Advice, please for someone very new to this game

Well, I have to say, maybe I don't belong here. Maybe I'm sweating something that's nothing...nothing conclusively says I do or don't have PCa. I don't even have enough numbers to put in the signature line, like most everyone else here does. Why am I so worried? Is my worry justified?

I got a PSA (4/6/2015) result back and it was 4.8; I got sent to a urologist right away and the DRE was normal. I'll have a Free PSA taken on 5/27/2015, and probably a regular PSA before then. The plan is for a biopsy, depending upon results of the Free PSA.

I'm only 47, and I have a family history of PCa. Dad was one of six brothers and won't get checked. His dad (my grandfather), his dad's brother, and three of his five brothers (my uncles) all had it...and one of his brothers is like him--too stubborn to get checked. But no one has been as young as me. No one in the family has died from it, and if I have it, it's probably very early. Again, why am I so worried?

I felt very reassured after the urologist visit. Heck, I worked for General Petraeus when he had it and we didn't even know he was being treated. But then I think about radiation, and prostatectomy...impotence and incontinence...tumors metastasizing and the like, and I get very worried.

What would you do this early in the process? Am I on the right track? Is the cure worse than PCa itself? The biopsy sounds like sitting on a nail...twelve times. How should I prepare for that?

Your questions in red below:

Is my worry justified?

Could be, depending on exactly how worried you are. There is cause for a watchful concern but anything past that is probably overblown.

What would you do this early in the process?

about what you are doing. There are other, better, blood tests besides PSA and free PSA. You might ask your urologist what he thinks of the Prostate Health Index (PHI) which is a new test that seems to have fewer false positives. Also, be sure to avoid sex, bicycle riding, DREs, bull riding, over-the-counter decongestants, and other things that can perturb your prostate in the 48 hours before your next PSA test. For extra credit you could ask your uro about a round of antibiotics before your next test. (Sometimes prostatitis can cause an elevated PSA).

Am I on the right track?

Yep.

Is the cure worse than PCa itself?

That's a heck of an interesting question. In way too many cases it is. Many men diagnosed with prostate cancer have cancers that will never cause them any trouble if left untreated. For those men the damage the cancer does to their lives comes from their panic at the word "cancer" and their insistence that their doctors provide treatment that often has unfortunate side effects.

There are other guys for whom treatment is necessary and will save them from a painful, undignified and untimely death.

The trick is to figure out which kind one is. Historically that's been hard but with recent diagnostic tests it is becoming possible for men with steady nerves.

In the mildly unlikely case you are diagnosed, come back and talk to us before you commit to treatment. We can suggest questions to ask your doctors that will help you evaluate the risks and potential side effects.

The biopsy sounds like sitting on a nail...twelve times. How should I prepare for that?

It's rather more like having a staple-tacker shoved up your behind. I always found them more annoying than painful. But I found them really, really annoying. The biopsy gun makes a noise like a rat trap going off and I tended to jump a foot off the table with every CLACK. I found that a couple Valium swilled down in my uro's waiting room vastly improved the experience for me.

If your doctor offers the option of a bit of pharmaceutical detachment I'd take him up on it. There's no shame to it. Men is white coats sneaking up behind us with spring-loaded "novelties" that shoot needles into our man bits... make us all nervous.

InTheShop said...
Remember that PSA is a cancer test.

Didn't you mean "isn't a cancer test"?

NE-skier said...

InTheShop said...
Remember that PSA is a cancer test.

Didn't you mean "isn't a cancer test"?

yup, edited.

Thanks everyone for the quick replies. I started getting PSA checked when I was 39. Was in the military, and they insisted. I was a pretty stable 1.9 then and at my last one (three years ago). I appreciate the advice and the reassurance that I'm tracking with a reasonable plan.