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Board: Cancer: Prostate 07-21-2013, 12:21 PM
Replies: 5
Views: 1,182
Posted By Tall Allen
Re: Multiparameter MRI Diagnosis Facility Help

That was about my age at diagnosis. Keep in mind that most prostate cancer is insignificant and indolent and does not require immediate treatment, if ever. You might want to read up about Active...
Board: Cancer: Prostate 07-21-2013, 11:15 AM
Replies: 5
Views: 1,182
Posted By Tall Allen
Re: Multiparameter MRI Diagnosis Facility Help

No. I would get the first biopsy locally. A normal TRUS-guided biopsy isn't a highly specialized procedure. Only about 30% of first biopsies are positive for cancer. I'd save my money for later, if...
Board: Cancer: Prostate 07-02-2013, 03:12 PM
Replies: 3
Views: 1,112
Posted By Tall Allen
Re: Prognosis indeterminate: Always?

He's having ADT+HDR+IMRT -- right? The following retrospective study of almost a thousand men showed that the 8-year biochemical failure rate for that combo therapy was only 14% and the 8-yr cancer...
Board: Cancer: Prostate 05-25-2013, 10:35 AM
Replies: 20
Views: 2,787
Posted By Tall Allen
Re: Husband recently diagnosed

I'm happy to have helped in any way. After all this information-gathering and doctor-consultations, you both will have some difficult decisions to make. I hope you will keep posting and share your...
Board: Cancer: Prostate 04-21-2013, 10:28 AM
Replies: 14
Views: 4,890
Posted By Tall Allen
Re: IADT, 8 months on vacations

Hi Baptista,

If your previous SRT already irradiated the pelvic nodes with sufficient dosage, I agree that there is no point to looking there for the cancer. In my friend's case, his SRT was...
Board: Cancer: Prostate 04-16-2013, 11:34 PM
Replies: 14
Views: 4,890
Posted By Tall Allen
Re: IADT, 8 months on vacations

Hi Baptista,

I'll try to address your questions as far as I know.



He is now on his second "on" cycle, not counting the adjuvant ADT he had with his salvage radiation. He expects to be on...
Board: Cancer: Prostate 04-08-2013, 10:59 AM
Replies: 14
Views: 4,890
Posted By Tall Allen
Re: IADT, 8 months on vacations

Congratulations on the vacation. From everything I've read, the kind of complete PSA response you are getting is the best indicator of continued response. In the US, Zytiga (abiraterone) is only...
Board: Cancer: Prostate 02-15-2013, 09:12 PM
Replies: 7
Views: 1,781
Posted By Tall Allen
Re: vitamin supplements?

Vitamin D is a great example of a substance that has had a lot of studies, but no proven benefit to PC. There seems to be a lot of misinformation out there about Vitamin D. I pulled the following out...
Board: Cancer: Prostate 02-14-2013, 08:57 PM
Replies: 7
Views: 1,781
Posted By Tall Allen
Re: vitamin supplements?

Thanks, Tommy, for letting me address this issue -- I think it's important that everyone be able to distinguish what constitutes "proof" from what doesn't, especially because these days we all have...
Board: Cancer: Prostate 02-03-2013, 09:26 PM
Replies: 7
Views: 1,781
Posted By Tall Allen
Re: vitamin supplements?

None have ever been proven useful for preventing PC, but Vitamin E has proved harmful in the incidence of PC. But after RP with no indication of residual disease, I seriously doubt that any vitamins...
Board: Cancer: Prostate 12-22-2012, 09:57 PM
Replies: 8
Views: 5,647
Posted By Tall Allen
Re: Rising PSA Level - Options to Control?

Not every anti-oxidant, just some particular ones.You might want to try the more concentrated extracts. EGCG is green tea extract. Broccoli sprout extract or sulfurophane may be helpful. Also: soy...
Board: Cancer: Prostate 12-19-2012, 11:16 AM
Replies: 1
Views: 1,142
Posted By Tall Allen
Re: "Double" Bump after Radiation

I was told to expect bounces at any time. Bounces are associated with treatment success. They are not a cause for concern unless they are at least 2 full points over your lowest PSA, which would...
Board: Cancer: Prostate 12-19-2012, 10:40 AM
Replies: 8
Views: 5,647
Posted By Tall Allen
Re: Rising PSA Level - Options to Control?

Hi Gatt,
I'm sorry to hear your father and you have so much to contend with. I think maybe you're in Europe, because I do not recognize the names of the medications you listed. They may have...
Board: Cancer: Prostate 11-30-2012, 04:11 PM
Replies: 15
Views: 3,992
Posted By Tall Allen
Re: Dad Diagnosed With Gleason (3+5)

A lot has been learned in the last 5 years.
Board: Cancer: Prostate 11-30-2012, 03:47 PM
Replies: 15
Views: 3,992
Posted By Tall Allen
Re: Dad Diagnosed With Gleason (3+5)

Are you looking at an old edition of Dr Snuffy Myer's book? The problem with books is they get outdated so quickly.

There was a large study conducted on Selenium and Vitamin E and the risk of PC,...
Board: Cancer: Prostate 11-28-2012, 05:38 PM
Replies: 17
Views: 16,280
Posted By Tall Allen
Re: High PSA level 56

I'm sorry to hear about the diagnosis. If you're like most of us, "cancer panic" sets in quickly. Because of that, it is important to take a deep breath and some time before making critical...
Board: Cancer: Prostate 11-15-2012, 09:05 AM
Replies: 8
Views: 2,667
Posted By Tall Allen
Re: Psa velocity

I saw a study that showed an increase after vigorous bike riding -- stationary bikes are a smoother ride. Unless there is some other reason, like a positive DRE or unexplained urinary symptoms,...
Board: Cancer: Prostate 11-15-2012, 12:05 AM
Replies: 8
Views: 2,667
Posted By Tall Allen
Re: Psa velocity

Your PSA is ridiculously low. PSA velocity is meaningless on such low numbers.Congratulations!

- Allen
Board: Cancer: Prostate 10-26-2012, 11:52 AM
Replies: 33
Views: 8,479
Posted By Tall Allen
Re: New diagnosis, age 48 no symptoms

Most clinical trials for the really interesting new medicines are limited to men who are already castrate resistant. Many include other restrictions. Phase 3 clinical trials always include placebo or...
Board: Cancer: Prostate 10-23-2012, 11:57 AM
Replies: 7
Views: 1,885
Posted By Tall Allen
Re: Cryosurgery Advice

Hi Landcrab47,

A very good friend of mine is in a similar situation. He's experiencing rising PSA after RP and SRT, and has been through a cycle of HT. Like you, he is now letting his PSA rise to...
Board: Cancer: Prostate 10-21-2012, 01:32 PM
Replies: 33
Pca
Views: 5,344
Posted By Tall Allen
re: Pca

Yes. Tom was overweight. He went on a Mediterranean-style diet with plenty of fish and highly colored fruits and vegetables, broccoli, low dairy, no red meat and lost about 30 lbs on it. He worked...
Board: Cancer: Prostate 10-18-2012, 11:48 PM
Replies: 33
Pca
Views: 5,344
Posted By Tall Allen
re: Pca

RJV,
Since you seem to be a fan of anecdotes, let me share one with you. My friend Tom, in my PC Support group, found out he was Gleason 8 about 10 years ago. He had a prostatectomy, but several...
Board: Cancer: Prostate 10-12-2012, 03:04 PM
Replies: 2
Views: 2,580
Posted By Tall Allen
Re: How long can remission last?

Congratulations on your successful salvage radiation treatment. It sounds like you've been cured. Usually, not always, if it's going to reappear it would have done so. There have been rare cases...
Board: Cancer: Prostate 09-28-2012, 12:45 PM
Replies: 1
Views: 1,557
Posted By Tall Allen
Re: Cancer recurrence after 9 yers

It may be that some cells had escaped the prostate before you ever had the radiation and were lying in wait somewhere else all that time. It may still be too small to be detectable on a bone scan. Or...
Board: Cancer: Prostate 09-28-2012, 11:12 AM
Replies: 33
Views: 8,479
Posted By Tall Allen
Re: New diagnosis, age 48 no symptoms

What a shock this must be to both of you. I found that psych counseling was very valuable to me at the time of diagnosis. I also joined a PC support group that I still attend. On top of the possible...
Board: Cancer: Prostate 09-26-2012, 05:26 PM
Replies: 1
Views: 1,696
Posted By Tall Allen
Re: PSA jumped 2 points in 5 weeks

Those are classic symptoms of prostatitis, including PSA shooting up like that. It's been estimated that only about 5% of prostatitis is responsive to antibiotics. If one doesn't work, you can try...
Board: Cancer: Prostate 09-26-2012, 04:19 PM
Replies: 30
Views: 6,107
Posted By Tall Allen
Re: A little concerned

That's what I suspected the DRE would show and was hoping for. Prostate cancer usually has some lumpiness because the tumor areas are harder. When the whole thing is hard in a man your age, the most...
Board: Cancer: Prostate 09-24-2012, 04:15 PM
Replies: 4
Views: 1,632
Posted By Tall Allen
Re: Meaning of a "clear" biopsy

Congratulations on your negative biopsy. It sounds like you don't want to take no for an answer.:)

Not every PC survivor is a PC expert. Evidently your friend did not know that PSA is not specific...
Board: Cancer: Prostate 09-24-2012, 12:47 PM
Replies: 11
Views: 4,022
Posted By Tall Allen
Re: elevated PSA after TES treatment

As you can tell from my previous comments, I agree with your urologic surgeon. Biopsies are way overdone and often lead to missed cancers, on the one hand, or overdiagnosis of insignificant cancers,...
Board: Cancer: Prostate 09-22-2012, 12:08 PM
Replies: 33
Pca
Views: 5,344
Posted By Tall Allen
re: Pca

Your exercise regimen will pay off in improved results, so I'm really happy to hear how well you're doing it.

For some tips about the hot flashes, go to this link:...
Board: Cancer: Prostate 09-20-2012, 04:19 PM
Replies: 35
Views: 8,534
Posted By Tall Allen
Re: Confused, Anxiety, All so fast - what next?

The experience of the surgeon at performing that specific technique is the single most important factor in determining the outcome, and it sounds like you've found a very experienced surgeon. I'm a...
Board: Cancer: Prostate 09-20-2012, 12:14 PM
Replies: 11
Views: 4,022
Posted By Tall Allen
Re: elevated PSA after TES treatment

The subject of testosterone replacement and prostate cancer comes up a lot, and I welcome the opportunity to address it, as I've looked into it. A lot of people, urologists included, draw an...
Board: Cancer: Prostate 09-19-2012, 05:22 PM
Replies: 11
Views: 4,022
Posted By Tall Allen
Re: elevated PSA after TES treatment

Ordinary MRIs or USs are lousy at detecting small lesions, and would be a waste of time right now, inho.Save the imaging for later if you need it. Testosterone can certainly make BPH flare, or you...
Board: Cancer: Prostate 09-18-2012, 02:10 PM
Replies: 11
Views: 4,022
Posted By Tall Allen
Re: elevated PSA after TES treatment

With an enlarged prostate (BPH), it is likely that the testosterone aggravated your BPH causing your PSA to rise. Testosterone is metabolized into DHT which will further aggravate your BPH. Proscar...
Board: Cancer: Prostate 09-13-2012, 09:58 AM
Replies: 2
Views: 1,778
Posted By Tall Allen
Re: Stunned by the diagnosis?

Celebrate! (I think you meant it was not positive for tumor). No atypical cells, not even PIN is great!

You might want to review my initial advice to you when you announced on here that you wanted...
Board: Cancer: Prostate 09-10-2012, 10:19 AM
Replies: 2
Views: 1,808
Posted By Tall Allen
Re: My biopsy experience... results pending

I hope they gave you the additional antibiotics.

Prostate enlargement (BPH) happens to most of us as we age. You can take a 5-ARI (Proscar or Avodart) and an alpha-blocker like Rapaflo if you are...
Board: Cancer: Prostate 09-02-2012, 04:57 PM
Replies: 3
Views: 1,326
Posted By Tall Allen
Re: chances of this being cancer?????????

Is it the left testicle? If so, it's probably a varicocele, which can lead to infertility if left untreated. It's not prostate cancer, if that's what you're worried about. You may want to pick up...
Board: Cancer: Prostate 08-30-2012, 05:38 PM
Replies: 3
Views: 2,279
Posted By Tall Allen
Re: Anybody thinking about Immunotherapy as a treatment?

That's because there's not yet much available to discuss. The only FDA-approved vaccine for PC is Provenge, but it has only been approved for mCRPC so far. Yervoy is in clinical trials but is...
Board: Cancer: Prostate 08-16-2012, 04:34 PM
Replies: 18
Views: 3,949
Posted By Tall Allen
Re: Diffusion weighted prostate mri or mri spectroscopy

The endorectal coil gives a much better image -- makes a big difference. You're looking for really small soft tissue differences. Some places now have as much as a 10T MRI -- might not improve much...
Board: Cancer: Prostate 08-16-2012, 01:55 PM
Replies: 35
Views: 8,534
Posted By Tall Allen
Re: Confused, Anxiety, All so fast - what next?

Hi Eddie,

In my experience urologist-surgeons are often a pain in the keester to deal with, and some of the best ones are the biggest pains, unfortunately.

You wrote:


You should...
Board: Cancer: Prostate 08-13-2012, 09:51 AM
Replies: 3
Views: 1,011
Posted By Tall Allen
Re: surgery for urinary incontinence?

I know one guy who had the sling and one who had the sphincter. They were both completely successful -- they use no pads anymore. They tell me the new ones work great. The sling is the less invasive...
Board: Cancer: Prostate 08-03-2012, 10:34 AM
Replies: 33
Pca
Views: 5,344
Posted By Tall Allen
re: Pca

That's great news that your bone scan was clear.

With Gleason 8, and evidence of lymph node involvement, many men take a multimodal approach: neoadjuvant (started 2-3 months before the radiation)...
Board: Cancer: Prostate 08-01-2012, 06:34 PM
Replies: 8
Views: 3,575
Posted By Tall Allen
Re: Sudden PSA rise & Hormonal changes

Hi,
You seem worried about something, but I can't tell what. % free PSA is good. In Europe, you can get the new PHI test (It's been approved in the US, but isn't yet available here) and the PCA3...
Board: Cancer: Prostate 07-22-2012, 04:15 PM
Replies: 34
Views: 8,928
Posted By Tall Allen
Re: Trus biopsy versus mri-ultrasound fusion

As to your other question:


Increasing the diagnostic accuracy of your PSA is certainly a good idea. You can do that by eliminating the sources of error due to BPH and prostatitis. You already...
Board: Cancer: Prostate 07-17-2012, 10:57 AM
Replies: 35
Views: 8,534
Posted By Tall Allen
Re: Confused, Anxiety, All so fast - what next?

Sorry to hear about your diagnosis, but as PC diagnoses go, that's about the best one can hope for. Now is the time to slow it down and not rush into any decisions. PC, especially Gleason 6 with low...
Board: Cancer: Prostate 07-16-2012, 11:02 PM
Replies: 7
Views: 9,744
Posted By Tall Allen
Re: Psa 90

They all can contribute -- there is no formula, it's different in each case. Sometimes very small amounts of tumor generate large amounts of PSA. Sometimes large tumors generate almost no PSA....
Board: Cancer: Prostate 07-16-2012, 06:18 PM
Replies: 7
Views: 9,744
Posted By Tall Allen
Re: Psa 90

Bacterial prostatitis often responds to Cipro. Sometimes it takes a longer course of treatment. Sometimes other antibiotics are required. Many of his urinary symptoms may get better if he takes it. ...
Board: Cancer: Prostate 07-16-2012, 05:59 PM
Replies: 7
Views: 9,744
Posted By Tall Allen
Re: Psa 90

On the prostatitis issue...

If he had a blood test before his biopsy that showed an elevated white blood cell count, particularly neutrophils, that would be a good indicator that he has concurrent...
Board: Cancer: Prostate 07-16-2012, 04:49 PM
Replies: 7
Views: 9,744
Posted By Tall Allen
Re: Psa 90

Staging is based on the DRE and imaging, so if all that was clear he would be T1c. His high PSA and enlarged lymph node may very well be the result of concurrent prostatitis. However his very high...
Board: Cancer: Prostate 07-15-2012, 10:47 AM
Replies: 20
Views: 4,039
Posted By Tall Allen
Re: Active Surviellance - viable option now?

I think AS is a great option for you. NCCN hospitals, most of the top cancer centers in America, now include AS as a recommended therapy for all men with low risk PC, regardless of age. Some are even...
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