PCa vs Breast Cancer experience

My wife was diagnosed with breast cancer 3 years ago. She'd had a biopsy on Thursday and her doctor called her with the result on the weekend. That call was followed up with one from the "nurse navigator" who set up all the appointments and we went through meetings with all the team players: oncologist, radiation oncologist, genetics, surgeon, nutritionist, etc. and once decisions were made she was guided through the entire process (surgery and chemo) by the team.

A year ago, at the same hospital, I my primary care doc noted something on the DRE and recommended I see urology. I made an appointment and saw a PA. By the time I did I had my PSA, 4.47. She said I could do an MRI or a biopsy. The biopsy seemed more definitive so I went for that which I had later that day. After almost 2 weeks I hadn't heard the results and called. I couldn't get a return call so I looked at my results online and had to use Dr. Google to explain what a Gleason 7 (4+3) was. I called my primary care doc and asked if someone could explain this too me. They passed me back to urology who squeezed me for an appointment 4 days later. The urologist apologized, gave me an overview of my diagnosis and a book to read and told to call for an appointment when I'd made a decision. My decision was to fly to Ohio to Cleveland Clinic.

After my surgery I went back to the local hospital for all my followup. I was having major discomfort in the groin and had a lump that wasn't there before. The PA in urology said it was probably a hernia and sent me to ultrasound which said I had a small one and sent me to surgery. The surgeon said he couldn't feel it and the lump wasn't a hernia and sent me back to urology. The urologist confirmed what I'd already figured out with the help of Dr. Google, I had a spermatocele, which, by this time, had become tolerable and I'd elected to just leave it.

So, why is it that when my wife was diagnosed she got first class service and with mine it was almost a DIY affair at the same hospital? Is PCa so trivial that it doesn't matter? I'd go somewhere else but options require a flight.

Perhaps society values females more than males these days? I don't really know, but I do hear many times more about BC than PC, or I think I do. But I am not prepared to prove it.

I think it’s also a function of having a clearly defined protocol for treating breast cancer. There is a decision tree in place. But with prostate cancer, nothing is black and white

My wife is a 15 year survivor of breast cancer and her mamogram, biopsy, mastectomy, and chemo treatments happened very quickly. Each option was explained by the various doctors and evaluated by us. My PCa adventure was much slower in contrast.

I think it is just a matter of breast cancer diagnosis (mamogram) being around for some 20 years before the PSA test. Women are also more apt to look after this stuff as a group whereas men tend to go it alone with health issues. I don’t think we will ever catch them but I certainly have become a PSA testing ambassador since I got tagged.

It is true they have a better set of diagnostic tools, specially their genetic tests are many years ahead of ours. However, they do not have anything similar to the simple and sensitive psa tests following prostatectomy.

It's not breast cancer but all cancers that are treated differently than PC. In PC the diagnosis and treatment recommdation is done by a urologist and not an oncologist like other cancers. The Uros fought radiologist over Doppler ultrasound and MRI guided biopsies for years. Thought biopsies should only be done by URos.
In other cancers the oncologist does the Dx and recommends treatment, then acts as the team leader, coordinating surgeons and radiologists as well as doing all the follow up.
My wife had BC and the oncologist centered treatment went very well. When I got PC I was surprised of the urologist's role. It does not work well. Things got much better when I got an oncologist that managed the diagnosis and staging and vetted the ROs that I used for Brachy and IMRT. The results were also excellent and I'm glad I was able to get off Uro centric treatment.

Redwing57 said...
This comes up periodically. Here's my usual cynical response.

Breast cancer.... Well, everyone loves boobies after all. BCa affects younger women to a substantial degree. We care about our wives, daughters, mothers, and are accustomed to the concept of protecting and caring for them. Damsel in distress, and all of that. Mobilize the care team! And if nothing else, women are really good at mutual support, and seem to readily reach out to help each other.

Prostate cancer... Problem for old guys. Old guy loses sexual ability? Cool. They're just icky anyway. Old guy dies? Company doesn't have to pay pension anymore, Social Security doesn't pay anymore, no disability payments, no cost for assisted living, heirs get the estate assets, maybe even life insurance. Cool. Everybody wins if the old guy dies. Well, not the old guy, but who really cares? One less guy to yell at kids on the lawn.

Totally agree on the Brest cancer quote. As far as men and PC, I think a lot of it has to do with the area involved, and the side effects of the treatments. men dont want to talk about it, at least to other guys that havent had PC. No one wants to tell there buddys about their incontinence or impotence problems. After I was diagnosed, I talked to 3-4 others in my town who I know had the surgery in a one on one situation. They wouldnt say much untill I told them I had it and then they opened up and talked to me frankly about it, well everything except the potential impotence, thats a little too personal in that type of setting.

Most people dont know anything about PC and the treatments, I know I didnt before my DX. I've had people who have heard about my surgery tell me "oh I've had my gallbladder taken out, you'll be back to normal in a couple of weeks" I just smile and nod and say yah I'll be ok. meanwhile I'am thinking to myself "you didnt have to worry if you were going to be impotent or incontent after your gallbladder surgery.' They mean well, and are just trying to encourage me, but they have no idea.

Thats why I'am glad there are places like this, where we can talk about things we cant in the outside world.

I like the post of redwing about breast cancer...and yes I am still one of those men who feel protective of women...and not an ounce of shame there...nuff said on that one




I will...verb...not the other... that redwing...is having a bad morning....who doesn't...a cry in the light...if you will...my DoG...do you want to be healed...yea or nay...if yea or nay...put it behind you in.../stand in the gap...its ONLY death you fear...how silly...I mean really...you know this...