Small Prostate, Propecia, Low Grade Cancer, and other issues...

You and my PCP would get along famously. It was his hypothesis that because my PSA wasn't increasing....it wasn't cancer. He had a willing partner in denial. That's all I needed to hear. Until I developed symptoms. He laughed when I told him I was no longer willing or able to go along with his hunch. I was going in for a biopsy against his better judgement. The irony is....that on his way out of the examination room, just as he was closing the door behind him....his last words to me were...."Don't be surprised if they find a few cancer cells in your prostate". The door then closed.


So I waited how many years, (? we'll never know...as mine was high at base line) with a high psa, before having a biopsy... and...I also had a positive margin. Had I had a biopsy when most doctors (especially urologists) would have prescribed one (IE...years earlier)....would the cancer have grown to the side of the prostate so close as to *help* contribute to my positive margin? My pathologist wrote in his pathology report....that, in his opinion, my waiting a year from diagnosis to treatment *might* have contributed. So...was the pathologist covering for the surgeon's mistake? Would I have had a PSM had I had my operation 5 years earlier? A million questions that really cannot be answered. The facts are....I believed I was at higher risk for cancer for years....and I did nothing about it.

It's my hypothesis that had I done something other than listen to who I wanted to listen to, and listened to my own internal guidance....I might not have had this positive margin. but, who cares....and what difference that makes now....is neither here nor there. I say all of that to say this.....

What I'm hearing from you is that you *really* don't want to be treated for Prostate Cancer. And according to all indications....you can probably doctor shop and find a doc who agrees with your wishes. But....I'd just caution you about "wanting what I want" with justifications and personal hypothesis.

You don't wanna get on the wrong side of this stuff.

good luck

Davd

www.urology.jhu.edu/newsletter/2009/prostate_cancer_2009_10.php


edit.....Another hypothesis of mine is that had I done no PSA's or biopsies...ever....I would might have died an old man....never having known I had prostate cancer. But....now you know you've got it...you know you've had a positive DRE...and you know you've taken drugs alot of your adult life that reads problematic. You've got some decisions to make.

wishing you the best....take care

So... You can't rely on your low PSA because Propecia as you know has perhaps artificially kept it low...which complicates things. Are you considering stopping the Propecia to you can establish an accurate PSA baseline? I think it's important you do so... but consult your Dr.

Because your biopsy indicates a Gleason of 3+3 doesn't mean you don't have a more aggressive cancer present, hopefully you don't. But a biopsy is akin to sticking knitting needles in a loaf of raisin bread. The raisins are cancer. Sometimes you hit them and sometimes you don't, regardless the size of the loaf.

What you do know is you have prostate cancer and you need to develop a course of action. The comments by Fairwind and Island Time should cause you to pause and then prompt you to further your research.

More knowledgeable members will be weighing in.

All the best.

FYI I was 54 when diagnosed. My biopsy indicated two cores with a Gleason of 3+3. The third core indicated a Gleason of 3+4 in a core that contained 5% cancer. My pathology report 3+4 with some 5. As you may know 5 is very aggressive.

Post Edited (samster) : 8/4/2017 3:50:43 PM (GMT-6)

just my opinion only...

i'd give anything if my husband would have caught this beast early. you just never know if you're going to be one of the lucky ones. what is your family history like? any prostate cancer? what about breast cancer? did you have your biopsy read at johns hopkins? did you have an MRI?

i just wrote this on another PC forum:

we went into this whole thing with a 6.4 PSA & a biopsy that showed mostly 3+3 cancer with one spot of 3+4. dr. mark scholz here in the marina said he might not even treat it at that point. he & his partner reviewed our case & said they might opt for active surveillance. we had "favorable" intermediate cancer. until we didn't. fast forward to an upgrade from dr. john epstein at johns hopkins (additional 3+4s) & then another upgrade after surgery to (are you ready for this?) 4+3 with tertiary 5, EPE breakthrough in two different places, extensive PNI & a very rare cancer called intraductal carcinoma. yep. we went from "ahhh it's no big deal" to "what in the hell is even happening" very quickly.

i wish you the best with whatever you decide! deciding on treatment is one of the hardest parts!

p.s. you have plenty of time to figure this out! i just want you to catch it b4 it turns into anything "unfavorable" -- maybe look into one of the more reputable AS programs.

Post Edited (pwallace) : 8/4/2017 7:10:41 PM (GMT-6)

I was on finasteride for ten years starting around age 58 for BPH and PSA was always around .4. Then around age 67 PSA started to increase but still was below the infamous "4.0" . I and apparently my PCP were unaware that PSA was actually double. When at age 69 I had a bx my PSA was 6.6 , really 13.2 and I was Gleason 9! Do I wish I had found it earlier? You bet! My signature shows what I've been through since . Compared to some guys I'm pretty well off for a G nine.
Bob

While your hypothesis that propecia made the cancer easier to find may be true, it is completely irrelevant.

You have to deal with things as they are, not as they might have been. You seem to be an excellent candidate for Active Surveillance.