That walnut sized organ: the Prostate

Trondheim

https://www.boards.ie/discussion/comment/120713591#Comment_120713591

Where do you get the full rigorous DRE? That doesn't sound like something my gp would do!

Calahonda52

https://www.boards.ie/discussion/comment/121127983#Comment_121127983

The consultant I went to see once the second PSA test was high.

He could feel the lump on the gland

Good luck!

Trondheim

https://www.boards.ie/discussion/comment/121129475#Comment_121129475

Thanks. So the DRE only comes after a high PSA test?

So in terms of precautionary testing, it is PSA test and if that is fine, no further action?

Calahonda52

https://www.boards.ie/discussion/comment/121132479#Comment_121132479

Not necessarily, the PSA is not fool proof but generally a good indicator.

[I have a friend whose PSA is 12 for years but there is nothing to concern him.]

A DRE by someone who knows what they are about is one approach, an MRI is another.

A lot depends on your GP, I moved from my one as discussed way back in the thread as he was against the PSA test: If I had not got it done I would be long dead so you really need to take charge here, its your life/health and no point in being that statistic where X$ of PSA yes give a false negative.

As noted earlier, two things to watch, the absolute number and the rate of change over time.

If you have any concerns get the DRE done by a consultant

Keep well

AndrewJRenko

GP should generally be doing DRE from age fifty.

My union organised DRE checks as part of a medical for members also.

Hotblack Desiato

..

Calahonda52

More for the ignore list, if you cannot be bothered to make useful contributions to this thread which was set up nearly 8 years ago to be a contribution to other members, then stick with what you know best.

PMBC

the first time, about 6 years ago, I aked about Prostate, my GP did a DRE. Every year since Ive had th same followed by bloods including the PSA. So fat all good at 71.

Gael23

Had a DRE yesterday. Didn’t expect his finger to so far in

Calahonda52

https://www.boards.ie/discussion/comment/121231556#Comment_121231556

Well if you thought it would save your life

I could hear you hum a few lines from A whiter shade of pale

I was feeling kinda seasick

But the crowd called out for more

The room was humming harder

As the ceiling flew away

Bob_Average

Hello all, joining this conversation as I have found myself going through the same process (albeit different treatment pathway) as the OP, and want to share my own journey, as well as back up OPs message re testing.

I'm a reasonably long-term member (occasional poster) to Boards under another name, but have decided to re-reg for this, so I be more frank if needed.

My journey so far:

GP picked up an elevated (4.5) PSA on a routine blood test in April 2023. Said not to worry, probably a fluke, would retest in six weeks time using the same lab.

The retest in early June came back with a higher score - 5.1 - and it was at that point that I started to be concerned. Was referred to Rapid Access Clinic at The Mater. That appointment was in July, and consultant did the DRE and said he wasn't happy with what he could feel - hardness on one side. He referred me for MRI scan.

MRI scan in August showed a mass of some sort, and I was referred for biopsy (October). (the biopsy process itself is something I may discuss in a later comment).

So a couple of weeks later, I got the result - cancerous, intermediate, Gleason Score of 7 (4+3).

Consultant spoke about the treatment options, and based on my particular circumstances (smaller size of cancer, and large body size) he tended towards radiotherapy rather than surgery. I have an appointment with an Oncology Radioligist later in November at which point a final treatment plan will be decided.

In the meantime I'm awaiting results of bone scan (to confirm no spread - they are very optimistic about this).

I might add that I was entirely symptom free - had this not been caught on a routine blood scan, it would be growing away happily and I would be none the wiser until it was more advanced.

So I would echo the call to get tested, and ask for the results.

I'll update here as I go through the treatment, or answer questions if it is helpful to anyone.

Bob

Calahonda52

Good post, thank you.

I was at 8

Have you access to the keyhole surgery option?

I have written about it somewhere early on but am happy to discuss off line if you wish.

In any event good luck with it

Alkers

https://www.boards.ie/discussion/comment/121320191#Comment_121320191

Can I ask how old you are?

Is the PSA typically done on routine blood tests?

Must check if it's included on my work testing

Calahonda52

https://www.boards.ie/discussion/comment/121327369#Comment_121327369

1: Recommended you start at 50

2: By far sighted doctors yes, not by T rex's

3: doubt it

Heighway61

Has anyone any experience of hormone therapy? It's my only option when the time comes. I'm not suitable for radiotherapy or chemotherapy.

Bob_Average

https://www.boards.ie/discussion/comment/121321355#Comment_121321355

In my particular case, they are not advising surgery - due to my specific circumstances they feel that I would have very little chance of regaining bladder function. I have yet to see the radiotherapy consultant to have this finalised though - due by end of month.

Bob

Bob_Average

https://www.boards.ie/discussion/comment/121327369#Comment_121327369

Sorry, I meant to include that in my post.

I am 59.

Bob

Justjens

Been meaning to add my experience....

Started with a raised PSA 5.4 just over two years ago when I too was 59.

Urologist did DRE in October '21 and recommended an MRI which I had done in Jan '22 after referral letter got lost...

Sent for a biopsy in Waterford shortly after, right side was riddled left ony half

'You have cancer' was the diagnosis in May '22

Referred to Radiologist Oncologist in Mater Private UHL in May

Another DRE and his opinion was you have agressive Gleason 9 prostate cancer, didn't hear much after that

Scheduled for CT of abdomen, and a deep bone X Ray, most anxious time, both can back clear.

Decision was made to treat it in situ, PSA now 11.5 (June 22)

Mid July started slow release hormone treatment, injection under the skin in your belly fat, didn't have much then, expect to add weight I have

Not pleasant, hard lump for a number of weeks and sore for a numer of months. The sweats are/were a right bo!!ix, thank god radiation oncologist put me on a wonderful drug 😊

Scheduled for Spaceor Hydroel in September as a day case, they put a disolvable gel between your prostate and bowel to protect the latter from radiation. That didn't go well and needed a colonoscopy, that took another six weeks, came back clear.

Early December I was in Mater for HDR brachytherapy and insertion of gold markers, no gel.

Mid December I was called in for CT to sight in my prostate using the gold markers they inserted in Dublin Mater and then I got my first tattoos, three dots to aide them lining me up for my daily treatment of external beam radiation

Christmas I was pretty wrecked, HDR was taking affect

First workday in January of this year I was back in Mater private radiation clinic UHL to start my external beam radiaation

25 sessions on a daily basis with weekends off

That discipline was very hard and there were serious moments of doubt, lost my rag a few times. Drinking water, full bladder at time of treatment, some ran late a few times, not fun. Bowels are to be empty, even less fun.

I'm self employed (farming) so kept working through it all, think that's what kept me going

Mid January had second slow release hormone injection, same side as my doctor is left handed, and this one was sore or nearly six months

Finished external beam first week of Feb, radiation oncologist said come back in six months and we'll review bloods, I was out of there

The urgency with bowel movements and the diarrhoea were a bloody curse, the urgency is still there now but getting better

I had been in A Fib throughout all of this and now couldn't function, had a double cardio ablation in April which seems to have cured it

Mid July third hormone injection, got it in the other side and has not been any bother

Back in for consultation with radiation oncologist end of August, PSA now 0.03, I'm in remission, it's undetectable.

I was then referred to a medical oncology for review, early October, and was told because my type of cancer was particularly agressive it can grow undetected and feed off other parts of the body, not just the prostate. I was put on more hormones (tablet the size of a supository) and streoids to combat any side affects, there are too feck!ng many to list. Have since been back to my cardiologist for a change in medication

Now it's fortnightly blood tests and visits to the clinic for two months to monitor side affects, 5 weeks in so far so good. Then I'm in monthly for the remainder of the two year treatment.

Haven't had to use a bag or pad so far, if I get anxious or rushed I need to pee even if I've only just gone, working outside has it's advantages 😉 Majority of the time it's pain free but sometimes it's very slow and painful.

I do manage most nights without getting up, that's usually based on what I've eaten. Gave up Barry's tea for breakfast and now drink Rooibosch which is caffine free, try to avoid tea as much as possible during the day

My sex life is now non existant, radiation did damage but the hormones have decimated me, everything has shrunk 😥, there are treatments to change this but none have worked so far and I'm not giving up.........

I am very lucky to have a wonderful woman beside me that keeps me motivated and positive

Calahonda52

JJ, Thanks for posting and the insights on the sessions: I am looking at 35.

For the benefit of others, Just wonder when you started the PSA tests?

Re the cuir insteach gone awol, to misquote Spock

" It's sex, Jim, but not as we know it"

For me

I am very lucky to have a wonderful woman beside me that

has given me some of the best sex ever, despite nothing to hang the soap on since the surgery

Good luck with the rest of your journey and remember:

Every day you feel the rain wind or sun on your face is a GREAT day.

Justjens

https://www.boards.ie/discussion/comment/121387347#Comment_121387347

Started PSA testing when I hit 50, doctor flagged it in 2020 when it hit 2.5, doubled then in six months so he referred me to urologist.

Prostate was pretty well riddled with it, no symptons, and luckily it was contained.

Lost one uncle in mid 80's to it. Father's brother died of 'stomach cancer' in the early 70's, how would you explain prostate to a 10 year old...

Justjens

https://www.boards.ie/discussion/comment/121387347#Comment_121387347

Pumps do work, my cousin uses one, unfortunately for me the hormones have my switch turned off. The pump does work for me but whatever size ring I use I don't stay hard

Heighway61

https://www.boards.ie/discussion/comment/121388890#Comment_121388890

"hormones have my switch turned off", an invisible but maybe biggest change. Can be difficult for the partner to understand.

Cpxxc

After I ignored my my Doctor's advice for years about the PSA thing. I finally surrendered and got the digital test. It went well I thought and the Urologist was a woman. I was embarrassed for her.

But I was sent for an MRI. That's a weird experience.

All this time I'm thinking this is fun. I've no symptoms. It's a sensible precaution.

Then they wanted a biopsy.

Just before the Doctor performed the very unpleasant deed. I made the mistake of asking him why it was necessary after an MRI. He was frank and told me that the MRI was 93% accurate.

I scored a 4. Likely I have cancer. I flushed but said nothing.

I went home in shock.

Because of the glacial slowness of the public system my final fate won't be exposed until early December.

So I've a lot of time to worry.

Heighway61

The public system, tell me about it. It was over a year between my doctor being concerned and making the referral, to the prostatectomy. I'm pretty sure the cancer progressed at least one stage in that time. RAPC?

I was never told straight out that I had cancer. I realised when the surgeon began a sentence with "Your cancer...". Didn't receive a Gleason score, he never spoke the words to me.

I hadn't a clue what questions to ask. My wife asked most. Nobody ever sat down with me and said "this is what your cancer means for you...".

Cpxxc

https://www.boards.ie/discussion/comment/121418964#Comment_121418964

Yes

Calahonda52

https://www.boards.ie/discussion/comment/121418856#Comment_121418856

Sorry to read this.

Worry won't help, its actually very counter-productive

1: Eat well

2: Sleep well ( ideally unaided: but aided if needed)

3: Exercise well: nothing mad, just get out and feel the rain on your face

4: Only communicate with people who have a positive influence on your thoughts.

[This includes radio and TV and social media]

5: Be a positive contribution, in however small a way, every day: family, work, neighbours, community, what ever.

Give this some thought:

Unlike the Lotto ad: This IS YOU, even though you probably never saw it this way.

“This is the true joy in life, the being used for a purpose recognized by yourself as a mighty one; the being thoroughly worn out before you are thrown on the scrap heap; the being a force of Nature instead of a feverish selfish little clod of ailments and grievances complaining that the world will not devote itself to making you happy.

*

I am of the opinion that my life belongs to the community, and as long as I live, it is my privilege to do for it whatever I can. 

*

I want to be thoroughly used up when I die, for the harder I work, the more I live. Life is no ‘brief candle’ to me. It is a sort of splendid torch which I have got hold of for a moment, and I want to make it burn as brightly as possible before handing it on to the future generations.”

 George Bernard Shaw


Bob_Average

Hi All,

Quick update.

I have seen the radiotherapy consultant (Beaumont) and will be starting Hormone therapy next week, and radiotherapy in early Jan.

PSA now 7.2

In good news, my bone and other scans came back clear.

I am continuing to tell every man I know of my age or a bit younger to get tested. Spoke to a former work colleague yesterday, he is 60. Asked if he has been tested, he said no, his doctor (and his wife) have been urging him to get tested for three years now, but he'd rather not, as he's afraid of what he might hear . .

I'll check in here once I've started the treatment.

Can I just say to Calahonda, and everyone else here, thanks for all your posts, they are both a source of information and support (as well as scaring me silly sometimes!).

Bob

Justjens

https://www.boards.ie/discussion/comment/121456964#Comment_121456964

Bob,

Good luck with what they throw at you, hormones can be tough at first til your body gets used to them, found the flushes hard to live with but there is a drug the consultant can perscribe, ask for the 100mg as it's the only one on the drug payment scheme, i'm taking half a day.

Radiation, depending on how many sessions, will fly, get into a routine of drinking a lot of water at the correct time. one man I met regularly said to me: 'I've drunk a lot of Guinness in my time but I never thought I'd drink this much water!'

And most of all keep postitive, I don't have cancer....

Bob_Average

Thanks to JustJens and Calahonda for your continued advice.

I'm a while on the hormones, and just about to start the radiotherapy, so possibly a good time for an update.

I started the hormone therapy (the high dose pill) in early December. Longer term side-effects are the obvious (and intended) one around libido etc. I'm also finding that I don't have as much energy as previously - tend to get tired in late afternoon/evening. But nothing I can't live with.

I had some short terms side-effects, between about days 3 to 7 on the pills. Some mild hot flushes (quickly went away and haven't returned) and severe muscle cramps which could be anywhere - legs, neck, arms, lower torso, chest etc. They were probably the worst - made travelling difficult. Easier on the bus than driving, as at least you can shift position and move around. Thankfully after peaking in day 4/5 they ebbed away and were gone after day 7.

Then I got the slow release shot. Side-effects from this were decreased appetite for a while, and the same tiredness as the pills. But again, nothing that I can't handle.

I think, compared to other accounts I have read, both here and elsewhere, I have been extremely lucky so far.

We'll see how I get on heading into the treatment itself.

Thanks again to everyone

Bob

Calahonda52

Good luck Bob,

Was chatting with a friend at weekend who is facing 6 moths of chemo, I was reminded of the 5 commandments i got after I nearly check out with the septicaemia

Eat well

Exercise well

Sleep well ( unaided) if needed up the exercise

Be a positive contribution every day: family/work/friends , community, whatever

Only talk to people who are a positive contribution to you, control social media/news feeds / TV and radio along the same line.

Even when you feel down/crap/ etc, if you still feel the rain on your face you are ALIVE😀