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The earlier you catch prostate cancer the easier it is for fix. Waiting will only allow the cancer to spread to the lymph nodes and nearby bones. Treating that condition is much harder. I hate to be blunt but if left untreated, you may very well die from it. I understand your desire to maintain your quality of life but sometimes you have to make sacrifices to stay alive.
Tony,
I'm assuming that w/o symptoms your staging would be T1c. I would be concerned with the PSA > 10 factor though. No, you don't need immediate treatment but I would have the PSA checked on a quarterly basis to see if your PC is aggressive (doubling time. I would also send that biopsy off for a second opinion, just to make sure you're 3+3. In the meantime continue to communicate on this site and do your homework. There may come a time when you may need to change your mind as to need for treatment and you'll be ahead of the game if you're familiar with all the options. As far as ruining your life, treatment under the guidance of a skilled medical professional will result in some profound changes but it won't "ruin" your life. It will just send you through a detour for awhile.
Hi Tony;
I recommend that you look at "Treatment Choices" on the website and read
Active Surveillance/Watchful Waiting and Proton Therapy to learn more about less invasive treatment options that may be available to you. Read the Mentor stories to learn more.
In 2000, at age of 53, I had psa of 4.1,
DRE found Gleason score 5. Prostate removed. psa wen down to .3. The psa then began to rise at about .3 every 3 months.
In 2001 I had 36 Radiation treatments. psa went down to .3.
Since then the psa has again risen. 7 years later it is at 11.
Tomorrow (July 11, 2008) I will go in for bone scan and prostascint. I agree with Tony. The earlier you deal with the cancer, the better your chance of solving the problem. I agree with Tony.
Tony. You are too young to wait too long on this. In the hands of a skilled surgeon you have a good chance of enjoying life as well as your younger partner. It is my opinion that you should have it taken care of before the cancer escapes the prostate. It is your call though. See my signature below.
Age 59, psa 4.7 in Jan. 08. Biopsy: one positive sample out of 13. 1% of one sample cancer. Prostate removed on 3/5/08. Nerves spared. Cath out 12 days later. Continence good. No pads needed since 6/10/08. First PSA: Less than 0.1 on 6/17/08. First erection five days post op and have been improving well since then. Full erection now possible (less than four months post op) with the assistance of Cialis. I am pleased with the progress so far. Married to same wonderful woman for 39 years.
She is still beautiful and sexy as ever. A great help in my recovery !!
You ask Do I really need to go ahead with treatment that will stop me enjoying my life ?? The simple answer to that is probably not, although you should not just ignore the diagnosis, but ensure that you verify it by referring to an experienced pathologist and finding a medical advisor who will help you keep an eye out for any potentially dangerous developments. You need also to bear in mind that if you were to choose conventional treatment that wouldn’t automatically stop the enjoyment of life - as many of the men who have shared their experiences on the Yana site can testify.
You go on to say I believe I will not die from PC……. It is indeed highly unlikely that you will die from PCa. The argument against not having early treatment is that what has been identified as prostate cancer will definitely continue to grow and may then become a fatal disease. But all available evidence points to the fact that this is simply not so. In the substantial majority of cases - there is an enormous amount of argument amongst the experts as to just how big this majority is, but all agree it IS a majority - death will come from some other cause.
When all is said and done, with prostate cancer deaths accounting for a minuscule part of the total male deaths (less than 3% in the USA) the chances are very much greater of men being carried away by something else - usually heart failure which accounts for about 35% of deaths. The number of male deaths from prostate cancer does indeed rise with age, but given that the median age for PCa death in the US is now about 83 or 85 - more than half the PCa deaths occur after that age, so you’d likely have many years ahead of you and in every one of those years there would be what are known as competing threats that could carry you off.
The other half of your sentence …… and treatment will wreck my whole life is not necessarily true. All conventional treatment procedures for PCa carry a risk for side effects (more properly termed morbidity) but these do not automatically wreck the lives of the men who have these procedures. Lives are changed, some are badly damaged, but time and again, men say that they are glad they had the procedure they chose – because that choice matched their individual paradigm or view of life. In other words they were prepared to take the knock of the morbidity rather than face the daily worry of not treating a potentially fatal disease. For some the contemplation of the latter was of more concern than the former. It seems that this is not so in your case, nor was it in mine.
The key issue that I think needs to be understood by everyone (and especially by medical advisors) is that there should be some term other than "prostate cancer" for what most men are diagnosed with. Dr Jon Oppenheimer, one of the leading pathologists in the USA has some things to say about this on his Blog which you may find interesting. He is in fact echoing what Dr Christopher Logothetis said about 15 years ago at an US-Too meeting in Texas. He had been commenting on the relative inaccuracy of the diagnostic process. The question was: "Does this mean that a lot of people who are diagnosed as having cancer really don't? His answer was: "Yes, if one accepts the diagnosis that the cancer is a disease that is potentially lethal……. One of the problems with prostate cancer is definition. They label it as a cancer, and they force us all to behave in a way that introduces us to a cascade of events that sends us to very morbid therapy. It's sort of like once that cancer label is put on there we are obligated to behave in a certain way, and its driven by physician beliefs and patient beliefs and frequently they don't have anything to do with reality. And they are only worrisome because the pathologist has decided to call it a cancer." Or, to quote Dr Lu-Yao more recently: "The deep-rooted fear about cancer may drive the decision-making process, rather than scientific evidence."
I mentioned Dr Jon Oppenheimer and his blog above. One bit of advice he gives there is this:
For the vast majority of men with a recent diagnosis of prostate cancer the most important question is not what treatment is needed, but whether any treatment at all is required. Active surveillance is the logical choice for most men (and the families that love them) to make.
Difficult decisions, Tony, no doubt about that. Much will depend on your view of life and how you think the odds are stacked for you to live out the rest (and may that be long) the way YOU want to. I must say that I have no regrets at my choice despite it being seen as pretty darned foolish when I made it, especislly because I was regarded as being to young, at 54.
Tony I fully back what Terry wrote. Do not ignore the cancer, but do not let it dominate your life. Do a psa test every six months and have a urologist who understands PCa do a DRE. This way you will have a warning if the cancer is growing. Terry gained 12 years before having to start treatment.
I carry some unease when I read about Tony's situation. His prostate is small like a young mans, he has cancer cells in only 5% of a couple of cores on one side only. Yet his PSA reads 16. What is generating a PSA number that high? I know there is variability amongst men, but seldom this much. Maybe there is something else, like an infection, I have no idea.
There is no substantial data on the normal PSA range that is not associated with PCa.
The highest PSA I have seen reported where no tumour was found was from an Australian who said his patient had a PSA over 300 ng/ml. He was treated with antibiotics and his PSA returned to normal levels. There are many reports of men with PSA levels in the high 80s and 70s responding well to treatment for bladder or prostate infections.
It is very important for everyone to bear in mind that PSA is NOT prostate cancer specific - as this posting states so clearly. Most of the men with elevated PSA levels (at least 65%)do not have PCa on biopsy. The elevated PSA is due to other causes, some identified, others not.
THat could certainly make a difference, Tony. This kind of infection is notoriously difficult to clear up and even if there are no obvious signs, the disease may well be pushing up the PSA.
Suggest you discuss this with your urologist and look for treatment for this before making any decision on PCa treatment.
Just had a psa test and it was 12, down from 13 so I have decided on active survalance, take psa test every 3 months and if it raises too high then i will treat. I believe if I had,nt checked the problem would not have arose till I was ancient as it is its caused me untold stress and loads a money. Thanks for your kind help.
