4 days in, where to begin...

Ok.
This is my first post and I may be a bit of a pinball as I stagger through the data share.

I google something and came up with this thread by needadvice1911
https://www.healingwell.com/community/default.aspx?f=35&m=2901957

It may be 3 or 4 years old but what a great introduction. Very similar to me but more importantly the tenor was so very welcome and reassuring. I have participated in recreation (boats and motorcycles) forums and there is always misinformation, sometimes even dangerous.

Not here.
Ok, one thread does not a forum make but it was enough to make me sign up.

I will leave it there, while I step outside and create my second post, to follow here, with my specifics. I will also start reading the "Newly diagnosed with PC? – read this thread first"

Forgive me if I mess up initial postings as a new forum sometimes has a format learning curve. To that, I often compose in "word" on PC before posting, so if there are formatting tips, let me have it.

More to come…

Tim.

Andrew, thanks.

Ok, so here we go.
Yes, 4 days in.

I was doing biannual physicals and the last, in the spring of ’15 was good and uneventful.
I relocated shortly after and hired a new GP.
Spring of 2017 is time for the biannual.
I had never done a PSA.

Monday April 03;
I do the physical and when she gives me the finger, informs me I have a nodule on my prostate. She requisitioned blood work and said she would book a Urologist
Tuesday April 04;
Lab work returned showing PSA 4.7
Thursday April 06;
Meet with the Urologist.
Friday April 07;
Here I am.

Let’s back up.
I turned 73 in March.
No known family history of PCa but lots of other cancers.
Me; no real current issues, unless we include the dumb things my old brain does.

Urologist:
First thing, even before the bend-over, he says; “at your age, there aren’t a lot of options” or something very close to that. He probed, came out and said yup something there and no, it’s not corn. He gave a bunch of statistics, showed me images of 4 stages and said I was between 1 and 2 and there is a 70% chance it’s PCa.
I asked if it could have grown in the two years since my last check or could it have been missed. He said it was high up and a short finger could have missed it. Hmmm.

I ask what he meant by not a lot of options. Too far gone? Too insignificant? Too costly? What? Still not sure what he meant but when I said I have to get past 78 to break the family paternal, male record, he said pfft, you have decades.

So he wants to do a biopsy and bladder scope. He had openings May 18, June 2 and June 12. Since I had already booked an Asian trip May 20 to 30, I asked if it could wait until I got back. He said yes, not a problem. So, now I wonder if that was good news or bad news.

The boy gets very high reviews and I sense he may not be all that concerned. Unless he thinks I won’t make it to Asia. I will be seeing my GP in a week or so and she will do a good job on my questions.

Early, early, I know but feedback will be gobbled up.

Thanks.
Tim.

Post Edited (Tee Emm) : 4/7/2017 10:13:38 PM (GMT-6)

I would guess that he was saying that surgery would not be recommended because you are over age seventy. That is a common practice. In my opinion, that is no loss, as radical prostatectomy has the most severe side effects of any treatment.

Get the biopsy done. There are good odds that you may need no treatment beyond active surveillance. The biopsy is the first step in determining what is the appropriate course of action.

Welcome Tee Emm, Yes, PCa is a slow progressing cancer, and I'm good with taking some time to study options and make choices. But it also may be that one day it is organ-contained and the next micrometastic. That can be an important transition in treatments and disease-impact. Where I have the chance to accelerate or gain info, I jump on it. But what works for you.

Best to you & hoping your scene is quickly and happily resolved. In any event, enjoy your travels.

Wilderness,

A link to what AS is:
/www.pcf.org/c/active-surveillance/

trailguy;
As in Trail BC?

Why do you say "get that biopsy (have them knock you out for that - enjoy the propofol!)"?

The Urologist says I can self drive, both ways, in and out in 2-3 hours.

Tee emm, biopsies aren't fun, but aren't horrendous for most. It's uncomfortable, and frankly kind of embarrassing for us guys due to the handy location they use to access the area.

I had a couple of early biopsies with no anesthetic at all (negative, and back in my mid-40s). The last one was done with local, and was marginally better. The 3 or 4 small shots of local anesthetic were much like a biopsy sample. The local is probably worth it. I don't know, for me I wouldn't bother with a general, or twilight, or whatever, but that's just me.

The biopsy "pop" feels rather like someone snapping a rubberband against you, but inside. Odd, uncomfortable, but not usually a white-knuckle event. Some guys have much discomfort though.

I imagine a good chunk of you, like me, landed here by going through a “where do I start” routine and doing online searches.

Following my discovery of this forum, by accident, I did a further search and came up with “The 8 Best Prostate Cancer Forums of 2016”
http://www.healthline.com/health/prostate-cancer/prostate-cancer-forums

They listed;
HealthBoards
CyberKnife
The Cancer Forum’s Prostate Cancer Forum
CancerCompass
American Cancer Society
Patient
HealingWell
MacMillan

Perhaps some, or many of you, have been to the sites listed and might even be active on them. So, not wanting to spin my wheels too much, can you folks give me some objective feedback on those (and/or other) sites with respect to PCa help specifically?

Tim.

Pratoman, welcome comments, thank you.

The following is general and not specifically to you.

I have a couple of terminology questions. It would be nice if they can be answered here or I can be redirected.

Are “PSA” and "PSA density" the same thing?
i.e. PSA > (number) ng/ml vs PSA density < (number)

I come across Gleason = 7 as opposed to, for example < 7 or 8-10.
Is there a significance to the = 7?

The tumor maze;
cT3
cT2b-c
cT1-T2a
cT1c
etc. as laid out in the Risk Categories and elsewhere.

My Uro seemed to be keeping it to a simple T1, T2, T3 and T4.
Oversimplified?

TM-

Welcome to HW, but I certainly hope you don't have to be here.

Before you drive yourself crazy learning stuff about PC, I suggest you actually get a diagnosis of it. If the biopsy is positive, you have plenty of time to learn all you need to know. If it is negative, you can spend your time learning other things. I think it is very important to live in the present moment.

A PSA of 4.7 in a 73 y.o. man is not all that high, especially if your prostate is enlarged, and benign nodules are common. So you really have to have a biopsy to tell you what it is.

For the biopsy, ask for a "periprostatic nerve block" or a "pelvic plexus nerve block" - use those exact words. That will insure you feel nothing. There may be a little rectal bleeding the first day, some blood in urine for a couple of days, and blood in semen (it is really gross looking) for several weeks. Also, tell your doctor if you've had a lot of antibiotics in the past.

Have a great trip - we can talk afterwards.

Tee, welcome to our club, let's hope your stay is short and your biopsy a bump in the road. Reality is, that at 73, your probably have diagnosable PC. Most men your age do. The question is, what do you do about it. And for that answer, you need the biopsy to understand what is happening.

So, take your trip, enjoy yourself, and come back after you have the biopsy report. Did we tell you to have your slides sent to Epstein's lab at Johns Hopkins for second opinion?

Yeah, the uncomfortable truth is that PSA is not a cancer test. It's a test of prostate activity...it's been likened to the 'check engine' light on your car. Frequently it doesn't mean much. Occasionally, however it does.

Hang in there, come back when you know more.

halbert, I just got here and you want me to get lost already.

I take that well, along with a couple of the other old hands.
I've read parts of the NCCN link froggy provided and I'm good to back off now and wait for June.

Thanks everyone, big help

halbert, I meant to comment about " Epstein's lab at Johns Hopkins." Not sure if Canada has a connection there. Will ask.