Prostate cancer....possibly.

[John Schmidt]

Wondering if anyone has experienced this in their life, and if so....what action did you take. My PSA jumped two points in a short period of time so my urologist wanted to have a 4K blood test done following his physical exam. The exam didn't divulge any nodules and only slight enlargement(using my daughter Toni's description....I can still pee like a race horse most days). Today, I got the results of the 4K and it shows a 75% probability of cancer being present in the prostate, plus the PSA has jumped another full point in the last month. The dr. said I have three choices; have an MRI to pinpoint where it is in the prostate and how advanced it might be; have a biopsy done to determine the type and extent of growth; or do nothing for now. He then told me if the biopsy showed it should have immediate attention they would only do radiation. I asked about complete removal and he said at my age they won't do it(80 in a couple weeks). It puts me in quite a quandary, I don't know at this point just what to do. He told me he could pull 100 men age 80 off the street and better than 70% would be in much the same boat.

I need to be completely mobile and in relatively good health for my wife's sake. She's been in hospice care at home since mid-January and I'm the only one doing everything around here, hospice is only involved in handling pain. The pain meds are rather potent, causing her to rest/sleep most of the day. I just wonder how bad my situation is and can I let it go for possibly the rest of the year. If anyone has been through this....or similar, I'd like to hear from you.

[baldo]

John,

I have no experience at all in this matter. I just wanted to lend some support while you go through it....

Bob

[The emperor has no clothes]

John, I also have no firsthand experience. But, my Dad had almost the exact symptoms and tests as you. His doctor recommended doing nothing. He was never bothered by it. He lived another 15 years and was taken by congestive heart failure, unrelated to his prostrate issues. Live your life to the best of your abilities and make your decisions the best you can. Please feel no guilt if you are not able to give Rita 100% of yourself. You have done more already than most would have.

God be with you my friend.

[Savago]

Damn, John... that sucks, brother!

I will pray to God to enlighten your mind to do what is right.

[DDT (12)]

John,

No experience here either... at least not yet. Stuff just keeps happening as we pile up the years, and eventually something will get us. You've done a good job of utilizing the time you've had, though, and unlike most, I doubt you have many regrets...

You are a good person with a huge heart and a keen mind... You'll do the right thing when it counts, and of that I have no doubt. None of us have answers whose value amounts to that of even a pint of piss... So, just trust your own instincts and judgement, and things will work out... We're all pulling for you, my friend!!!

DDT

[Bigwolf]

John,
My experience: From January 2015 to January 2016 my PSA took a jump so my primary doc referred me to a urologist.  The urologist, after the finger in the butt exam, said he did not find anything unusual but wanted to do a biopsy to be sure.  If I remember correctly, he mentioned the 4K test but preferred to go straight to biopsy.  While not seriously painful, the biopsy did come with some temporary pain and it is rather unnerving to be pissing blood for a few days after. The biopsy results showed some cancer in 8 of the 12 samples and the affected pattern was from top left to lower right.  The scale average was 7.2.  I was told that I had 3 options; radioactive seeding, pinpoint radiation (I think that is how they described that option), or complete removal.  I was also told that removal would not have been offered to me if I had been 70.  I felt lucky to have had this at the young age of 68.  I had mine robotically removed.

My brother inlaw had the seeding about 20 years ago and is still doing well with that.  Other parts of his health are slowly giving out though.  He is 84 now.

Some other thoughts; I say these things not to intimidate or scare you but because it has been my experience that even doctors sometimes hide information, downplay risks, and even misinform.  This may seem blunt but I prefer to have all the information undiluted and not sugar coated.  I suspect you may feel the same way about that.
I was told by more than one doctor that prostate cancer is no big deal.  To quote a common phrase, "at your age, you will surely die of something other than prostate cancer". 
Well, obviously we do not have to have a prostate to live............however, when this same cancer gets outside the prostate, we no longer refer to it as prostate cancer.  Therefore, you won't die from prostate cancer.  But make no mistake, prostate cancer is in truth adenocarcinoma.  Colon cancer, pancreatic cancer, lung cancer, esophageal cancer, and breast cancer are all adenocarcinoma.  You can die from adenocarcinoma in those parts of the body.
Couple that with the fact that the prostate is surrounded by 12 lymph nodes and lays against the colon.  It may be unlikely that prostate cancer will spread outside the prostate but I was not willing to take the chance given the potential disaster possible if it did.

Well that is my experience with a few thoughts and bits of knowledge thrown in for good measure.

Best wishes for you in making this decision and for your health in the coming years.

Bigwolf

PS: pm me if you have more questions or if you would like to talk over the phone.

[Pete]

We are about the same age.
My PSA is normal, prostrate is enlarged, but not causing any issues.

A very close friend did not listen to his doctor (on testing/treatment) and it turned out that he had the aggressive verses the non-aggressive.

So get a second opinion if you want to, and if it is the aggressive - get it treated now.

Best wishes and prayers.

[Skinhead]

I believe my BIL had prostrate cancer about 5-6 years ago and they did a procedure where they inserted a metal probe through the anus that they then circulate a refrigerant through and freeze the tissue, which dies and is removed by your body.  I'm not sure of the details, as at the time he said it was no big deal and didn't make a fuss about it.  I believe he was in his early to mid sixties at the time.  I can get more specifics if you'd like.  Best of luck to you.

[Art708]

John, I was diagnosed with prostate cancer back in 2012.  They said that they caught it early and gave me the choice of removal, chemo and radiation, or radioactive seeding.  I went for the seeding and my PSA has been less than .01 since then.

I hope that you have good results from whatever course of treatment you end up having!!

[solo1]

John, About 12 years ago, I had a false positive PSA.  A month later it was normal. I declined to have any more PSA tests.

Move to 2017. During cancer removal from my bladder, they removed a good portion on my over sized prostate to increase flow. No cancer and I'm peeing like a 20 year old, not bad for being 90 next month.

My brother-in-law had prostate cancer and they did the seed approach. He lives out of state but evidently still ok.  He's about 78 and now suffering from dementia not connected with prostate.

In our chapter of the Korean War vets, our commander was diagnosed with prostate cancer last year. He's gone through radiation and, as of now, good numbers on his PSA.  He only missed one meeting (we have them every month). Another member had radiation and chemo for bladder cancer Metastatic) and he has missed just one meeting. It is Hell getting old.

I personally know of your special concerns since you are a caregiver. I had the bad flu when I was a caregiver for my wife but I kept on, I had to.

My advice?  From what I hear and seen, prostate cancer is very common as we age, some slow growing, some not.   If you trust the doc, go with his advice. mentioning that you cannot become disabled because of caregiving. My prayers are with you no matter what you decide.

Wayne, solo1

[henry 008]

john, my personal dr. told me once he would never test me for prostrate cancer because the cure is almost or is worse than the disease. good luck in figuring this out! 

[bassman]

John…..I was diagnosed with PC about 18 months ago - low risk category and on Active Surveillance.  Have had two biopsies; 4K screen and one or two others to check for the presence of cancer during that period.  From MY understanding, and I am NO doctor, the biopsy helps to determine what type of cancer and how aggressive it might be.  All the other tests just let you know there is or is not a presence of cancer.  The biopsy will let you know what type and how aggressive it is in your system using the Gleason Score to help determine a course of treatment.

https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/prostate-pathology/prostate-cancer-pathology.html

https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/newly-diagnosed/gleason-score

My doctor gave me all the options and told me he makes his money on total removal but highly recommended Active Surveillance for me and assured me, based on my score and age (74), there is a HIGH likelihood I will die WITH PC and NOT from it.

I have several friends who have been treated one way or another for PC - one with Proton Therapy years ago but they recently discovered they missed part of it and it has come back with a vengeance.  Another with the seeds last year (age 74 and had heart surgery in the past and docs would not do the removal) and his PSA has gone from 17 to 0.  One had total removal but is having second thoughts about it - his dad died from PC and his 4 older brothers have all been diagnosed with PC and he did the removal as a preemptive procedure at age 58 to avoid what he knew was coming down the line for him.  Each of the various treatments has its own case of side effects possible.


You stated your PSA doubled but it’s important to know how it doubled - 1 to 2, 2-4, 6-12 etc.  I know you are aware a PSA 4 or below is considered OK or normal.

Good luck and PM if you have any more or other questions - would be more than happy to discuss with you.

bassman

[MarkT]

Sorry to hear that John.  Have nothing to add, or experience but I'm pulling for you. Here's hoping it stays benign and doesn't spread.

[old2soon]

Damnit John! I Hope and PRAY all turns out well for you. Last year? my saw bones put me on tamsulosin hcl 0.4 MG cap once a day for my-his words-slightly enlarged prostate. I go in the 3d of April for my annual exam and my list of questions is gittin longer.   I have recently turned 73 and along with some others here thinkin my warranty is long past!   If it ain't too much trouble John keep us updated please. You just KNOW what kind of support network we have here. Take care my Friend. RIDE SAFE.

[Atl-Jerry]

John,

I am scheduled for my prostatectomy next Wednesday, the 21st.  My PSA started rising, the rectal exam indicated an enlarged prostate with more firmness on one side.  Had the biopsy in Dec then in Jan on my 65 birthday got the results that it was an agressive cancer and a high gleason score.  MRI and bone scan indicated it was contained within the prostate.  After reading everything I could find and talking to many others, including health care professionals I opted for the surgery.  I chose this because I felt that for me, I would produce a better outcome.  In the case of a second recurrence, radiation following surgery usually has better results than does surgery following radiation.  It's a crap shoot either way, just had to choose the least objectionable.  With a long family history of cancer, I've been expecting this for some time and my original plan was not to worry about it until I was pissing blood.  But reality set in and I realized my life was not just about me and I need to be here a bit longer.  Our 50th anniversary will be here in a few years and I want to see it!

Good luck with whatever you choose!

[Karen]

John, obviously I can't speak from experience, but one of the gentlemen who I worked with had an issue with prostate cancer. One of the things they treated him with were hormones, female hormones, and another guy in our group cracked us all up when he said that he suddenly found Bob more attractive! Don't know what his regimen is, but he has been stable for several years, walks and works out every day and is in good health, shape and spirits. Bob was my mentor on one project, I remember him coming to my cubicle door after I told him I couldn't get the code to work. He stood there, glanced at the screen, said "typo" and left. I trust you will be in great hands, and pray for even better results than Bob, who is even older than you or I... 

[czuch]

I have nothing good to say about PC.
I hope and pray your gonna be OK.

[shortleg]

   John go with the MRI first to take a look that will not be evasive at all.

[John Schmidt]

Bigwolf and others that have had removal of the prostate, what was the aftereffects of it? Was there any incontinence, loss of control over elimination? The last thing I want is to be a doddering old man that ends up wearing Depends because of it.

[Bigwolf]

John,

I sent a PM to you.

Bigwolf