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Prostate Cancer, fear, and anxiety

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Posted 5/18/2011 3:36 PM (GMT 0)
This may be stupid question. I know you had radiation. But were you in fact diagnosed with PCA? I did,t see that in your post , inferred by radiation. Never heard of a GP ordering biopsy. Uro's do this. Cant see why any one would do a biopsy on a diagnosed patient, much less a radiated one,
No bad on you but this is why the forum should require a bare bones stat report at least by 2nd post. Save time and and frustration on both sender and receiver!

Know the question seems stupid, but after seeing some of the posts , I am not surprised by anything.
Posted 5/18/2011 3:40 PM (GMT 0)
I agree, never ever heard of a GP ordering a prostate biopsy. They would normally send you to a Uro for that. And based on your posts, it makes zero sense to have a biopsy done if you have been radiated. There must be more to your story, it would help if you would fill in the holes.

David in SC
Posted 5/18/2011 6:36 PM (GMT 0)
the original biopsy was read by Bostwick Labs.
Biopsy left mid anterior nodule - adenocarcinoma (Gleason 3+4) 10% Of the specimen (10% course contains cancer) gleason pattern comprises 50% of the cancer.
Biopsy left lat base adenocarcinoma (Gleason3+3) <1%

Dr. Bostwick reissued the report correct this score on the side to left mid anterior nodule from 4+3 equals 7, to 3+4 equals seven and a DNA Ploidy test was done

PSA scores
July 28, 2008–4.26
December 3, 2008–5.9
January 2, 2009–7.29
August 10, 2009–2.8 (Three months after final radiation treatment)
June 1, 2010–3.1
December 5, 2010–6.0
March 24, 2011–6.08
May 10, 2011–6.92
radiation treatments were 25 sessions of Tomo radiation and 2 internal HDR treatments two weeks apart with 19 entry points each time.

The reason my GP ordered the biopsy was to save me from having to go to see my urologist and pay him another huge amount of money. Since my post this morning my urologist has canceled my appointment this afternoon and my oncologist has canceled my appointment for Friday and they are in the process of writing up a whole new series of tests to include bone scan, CAT scan and what else I'm not sure yet so I don't know what other information to give you.

Post Edited (hlc1948) : 5/18/2011 12:40:44 PM (GMT-6)

Posted 5/18/2011 11:55 PM (GMT 0)
Hlc, I find it hard to fathom that not one of your doctors has mentioned HT or at least I did not note that in your posts. Most urologist jump on this because they can make a wad of money. My HT was around $2000 per dose once every four months. I was getting a decent discount on this. Lupron Depot only.

As for the "attitude" let it slide by. You need information and these folks have it or at least some do. May be time to shop around for a medical oncologist and drop the other two.


Don
Posted 5/19/2011 12:08 AM (GMT 0)
So far no HT mentioned.

In December I had a FISH exam with no cancer cells found and a Xray that was clear and a Cat scan that was clear.

There is some thought that there might still be an irritation of some sort that is causing the PSA to rise. Even after antibiotics and anti-inflammatory drugs. One person, who was speaking out of line and who should have never mentioned it said that she felt that some cells may have escaped and were hiding elsewhere in the body so the radiation would not have affected those but I don't know how much credence to put in that statement since she was not a doctor or even familiar with my case.

In defense of my GP, he has courage, hutzpah, cajones and not afraid to stand up to what he feels is right and needed. He is about the only doctor I trust with anything/everything. The others leave me with to many questions and doubts, the GP does not. He isn't afraid to get on the phone and raise a bit of a ruckus if he feels it is needed.

Post Edited (hlc1948) : 5/18/2011 6:12:51 PM (GMT-6)

Posted 5/19/2011 12:57 AM (GMT 0)
Did anyone explain to you the benefit of a biopsy for a radiated prostate ? I hear everything you say about your GP and that is fantastic for his area of expertise. I can only say this about my GP, I know I know more about PCA than he does, from the questions he asks me about my case, since this all began. He is learning from me. there are many on this site that will say the same thing or think it , IMO. when I returned here after retiring 6 years ago He did a dre, normal, then wanted to do a psa test, no, no #1. I had never had a psa test, cause I bought all the stuff about the controversy of it and of course thought I was immune to anything due to my fitness level. I explained that to him, the psa controversy part anyway. He was fine with that. But after that he never did another DRE, final line of defense now, mind you, and I never asked, shoulda, coulda, dint, my bad, but.......... I only found out about the cancer, cause my cardioologist would put it on his blood workup, I would erase it, this happened 1 more cycle. On the 3rd cycle, out of deference to him I did not erase, rest is history. Suffice it to say, he,s right up there for sainthood, with my wife and surgeon. I am still with GP cause I like him, but do watch him. Find out benefit for biopsy.
Posted 5/19/2011 1:11 AM (GMT 0)
The GP wrote the biopsy order because the urologist had it listed as a future order after my next PSA test results (if elevated). The GP wrote the order in an effort to avoid me having to visit the Urologist to have the order written and pay for an unnecessary office visit. It was not a willy nilly decision, but, in fact based on the report from the urologist. None of that matters now since the urologist and oncologist are rewriting all the orders and setting up other tests.
Posted 5/19/2011 5:11 AM (GMT 0)
why are we doing a biopsy on a diagnosed and radiated prostate should be the 1st question.
Posted 5/19/2011 12:29 PM (GMT 0)
That question and test seem to be going away. It didn't take much research to find that there are forms of prostate cancer that are radiation tolerant/resistant and may require a second biopsy.

Again, in my case, the biopsy appears to be going away, they are setting up other tests and should be announced in the next day or so. Again, at the moment, the biopsy seems to be going away.

I am also beginning to read that there is not just on prostate cancer but in fact variations.
Posted 6/10/2011 10:20 PM (GMT 0)
Just an update.

Last week was a bit insane.
Lots of tests and prodding and probbing and such.

The results are good

So far
CT good. have hiatal hernia, arthritis in my feet
Bone Scan is clean.
Biopsy showed atypical cell structure but no signs of cancerous tissue.

Only roadblock now is the PSA number. Still high, so, they are going to watch it and get it tested in three months and six months with an office visit after 6 months.

Finidng my doctor is a conservative and cautious one. Fine by me. He was trained and taught at the Mayo Clinic and is highly respected. I have to have faith in someone....he is as good as any.

Working up a semi-log scale following the prostate numbers as they come along. Will follow that for a while and see what that means.
Posted 6/11/2011 1:05 AM (GMT 0)
Thanks for the update and sorta good news. At least they haven't found any really negative stuff yet. Wishing you continued good news and to finding a manageable reason for the high PSA
Posted 6/11/2011 1:14 AM (GMT 0)
I think it rather good news. The PSA is not doubling in a two year span according to the guy who did my semi log chart so that is good. There is still the probability that it could be a PSA jump or bounce.

I have come to the conclusion that when you have prostate cancer it becomes a friend for life, no matter what you want from it. The friend you can't get rid of it seems.

This week has been an emotional roller coaster as I am sure many of you can understand.
Posted 6/22/2011 11:35 AM (GMT 0)
The test results are in and they could find no cancer tissue anywhere. There is now a theory that it may be a benign psa and should drop on the next test. Apparently the second biopsy can trigger the reaction that drops the PSA score. I hope they are right. This is starting to haunt me.
Posted 6/22/2011 1:10 PM (GMT 0)
I am very sorry to hear about your loss of insurance, but all is not lost, you just have to know how to play the game and use the system.  One option is tell the hospital you are an illegal immigrant.  Sounds rediculus , but it will work.  If you walk into a hospital with a problem, by law they can not turn you away.  When they ask for ID or billing information, you give them some foriegn sounding name, and your regular address, and you tell them you are undocumented.  By law, they can not  ask you any more questions, and they can not deny you services.  If they ask you why your english is so perfect, just tell them your parents brought here as a kid.   Matter of fact, in NY where I live,  illegal immigrants get preferential status and get more percs and services than regular citizens.  .   In this country, especially in liberal states like NY and Ca, illegals are the previledged class and they have more rights than US citizens.   
Posted 8/20/2011 9:45 AM (GMT 0)
Finally some good news.

8 weeks after the most recent biopsy, the PSA went from 6.93 to 1.2.
Posted 3/8/2012 11:54 AM (GMT 0)
Coming up on a year since the second biopsy and the PSA is slowly dropping. Now .98.

Urologist seems to be fairly pleased. GP is pleased. All seems to be falling in place. GP says this is as good as it is going to get. So, from here on just trying to enjoy each day
Posted 6/4/2012 1:55 AM (GMT 0)
After the biopsy the PSA fell dramatically. Last few tests have all been within normal and toward the lower end of the scale.

Things have been going along fairly well, but far from where I want it to be.

Having pain on urination still. ED is a major issue. Still a great deal of pain involved. Urologist feels it is going to be that way from here on in.

Found that I have become rather emotional about almost everything and anything. Depends on the day.

On a 1500 calorie diet and gaining weight. Walking 2+ miles a day in 33 to 34 minutes.

Not one of my doctors has really been truthful with me to this point. I hear way to much "well, that is to be expected" or "that is normal" only after I have a complaint. Never warned beforehand. That makes me crazy or crazier.
Posted 11/30/2012 2:19 AM (GMT 0)
Quick update

PSA in May was 1.19 still within reason.

PSA in Nov was 17, not within specs

Have urology appointment next week.
Posted 11/30/2012 12:30 PM (GMT 0)
Have you ever taken an antibiotic (cipro) for a month to see if that will bring your PSA down ?? Sometimes there is a low grade infection or inflamation that can elevate the PSA .
Posted 11/30/2012 1:03 PM (GMT 0)
Did that treatment over 3 years ago. Hoping when I see the urologist this will be the first treatment.
Posted 11/30/2012 1:19 PM (GMT 0)
Hic 1948
I am sorry to hear about your problem with the insurance company .
I just think you and other who are having the issure with them should
find away to go public . because it is wrong for them to treat you and other that way.
Maybe, we all should write DR Phil and see if he would do a show about the way the insurance company are treating people.

i pray that things will get better for you. takecare and good luck to you
Posted 11/30/2012 5:30 PM (GMT 0)
I saw your earlier post about being self-employed, and as a fellow independent, I definitely understand the insurance challenges. Is self-employed the only option (I dk your field, where you're located etc.)?

I much prefer remaining self-employed; especially after my husband's diagnosis, I think it'll help me be able to do what I need to to take care of him, and to be around for my grade school age kids, who are going to go through a lot in the coming years (in my field, corporate jobs mean tons of travel; as a self-employed person, I'm able to cut that down). Our diagnosis is new enough that we haven't had to renew our policy so it remains to be seen what they'll do to our rates. So as much as I hate the idea, I know there's a good chance I will have to find a big company with medical benefits. If that's an option for you, it is probably worth thinking about sooner than later.
Posted 12/1/2012 3:29 AM (GMT 0)
Got a letter today from the medicl center that they have been unable to reach me, that my doctor has scheduled a test and I need to come in ASAP to get the paperwork done. The office was closed today so I can't find out what test until Monday at the earliest.

Doctor didn't even have me come to the office. He just placed the order.I wonder what this is all about.
Posted 12/12/2012 10:43 AM (GMT 0)
Well, a bit of a flurry here. Doc ordered a second PSA test (I had one just two weeks before), it came back at 18.31. Last Friday had a nuclear bone scan. I had the weekend from hell. Finally called the urologists office on Tuesday morning and they still hadn't gotten the report. so went to the hospital records and got two copies of the report and hand delivered it to the doctors office. They made an appointment for the 20th, 9 days away. I could see the holidays coming and nothing being done until after the new year. So called my doctors nurse and left her a message that if there was a cancelation I would be able to come in at the drop of a hat. I also stated that my anxiety level was rising, I didn't feel I had enough information or idea of what was going on and where this was all heading. Got a call back 20 minutes later and they have me seeing the doctor today after 3:00 PM. My GP has been checking on me via phone to be sure I am following up on things. Highly irregular but most appreciated.

I also have come to the realization that I have no proof that the cancer is back. I have had a bone scan and the psa tests which means the antigen is increasing. The likelihood of cancer is there but in reality there has been no test to prove it.
Posted 12/13/2012 12:59 PM (GMT 0)
So, met with doctor yesterday and went over the bone scan results, he was most pleased by the report. We had a chat about communications as well. We both agreed to try and be better about it.

He consulted with another doctor and the thought is that it might be an irritation or infection and they started with a regimen of antibiotics and nsaids for a month. Then another psa test and office visit. The current thought is that the psa rose to high to fast for it to be a return of the cancer, especially with a clean bone scan. I'll take that option for now. At least it gives me some hope.
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