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New Guy Here Fighting The Higher Odds of Black Men Developing Prostate Cancer

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Posted 7/22/2014 5:29 AM (GMT 0)
Hi everybody. Glad to be in the house. I am 58, and African-American. My race doesn't matter except that studies show black men are 60 percent more likely to develop prostate cancer than others. So I am making that point simply to encourage AA men to see their doctors.

My last visit was today -- my 2nd biopsy after my PSA began climbing in the past 5 years, from 3.9 to 4.1 to 4.7 and then 10.2 and now 11.7.

During that time I also had multiple DRE examinations that revealed a huge prostate -- now 62 grams and about 2.5 times the normal size. The greatly enlarged prostate has apparently played a role in pushing up the PSA count.

i had the first biosy in 2012 in the doctor's office, and all 12 samples came back negative. Took the second biopsy in the hospital to avoid the discomfort, and all clear again -- except for a single finding of Atypical Small Acinar Proliferation. The doc says it is a precancerous situation that could turn into full cancer. She says its about 50-50 that cancer will show up in the next biopsy. So we have set the next PSA test for 6 months, and then another hospital biopsy over the next six months.

We'll see how it goes. I'm fully prepared to undergo prostate surgery when and if cancer is detected. Gonna watch and wait for now, though.

My doctor has already agreed to allow me to start testing injections, although my wife certainly doesn't need 4-hour love sessions, or even 45 minutes. Me, I want to be ready to go hard, if only with the help of my right hand. An implant could be next depending on if I really am diagnosed with PC.

Key takeaways from my experience thus far:

-- See your urologist religiously.
-- Take all the PSA blood tests and biopsies and digital rectal examinations as necessary.
-- Take your biopsies in the hospital under anesthesia if possible. You won't feel a thing; I found the office visits brutal.


Good luck, everybody

Post Edited (Cigar56) : 7/22/2014 6:05:41 AM (GMT-6)

Posted 7/22/2014 11:59 AM (GMT 0)
Hello Cigar and welcome to HW. Hopefully your stay will be brief and your results will continue to be negative. However, if you want to educate yourself about the disease a good place to start is the sticky thread at the top of our forum that is designed for newly diagnosed patients: www.healingwell.com/community/default.aspx?f=35&m=2652250

Your enlarged prostate is surely pushing up the PSA count.

You say you are fully prepared to undergo surgery if the need arises. Might I suggest that if the need DOES arise that you fully explore other options in addition to surgery. There are various forms of radiation treatment that might be suitable for you with a lower chance of side effects. You will also want to see doctors that specialize in the different treatments to make sure you have the proper perspective. You will want to choose a doctor with LOTS of experience in your chosen protocol because, with PCa treatment, experience does count.

Finally, you may want to consider have a multi-parametric MRI or color dopplar to help locate suspicious areas in your prostate for biopsy. Given the size of your prostate, the biopsy you had was literally looking for a needle in a haystack.

Best of luck,

Jim
Posted 7/22/2014 2:23 PM (GMT 0)
Cigar,

You've come to the wrong forum to brag on your 62 gram prostate. Before I had mine removed I had you by more than 20 grams but I seldom mention it because we have guys here who go into the triple digits.

One thing you said jumps out at me and seems worth a bit of discussion. You said "it is a precancerous situation that could turn into full cancer... I'm fully prepared to undergo prostate surgery when and if cancer is detected.

Prostate cancer comes in several different varieties -- some are really aggressive and you need to jump on treatment as soon as you are diagnosed but others are so sloooooow moving that you can go on watching them for years pretty much like you are watching your Atypical Small Acinar Proliferation now. In the event you are diagnosed it doesn't mean you need surgery right away, surgery is only one of your treatment options and, as Jim said, there are others that might suit your situation better. But you should also bear in mind that, depending on the type and extent of the cancer found, you may be able to go on "Active Surveillance" which is a stepped up monitoring of the cancer to allow a man to stay intact until he actually needs treatment.

Since you are talking about injections and implants I assume that you have tried the PDE5i drugs with disappointing results. (PDE5i drugs are Viagra, Cialis, Levitra, Staxyn, etc., etc., etc..) If they sorta-kinda work but you are put off by the price you might talk to your doctor about generic Revatio which is the same drug as Viagra but cheaper.

Oh, and welcome to the forum. We're glad you found us.
Posted 7/22/2014 4:18 PM (GMT 0)
Jim, Peter:

Thanks for the warm welcomes. I might not have stated my position correctly when I wrote, "I'm fully prepared to undergo prostate surgery when and if cancer is detected."

However, my quote doesn't mean I'd op for surgery immediately.

I have been preparing for the possibility of prostate cancer for four years, which is when my PSA started to rise. Since then I have been frequenting various discussion groups online and recently found this one.

I won't opt for surgery unless I really have to. That's unlike a strategy adopted by one of my close friends, who opted to have his prostate removed solely because of a rising PSA count.

Yes, that's right. My friend was never diagnosed for prostate cancer, including analysis of his biopsies. Yet his PSA kept rising and he simply elected to have his prostate removed. I know, sounds crazy.

I would never take the path my friend took, but like everyone else, I also would not want the cancer escaping the prostate through too much waiting on a course of action.

As for the ED pills, some work fairly well for me, but I sometimes find myself really having to concentrate to maintain the erection. I long for the good old days when it was just ... there. That said, I doubt I'd ever really opt for the implant, because my wife has very low drive and it just wouldn't be worth the expense and discomfort. But I could see staying with say, Viagra, as a drug of choice, and using Trimix for special events like vacations, holidays, etc. -- maybe 5 or 6 times a year.


Thanks again for the welcomes, and I do like the suggestions about getting more than one opinion about my condition.

Barry
Posted 7/23/2014 3:01 AM (GMT 0)
Hi Barry- Welcome to this board. Great people, great advice to be had here. I hope you stay negative but am glad you are arming yourself with knowledge and advocating for it in AA men as well.

I am an RN and my husband has PC at a young age. Since then I have been talking to patients about this when I can and when appropriate. I was speaking to a black man recently and he was aware of the higher risk, later stage at diagnosis, etc but said simply "Its because a brother doesn't like going to the doctor" which I have been thinking about ever since.....

How do we change cultural mores like that? To really change it, everywhere? How do we reach the men most at risk (as well as more men in general)?

Also, where do you live? There could be some regulars of HW nearby....
Posted 7/23/2014 5:51 AM (GMT 0)
Barry,

Welcome. I'm glad you are negative, and I'm also glad you are watching this closely.

The enlarged prostate (BPH), while it may be a problem for peeing, is actually a good sign as far as PC goes. While it's possible to have both BPH and PC, it's the small prostates with high PSA that are really concerning.

I wanted to raise the subject of anterior tumors with you. AA men are far more likely to have them, but they still account for a minority of all prostate cancers. The problem with them is that they are hard to get to from the posterior end. Transrectal TRUS-guided biopsies, the kind most of us had, cannot see or take samples from the front part of the prostate.

Since you have rising PSA after a negative biopsy, anterior tumors are suspect. They have multiparametric MRI-guided biopsies that can detect and take cores from that area. You might want to discuss this with your urologist.

The other thing I suggest is talking to your Uro about taking Avodart or Proscar. Not only will it shrink your prostate and make peeing better, but there's a lot of evidence that it prevents PC and may even shrink low grade tumors. It re-sets your PSA, making PSA a much better tool for detecting PC. If your PSA doesn't go down while taking it, or if it goes down (usually by about half) but then rises again, it's time for another biopsy.

There are 2 biochemical tests that your insurance will cover. PCA3 is a urine test after a prostate massage. It detects a kind of RNA associated with PC. The new test in town is called Prostate Health Index or PHI. It is less affected by BPH or prostatitis than PSA or % free PSA. Here's a link to show your Uro:

The Prostate Health Index (PHI) is 3 times better than standard PSA testing for detecting prostate cancer.

These two tests together will tell you a lot without spending big bucks.
Posted 7/23/2014 5:53 AM (GMT 0)
PS. Have fun, but don't go crazy with those injections. They have been associated with scar tissue formation and abnormal curvature (Peyronie's).

- Allen
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