not happen. Deal with it as it comes. Good luck tomorrow. Let us know the results and perhaps we can steer you in some good directions.

- Allen

 
Old 02-22-2011, 03:46 AM   #13
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Re: I need moral support --- PLEASE!

Quote:
Originally Posted by jellybean3009 View Post
Hi Guys,

It's me AGAIN! I have one more question before the date with the dr. tomorrow. Can you think of ANY specific questions my son should ask the dr after he gets the results of his tests?

I am trying to stay upbeat but it's SO difficult! I know you all can identify with these emotions.

Thank you!
Hi Jellybean

You can find a list of questions by typing this sentence in a net search engine; “questions to ask your doctor about prostate cancer diagnosis”.
The more knowledge you have, the easier it is to understand prognosis and make decisions about your son’s cancer and its treatment. Do not be shy about asking questions even if they seem weird to you.

You could add these items to your list:
1. How aggressive is the cancer?
2. How far advanced is it? (What stage is it?)
3. Should I get a second opinion?
4. What are all my treatment options?
5. Should I consider Active Surveillance as a preventative treatment?
6. What treatments are best for me?
7. Can such treatment lead to other problems?
8. What can I do to cope with side effects?
9. Will I have to stay in the hospital for treatment? How long?
10. Will treatment keep me from doing certain things I enjoy?
11. How often will I be checked after treatment?
12. Can I go back to normal daily activities after treatment?
13. What experiences have other patients had with similar treatment regimens?
14. Is there any new type of treatment that might be beneficial?
15. What has been your experience with prostate cancer patients similar to me?
16. Can you recommend any patient support groups in my area?
17. Are there materials I can read about my cancer?

You can request later for specific answers on your first consultation as Allen indicates above.

Take care
Baptista

 
Old 02-22-2011, 03:38 PM   #14
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Re: I need moral support --- PLEASE!

Here's the report from today's dr. visit:

(A) Right: Benign prostatic tissue. Mild acute inflammation. Mild chronic inflammation.
(B) Left: Adenocarinoma (Gleason Score - 3+4 =7) involving less than 5% of the specimen (2 of 3 cores contain cancer.)
Gleason Pattern 4 comprises 25% of the cancer.
Cancer length 0.24 cm.
Stage T1c

PSA: 7.7

His dr. said considering his age (50), health (good), etc. he would recommend a radical prostatectomy as his best option.

My son plans to get at least 2 more opinions before deciding what route to take. The dr. also stated he would recommend treatment no later than May 3which would be 3 months from the date of his biopsy. What would your opinion be?

Thanks again!

 
Old 02-22-2011, 04:22 PM   #15
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Re: I need moral support --- PLEASE!

Quote:
Originally Posted by jellybean3009 View Post
Yesterday my 50 yo son told me he just found out he has prostate cancer. Needless to say I was devastated! His PSA was 4 when he had his yearly physical in Dec/2010. The year before it was 3.8. His internist sent him to a urologist for a biopsy. The dr. called him yesterday with the positive results. The dr is trying to schedule him for a CAT scan and bone scan soon as possible. I need to be moral support for him but this news has made it difficult to do right now. I asked my son if he had any unusual symptoms and he said the only thing he had noticed was difficulty totally emptying his bladder and lower back ache. He attributed his back ache to the 120 miles he drives each day to work and back. NO other symptoms. Is this normal? What is he facing now?

ANY suggestions you have will be sincerely welcomed.

Thanks for listening.

I am so sorry. They never stop being our babies, do they?
It's so hard when an adult child is suffering, and there isn't much you can do to help. I think you're holding up amazingly well. Just keep hanging in there.

I wish you peace and your son the best of luck.

Last edited by Kali333; 02-22-2011 at 04:22 PM.

 
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