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Cancer: Prostate Message Board

  • Possible Prostate Cancer

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    Old 01-23-2020, 08:20 AM   #16
    guitarhillbilly
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by DjinTonic View Post
    GuitarHillbilly brought up the issue of conditions other than PCa affecting PSA levels. Absolutely true. Uro's tend to push for biopsies more than we might expect or want. We may be thinking Hey, maybe my PSA rise is being caused by inflammation, or BPH, etc. But your uro knows that these conditions can and do exist alongside PCa.

    I never doubted my uro's or complained about any of my nine (!) biopsies for my slowly rising but fluctuating PSA over some 25 years of BPH. On the contrary, I wanted to know if I was harboring cancer. Neither my doc's or I said or though We'll, that biopsy was unnecessary -- no cancer was found.
    Djin
    To my UR's credit he wanted to do the biopsy immediately after seeing the MRI results because he was zeroing in on the Prostate Density Value and explained that to me. I'm the one who made the decision to wait another 11 months before having the biopsy when my PSA jumped from mid 5's to 6.9.
    There is no doubt that PCa denial plays into the numbers and also my decisions. It was a risk that I was willing to take but everyone has different risk tolerances. That is the purpose of this forum to share our individual experiences and that's what I've done.

     
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    Old 01-23-2020, 08:34 AM   #17
    Pbriga41
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by Steve135 View Post
    Pbriga41, welcome sory you found yourself here. Like all the post above relax this whole deal will make you nuts, we here have all gone through our own journey. Some for 20 plus years and others still at the begining! What we all can say for sure everyone of us is different than the next guy, and therefore what treatment works for me won't work for you. What options are offered to you won't be offered to the next guy. The waiting not knowing will eat you up if you let it. I delt with my PCa dianosis by sharing it with who ever crossed my path. I deliver mail to 500 homes and every one of them knew what was up with me. It kept my spirts up...knowing I wasn't alone and quite a few other men on my route were going through or had gone through the same journey. I gained so much knowledge this way. And remember there is still old thinking out there in this field that 4.0 psa is a magic number for possible PCa. Hogwash I've seen some many posting PCa with smaller numbers than 4.0 while other have psa of 20 and No PCa!
    I noticed you posted no symptoms? I'm pretty sure evreyone gets there very own symptoms and may share others as well. Mine were as simple as low pressure urinating with a dribble, followed by a weak erection and a slight raise in psa of only 0.9 from 1.5 to 2.4. The other thing you posted was Low T. Low T is a good thing if you have PCa not the other way around. My testosterone is 7, as testosterone feeds PCa which is the last thing I want to be doing is my fertilizing cancer!
    steve d
    ________________
    Diag. 56 DOB 2/59 PSA 01/14 2.0 6/15 2.4
    Biopsy 6/15 5 Gleason Score 8
    RP 10/15 Path 54g 5x4.2x2.8cm 4+3=7 Tumor location quadrants Bilateral
    Extra-capsular extensions present,SV no invasion
    Vascular invasion none, PNI ,Multicentricity multifocal
    Margins NP lN's 5 neg pT3a,N0
    PSA 10/16 0.1 1yr 02/7/17 0.4 02/15/17 0.5
    Pet Scan 2/17 Neg PSA 03/17 0.6 Axumin trial 17.4mm BCR rt. SVB Casodex + Trelstar
    04/17 SRT (42)
    08/17 PSA 0.1 Last 6 uPSA 0.006 uPSA 2/19 0.030 2nd BCR 5/19 0.235 5/30 0.32 6/19 0.34 7/19 0.06 8/19 0.08 9/19 0.056
    10/190 0.08 11/19 0.07 12/19 0.07
    7/19 Trelstar, Xtandi, Zoledronic Acid
    12/19 (3) SBRT Iliac bone liasion
    Thank you for your reply, Steve, you put it in layman's terms that I understand. His only symptom is with erection..which was put on Viagra months ago and seems to work fine.. PSA levels vary as I have been told by his UR and UR wanted to put off biopsy and do any psa test end of Feb. I or we said no...even with the "infection stats" of biopsy. Low risk compared to having cancer and putting it off. His UR will be taking 12 samples of biopsy. I k ow when shag used..you are a zombie going through the motions and it is killing you inside. That is where we are now. If you read my early posts .. I was a widow and husband passed from colon cancer...diagnosed at 45 with stage IV. The biopsy is scheduled for Feb 4 and UR says it takes 7-10 days to get back. I will be calling frequently as the colon cancer results were in and presented to us in 5 days. I am proa give..not reactive...maybe because I have been down a similar road in my past. He is having g a bacterial swab today ..idk why they do this and not put on preventative antibiotics prior to biopsy. Today I will be going with my Fiance' with a?boatload of questions for. PSA results..free..density..velocity...all that I am learning on this site. I can handle just about anything..as long as he can be here in 20 years ...I am good

     
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    Old 01-23-2020, 08:38 AM   #18
    Pbriga41
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by DjinTonic View Post
    GuitarHillbilly brought up the issue of conditions other than PCa affecting PSA levels. Absolutely true. Uro's tend to push for biopsies more than we might expect or want. We may be thinking Hey, maybe my PSA rise is being caused by inflammation, or BPH, etc. But your uro knows that these conditions can and do exist alongside PCa.

    I never doubted my uro's or complained about any of my nine (!) biopsies for my slowly rising but fluctuating PSA over some 25 years of BPH. On the contrary, I wanted to know if I was harboring cancer. I never said or thought, We'll, that biopsy was unnecessary -- no cancer was found.
    I agree 100% ..I pushed for biopsy after 2 psa results "still under the technical number 4" which means. Othing to me. I want to know what's in there and if there is anything g I want it gone..bring on tbe biopsy
    Djin

     
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    Old 01-23-2020, 09:13 AM   #19
    guitarhillbilly
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    Re: Possible Prostate Cancer

    [QUOTE=Pbriga41;5500316] He is having g a bacterial swab today ..idk why they do this and not put on preventative antibiotics prior to biopsy.

    The purpose of rectal swab is for the UR to determine the type of anti-biotics needed before the biopsy. In my case I had IV antibiotics the day before - the day of - and the day after my biopsy.

     
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    Old 01-23-2020, 09:41 AM   #20
    guitarhillbilly
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    Re: Possible Prostate Cancer

    Steve135 : "And remember there is still old thinking out there in this field that 4.0 psa is a magic number for possible PCa. Hogwash I've seen some many posting PCa with smaller numbers than 4.0 while other have psa of 20 and No PCa!"

    Thank you for saying this. PSA Velocity - Prostate Density - Free PSA and other factors are very important in the diagnosis of PCa.

     
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    Old 01-23-2020, 09:43 AM   #21
    Pbriga41
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    Re: Possible Prostate Cancer

    [QUOTE=guitarhillbilly;5500320]
    Quote:
    Originally Posted by Pbriga41 View Post
    He is having g a bacterial swab today ..idk why they do this and not put on preventative antibiotics prior to biopsy.

    The purpose of rectal swab is for the UR to determine the type of anti-biotics needed before the biopsy. In my case I had IV antibiotics the day before - the day of - and the day after my biopsy.
    Thank you. I had no idea .. I appreciate all the knowledge and support from all

     
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    Old 01-23-2020, 10:24 AM   #22
    guitarhillbilly
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by DjinTonic View Post

    I never doubted my uro's or complained about any of my nine (!) biopsies for my slowly rising but fluctuating PSA over some 25 years of BPH. On the contrary, I wanted to know if I was harboring cancer. I never said or thought, We'll, that biopsy was unnecessary -- no cancer was found.

    Djin
    I will NOT do 9 biopsies! My case proves the risks involved with a transrectal biopsy because I had to have IV antibiotics [ nurse told me they were high powered] the day before / the day of / and the day after my biopsy.
    I asked my UR what percentage of his patients required IV antibiotics before the biopsy. He told me 10 % of his patients. This means the other 90 % get to take pills before the biopsy. That is all I need to know about the risks involved in a transrectal biopsy.
    I MIGHT consider an Transperineal Biopsy in the future if needed.

    Not trying to scare anyone out there but just laying out the facts in my case.

     
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    Old 01-23-2020, 11:07 AM   #23
    DjinTonic
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by guitarhillbilly View Post
    I will NOT do 9 biopsies! My case proves the risks involved with a transrectal biopsy because I had to have IV antibiotics [ nurse told me they were high powered] the day before / the day of / and the day after my biopsy.
    I asked my UR what percentage of his patients required IV antibiotics before the biopsy. He told me 10 % of his patients. This means the other 90 % get to take pills before the biopsy. That is all I need to know about the risks involved in a transrectal biopsy.
    I MIGHT consider an Transperineal Biopsy in the future if needed.

    Not trying to scare anyone out there but just laying out the facts in my case.
    When deciding whether to go ahead with a TRUS biopsy, one should also consider (1) your risk based on your past biopsies (e.g. infections with resistant strains) and (2) your doc's infection statistics. Speaking for myself (9 TRUS biopsies, 4 or 5 different uros, each 12 to 24 cores, with oral antibiotics), I had no infections. Discussing infection rates not that long ago, my current uro told me that since he started isopropyl-alcohol needle washing between cores some years ago, he hasn't had a single case of infection requiring hospitalization (BTW a single biopsy needle is used throughout the procedure.)

    Nonetheless, infection rate is a good reason to consider a transperitoneal biopsy, which may even replace TRUS biopsies.

    However for now a biopsy is the only way to diagnose PCa. I don't know if my uro's vigilance saved or prolonged my life, but I am certain that early diagnosis gave me my best chances.

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    11-10-17 Decipher 0.37 Low Risk; 5-yr met risk 2.4%, 10-yr PCa mortality 3.3%
    LabCorp uPSA: 0.010 (3 mo.)…0.015 (1 yr. 6 mo.)…0.015 (2 yr. 4 mo.)

     
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    Old 01-25-2020, 08:08 AM   #24
    guitarhillbilly
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by Prostatefree View Post
    To the original poster,

    If using testosterone supplements or boosters I recommend he stop with the consult of his doctor. It is a current and dangerous fad to use these to counter the effects of aging. It is not good medicine, and there is a good risk it will fuel prostate cancer. If he recently began testosterone supplements his recent spike is very concerning.
    You are very correct and I hear ads on the radio every time I drive to work about local Men's Clinic giving men back their youth. I wonder how many of their clients understand the possible ramifications of testosterone boosters? How many of the men who visit the clinic have even ever had a PSA test much less know what their PSA velocity is?
    There are still MD's out there who do not even do PSA testing as part of routine blood tests.
    To my PCP credit he started PSA testing with my annual physical when I turned 40 years old. For almost 20 years my PSA was always 2.0 -2.4 and when it jumped to 4.7 he referred me to a UR.

     
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    Old 01-25-2020, 08:14 AM   #25
    Pbriga41
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by Prostatefree View Post
    To the original poster,

    You're doing fine. Don't over react and don't under react. Getting a biopsy now or waiting a few weeks and retesting to confirm with another test or wating a few months then retesting to see if it's still rising are all good pathways forward for you.

    His PSA starting to move at his young age is something to pay attention to. To our advantage, prostate cancer is slow moving.

    At this point, my choice is to following you doctor's advice. More on your doctor later.

    If using testosterone supplements or boosters I recommend he stop with the consult of his doctor. It is a current and dangerous fad to use these to counter the effects of aging. It is not good medicine, and there is a good risk it will fuel prostate cancer. If he recently began testosterone supplements his recent spike is very concerning.

    Back to the doctor, if the current urologist recommended testosterone supplements to counter the effects of aging I suggest you find another urologist. If your fiance has a serious hormone heath issue he should be seen by endrocrinologist.
    No testosterone hormone ..Gp said it was low UR said it was not

     
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    Old 01-25-2020, 08:28 AM   #26
    Pbriga41
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    Re: Possible Prostate Cancer

    Quote:
    Originally Posted by Pbriga41 View Post
    No testosterone hormone ..Gp said it was low UR said it was not
    In a zombie state until results from biopsy comes in on 12th.. I have been down this path before and outcome was horrific

     
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