Prostate cancer after Thyroid cancer

Anyone have experience or comments on developing prostate cancer after being treated for thyroid cancer?  That's my situation & I'm a bit freaked out right now. 

The thyroid cancer was papillary (which is the least aggressive) but it was a 2.8 cm tumor, so it was T2, and there was a positive margin.  It was surgically removed in January, 2012, and I had radio-iodine therapy (a form of radiation) in March 2012.  A whole body scan last fall showed no sign of any remaining thyroid tissue.  So that cancer seems to be under control.

Then in June of 2013 my PSA jumped to 4.2.  A year before it was .8.  I have a very significant family history of prostate cancer (my dad died of it in 2006, and 3 out of 4 surviving uncles all have it), so a biopsy was performed on June 15.  I had only one positive core, a Gleason 6, and it was only 1% of the sample, and two other cores were ASAP (suspicious).  My prostate volume was reported at 22cc, which I understand is really small.  I've been taking Rapaflo and Proscar for about a year and a half, which might account for the small size.

I generally would be considered very low risk, but given the family history, and the prior cancer, I'm concerned.  Active Surveillance might be appropriate for a little while, but it seems inevitable that I'll need to move on to treatment at some point.  I'm 63 years old and generally in good health.  I'm not at all anxious to have radiation.  I just don't want to cause any more cancers.  So there's surgery.  I appear to be a good candidate, but it seems a bit crazy to consider surgery with my low numbers.  Any thoughts or suggestions?

I was diagnosed for thyroid cancer (turned out to be mixed papillary and follicular), which led to surgical removal in 1973, followed by I-131 ablation. No recurrence.

I have no family history of either thyroid or prostate cancer. On the prostate side, a biopsy last month indicated Ca in 5 of 12 samples (2 at 80%, other 3 at <5%). Presently considering treatment options: most likely I'll pick robotic surgery.

Your prostate Ca numbers are really low. I wish I had them. The urologists I've seen both think that my thyroid and prostate cancers are unrelated.

2nd C,
Why do you assume that you will eventually have to be treated? With your stats less than 30% actually progress. The Proscar should also help in stabilizing the prostate cancer (see "Invasion of the Prostate Snatchers" addendum on Proscar and Advovart).
There has also been no survival benefit associated with treatment of low risk PC for those over 65, and you are pretty close to that age with "very" low risk stats.
You should also be a good candidate for focal therapy if needed.

I am in the process of getting a second opinion on the biopsy slides. I'm planning to have them sent to Dr. Epstein at Johns Hopkins. It looks like that will only cost $250. I plan to also get another PSA test done once my prostate settles down from the biopsy. I'm not sure of the significance of another PSA test, but it's just a needle poke, and the surgeon thought it would be a good idea, at least for my decision making process.

I attended the Kaiser Permanente Brachytherapy class and came away feeling that brachytherapy would be a reasonable option, but I just don't like hearing that side effects can include (IN RARE CASES) cancer of the bladder or rectum. In many ways surgery feels to me like the cleaner treatment option. Plus if the need arises to move on to salvage treatment, salvage radiation sounds a lot better than salvage surgery.

I am close to the magical age of 65 where life expectancy does not go up with treatment, but I expect to live at least another 20 years, if not 30 years, based on family history (father died at 82 of PC, mother still alive at 93, etc). It seems unlikely that my PC will just sit there in my prostate and do nothing for all that time. I don't know that I can take the stress of wondering what's happening down there. It seems likely that PSAs will go up (perhaps slowly) and re-biopsies will show more and more involvement over time.

Isn't the best time to get surgery when you are younger and in good health, except for the PC? Isn't this a bit like a woman with a strong family history of breast cancer, and perhaps genetic testing to confirm her increased risk, who gets a double mastectomy when she hasn't been diagnosed with breast cancer?

2nd Cancer,

I did not see you later post so I will chime in again. If you are a healthy 63 then you have many options and only a few with long-term history of survival. I am not a doctor so please take this as an opinion of one who has walked a similar path to yours. Your fathers history of PC is real and the genetic disposition for you is documented by science.. you are at a significant risk to get PC. You have been diagnosed and the steps you are taking are right on. Check out your options and follow your heart on the decision.

I chose surgery because I felt I was healthy enough to handle it and I felt it was the best option for a cure for me because of the definitive ability to test PSA of recurrent cancer. I'm the kind that needs that assurance. I have RALP robot surgery. The surgery is necessarily easy or hard. The risks are real and need evaluation by you and those who love you. I had complications following surgery post 2 months. I had a fever and was diagnosed with an infected lymphocele. This is a rare risk/condition that happens infrequently with lymph node removal. It took 3 proceedures with drains installed to clear up the infection and lymph fluid from pooling. Today I fight what I would call lymphodemia which collects daily in my pelvic region and goes aways at night so it is a daily reminder that I am alive but not without a reminder. I am dry as dry and ED improves year after year since I lost one side of my nerve bundle in surgery.

Take your family history serious and your diagnosis serious and get the opinions you deserve to make the right decision for you and your family. As strange as it may sound I would not take away my cancer trials for nothing as I beleive they have made me a better man, a better husband, a better father and now a proud grandpa. The view out the otherside of cancer is bright and beautiful but in the midst of it is emotional anxiety, disbelief and uncertainty. Real experiences that require the right attention.

JP