That walnut sized organ: the Prostate

PMBC

Well done.
Whats the difference between the blood test and the physical exam - I usually have both done annually.

Water John

I thought the PSA (blood test) was not accurate and used to get a physical also, but my GP tells me I'm incorrect in that.
Maybe he doesn't like that aspect of his job.(joke ) Getting one or both done is no hardship for peace of mind. My BIL had no symptoms and was picked up on PSA test.

westgolf

All the quiet followers and non contributing followers of this thread, ( and there are many, ) thank you for your honesty, clarity and determination.

All the same group wish you the best of health and the energy to live life to the max.

Well done sir and Best of luck.

SuperS54

For all of us approaching the age where prostate cancer is becoming a possibility, looks like there is a new treatment option showing very promising results in trials, hopefully it becomes a reality in the not too distant future. https://www.dailywire.com/news/new-technique-eliminates-clinically-significant-prostate-cancer-in-80-of-subjects?utm_source=facebook&utm_medium=social&utm_campaign=benshapiro

Slasher

SuperS54 wrote: »

For all of us approaching the age where prostate cancer is becoming a possibility, looks like there is a new treatment option showing very promising results in trials, hopefully it becomes a reality in the not too distant future.

That looks very promising. But, "transutheral" - hopefully under general anesthetic.

Heighway61

Is it usual or possible for PSA to go down? Mine had been increasing slowly in two years since op but last reading down by .01.

notobtuse

Chose radioactive pellets placed into the prostrate rather than removal. Was guaranteed 10 years at the time with the treatment I chose. PSA has been kept to under 1. This is year 10. Going for my physical and PSA next month. Skipped last year... foolish I know, but can't change things now. Fingers crossed, but resolved to the fact things could take a turn for the worse.

Slasher

Heighway61 wrote: »

Is it usual or possible for PSA to go down? Mine had been increasing slowly in two years since op but last reading down by .01.

Well this is based only on my own experience, i am not an expert. The PSA can go up or down, but should stay within a fairly narrow range. A reduction by .01 would, in my experience, be considered negligible. However, suggest you discuss with your GP.

PMBC

Interesting article 12/1/20 Sunday Independent on prostate treatment now available in Mater Hospital - SpaceOAR technology.
Apologies that I dont know how to post a link. Hope it helps someone.

Heighway61

Peed off with the RAPC appointment cancellations. All this year's cancelled, just had August put off to 2021, while my PSA continues upward. Just one 6-minute telephone consulation in March.

Ah well, suppose it will be OK.

LostinBlanch

I saw this article on steam treatment for an enlarged prostate yesterday and thought it might be of interest to some on here.

Calahonda52

Test done last week. My annual one.
PSA is now detectable, at 0.04, up from undetectable.

Another test to do in 3 months and then most lightly the ray gun, assuming the cancer is still in the pelvic area.
As before, the rate of change in the detectable level, is key to what is happening.

If the rate of increase is high, then the ray gun won't help.

Just to recap, I had a Gleeson score of 8, so if it had not been detected, I wouldn't be writing this email.

Keep safe and well and live life to the full, every day.

If 50 or older and male, you know what needs doing.


As before, I don't follow this thread.

This sets the numbers game scene
https://www.health.harvard.edu/blog/how-to-handle-a-relapse-after-treatment-for-prostate-cancer-2009031122

Metric Tensor

All the best CH. Good luck with the next test.

John Hutton

Hi folks, hope all are doing well. My father is 65 now, 10 years since he first got treated and like some previous posters had a very high Gleeson score. It recurred and now he is basically having it managed with PSA undetected and is doing very well with a good quality of life.

Given that my Dad was diagnosed in his mid fifties (and likely had it for a couple of years before) when should I start getting checked up and tested? I'm 30.

Calahonda52

I don't know if its heredity, however a base line now can't hurt.
Your GP may say not to, you need to say yes to!

greenspurs

Slasher wrote: »

That looks very promising. But, "transutheral" - hopefully under general anesthetic.

Apt user name :P

Calahonda52

Dear

Thank you for forwarding the psa.

This is the first detectable reading and it comes 4 and half years post surgery for locally advanced, margin negative high grade disease.

I would be appreciative of another psa after 3 months to establish whether this is a real psa relapse, and indeed whether this is likely to require onward referral to radiation or medical oncology.

I will correspond on receipt of the next psa in due course.


Am not waiting 3 months, will get one done in first week in Jan, 6 weeks after the last one.

ps appt booked for 5th Jan

Hippo

John Hutton wrote: »

Hi folks, hope all are doing well. My father is 65 now, 10 years since he first got treated and like some previous posters had a very high Gleeson score. It recurred and now he is basically having it managed with PSA undetected and is doing very well with a good quality of life.

Given that my Dad was diagnosed in his mid fifties (and likely had it for a couple of years before) when should I start getting checked up and tested? I'm 30.

My dad died from prostate cancer. I started my check ups from my mid-40s, minimal psa readings annually until this year (I'm 60 now) when it increased suddenly. Biopsy etc, all ok thankfully. I don't think (and I could of course be wrong) that any prostate difficulty doesn't show up until around the mid-40s at least.

Hippo

Heighway61 wrote: »

Is it usual or possible for PSA to go down? Mine had been increasing slowly in two years since op but last reading down by .01.

Happens all the time, all kinds of reasons for occasional spikes and drops.

Calahonda52

So it came back, same as last time 0.04 so have asked for a game management plan that I can discuss with family and friends, including you lot

I did not share the last result yet as the second test and a plan is the key.

Must say was impressed with the GP service, went down for 10:45, sample was with a courier by 11 and the result this morning.

Assuming its not terminal at this point and assuming we go for the ray gun or/ and chemo, anyone here got any personal experience of remaining at work while having radiotherapy or and chemo.

Water John

BIL had radiotherapy after prostrate removal and he found it tiring, but he had retired at that point.

John Hutton

No personal experience aside from living with and observing my dad.

He had retired early so work wasn't an issue. He first had radiotherapy instead of an operation to remove the prostate. He found this treatment good and could have worked at a non physical job, physically.

Afterwords he received much hormone therapy. He could not have worked during this as it made him too tired. He did keep up his hobbies though, which in reality are "jobs" for some people, but the key thing being he was able to do it at his own pace with no stress.

When it eventually returned (like you he has a very high score) he has oral chemo and more hormone. He would not be able to work full time due to tiredness. That said, it would depend on whether the job was stressful and if he liked it. For example, if he enjoyed it and could work away on at his own pace he could do it.

I'm over egging it here, basically I'm saying that, based on my dads experience, he could work if it was at something he enjoyed and had little to no pressure or stress. If it was like his previous job, he probably could have done it if he forced himself, but would be perpetually exhausted resulting in little quality of life as he would expend all energy on work.

Hopefully it will still be in the pelvic area (have you heard anything about going to Germany for a body scan? Dad went, its some fancy machine that can show cancer which is undetectable on our machines) and they can zap it with the rays.

You don't seem the type to be too downhearted but I would remain optimistic. My dad thought it was curtains after his came back (and as he had the ray gun they couldn't operate) but his treatment is working great, and when/if this stops working there are other options too.

Calahonda52

Okay, consultant has written to a ray gun expert, with whom I will have a consultation.
.
At 0.04, they can't tell where it might be as alluded to by JH, so any ray gun work would be scatter gun in terms of area and intensity rather than focussed.
or they will do nothing and wait to see where the number gets to.
.
Downsides include 60% chance of permanent urinary incontinence.
.
I will get another test in 6 weeks to track the rate of change.

TheBoyConor

I'm sorry to hear that it may have returned. Wishing you the very best of luck with the upcoming tests and treatment if it is required.

Calahonda52

Elected for a phone conversation, she is in Dublin, I am in Nenagh, as she would not be doing a DRE, not point in travelling:D

Interesting that she will not use Zoom or Teams or Skype... just the phone.
Will update this after the call.

Okay, good conversation: 1 hour long, no waiting in waiting rooms.
She is v good and clear and no high brow language.
Bottom line, wait another 6 weeks for a blood test and review then.

To get on the list for the PSMA scan, I need result of >=1 or >=0.5 and it has doubled on 6 months.
The PSMA scanner in James H has a waiting list of 18 months so thats out.
Can have it in Germany, but not at 0.04, nothing to see.
Radiotherapy (RT) is an option, 50% chance of it getting the source, they assume its the surgical site of where the prostate was removed so its a shot in the dark.

7 weeks, 5 days a week and then a wait of 6 months to see does the PSA go down to zero.
If it doesn't then hormones/chemo options.

She went through the acute (short term) and chronic (long term/permanent) side effects risks, main chronic one is urinary incontinence, it clicks in about 2 years from end of the RT

Calahonda52

Just to say it seems I can get the ray gun work done in the Mater private sub office in Limerick so it would mean I could get some work done over the seven weeks.
Dublin would be a non runner for work from Nenagh: 2.5hrs each way and to be there a hour beforehand.
21 days to the next blood test.:)

Calahonda52

Star date 4th March 2021
Bloodtest back: same 0.04 so medical advice is another test in June as it hasn't changed.

Keep safe and well and if you are over 50 and reading this and have not had a PSA test well....go do it!:D

Calahonda52

Went to Limerick this morning for F2F with the oncologist in the Mater Private down there.
Good guy, very clear communicator.

As well as filling out all the paperwork, he did a Rigorous DRE, hence the post title:D
.
His advice is to have another blood test in 6 months, and review then, I will have one in three.
.
He went through the process and the side effects which u can research on
https://www.mayoclinic.org/tests-procedures/external-beam-radiation-for-prostate-cancer/about/pac-20384743#
.
If I want to go for it now, it will take 3 weeks to do the prep and then 7 weeks straight.
[They first do a scan to set up the coordinates on the ray gun, and then do a dummy run to make sure the patient can tolerate the setup, including what sound like a mini self-administered enema which will be required before each session.]
.
His advice is that, at 0.04, is to defer the radiotherapy so as to defer the side effects.
.
His take on the chances of the cancer being at the prostate site, ie where it was, and not anywhere else, is 90% plus so my thinking is get the summer done and go for it mid September so as not to have too many dark nights/mornings driving.

The one downside is that the appointment times may not be the same time every day so thats a bit of a drag from a work perspective.
.
For those of you over 50 and reading this, when is YOUR next PSA test?

Just remember, back in 2014, the test at least extended my life.

Water John

I think each session is quite short, just interrupts your day. Might do with someone to drive you there and back.

Calahonda52

Water John wrote: »

I think each session is quite short, just interrupts your day. Might do with someone to drive you there and back.

.
The pre session prep takes about 45 minutes to an hour so need to be on site 60 mins before hand, the zap I believe is one minute spread over 10 minutes as they move the raygun around through an arc.

Can self drive , no issue there