Prostate cancer - new treatment approved

BrianD3

It's certainly not a "cure" for prostate cancer but in clinical trials has been shown to improve survival. Good news.
http://www.medicalnewstoday.com/articles/187169.php

lonestargirl

Looks interesting, it is for a very specific group of prostate cancer suffers though (people with metastatic hormone refractory disease) and as such I can't see it replacing current treatment but rather something that is used when other avenues have been exhausted.

Condo131

This treatment, called Provenge, treats rather than prevents prostate cancer. An FDA rep described it as "A new treatment option for men with advanced prostate cancer, who currently have limited effective therapies available."

The most effective strategy, as with all Cancers, is EARLY DETECTION. Unfortunately there is a reluctance among many GPs in this country to offer PSA screening, for fear of "unecessarily worrying" many patients. The other side of that is that many men are then detected far too late for effective treatment.

Luckily for me, my GP did offer PSA screening and it has saved my life!
Condo131 - prostate Cancer Survivor.

LostinBlanch

Condo131 wrote: »

The most effective strategy, as with all Cancers, is EARLY DETECTION. Unfortunately there is a reluctance among many GPs in this country to offer PSA screening, for fear of "unecessarily worrying" many patients. The other side of that is that many men are then detected far too late for effective treatment.

Luckily for me, my GP did offer PSA screening and it has saved my life!
Condo131 - prostate Cancer Survivor.

Agree with this 100%, and the PSA test is only a blood test and not the "golden finger" one. Having an early PSA test can set the baseline for what is your "normal" result and could be compared against later tests and could pick up any anomalies earlier than would normally happen. Or so I've been told.

Glad to hear yours got caught in time Condo.

lonestargirl

Although screening is important it should really be carried out in a national scheme with defined criteria for those who should be included as certain people are being over-screened. The American Cancer Society recently updated their screening guidelines for the early detection of prostate cancer (link).

Condo131

LostinBlanch wrote: »

Glad to hear yours got caught in time Condo.

Thanks!

I had surgery - a radical prostatectomy - just 23 months ago (but who's counting! :rolleyes: ). When the pathology came back, my surgeon said "You're a lucky, lucky man" It would have been metastatic in just a few months.

To give you an indicator of how far I've come. I hope to finish the Dublin City Marathon in October next, in a time of 3:18 or better. :cool:

There is life after Cancer - take my word for it!

Khannie

How old were you when you started the PSA testing if you don't mind me asking Condo?

Condo131

Khannie wrote: »

How old were you when you started the PSA testing if you don't mind me asking Condo?

I don't mind you asking at all - it might save someone's life!

I'd been having annual checkups since I was 23, through work and continued this when I became self employed. I didn't have a PSA check until I was 53. I saw a different GP in the practice who suggested a PSA check as I was over 50 - I thought "wtf is that?"

My initial PSA results was 4.3ng/l. 6 months later it was 4.9 (I was back with an infection) and it was off to see a urologist (because of the sharp rise in a short period), who did the 'finger job' and found nothing. I was scheduled for another test 6 months later. This came back at 6.8, so I had a biopsy, which was clear. Nevertheless, I *KNEW* I was in trouble as a PSA doubling time of under 10 years is not good. Mine was 17 months.

I had an other test 6 months later, 18 months after my first, and this was 9.4. Another biopsy and a nasty tumour was found - Gleason 4+4.

I opted for a full open radical prostatectomy because i felt that it gave me the best long-term prognosis. I had that in May 2008, just after my 55th birthday. Two years on I am 'absolutely flying' - side effects are minimal and lessening literally by the day. I resumed running 3 months after the surgery (could have do so earlier but the GP said "absolutely not!" - surgeon said Ok, but OH said "No!" and, as OH was taking care of me, I had to comply :o:o ) I recently ran a 10 mile race in 71:06, so I guess, from that, you can judge for yourself how well I'm doing.

The thing that scares me is, had I had a PSA test a year or two before I did, it probably would have come in within the 'normal' range and I may not have had another for, say, 5 years! Had that been the case, I would now be in deep 'do-do'. Someone really was looking out for me!

I *CANNOT* stress it enough: EARLY DETECTION IS KEY

Another thing - right up until the day of my surgery, I NEVER had ANY symptoms!! :eek::eek::eek: - Nevertheless I had a very agressive Cancer.

lonestargirl

Khannie wrote: »

How old were you when you started the PSA testing if you don't mind me asking Condo?

The American Cancer Society recommend that screening for those with an expected lifespan of at least 10 years begin at 50 for normal risk but at 45 for those at higher risk. The high risk group is African-Americans and men who had a close relative diagnosed with prostate cancer before the age of 65.

They also stress the importance of informed decisions - for some people surveillance is the appropriate option.

the watchman

That last paragraph by Condo 131 about the psa tests is important.
I am 58 and have had about 3 psa and 'golden finger' jobs lol, (sorry for smiling but that term makes me laugh) since turning 50.
My father has prostate cancer thats why I have been keeping a 'casual' check on mine.
But you can be sure that having just read Condo's post I will be making absolutely sure that I have the checks at least every 12 months.
Thank you Condo.

Dr Galen

lonestargirl wrote: »

They also stress the importance of informed decisions - for some people surveillance is the appropriate option.

this is a hugely important statement.

There are several, well recognised and researched methods of dealing with Prostate Cancer. "Watchful waiting" is the term used, for the above. We know its there, but we also know the cancer is of a slow growing and unlikely to spread type. In that case, its better to keep an eye, and see how things progress. Many men are treated in this fashion, with no undue effect, go on and live more or less as long as they would have without the cancer.

Having a Radical Prostatectomy is a fairly big procedure, not without risk or complication. Sometimes though, it is the best option. Condo is a great example of someone, who took the time, weighed up the options and asked the questions. I'm so glad your doing well mate.

As for PSA tests and rectal exams, they aren't foolproof by no means. To an extent, neither is he biopsy either, as some forms of Prostate CA can be really aggressive, and g from 0 - 60mph in relatively no time. Like I'm constantly saying, regular checks and nipping things in the bud are ALWAYS the best form of treatment lads.

Condo131

Dr Galen wrote: »

There are several, well recognised and researched methods of dealing with Prostate Cancer. "Watchful waiting" is the term used, for the above. We know its there, but we also know the cancer is of a slow growing and unlikely to spread type. In that case, its better to keep an eye, and see how things progress. Many men are treated in this fashion, with no undue effect, go on and live more or less as long as they would have without the cancer.

This is true...in part...but not the whole story....and ....unfortunately, even between us, we're not educate everyone on this thread. Maybe we can go a little way though.

The average age of diagnosis in Ireland is approx. 70 years, clearly meaning that may men will be over, and sometimes well over, this age when diagnosed. In such cases there is often a co-morbidity issue or some other complication and it may be best to have 'watchful waiting' (aka 'do nothing').

However the first thing is a diagnosis. If there was national screening campaign, the vast majority of men tested would only have a marginal PSA reading, if any, and have no worries. A minority of men would have levels that suggest further investigation, yet only a minority of those whould go to be diagnosed with an aggressive strain of Cancer. The vast majority of reaminder will have elevated PSA only, or have an indolent cancer - they will die with it, but not because of it. These are the people that some medical professionals suggest should not be screened and why a national screening campaign should not be conducted - very many of these will be unnecessarily alarmed and demand treatment that they really do not need.

However if we don't screen, then many men, including many of my colleagues, and of course myself, who have been diagnosed because of screening, suggested by their GP, would be doomed to an early death.

Imho, the fact that many younger men, aged between 40 and 60, will develop aggressive proastate cancers is reason enough to warrant screening. I think their needs outweigh those of unnecessarily distressing a larger number of men with indolent cancers.

Dr Galen wrote: »

Having a Radical Prostatectomy is a fairly big procedure, not without risk or complication. Sometimes though, it is the best option. Condo is a great example of someone, who took the time, weighed up the options and asked the questions.

Yes - imho, you understate it - it is a major, major procedure! :eek: I had it two years ago this month and I'm still recovering my strength. Providing it is diagnosed early enough, you will still have several options. YOU are the only one who can decide what potential life-changing side effects YOU will accept. Fully researching your options is best...AND...check out your surgeon. There are several world-class surgeons in ireland. If you have a choice, go with one of them. oth, as in any job, there are those on the other end of the scale - with this procedure you do NOT want them!

Dr Galen wrote: »

I'm so glad your doing well mate.

Thanks! (me too!!:D )

Dr Galen wrote: »

As for PSA tests and rectal exams, they aren't foolproof by no means. To an extent, neither is he biopsy either, as some forms of Prostate CA can be really aggressive, and g from 0 - 60mph in relatively no time. Like I'm constantly saying, regular checks and nipping things in the bud are ALWAYS the best form of treatment lads.

I agree. I call them "go - no go" gauges. Neither on their own will give a diagnosis - merely an indicator that something 'might' be amiss - and even if it is - it isn't bnesessarily PC. (My original uro found nothing on his DRE, whereas my surgeon thought I was "borderline inoperable". Thankfully that wasn't the case - but in his words after teh post-op pathology came back: "You're a lucky, lucky man!"

Make YOUR own luck - check it out!