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Posted 4/17/2008 12:31 PM (GMT 0)
Selmer's comment......"Now you've got me second guessing my own situation. You see, the first time I ever had a DRE was about 15 months ago. It was not done by a urologist nor a primary care doctor. It was actually done during a sigmoidoscopy which was conducted by a nurse practioner... IN my HMO, Kaiser, they have everyone over 50 get a sigmoidoscopy and doing so many they make use of nurse practioners. They do sigmoidoscopies all day long, and probably get more competent than a normal doctor who has many other duties.
Anyway, on all males the nurse practioner does a DRE along with the sigmoidoscopy, since they have you on a table all in position and all pre-cleaned out with that stuff you drink.
I suppose it wouldn't hurt me to have a urologist do a DRE on me? The NP told me mine was a bit enlarged but otherwise normal."


It's about time someone got you thinking of taking a proactive path Selmer. NO idet in the world will prevent cancer. If a person is going to have it, he/she is going to have it...hint, hint, as in the genitic factor. The only real proactive thing to do is to rule out cancer so one can move forward.

Swim
Posted 4/18/2008 3:18 AM (GMT 0)
Diets a great. I really advocate a good healthy diet for overall, general well being. I'm a bit of a mulch muncher myself. In part because I personally, have never been a big meat fan. Partly because our daughter has significant heart disease. I feed em bark and twigs as Paul puts it. Our diet is more muscle / heart smart than anything.

Being pro-active is more than just a diet. It's more than reading a book and it's more than a workout. It's knowing when to listen to one's body and when to take active action on things while control/cure is most likely. Yes, diet plays a huge role but diet isn't everything. I rather think a nice mixture of All the things that help keep us healthy is about the best we can do. If that means an ice cream sundae once in a while for those who get a lift from something sweet....I say enjoy! Life is too short.
Posted 4/18/2008 11:58 AM (GMT 0)
Selmer, I'd say you've got the diet thing down cold. I didn't get involved to that degree, and most of it was directed toward keeping my heart healthy and weight and blood pressure down. My blood pressure is still low, I weigh 169 lbs and I still eat very little meat, and red meat only rarely. I just got in the habit of hating grease and cleaning up grease, so I don't fry. I do binge on some fried stuff now and then, it's hard to avoid and tastes so good. You should see what these country people eat up here. First, they eat three times a day, rather than twice that I prefer, or simply grazing throughout the day. They eat meat and eggs at breakfast, meat and veggies at lunch and meat and veggies at dinner. Needless to say, there are some big, big people around here. I've seen trim local high school girls get married and suddenly blow up like ballons. It's really amazing.

Anyway, I applaud your efforts to beat the disease. I've sort of felt doomed given my father's death from pc, but also thankful I am forewarned. But then, I'm not overly concerned about a long life. I've seen pretty much what the soap-opera of life is all about, and have no desire to suffer indefinitely for any reason, so I'm strictly on the pragmatic side. Curious that Oregon is the only state that cares about a more pleasant death for their citizens. I've seen people vegetating in nursing homes, and I choose not to be one of them, if at all within my power.

Whatever works is my thought. Seeing an article on the BBC yesterday that vitamins may not be of any value regarding longevity is a tremendous blow to science, not to mention the pill industry, and gives us all the cause to pause.
Posted 4/18/2008 12:13 PM (GMT 0)
Heyyyyyyy....watch that Corynski....yer talkin to a born and bred TN. Volunteer here :>) Most of my family still lives in west TN. We visit east TN twice a year...Maryville.

Nothin like a good ole family reunion to remind me of just why I don't eat southern. Mmmmmmm, a good bisquit IS heaven on earth sometimes though!
Posted 4/18/2008 4:44 PM (GMT 0)
Truth is I could say the same about alot of places. Some folks just eat like there was a famine scheduled for tomorrow. I'll blame it on my mother, as I remember growing up listening to her fear of putting on weight. And I'm stuck with no appetite at all, due to the tramadol and/or mirapex I'm taking.
Posted 4/19/2008 12:25 AM (GMT 0)

Aww Selmer, you're just very famous.

yeah
Posted 4/21/2008 9:36 PM (GMT 0)
Hello Selmer

Thunk! The other shoe falls. This PSA came in at 8.8 so I guess I'll schedule the biopsy. I feel alot better about it now that I've done some reading and gotten over the initial shock of it all. Something must be going on I figure.
Posted 4/21/2008 10:29 PM (GMT 0)
I raised a flag on the view counter of this thread to our Admin. He's seen it before and isn't sure why. It's not in the software but it could be a spyware or a malware on someones PC. That stated this appears to not be malicous and the counter should be disregarded. I was tempted to move the entire posts to a new thread, and still might, but we'll leave it to Peter to come up with something for now.

LOL or corynski has just started the million PCa man march...oh boy, back to the day job...

Tony
Posted 4/23/2008 2:15 PM (GMT 0)
Fat's in the fire..... Appointment for biopsy is the 6th of May, and I'll find out a little more of the puzzle. I'll get my signature up here today.
Posted 4/29/2008 11:22 PM (GMT 0)
Quick question:

How long following a regular 12 core biopsy do I need to wait before driving? I live about 40 miles from the urologist's office. An option is, I could have a friend drive me to their house for the night and go home the next day.
Posted 4/30/2008 2:22 AM (GMT 0)
Corynski,

You should be good to drive whenever you want. Good luck to you next week.

Swim
Posted 4/30/2008 3:07 AM (GMT 0)

Cornynski,

Best of luck with your biopsy.  As Swim said, you should be able to drive anywhere you wish after the biopsy.

My urologist made me wait 15 minutes to make sure I was okay, then released me.  You WILL have blood in your urine and ejaculate for some time....so do not let that startle you.

Here is hoping for a clean bill of health from the biopsy...but either way, please update us when you can.

DanMan

Posted 4/30/2008 12:33 PM (GMT 0)
Thanks so much,

I'm getting a little nervous, but reading and knowing what to expect sure helps. It's hard to imagine having the 90 core 3-D biopsy I read about yesterday, but whatever it takes I think.

I'm amazed there are so many men being diagnosed so young, but it's great that they can catch it so early. Lots of reasons for optimism regarding the treatment procedures too.

I'll update following the biopsy Tuesday.
Posted 5/7/2008 2:00 AM (GMT 0)
What luck, the biopsy was a piece of cake. No problems, and I was amazed at how little I felt. The two needle pricks for the lidocaine or whatever I barely felt, and the first two snips I felt a bit, then I hardly even noticed the rest. I had alot of anxiety over nothing, and it was finished in about 10 minutes.

So anyone who is up for their first biopsy, don't worry a bit about it. I was groggy from the 20 mg valium and the endocet, but after a four hour break I drove the 50 miles up the mountain and I feel like I haven't had a thing done to me.

Now the few days wait for some results. Thanks to all for the support, it really helped.

charley
Posted 5/7/2008 2:31 AM (GMT 0)

The lidocaine is the key.  After that, the noise was a little shocking at first (I still say it is similar to the sound of a nail gun slamming into a wall), but the discomfort was minimal.

Here is hoping for a good biopsy result, Charley!!!

DanMan
p.s. - Don't let the bloody urine and semen scare you....perfectly normal.  I ejaculated the night of the biopsy and it was a bloody mess.  I was just curious to see just how bloody it was....yikes!!!!


Posted 5/7/2008 4:56 AM (GMT 0)
Even the gun was less than I expected. After the first two samples, it seemed hardly noticeable. Some of the samples felt different than the others, as if they were tougher tissue. I'm really curious now to see the results. Seems he told me to relax and not jump when he sampled so I just went with it and the last 6 went quickly with little discomfort.

That's the key. It's not pain really, simply discomfort.
Posted 5/7/2008 5:16 AM (GMT 0)
Good to hear from you about your relatively painless biopsy today.  My experience was very similar to yours.  Here's hoping for a negative result...Tim
Posted 5/16/2008 12:30 PM (GMT 0)
It's been 10 days since my biopsy and still no word. I'll call when they open. I have a mental image of a group of doctors standing there examining my samples, discussing the findings, etc... Or is it just a single technician who makes a determination.

Another quick question: When does my ejaculate stop looking like used motor oil? Very disconcerting, I feel like I'm festering and rotting inside.
Posted 5/22/2008 11:52 AM (GMT 0)
Amazing. My urologist waited the full two weeks following my biopsy to call and schedule a discussion. The discussion seemed perfunctory, and he briefly outlined my results and the possible treatments, and took some questions from me. The puzzling thing was that the biopsy report says the sample was collected 5/6, received on 5/8, and reported on 5/8. I called on 5/16 and the nurse said my results were in the doctor's 'in' box, and that he would look at them and call on Monday, 5/19. The doctor called the afternoon of 5/20.

Perhaps I'm being picky, but why would the doctor wait a week to call me. Extremely busy? Granted, it's a large office, and he's practiced there for 20 years, so to me it just seems like I was a very routine situation. What did bother me was that it seemed he had already decided what treatment he would choose for me, by suggesting radiation therapy before even mentioning any others, or solicting more information from me. Anyway, I had to get that off my chest. Anxiety I guess.

My results below indicate where I'm at, and the doctor said I had a variety of treatments I could choose from. I said I had been reading Dr. Walsh's book and would try to come up with a decision in a couple of weeks. Also amazing to me, is that the amount of information I'm getting from this forum and from the book are far and beyond anything the doctor has talked about. Maybe I'm just being over critical, or expecting too much. And my guess is the country needs more doctors. Dr. Walsh's book is about as comprehensive as I can imagine, and your personal experiences are extremely valuable, so it's decision-making time for me. Somehow, the incontinence issue will be the deciding factor I think.

My first question is regarding the comments section of the biopsy report. Why did the doctor not mention them? Are they not important?
Posted 5/22/2008 1:05 PM (GMT 0)
The comments section is just that most of the time the pathologist doesn’t list anything but if the three (most of the time) pathologist can’t agreed then a comments should be listed. My question to you is why didn’t you have a biopsy back in 2000 when you had a PSA doubling? Also, I would get a second option on those biopsy sides with LLM reading “There is focal perineural invasion” and a Gleason of only 3+3=6 doesn’t seem right to me
Posted 5/22/2008 2:06 PM (GMT 0)
Hello Jim
Truthfully I don't think I knew about the doubling concept at that time. And I think I was getting a yearly PSA test at the city where I worked, and not at a urologist's office. My guess is I figured it was still under 4, the magic number.

Let me get to my book to learn what perineural invasion is.

thanks
charley
Posted 5/24/2008 2:23 AM (GMT 0)
Hello Selmer

Thanks for the reply. Yes, I'm sort of in a daze but none of it is unexpected. This forum is of tremendous value, and having some knowledge always calms me.

Regarding the core samples, your comment that had they missed completely it would be worse is absolutely correct. I felt relieved that they found something actually. Mainly it seemed to confirm my PSA graph that something was growing inside me.

And you were right concerning the term invasion, it really set me off. The book definition didn't clear it up, then finally a nurse friend said she thought they were refering to nerves within the prostate gland, while I was thinking of the nerves outside the gland. The urologist remarked that he thought the cancer was contained, and this seemed like a very important fact that would help determine which treatment would be appropritate. He seemed to give equal weighting to the different treatments, saying only that he cryoablation had little history to rely on.

He didn't seem concerned about the prostititis and that's my first question for him. I didn't think I had symptoms for it, but then my body is changing rapidly lately and I always ache.

I got the percentages you mentioned on the second go around with my signature page. It did occur to me to send the report to my old urologist down in florida for a second opinion. Sometimes I lean towards the 'just get rid of it' solution. I can see how this decision will become mindboggling before it's over.

And your last statement summed it up alright: "I'm thinking that were I in your situation at your age, this set of events would be less about fear of shortened years, and more that you'd just rather not deal with all the trouble associated with the various choices." It's definitely about quality of life rather than quantity. Getting old is a ridiculous affair to be sure, and incontinency seems my biggest fear. This will be a tough decision for sure.

thanks again, charley
Posted 5/25/2008 3:11 AM (GMT 0)
Selmer, you said:

"In other words, it could well be that your true psa is only in the 5.5 to 7 range rather than the 8 to 10 range.
Now, as you know, I'm no doc but this difference in psa together with your Gleason scores could influence your thinking about treatment choices."

I've been thinking about this, and today I finally read Walsh's chapter six, Diagnosis and Staging, and he covers the subject well there. There are other factors that probably have affected my PSA, so it's hard to know. I did see from the insurance paperwork that Medicare doesn't cover the 2nd PSA test I requested, only after 6 months. Maybe that's why my primary doctor wasn't interested in doing it, he had to eat the cost. I need to research what Medicare pays and doesn't pay soon.

I am really on the borderline, being 70 in otherwise good health and T2a. The biopsy confirmed the urologist's original DRE of a firm left lobe. I realize I do have a prejudice against radiation, and am leaning towards the surgery, but I've still got half of Walsh's book left to read. He stresses that Pc is more aggressive in us old geezers. Same as I've recently read in some posts here. I know my father's cancer spread within a few years at my age.

Thanks for your help

charley
Posted 6/3/2008 4:40 AM (GMT 0)

charley,

are you familiar with 3d mapping biopsy.  If not read the ziggy9 thread.  He had what is called focal ablation, which is removal of only the part of the prostate that is cancerous.  This only works if you only have a small tumor.  But the good thing about this cryosurgery is that the biopsy seems to be much better and thorough then the ones normally given by the urologist.  Just thought that you might want to know that there are other forms of biopsies as well as surgery.  We do not hear to much about cryosurgery.  Thanks to ziggy9 and his thread,--it is now in the forum knowledge bank.

Siberian

Posted 6/4/2008 3:32 PM (GMT 0)
Thank you Siberian

Yes, I've been reviewing the cryosurgery as you are, and I'm reading Dr. Walsh's book where he mentions the 3D mapping procedure. He does mention that prostate cancer is a multi-focal cancer, and the average is 7 focal points in the prostate, according to pathology reports. I show 4 on my biopsy, so far, assuming there likely are more. He also mentions that the cancers grow towards the periphery. It's time to check with Medicare to see how much they'll pay for second and third opinions, and the more involved techniques.

I'm going for a second biopsy in another week, and I'll ask alot of questions to see what I'm treatment I'm elgible for. I like the idea of cryosurgery if possible. And possibly the seeds.

charley
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