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Prostate evaluation 12-1-2016

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Roger2Dodger
Roger2Dodger

Most in here know my story. I have been on Active  surveillance for the past 7 months.

I visited my Urolgist today 12-1-2016 for a re evaluation. I had a PSA test done prior to the visit, and my PSA had increased from 5.83 to 6.87. I was disapointed to say the least of the increase.The last PSA was taken 7 months ago. So that's an increase of 1.04. (not Good)

I discussed my options going forward and I have agreed to have a MRI-guided prostate biopsy After  January 1  2017. My  TRUSS biopsy as I indicated in other threads, and the results were.. 2 cores 4-3=7 and 3 +3 =6

I will meet with my Urologist again after the  results of the  MRI- guided biopsy and discuss my treatment. Whether or not I stay on AS or go for treatment. We did discuss another PSA test after 3 months, but I declined on that plan, My opinion, The MRI would give me a better indication of my PCa, and let me make a sensibile decision.

I would like some opinions from the group, I would be very appreciative!

Emis Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

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  • MK51151
    MK51151 Roger2Dodger

    Posted

    Roger,

    what ever you do, don't make it worse. Choose your options carefully. Still, does not look to bad and do not rush into making decision on treatment. At your age, you don't want to choose treatments with debilitating SE. IMHO, I would stay on AS as long as possible and enjoy life to the fullest.

    i case, treatment is necessary, look for something with SE that you can tolerate and that won't affect quality of life. Look for something that is least invasive especially you mentioned that you paying out of your own pocket. It is there many choices available.

    i just want to mention my case. Age 51, Gleason 7 4+3 and I had robotic assisted RP on November 2nd. Catheter came out on November 10th and ever since I am having severe incontinece using 2 pull ups and 5-6 heavy absorbency pads per day. I feel miserable. I used to lead very active life like I was in my mid thirties and know I did not leave the house ever since I was discharged from the hospital on November 4th. My only time out of house is when I take my dog to the park. Thanks Good,  I am lucky to work from home.

    I do not want to stear away anyone from surgery but for me that was big mistake and now I am suffering consequences of being incontinent and who knows for how long. At this point, I am not even thinking of ED and with the surgery that side effect is unavoidable. Here in USA men are very discriminated by insurance companies. Medications are not covered and they are very expensive so recovery from ED does not look bright for many men.

    Good luck and happy holidays!

    MK

     

    • rick75354
      rick75354 MK51151

      Posted

      I had my prostate removed Sept 21, and I know exactly how you feel when you say miserable. I wasn't just wetting my pads at first, they were soaked! I took a chance and went grocery shopping about 2 weeks ago and while standing in the checkout line, I could feel my pad leak and my pants start to get wet. I managed to get out of there with no one the wiser but that could have been horrifying. I did not want to leave the house after that but in the last week I have been seeing progress. Most of the time now I change my pad after a cough or sneeze and I feel a leak but the pads now are never soaked and I am sleeping through the night and waking up dry. 

      The prostatectomy sounds like a big deal, and it is, but 2 1/2 years ago I had my Aortic heart valve replaced through open heart surgery and the recovery was long and painful. I seem to be making progress almost daily now so don't fret just yet. You will get better but it will take time. 

    • MK51151
      MK51151 Tybeeman

      Posted

      Thanks Tybeeman for encouragement.

      I don't smoke and I don't drink any alcohol. I did not stop coffee. I am still enjoying 2 espresso in the morning and 1 at 5 pm. I work from home sitting all day long in front of my computer so morning coffee is very powerful full that keeps me going.

      I regards of Kegels, I am doing it twice, in the morning and at bed time. I had a TURP in June so my bladder neck was waidly open and needed to be reconstructed before being able to be reattached to urethra. This will play big role in regaining continence. But it is what it is and have to deal with that.

      The hardest for me is to accept that I can not lead same life what I used to do before prostatectomy. I lead the life like I was in my mid thirties. I tried to get out of pull ups using my regular underwear and heavy absorbency pads at night but I got wet all over and needed to change it in the middle of night.

      I am not on any therapy program for ED.

      Best wishes and happy holidays to you!

      MK

       

  • rick75354
    rick75354 Roger2Dodger

    Posted

    Your PSA levels are close to what mine were. 4.1 on the first test, 6.9, 8 months later and 9.1, 7 months after that. 6 samples tested positive from the biopsy and were classed as 6 on the Gleason scale. (Later upgraded to 8 after testing).

    I had my prostate removed Sept.21/16 and I am recovering now. 

    I am 62 so the decision to have the surgery was not hard to make. 

    With any type of cancer, the sooner it is taken care of, the better.

     

    • Whiteplume
      Whiteplume rick75354

      Posted

      Good move, I was 64 when I Hadith removed and so far doing great!

      99.5 % drip free only under stress!

      Back in the saddle special seat, hiking etc. To many people take to many chances thinking more of satisfactorily satisfying their sexual needs, Well to those who take inessential risk, think about it once it's spreads it's gets very difficult to treat,

      So the little fella will recover too so don't get so worried about that side of it and anyway he will be of no use to you or your other half 6 ft under!

      Think about it it's sometimes better out than in!!

      Good move hope your recovery goes Well

    • geoff90305
      geoff90305 Whiteplume

      Posted

      Whiteplume, Having varying degrees of incontinence is very annoying BUT, I agree, being prematurely dead is a damn sight more so.

      I think there comes a time when a guy has to make his decision. Guys need to stop worrying about their peeing and sexual side and think how much do they want to live. AS is sort of gambling. You assess the facts and make a decision that lets you sleep at nights. If you are in your late 60 or 70's, the the AS decision is much easier. If you are in your 50's or early 60's, then you really need to make sure 'your' PCa is under control. If you have any doubts, then off to the surgeon or radiologist

        

       

    • rick75354
      rick75354 greg43014

      Posted

      Yes. Lots of leakage still so I have been wearing pads. My cathater was in for 4 weeks so I think getting control might take longer.

      As far as ED goes, it might be a little early to tell. Nothing happening down there yet but the doctor spared the nerves on both sides so I am hopeful.

  • derek51088
    derek51088 Roger2Dodger

    Posted

    Hello Roger.I was dianosed with Prostate cancer in 2012.My PSA was 8.5.After another 3 blood tests over the next few weeks,the PSA flucuated between 8 and 9.Then came the biopsy where i was told that out of the 12 samples taken 3 were positive for cancer.The Gleason score was 3+3.The specialist nurse told the good news out of the bad news was that the cancer was slow growing.So over the next 4 years i remained on active surveillance.Then during the latter part of 2015 the PSA reading started to rise.Reaching a peak of 13.7.So it was time for a decision,was it to be More AS.Radiation treatment or Prostatectomy,i could not have Brachia Therapy because my prostate was also enlarged.So we opted for The removal of the Prostate gland.Which was carried out on the 10th Aug 2016.The only thing i can say is that everyman is different.Some men can live a normal life with prostate cancer,If like in my case it was slowing growing,i opted for AS.Over the 4 years i had 3 biopsies,and 3 MRI scans.Good luck.
    • Roger2Dodger
      Roger2Dodger derek51088

      Posted

      Derek,

      If you don't care to say, how old are you. I am 76. A 3+3 Gleason certainly qualifies for AS.

      During the 4 years of AS your PSA scores was cetainly a trigger that the PCA was growing .

      My Gleason was 4+3 =7 And I was told mine was non aggressive. I went 7 months on AS and my PSA went from 5.88 to 6.87.I am done with AS. I am going for a MRI-GUIDED biopsy in Jan. And just see how aggressive my cancer is and how much. I will probably opt for radiation or Brachy therapy . If my Gleason was 6 instead of 7, I would probably wait and see more.

      May I ask, did your cancer leave the capsule? That is my biggest fear. I know I cannot live forever,and I could die of something else, but I am pro active with what I know, and I will deal with it.

      Thanks for the reply

      Roger

    • geoff90305
      geoff90305 Roger2Dodger

      Posted

      Roger,

      Great comment. I think this pretty well sums it up. In your shoes, I would do exactly the same. Super important to make sure the PCa remains inside the capsule. If the little sod escapes, then it is all about surviving, not curing. At 76, the radiation or brachytherapy would be my choice.

  • derek51088
    derek51088 Roger2Dodger

    Posted

    Hello Roger.Read your reply,you have a good attitude,dont let the cancer consume your life.You are 76, i was 54 when diagnosed with PC.After the first biopsy 3 cores of 12 taken 3 positive for cancer.After 4 years of AS.Had operation to remove prostate gland.The cancer was enclosed in the prostate gland.As i said in previous post it is your decision what treatment you want.The way treatment is progressing your outlook looks good.Good gleason score non aggressive.Who knows i could have had another 5 years of AS.but at the back of your mind,how much longer i stay on AS. Be up front with your consultant and ask the question,do you think i need treatment now.Good luck.
    • Roger2Dodger
      Roger2Dodger derek51088

      Posted

      derek51088,

      The more you read, and the more you research your options, the more confused a person can get. It boils down to  a damn if you don't, and damn if you do. So, you flip a coin going forward and decide what you do. meaning it's entirely up to the victim of PCa.

      Having said that, Research and study, and along with wonderful support and advice from people in this forum doesn't mean it is not valuable and most of all helpful. No one can make your decision, it is  in your ballpark!

    • geoff90305
      geoff90305 Roger2Dodger

      Posted

      Spot on Roger. Only YOU can make the decision that you can sleep at night with. It is the web with it's never ending knowledge and forums such as 'Patient' that make the decision process that much easier.

      My urologist was saying over the years he has noticed more and more patients are becoming very savy and not afraid to speak their thoughts and direct a treatment plan. 

    • Roger2Dodger
      Roger2Dodger geoff90305

      Posted

      geoff90305,

      I was wondering this AM, (my mind does that these days)...just when my. PCa raised it's ugly head.

      I went to My Chart from where my medical records are kept on line. A PCA test was performed on 3-9-2015. The result was 4.03. On 3-19 2016 It went to 5.88. 0n 11-14-2016 it went to 6.7.

      One can surmise it began to progress more between years 2015 and 2016. What does these numbers and dates tell you? I imagine not a whole lot. But I found the data interesting.

    • rick75354
      rick75354 Roger2Dodger

      Posted

      Mine went from 4 to 6 to 9.1 in a year and a half and it turned out that my cancer was fairly agressive. 8 on the Gleason scale.
    • geoff90305
      geoff90305 Roger2Dodger

      Posted

      Roger, have you ever put your PSA on excel? I have mine going back 15 years...you can see on mine it took 15 years to go from 1.95 to 2.4, then 4 months to get to 13.

      When I put your very small sample on excel, the graph is steeper for the first set compared with the third number. Be good if you can go back several years while the PSA was "normal" 

    • geoff90305
      geoff90305 rick75354

      Posted

      Rick, Yours looks like a textbook 'doubling' which is an indication of an aggressive PCa. Your Gleason 8 supports this.

      If people had a PSA done when they were 40, and if within limits, at 45, then every year onwards, they would have a great trend line to monitor. I am sure Rick if you had readings going back when things were pretty stable, then your 18 month doubling, it would have set off the warning bells due to the big change over a fairly short time. 

    • MK51151
      MK51151 Roger2Dodger

      Posted

      Rodger,

      that is called PARALYSIS BY ANALYSIS moment and when you reach that point it is really hard to make informed decision because "WHAT IF" is hanging constantly on your mind.

      Whould be really helpful to avoid this STATUS QUO.

      MK

    • Roger2Dodger
      Roger2Dodger MK51151

      Posted

      Mk,

      I agree with you, so does my family. I know I drive my Urologist nuts.

      Thanks for the advice.

      Roger

    • rick75354
      rick75354 Roger2Dodger

      Posted

      I had the radical prostatectomy on Sept 21. First couple of months was frustrating but I think I'm seeing progress almost daily now.

      I'll go for my first bloodwork ppst-op in a couple of weeks.

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