New Member of the 42 y/o with PCa Club

Greetings my new friends,

As with many others, I have been following this forum since my dx last month. I’ve garnered quite a bit of information from you folks and am grateful to each of you who have opened up your lives and shared your experiences.

As my signature block below states, my PCa was discovered on a fluke. I am in the Navy and was due for a full physical. I went to a military treatment facility that was staffed by an all-civilian workforce and told them what I needed. The Doctor ordered what she thought was a full physical workup of labs which incidentally included a PSA test. I’ve since been told that this was not normal for a 42 year old healthy guy and that none of the other doctors would have ordered a PSA absent symptoms to indicate it. Long story short, my Urologist says I am a classic case of why PSA’s are still an important tool in the fight against PCa.

My biopsy (sedated) came back with 2 of 12 cores positive; as it was described to me, they hit two sides of the same tumor (details in signature block). Urologist and surgeon believe there is a very good chance that the PCa is contained completely in the prostate and that I am an extremely good candidate for RALP and a “cure”. I am certainly hopeful that that is the case as I have scheduled the RALP for the day before thanksgiving.

Fitness wise, I am relatively fit. I run regularly, lift occasionally, have great BP, pulse, and all around good general health despite high cholesterol controlled with Lipitor. I am about 10 to 15 pounds overweight which can mostly be attributed to my love of beer (home brewer) with consumption pretty much confined to the weekends.

I would really appreciate advice on the hours after surgery, hints about how to manage everything from potholes on the way home from the hospital to a walking routine to get back on my feet faster. I hope to return to work within about 19 days (for a week) and then take some Christmas leave. My main fears are going back to work wearing pads (wonder if the uniform will hinder inconspicuous pads), the possibility of total incontinence, life changing ED, and whether or not a “cure” is really a cure.

Happy Thanksgiving Everyone.

Welcome Bro,

My story isn't far from yours. Navy, my psa was ordered by an Over-Zealous HM1 that had taken it upon himself to order all men that would be 40 before there next PHA to get one.

Let see, I had my surgery right about a year ago. I still have a bit of a dribble from time to time. Only when I do certain things 'incorrectly' You learn what the new normal is. Pads are pretty inconspicuous. I wore them from about 2 months under the NWU's. No big deal.

ED, that varies with everyone. Basically as I said before, you learn a new normal.

As for it being a CURE, I don't know if I believe that. I was <0.1 my first two tests then I have been 0.1 since. They aren't saying its back with me but its definitely not looking good.

I am gonna PM you my number bro. So we can talk.

Ok, never mind.. apparently we are not allowed to have any communication offline from here. Anyways, good luck

NavyChief said...
Ok, never mind.. apparently we are not allowed to have any communication offline from here. Anyways, good luck

I was saying it for your sake only. Specially your work email. Best way is to give your email to the mods and ask Brewer to contact you after asking mods for your email. I think it would be brilliant if you two talked. Sorry for the misunderstanding.

Welcome aboard Brewer!
You'll do fine with the surgery. Too bad you will miss the turkey dinner this year. You won't be eating heavy meals for a few days after surgery until after your first BM.
Normally I would recommend trying to loose a few pounds before surgery but you are running out of time.
Going back to work in 19 days should be no problem. Most of us used the Depends underwear with a pad inside of that. You may go through a few pads doing the day and the Depends catches any over flow.
I think that is about it except, good luck!

As we say, keep in touch and see you on the other side!

Bill from Florida

Brewer,

I'm sorry to welcome you here. This seems to be moving very fast for you - biopsy in October and already scheduled for surgery in November.

I just wanted to make sure that before you went ahead with surgery, you understand that you have other options.

I'm assuming the two cores that were found to be positive were Gleason 3+3. If that is the case, you are classified as having "very low risk" PC. You have what is called an "insignificant" amount of cancer. Some doctors advocate not using the term "cancer" to describe it.

What all this means is that you can feel very comfortable not rushing into treatment quickly as you seem to be doing. PC is usually very slow growing.

You might want to read the sticky "Newly diagnosed with PC?"

It is a very good idea to get a second opinion on your biopsy from Bostwick or Epstein. You don't want to be treated for something that is not really there.

Active Surveillance is certainly a possibility for you - they monitor your prostate frequently and you would get treatment if the cancer seems to be getting active. Some men find that taking Avodart while on Active Surveillance actually makes the cancer disappear.

Focal therapy is also a possibility for you. There are clinical trials of destroying the cancer only and leaving everything else intact. They may use any of a variety of methods to do this, including ultrasound, cold, electricity, and radioactive seeds. Here's an example that uses lasers and fiber optics:

clinicaltrials.gov/ct2/show/NCT01377753

Other whole gland radiation treatments that may have lower side effects include: SBRT, temporary brachytherapy, permanent brachytherapy, and pencil beam protons.

Since you do have the luxury of taking your time to decide, all these are options you might want to investigate. I'm not saying that surgery is not a good option for you - it probably is - I'm just saying that you don't want to find yourself down the road wondering or regretting whether it was best for you.

Brewer,
We don't usually weigh in on a member's treatment decision once it has been made, but since you jumped onto the forum with your decision in hand, I would like to second Tall Allen's suggestion that you take the time to seriously investigate the full range of options available to one with such a low-risk profile, most especially if the Gleason grade for your two positive cores is 3+3. If nothing else, your numbers surely give you the luxury of taking a good, long time in making your decision without any risk in doing that. Studies have shown that there has been widespread overtreatment of low-risk PC to the great detriment of many men who suffer side effects, mostly ED and incontinence, for the rest of their lives. You just might be the poster boy for these studies, and have never had to do anything at all but keep an eye on your PSA. Or, you might find that one of the other treatment options is more acceptable in terms of efficacy and lessened suffering from side effects. But the main thing is that there is no rush whatsoever in your particular case. So, if you think you might benefit from further research and study on you part, I would definitely counsel you to postpone your operation and take as much time as you need in making a final decision. Keep in mind that you will be living the consequences of that decision for a long time. In any case, I wish you all the best.

Brewer
Not sure why you reached your decision for RP with your mild stats but there's no doubt that only RP tells you the extent of your PCa if that's what you're after.
You are really rushing a decision for no apparent reason. Good luck in whatever you decide to do.
Bob

Mikey I smile everytime I see you write "awesome sexy wife of 33 years" because I'm wonder if she is awesome and been with you for 33 years or awesome because she is 33 years old.

we had similar stats except your prostate was almost twice the size of mine.

I'm like you, almost no difference whatsoever in my life after surgery. We have a lot to be thankful for.

Brewer,

I did my own research in deciding to choose RALP added immeasurably by research provided by some of the most knowledgeable members of this forum. I could not have felt more comfortable with my choice without their assistance. Win, lose or draw, I'll accept the outcome because once you choose, it's in someone else's hands. Whatever you choose, believe you have made the right choice FOR YOU, based upon your specific situation and the things that may be unique about you, even if that is just your own psyche and how you deal with things. I could have gone AS if I did not feel that my personal "Wildcards" made RALP now the best choice for me.

And Mikey and DavidG, I am so glad to know that things can go well afterwards and "Hope springs eternal." I've got two more days till catheter removal and pathology report. I'm ready. Win, lose or draw.

Good luck Brewer.