How long have I had this?

Hey guys,

Earlier today, laying on the CT Scan table looking up at the mural they have painted on the ceiling, I had this thought, "how long have I really had Pca?"

I know I was diagnosed last month, but, how long has it really been "there": 1 year, 2 years, 5 years, longer? I really don't know. If I hadn't gone to the urologist on my own, would my future PSA tests continue to be less than 2.5, as they have been for a long time, and I would have just continued to have Pca without knowing about it? Until when? When does your body pull the trigger and let you know you have Pca with a lower PSA? I consider myself lucky that I went to the urologist when I did. I only did so because my GP Doc retired and my new GP did not do DRE's.

To tell you the truth, I hope there is another test on the horizon. Maybe, I had G6 and less volume 3, 4, 5 years ago. But PSA and DRE's were normal. I would really like to be addressing G6 rather than G4+3 right now, but it is what it is.

Here's a good question, can a gleason score change over time? That is, can it start out as a G6 and migrate to something higher over time (G7, G8)? Or, once a G6 or G7, always a G6 or G7?

So, yes, had the CT scan of the pelvic region today. Now I gotta wait for the results. With this one out of the way, I can go to my consults with tests in hand.

70 degrees here in NJ, and I get to watch my boy play a little high school baseball! It is a good distraction from what been going on lately.

J

8 to 12 years

DRE finding is a recent development for you. The 4's?

Those 4's can and do, like to multiply. The more ya got the more ya got the.more ya got kinda multipy.

J
I also was told and have read that Gleason score stays the same over time. You either have low, medium or high risk from day one. So it's really important to find medium and especially high risk cancer early before it escapes the prostate. High risk means high risk for progression not for increased score over time. My surgeon guessed that my PCa had started 9-10 years before I caught it. I wish I had caught it earlier.
Bob

Tall Allen,

You are correct in that it really doesn't matter looking backwards. I guess I like to be as knowledgeable as possible to educate others that I may come across, including my brothers and sons. I would like to tell them as much about Pca as possible. Like, it could sit in you for quite some time and you would not even know it. That low PSA (like me) may not mean anything. That slow rising PSA (like me) may not mean anything. That maybe G6's don't turn into G7's or higher (if indeed that is true). I am interested in any and all possible info.

I guess I am worried that my 2 son's (21 and 18) are in line for Pca someday, I am hoping that they can catch it and treat it at the earliest stage. I also realize that 20 years from now may result in somewhat different testing techniques besides PSA and DRE that would allow them to catch it early.

So, onward and moving ahead.

Thanks.

J

Its my view that "some " gleason scores do migrate{will not write a novel on why}. its fortunate that we live in a time where so much is known about Pca and imaging techniques are improving all the time. Pca can be a chronic disease based on the strain and the biology of host and how they commune. It also can be a remorseless killer based on same. Its a crap shoot as they say! But what isn't? Love your life…Live your love.

Most men are predisposed to PCa. In the US after age 50 the chance of being detected is about equal to the attained age. So the longer we live the greater the probability of being diagnosed. Should this be a worry? No. Should it be a concern? Yes. That is why we screen. Just like for hypertension, diabetes, cholesterol....and all the other things we are predisposed to developing for so many reasons.

So are your sons at risk? Of course....just like mine are. Does this keep me up at night or do I have to explain it all to them now? No. They are mid to late 30's. They know what I have done and we have all agreed that I will buy them a baseline PSA at age 40. We will go from there and they have all agreed to regular screening.

No one can tell you when the first cell mutated and knowing that would make no difference in your treatment plan, efficacy, or any effect on your sons or other men.

When my wife had her first bout of breast cancer at age 46 she was positive it was because of the higher air pollution we were exposed to living in large cities in southeast Asia. We read a very definitive book on breast cancer that showed the average breast cancer took about 15 years from the first cell mutation to the size of a pea.....which basically can't be felt. Her tumor was a little smaller than an almond so we figured she had cancer since about age 25. At age 59 she got hit again with a different form of breast cancer. Very likely it survived the first treatment only to become detectable some 15 years later. Go figure.

The point is that with most cancers, particularly the hormone based like PCa the development time can be quite long before they cause problems. For others they can develop very quickly, like those common to children.

In my opinion the message to men, especially those most important to us, is to become aware of the various conditions that for most are very manageable and pursue the screening programs that identify the condition early so that the most appropriate actions can be pursued. An even more important message is to pursue a moderate lifestyle with elements proven to reduce the various risks. That is something you can start instilling in your sons today. Talking to them about cancer today is a non starter. Help them understand the importance of not smoking, moderate alcohol use, no drugs, safe sex, wear seatbelts, exercise daily, eat your veges, get enough sleep, manage stress, listen to your body, etc.

Pretty much all the things their mother has probably been telling them.

When I was helping my husband with research about his prostate cancer, I came across this 2013 Harvard article that says most Gleason grades "are born that way." That's certainly my impression from reading these boards.

http://www.health.harvard.edu/blog/prostate-cancer-lives-as-it-is-born-slow-growing-and-benign-or-fast-growing-and-dangerous-201308146604[url]

Although I have no basis for my opinion, I kinda think of it like popcorn. Once the cells turn transitional, and "if" those transitional cells decide to pop,(read mutate) then there are a set number of types of popped corn they can be. Once mutated, type 3's like to reproduce other 3's, 4's like to reproduce other 4's etc. It's the base transitional cells that decide what they will be once they mutate in my opinion....not the "already type-determined" cancer cells.