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Prostate cancer suspicion !

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Posted 5/5/2017 8:11 PM (GMT 0)
Almost 49 in June .
Having symptoms for over 15 years now,urinating frequently ,pressures in my bladder etc ,prostate ultrasound,flomax,antibiotics (that was done in 2010 though)
Psa 2006,2007 0.8
Psa 2011,2012 1.0
Psa 2014 1.1
Psa 2016. 1.3
Psa just now. 1.9 ,free 0.26,% free psa 13.7
Dre ,doctor felt a nodule
Cystoscopy normal , except bilobar prostate hypertrophy
Psa done a week after dre
Dr says cancer,scheduled me for a biopsy
Please advise,thanks !!!

Post Edited (Novi68) : 5/5/2017 3:03:05 PM (GMT-6)

Posted 5/5/2017 8:31 PM (GMT 0)
Taking some "natural supplements over the years ,like: togkat ali,5000 mg vit d,vit k2,zinc,boron,creatine ,working out supplements etc,just to boost my testosterone that's in the 400!
Some of those supp are for dht also!

Post Edited (Novi68) : 5/5/2017 3:11:59 PM (GMT-6)

Posted 5/5/2017 8:33 PM (GMT 0)
No prostate cancer in my immediate family members .father died at 48 hard attack though.
Thanks!!!
Posted 5/5/2017 8:34 PM (GMT 0)
Hello Novi and welcome. Most of us who are diagnosed with prostate cancer do not have symptoms of the disease. The symptoms you describe sound more like an infection or BPH. Obviously your total PSA is still low and without the nodule it is questionable whether or not a good doc would recommend a biopsy. The free PSA % is generally only applicable for PSA levels over 4 anyway.

Are you seeing an experienced urologist rather than your PCP? One man's nodule is another man's normal. The other thing is that if a doctor told you it was "cancer" from your numbers and one DRE I think I would look for another urologist. A cancer cannot be diagnosed from a PSA test OR a DRE; only a biopsy can tell that.

Maybe you should get a second opinion before submitting to biopsy. That is a medical procedure that is usually routine but not totally without risk.

Jim

P.S. I just saw your questions about supplements. Perhaps one of our members who is knowledgeable in that area will chime in.
Posted 5/5/2017 8:38 PM (GMT 0)
Thank you for your reply ,it's comforting ...
I'm lucky enough ,I guess ,to live in Southern California ,and actually scheduled an appnt with doctor Duke Bahn in Ventura ,that's next week,just by reading some post here on this website .
What do you think?!

Post Edited (Novi68) : 5/5/2017 4:08:07 PM (GMT-6)

Posted 5/5/2017 8:48 PM (GMT 0)
Actually he told me ,most likely cancer right after the dre ,without the psa result on hand ,that was done after a week .
Just bluntly in my face .
Couldn't sleep for 2 days ....
Posted 5/5/2017 9:27 PM (GMT 0)
Welcome to HW.

There are worse things than a biopsy. That he felt something is worrisome. He was a bit blunt. A more measured reply would have been, "possible cancers." Nodes can form for other reasons.

Still, the biopsy seems like a reasonable response.

Likely your sleepless nights was because of your fear of the "C" word - cancer. I get that, but PC isn't like other cancers. It's slow growing and has tons of treatments. Even if the worst is true, you have every reason to expect a positive outcome. It won't be easy or fun, but you've got a ton hope that in 10 years this will just be a horror story you tell.

Hang in there,
Andrew
Posted 5/5/2017 9:39 PM (GMT 0)
Thanks InTheShop!!
Posted 5/5/2017 9:50 PM (GMT 0)
Nobody can tell you that you have cancer, without a biopsy and tissue looked at under a microscope and identified as cancerous.

And even if you do have cancer, with a slowly rising PSA of 1.9, its highly likely to be at a very curable stage. As IntheShop said, its more often than not, different than other cancers.
Posted 5/11/2017 3:59 PM (GMT 0)
Seen dr duke bahn on tue 5/9 !
He saw a darker area on my prostate !
Waiting on the biopsy results !

Ps doctor wasn't too concerned though !

Prostate 26 cc

Biopsy was my option

Post Edited (Novi68) : 5/11/2017 1:01:28 PM (GMT-6)

Posted 5/11/2017 4:07 PM (GMT 0)
Have recurrent Prostate cancer from 2000. What is acceptable PSA before Lupron is indicated?
Thanks.
Also. Urologist has done nothing more than suggest Lupron without any information provided on cause of blockage requiring inserted Cath. Shouldn't this be part of information before suggesting removal?
Posted 5/11/2017 4:35 PM (GMT 0)
I'm admittedly at the cautious end of the spectrum, so I'd go for biopsy and then discuss the results with your Uro. One step at a time, don't ump to any conclusions - the mind (and all the "what if" worrying) is definitely not your best friend at times like this.
Posted 5/12/2017 3:01 AM (GMT 0)
JDCILL, I suggest that you start a new topic with your questions. You'll get more of a response that way.
Posted 5/12/2017 4:42 AM (GMT 0)
Novi68,

I'm impressed that you got your biopsy early. Keeping you in the light for your results.

Suspicion of cancer is reason enough to see a psychiatrist, counselor, GP or nurse practitioner to be treated for anxiety. If you don't like drugs, you can do guided visualization, self-hypnosis, group therapy, meditation or whatever works for you. Maybe you reside in your happy place while awaiting your results. I climbed the walls (and took my family with me) until I got help.

Best of luck to you.
===
55 at Dx, married w/son. Good overall health.
PCa Dx. 3/17: 12/12 cores positive, G 4+3 avg 75%, left mid perineurial invasion
Imaging shows no bone mets, infiltration of one lymph node; stage T3c
PSA 12/16: 4.7; 2/17: 8.0; 3/17: 13.7
5/17: Start Eligard + EBRT; perm seed brachytherapy to follow
Posted 5/13/2017 11:56 AM (GMT 0)
Stop worrying. You're on top of it so you'll catch it early if you have it. When caught early it's quite curable. Problem occurs when you're a dummy like me and don't go to doctor for 20 years.
Posted 5/13/2017 7:03 PM (GMT 0)
goatts,
I was read this thread and read your post, WOW can I get an amen here. Your so right. I guess Iam dummy number 2. I did not know what a psa test was, when someone said psa I remember in LA that was an airline. I tell every guy over 40 to get a psa test since I was told "hey Iam going to hit you with a ton of bricks and tell you that you have cancer." Then after the scans my uro told me "Hey Iam going to hit you with another ton of bricks, you have stage four." I hope your new scans when you get them show what the scans said in 3/15 both clean. And your right again, stop worrying it will do nothing for you except give you stress and anxiety, both of which beat the heck out of me, physically, so I try not to worry anymore
Posted 5/17/2017 5:08 PM (GMT 0)
Biopsy results in:
The nodule turned out to be chronic inflammation ,but the other dark spot that dr bahn found on the right apex is cancer and I'm quoting him:
adenocarcinoma Gleason score 3+3 =6 grade group 1
Numbers of cores positive/total number of cores:1/1
Tumor length and volum: 1.5 mm of 9 mm core length :17%
Perineural invasion :not identified
Periprosthetic fat invasion :not identified
Blue inked area: very faint blue ink,spared by 6mm
Prostate 26 cc
Psa 2014 1.1
2016 1.3
May 2017 1.9 , free 0.26, % free psa 13.7
Ultrasound stage of T2a,clinical T1c malignancy


Any takes on this ?thanks!!!
Posted 5/17/2017 5:23 PM (GMT 0)
That's not much and a low risk cancer. Likely it doesn't need to be treated at the moment.

Likely you'd do fine on an AS (active surveillance) program.

Andrew
Posted 5/17/2017 6:24 PM (GMT 0)
Doctor Bahn took only 6 cores though ,is this like being underdiagnose or something ?!
Posted 5/17/2017 6:43 PM (GMT 0)
no. The doc had identifiable targets to hit. He got those and you have a DX.

Don't go looking for extra bad. Doubt it's there.

Andrew
Posted 5/17/2017 7:07 PM (GMT 0)
What's the diff between t1a b or c ?
I'm t1c

Post Edited (Novi68) : 5/17/2017 1:11:38 PM (GMT-6)

Posted 5/17/2017 7:24 PM (GMT 0)
the a,b,c is how it was found. c = needle biopsy. (a and b, found by TURP).
also note that you have some staged T2a - felt by DRE or seen in a scan in less that half of one side of the prostate.

at this point the real question is: what to do?
All your options are open, AS, surgery, and radiation.

did your doc offer an opinion on what to do?
Posted 5/17/2017 8:01 PM (GMT 0)
The actual nodule ,felt at dre was benign... ironically ,cause this is how all this ordeal started !

And yes,his pushing his focal cryotherapy ,but he said active surveillance is fine for now

Post Edited (Novi68) : 5/17/2017 2:05:42 PM (GMT-6)

Posted 5/17/2017 8:14 PM (GMT 0)
As Elmer Fudd says. . . "Be vewwy vewwy careful." Listen carefully to your doctor's recommendations but DO NOT commit to any path until you have a chance to learn of all your options. As the others have said, with your low-grade (G6) pathology and low tumor load, virtually ALL of the possible courses of action are likely to be open for you. That includes AS (active surveillance).

I don't know any of your doctors, so what I say may not be fair to them. . . BUT if any doctor says anything like "This is cancer. Don't you want to (fill in the blank) as soon as possible?" just stop and tell him you'll get back to him.

Your pathology sounds like low or very low risk. You have lots of time to decide. In your shoes, I would not opt for any active treatment (surgery, radiation, cryo, ultrasound. . .you name it) unless you personally have a driving reason to need to treat. All of the active treatments have physical side effects along with the emotional ones. Active surveillance is the only path of management that has no physical side effects - only potential emotional ones.

I had radiation treatment. I had a good reason to do so, in that I had G 3+4=7 pathology (although some AS protocols might have even accepted me). Read about AS, then decide.
Posted 5/18/2017 6:02 PM (GMT 0)
So I took that pre-radical prostatectomy nomogram test and these are the result:
Primary Treatment Outcomes

PROBABILITY OF CANCER-SPECIFIC SURVIVAL AFTER RADICAL PROSTATECTOMY

10 YR9915 YR99
10 year - 99%
This number shows, as a percentage, your probability of surviving prostate cancer for 10 years following radical prostatectomy. This probability means that for every 100 patients like you, 99 will survive prostate cancer and 1 will have died from prostate cancer.
15 year - 99%
This number shows, as a percentage, your probability of surviving prostate cancer for 15 years following radical prostatectomy. This probability means that for every 100 patients like you, 99 will survive prostate cancer and 1 will have died from prostate cancer.
This prediction addresses survival related specifically to prostate cancer; it does not exclude the possibility of death from other causes, such as heart disease or accident, within this time period.

Supporting Publication

Stephenson AJ, Kattan MW, Eastham JA, Bianco FJ Jr, Yossepowitch O, Vickers AJ, Klein EA, Wood DP, Scardino PT. Prostate cancer-specific mortality after radical prostatectomy for patients treated in the prostate-specific antigen era. J Clin Oncol. 2009 Sep 10;27(26):4300-5. doi: 10.1200/JCO.2008.18.2501. Epub 2009 Jul 27.
PROGRESSION-FREE PROBABILITY AFTER RADICAL PROSTATECTOMY

5 YR9710 YR95
Extent of Disease Probability
Each extent-of-disease probability percentage is an independent prediction. We therefore would not expect these percentages to equal 100.

ORGAN-CONFINED DISEASE

64
EXTRACAPSULAR EXTENSION

36
LYMPH NODE INVOLVEMENT

1
SEMINAL VESICLE INVASION

2
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