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Posted 10/16/2018 5:29 PM (GMT 0)
Hi Everyone,

I guess I will start my story here.

I am 53 and have been having my PSA checked since I was 38. My dad was diagnosed with prostate cancer a little before I started. Doctors told me I didn't need it but I wanted to get a good baseline so I could see any little movement.

I went to the Dr. in August for a regular physical and got a call about a week later to come in on October 1 for a recheck of my PSA. I asked what the number was and she said 4.17. That was up from 2.7 in August of 2017. I tried to be calm during the wait until the month was up, but must admit I cried all the way from work to the Dr. just for the test. I am only afraid of two things and this is one of them. I saw what the treatments had done to my dads way of life and want no part of that.

The results from that test came in at 4.7. I did not cry.

In about 2 hours I have my first visit with the urologist my Dr. recommended. We will see how that goes. I had several people at church pray over me on Sunday and we are believing it is going to be gone, but preparing just in case.

I have been doing research here on and off for about a week. I assume this will be a fairly routine DRE and just a medical history check. I will check back in tonight or tomorrow to let you know how it goes.

ps. I will also work on a signature for your guys.

Larry
Posted 10/16/2018 5:41 PM (GMT 0)
Hey bbqguy (I do love me some Tennesee barbq!)

Yes, you need to have a somewhat level of concern. You could be me 4 years ago. Similar family history (my dad died of PC in 2004), similar PSA trend and history.

Here's the good news: Lots has changed in how PC is treated in the last 17 years. More good news: You may not have PC at all, and if you do, it may not need to be treated now--or possibly even later.

Your next step is to see a urologist for a DRE (don't worry, they aren't bad), and he will likely want to do a biopsy. The biopsy is unpleasant, but it's over quick. The biopsy is the only way to diagnose PC. Once you cross those steps, and report in the results, we can help translate and suggest alternatives.

You're fortunate, by the way, to be in Middle TN. Within a fairly short distance of travel, you have access to some great docs and facilities. Vandy in Nashville is one of the good ones. Then of course there is Emory in Atlanta. But that is jumping the gun. Get the DRE, and probably a biopsy, and let us know.
Posted 10/16/2018 5:57 PM (GMT 0)
Welcome to HW.

Yup, seeing the URO is the next step. You're URO might recommend a biopsy or PSA retest. You might also consider the PHI (prostate health index) blood test as it looks at more blood markers to gage risk before jumping into the biopsy.

The biopsy isn't fun, but most tolerate it (some need a sedative) with minimum discomfort. Given your family history, it wouldn't be unreasonable to do a biopsy. Waiting for a retest would be fine to.

Treatment methods for PC have change a lot in the last 10 years and finding it early means less impact on your body and life style. If the (big if here) the worst is true, you'll have plenty of options with acceptable quality of life after treatment.

I get that it's scary to go through the process as there are a lot of unknowns and a lot of speculation. Our minds tend to go to the worst extreme. Reality is often not as bad.

Do let us know what the URO says. Ask all the questions you have, we're here most days.
Andrew
Posted 10/16/2018 6:01 PM (GMT 0)
Hey there, and welcome… and relax. You probably learned a lot about prostate cancer helping your dad through his treatments…I dunno. Did you know that prostate cancer is age related? Probably. Did you know that about 50% of all 50-year olds have some form of diagnosable prostate cancer? Probably not; I don’t mean to be presumptuous, but most people don’t know this, PLUS you wrote this:

bbqdude said...
I had several people at church pray over me on Sunday and we are believing it is going to be gone, but preparing just in case.

With a 50/50 chance you have PC now simply due to your age (and that probability going up every day, as I'll describe below) it's probably not "gone," and it’s time to learn a little bit more about the disease.

The first/next thing to know is that by far, most 50-year olds DON'T EVEN KNOW that they have PC, most will never know, and having it will never bother most of them. Let that settle in. It helps to get a reality check every now and then.

There was a landmark study done at the Wayne County (Detroit) Coroner’s office a number of years ago which demonstrated this. Over the span of years, they examined the prostates of men who died in accidents unrelated to PC. From that study, the rule of thumb was developed that says starting at about age 40, the precent likelihood of a man having PC is roughly equal to his age. So, about 60% likelihood for a 60-year old, 70% likelihood for a 70-year old, etc. At age 50-plus, you've got 50-plus percent likelihood of having PC.

But we know far fewer men than those percentages have been diagnosed. More specifically, far fewer men than that have gone through the set of circumstances—the “slippery slope,” many call it—which leads to an eventual biopsy, and ultimately to the likely diagnosis of PC.

Believe me, I know that men do die of PC…close to 27,000 per year in the United States, but that is far, far fewer than are diagnosed, and with the new information you just learned from the autopsy study you’ll realize it is far, far, far fewer than those who are walking around with PC every day.

This, my friend, helps highlight the importance of separating the mere fact that you might HAVE prostate cancer from what you might do about it, if anything. The best recommendation for the most commonly diagnosed form of PC is to do nothing other than monitor it.

Bottom line: prostate cancer is one of the most common and least lethal of all cancers.

Nothing to cry about just yet…

Post Edited (Normal59) : 10/16/2018 2:04:28 PM (GMT-6)

Posted 10/16/2018 6:08 PM (GMT 0)
Thanks Halbert and Andrew. I will definitely check out your story Halbert.
Posted 10/16/2018 6:39 PM (GMT 0)
You’ve gotten some good advice from the other members. The process for you now is to manage your anxiety as best you can and take things one step at a time. Please keep us posted on your progress.
Posted 10/17/2018 12:09 AM (GMT 0)
Dude - At the risk of getting ahead of things, let me give you a bit of advice about The Biopsy. If you read all about the procedure here on HW, you will find experiences ranging all over, from "no biggie" all the way to "Oh #(%*)!!! I'll never do THAT again." There are many reasons for this variety of responses.

The biggest reason I know of is what your urologist does to manage pain, and how insistent you are about getting the meds needed. Many urologists don't want to "bother" with any additional work, as the actual biopsy procedure is only a few minutes, then they can get on with other important work. They probably have never experienced a biopsy themselves. If your uro says no pain control is needed, ask him how HIS biopsy felt.

On the other hand, many up-to-date urologists use what is called a "peri-prostatic nerve block." This consists of a couple of tiny injections of medication directly into the specific nerves that transmit prostate pain to the brain. They can locate the proper spot to inject using the same ultrasound transducer they will use to take the biopsy samples. With this nerve block, there is NO pain. You just feel the pressure when the sample is taken, no pain at all. My urologist uses the block, and after I had my biopsy done, I took my wife out to lunch and then went back to work. No pain at all.

I don't want to scare you. I am hoping that my story will have the opposite effect and that if your urologist says that the next step (or one of the next steps) will need to be a biopsy, ask him if he will use a nerve block (not just some lidocaine injected at random. If he uses an ultrasound-guided nerve block, just go ahead and schedule the procedure. If he balks about the nerve block, if it was my choice, I would find another urologist.

P.S. In my "younger" years, I had a lot of good times in Central TN. Specifically around Humboldt and Jackson. I used to frequent the Old Hickory Club, on the way into Jackson. Just had to watch out for the Shelby County Welcoming Committee ;-) .
Posted 10/17/2018 3:15 AM (GMT 0)
Thanks for the advise Paxton.
Posted 10/17/2018 3:21 AM (GMT 0)
Hey Mid-Tennessee !! Just across the plateau from ya in K-town. (How ‘bout them Commodores??).

Cryin’ are ya? My hands used to shake when I’d read about this stuff before I even dreamed I’d ever get it!

Hey...if ya have a biopsy (don’t know if ya will or not)....but if ya ever doooo...you can do it under General anesthesia. (That’s what I did...and man enough to admit it lol). They won’t volunteer it...but if you ask....they’ll say “ok”. (More do that than admit...or that’s what I tell myself anyway).

You may not be here as long as you think.
Posted 10/17/2018 3:23 AM (GMT 0)
Well, that part is done.

They did a DRE and said it felt normal, but with my history they recommended the biopsy.

She asked if the did a free something PSA test and they hadn’t. She said we could do that first if I wanted to but since I already had a recheck and it went up she thought the biopsy was the right thing to do.

For the peace of mind I said let’s do it and have an appointment set up for October 26.

This ITO does a general anesthesia for the biopsy so I will be taking the whole day off.

The next day I will be going with my wife to watch her parachute for the first time. It is one of the things on her bucket list. We did NY city this summer and we are taking motorcycle lessons this weekend on the Can-Am spiders.

There have been a lot of people getting sick or dying that we know so she decided to not wait around for stuff anymore.

She went to the visit with me today asked all the questions she needed to feel comfortable with the next steps.

Good night all!
Posted 10/17/2018 3:27 AM (GMT 0)
Don’t have to wait long. That’s good. I HATE that waitin part. Let us know. (You gonna be ok either way....but let’s keep our fingers crossed).
Posted 10/17/2018 3:30 AM (GMT 0)
The biopsy is annoying, uncomfortable and undignified. You'll be fine for the procedure.

For me the hardest part of the biopsy was waiting for the results.

Jumping out a perfectly good airplane? Enjoy. I always say that you need to live all the life you have. Enjoy everything now, because the future is uncertain and you've lived long enough to have earned a little joy in life.

Keep us updated on your progress,
Andrew
Posted 10/17/2018 3:36 AM (GMT 0)

InTheShop said...
The biopsy is annoying, uncomfortable and undignified.

Keep us updated on your progress,
Andrew

He said they’re using general anesthesia. Nothin to it.
Posted 10/17/2018 4:17 AM (GMT 0)
except the needle in the arm - I hate that part.
Posted 10/17/2018 9:54 AM (GMT 0)
One thing to be aware of--post biopsy you'll be peeing blood clots for a few days. And your semen will start red, and over a week or two will turn almost black. It's pretty nasty looking.

It sounds like you're following the standard protocols. It usually takes 3-7 days to get the report back. And, yeah, it's nerve-wracking to be in that wait. Here's a few suggestions for how to handle 'the call':

If they say you're positive, ask how many positive cores (and if you don't know already, how many they took) and the Gleason scores for the cores. Make sure you get both numbers.

Ask which area was positive (PC is usually multifocal, meaning several different hot spots), and some areas are more challenging to treat than other areas.

Ask what their standard 'next steps' are. Most likely, if you're positive, they will want you to have full body CAT and bone scans--some docs don't do this if the G scores are low.

Ask for a written copy of the report. Don't let them move from "here's your diagnosis" to "when can we schedule the surgery" in one call or visit. Bring your results here and we'll help you translate them. Even if you wind up in high risk territory, there is time to research and choose the right treatment for you.
Posted 10/17/2018 12:37 PM (GMT 0)
Hey- Sorry to hear about your high PSA. You are me almost exactly one year ago. Yes, the biopsy is unpleasant (in my case, the needles themselves were painless, but the ultrasound probe...). In any case, it's over quickly and soon forgotten and really not all that bad in the end (see what I did there?).

With the PSA at a marginal value, even if the biopsy comes back positive you very likely have multiple treatment options. Do your research. Things have changed a lot since your father had this, so don't let that color your decisions too much.

I had surgery about a year ago, and side effects are almost done (no daytime incontinence at all - ED still pretty complete, but some signs of life so still there's hope).

Glad your church prayed over you - me too. In my case it didn't result in a disappearance, but certainly resulted in all the treatment details falling into place. If your prayers are answered and there's nothing, great!! If not, get to a top hospital, do your research, and you'll find that of all the things that could happen this one is usually not so bad...
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