First post from Christopher H

Hello Everyone,

I have been reading many posts over the past several days and this is my first time posting to the list. I am truly blown away by the huge burdens and challenges so many face but at the same time encouraged.

I am a biologist / molecular biology type who teaches and find myself wanting answers. Unfortunately, there are not many with this particular disease.

Not sure where to start.

In 2004 my brother was diagnosed with prostate CA. He was a construction worker who had had a surgery for a cervical herniated disk. His health began to deteriorate and he had horrible pain in his lower back and hips. Bone scans revealed tumors in lumbar vertebrae and ileum. His PSA was 622. I will never forget the day he called me and said: "Chris, they found out why I was in so much pain - i have prostate CA." He asked about the PSA. Knowing what I did, all I said was "that's not good." I thought he'd be gone in 6 months at age 49. That was January 2004; he died in August. It was a horrible journey for the family - and worse, obviously, for him.

My brother David had his out at age 56. He is doing well with no urinary or ED issues (or so he says). My sister had a stage III breast CA (and survives after 17 years) and now is affected by thrombosis, as was my mom, who initially dealt with polycythemia.

In 2006 I sought the assistance of a urologist at CA Center where I live.. PSA was low, genetics was not on my side. I have been on finasteride since then with regular PSA checks.

In 2010 my PSA went from 2.6 --> 3.4 --> 4.8 in 18 months. I have read and been told that one should double the PSA value when on this med (which blocks formation of 2 DHT). BTW, I was told the side effect was that it would grow hair. I am still waiting.... LOL.....Apparently it only works in my ears.... I have had no issues with libido or ED, but the watery ejaculate (preceded by the clumpy EJ) kind of stinks (though I can live with it).

In January I had a biopsy and the diagnosis was ASAP (Atypical small acinar proliferation). As I understand this, it is a hyperplasia / abnormality / pre-CA. No Gleason score. The biopsy was pretty yukky and I had bleeding issues. An April follow showed a drop in the PSA back to 3.5. In the interim, I was not happy with the Doc, the disgruntled staff and it just did not feel right.

October PSA (6 months) was a whopping 10.7 (or 21.4 on finasteride). At that point I went with my instincts and switched to Major University Medical Center Urology. I have well known doc who is the "best in the area and was recommended by an acquaintance. He has done 3500 robotic prostatectomies. I feel good about him and the entire staff.

However, I am worried about the tripling of the PSA in 6 months. I think of my brother and how aggressive it was (though I realize he likely had it for years.) Somehow, this does not feel right.....and I do not feel right.... I know many of you have dealt with much greater issues than mine (and I feel like a wuss).

Biopsy in 15 days. i am hoping the Gleason score will be favorable, but still I am worried.

I guess the question is: do PCAs become super aggressive / metastatic in such a short period of time? I feel a bit selfish asking this question as so many of you have been through a lot worse.

To quote the Walsh book: "Little gland, Big problem."

Thanks for listening,
Chris.

Hi Chris, sorry about your brother. It is no wonder that you are concerned about yourself with such family history. You are doing all the right things at this point it time. It is hard to tell just based on PSA what is going on. It such an unreliable number. My Dad had bone mets with a PSA of 7.5, and for someone else his age, that PSA would be normal. It is said that displasia preceeds PC, so I would keep a very close attention to your prostate. There is something called MRI-guided biopsy or Color-Doppler ultrasound guided biopsy, which is much more accurate at finding cancer, if it is there. All the best.

Welcome Chris and sorry you have a reason to seek us out. I am also sorry to read about your brother. Just the other day, I was discussing with another member via email, my surgeons continuing research. I would like to share with you, that the subject of finasteride came up. This is for your information only as I have no opinion on the subject.

"
Select
http://www.swog.org/Visitors/select/

PCPT (Finasteride)
http://www.swog.org/Visitors/pcpt/

These two trials were devastating to the notion that prostate cancer could be treated or prevented by holistic approaches or by finasteride. These approaches were touted by many big time book sellers like Myers, Scholz, Strum, Walsh. These trial proved these approaches were not true. In the SELECT Trial Vitamin E and Selenium were tested for their prevention capabilities. Not only were they proven to be ineffective, patients in the active arms of the trial were found to have a significantly higher prevalence of advanced and aggressive disease.

This is one of the reasons why I prefer evidence based approaches. There are similar studies under way for dutasteride similar to the PCPT trial. There seems to be a slowing of PSA rise and delay of disease onset but survival in these trials is no less so far than not using these drugs. In addition, it shows that there were higher incidence of more aggressive disease in the active arm of the PCPT trial.

These trials caused a lot of controversy as the doctors that believed that these agents worked questioned the trials on their merits. But it's tough to question Level one data with words and opinion alone. To date that's all that have been brought to the table. "

Again, I have no opinion. I just wanted to share so you could form your own opinion and I am sure there may be some other members on here that will share their opinion also. I also come from a family history of Cancer and I am sure you will be just a diligent as I, in beating this crap. Best wishes.

Thanks for your responses, which are welcoming and comforting.

Special Lady, from what I have read about prostatitis, that is no picnic either (nothing about this gland is a picnic - "little gland, big problem."

BTW, I read the new Walsh book that prostate gland is not present in carnivores (!) and that is is not essential for fertility. So much for "intelligent design." Perhaps it is the price we pay for our original sin.

Zufus: the path stuff and alternate markers seem interesting....like so much of the research based stuff, has it been translated to routine clinical applications. The AR was most interesting.

Startech: the finasteride seemed like a good idea at the time and maybe it has some effect, but likely very little, as does the Se and so on. Recent studies on all these vitamins (not only for PC but for CVD, etc.) reveal there is NO SOUND evidence to support their efficacy. We better off eating the FOODS and getting regular excercise

Intheshop: yes, have to wait for the next biopsy. Hope I don't bleed like the last one. The new urologist has smaller hands, LOL (yeah I know how it works).

This PC stuff lends it well to therapeutic humor (if I don't laugh I might cry)

Thanks, John. That is positive news and what I have been getting from my own research. With regard to the finasteride, that is pretty much what the URO said and we did establish a new baseline.

I can't believe you have had 12 biopsies..... by now there should be no prostate gland left!

Thanks again,
Chris