So glad I found this great site.

It's a pleasure to meet you.

Your husband's next real step will be to visit a urologist. A PSA test will be administered along with a digital rectal exam, and as your GI suggested a biopsy may then be in the future.

I'm also a nightly wine drinker--I prefer the California Cabs, but I'll try just about anything. In the warmer weather, on the boat, on some afternoons, I've been known to favor a chilled Sauvignon Blanc.

Welcome.

Post Edited (NKinney) : 2/7/2018 11:05:25 AM (GMT-7)

Here's some more information & knowledge to be equipped with...there's been "discussion" about the topic of whether or not PSA testing should even be done on men over age 70.

Prostate cancer is a very natural part of aging. Starting at about age 40, the percentage of men with PC is roughly equal to their age. So, about 40% of 40-year olds have some form of diagnosable (but not necessarily diagnosed prostate cancer. 50% of 50-year olds. 75% of 75-year olds. etc. This interesting finding was done in autopsy studies of men's prostates after they died in accidents. By far, the vast majority of those men never knew they had PC (the "incidence" rate of being diagnosed is much lower than those percentages), and most would never have been bothered by it. It's just a natural part of aging. A very small percentage of cases, however, do get aggressive and act like "real" cancer, but most are essentially benign. Most of those men simply don't encounter the set of circumstances which leads them, ultimately, to a biopsy, which is the only way PC is diagnosed.

So, if your husband has a biopsy, it is most likely (in fact, based solely on age, it's 75% probable) that he will be diagnosed with PC. That's your starting point.

In most cases, PC is a slow growing disease (as that autopsy study data also shows). So, the professional medical societies have generally said that older men who have not had previous prostate/PSA issues should stop testing for PSA...simply because it is unlikely that any treatment would result in any net benefit over their remaining life. There's a small amount of debate between the various medical societies about whether that cut-off point should be 70, or 75. Others want to make it more complicated by considering overall health, but those who advocate for 75 say that this cut-off pretty much covers everybody...the important point is this: a cut-off has been put in place to help protect the patient. In the dark days (20 years ago), there was a tremendous amount of PC overtreatment of elderly men which benefited nobody except the income of the urology practice...it was so prevalent that the professional medical societies had to put their foot down with this new age-related statement or risk more of a "black eye" reputation.

This issue should definitely be a point of conversation with your urologist.

-Norm

Post Edited (NKinney) : 2/8/2018 8:05:00 AM (GMT-7)

Welcome to HW.

It can be scary and overwhelming at the beginning. There are so many unknowns in each case. What you have right now is a good reason to see a good URO. Anything else is speculation.

Feeling something during a DRE is reason to get more testing, but a DRE can be subjective, so getting that confirmed would be good as well as a PSA test.

anything else would be speculation on my part. Even if the worst is true, PC is generally slow growing and very treatable. There's every hope for a positive outcome.

Get the tests done and keep us updated.
Andrew

Best to wait until you get PSA test results, and get through the initial URO appt. N did a great job of saying what I was going to say, that at least here in the U.S., treatment for many men after age 70 is contraindicated, especially for any low to low-medium risk (GS 6-7) PCa. At that age there is simply not enough testosterone left in the male body to fuel major PCa growth, unless he has a more aggressive form of PCa, which is unlikely statistically. It may also be worth getting a few of the genetic PCa tests done if PSA comes back higher than expected, just to arm you with some additional statistical data to help determine the risk of more aggressive forms of PCa specific to your husband's genetic profile, and to help determine what if any treatment should be considered. Even if PCa is in his future, at his age, IIRC surgery is generally also contraindicated, and any of the various forms of RT are very likely to produce cure and minimize side effect profiles for his remaining lifespan. All that said, let's not get ahead of ourselves until you get past initial PSA testing and appts. Let's hope and pray for no PCa and that this was just a temporary scare for you both. Either way, we are all here to help in any way we can!

Here is that scary article I was talking about: anything positive to walk away with??


http://www.practiceupdate.com/content/worse-prognosis-among-older-men-diagnosed-with-prostate-cancer/61025