You check your oil, have you checked your PSA lately?

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Like I said in my earlier post, I believe that CDC studied the surgical cost, recovery issues and permanent quality of life lost after surgery comparing that with no surgery after the age of 70. They concluded that considering both sides of the equation, surgery was on balance, worse.


If course that doesn't mean that a single individual couldn't benefit from a PSA test and surgery (or other radiation treatment), and that is what seems to have happened with Mike.


David
 
Yes. Biopsy, as I said in an earlier post. I had a "high" PSA such that a biopsy was recommended which, fortunately for me, came back negative. The PSA number is an indicator, not an absolute. Having surgery because of a high PSA without a biopsy to prove the existense of cancer is, in my mind, just plain crazy.
Finger test is a lot differant than a PSA. If your PSA is high, next move is a biopsy.
 
Yes. Biopsy, as I said in an earlier post. I had a "high" PSA such that a biopsy was recommended which, fortunately for me, came back negative. The PSA number is an indicator, not an absolute. Having surgery because of a high PSA without a biopsy to prove the existense of cancer is, in my mind, just plain crazy.

You are 100% correct. PSA is just an early indicator.
 
You are 100% correct. PSA is just an early indicator.

Many tests are indicators. That's why we do labs. Even things like echocardiograms are very limited diagnostic tools, but tell doctors places they should perhaps look.

It should proceed like this:

Dr. Mr. Patient, you are 70 years old and PSA's are no longer recommended for those your age. First, they may give inaccurate impressions. Second, it's felt at your age, the favored course of action, even if positive, is to do nothing. Would you like a PSA test done?

Patient: Yes, I prefer to have any possible information.

Then later.

Dr. Your PSA is elevated. There are now several courses of action. We can do a biopsy. We can do nothing. Or, if you're more concerned about other parts of your body, we can do some scans to see if we find signs of cancer.

Then pursues a discussion of each option and patient decides. Patient, not CDC, not Doctor, not Insurer, Patient.
 
I agree with the above. CDC, after some initial confusion, clearly said that the final decision was the patient's with consultation from his Dr. The op's real beef is that he wasn't given that option and that was quite wrong.

David
 
Mike,
Modern cancer treatment is remarkable. There have been huge advances in the treatment since i was diagnosed in 2003. For me, it came at 52. Second opinion from Johns Hopkins concurred, so I had the full zipper surgery. The surgeon felt very good about the results. However my follow up PSA test showed that there was still cancer. I was very fortunate that the new Linear Accelerator X-Ray equipment was just coming available and I had 16 weeks of radiation treatment. They got it and now 16 years later my PSA is still undetectable . This next few months is going to be tough. Modern cancer treatment is remarkable. Please check in here as you go along.
 
Mike,
Modern cancer treatment is remarkable. There have been huge advances in the treatment since i was diagnosed in 2003. For me, it came at 52. Second opinion from Johns Hopkins concurred, so I had the full zipper surgery. The surgeon felt very good about the results. However my follow up PSA test showed that there was still cancer. I was very fortunate that the new Linear Accelerator X-Ray equipment was just coming available and I had 16 weeks of radiation treatment. They got it and now 16 years later my PSA is still undetectable . This next few months is going to be tough. Modern cancer treatment is remarkable. Please check in here as you go along.

You point out something so important, that medicine evolves constantly. I'll point out something else too and that is much of the data they look at is old. As an example, look at the 5, 10, 15 year life expectancy of people having a specific treatment. Well, you're not looking at treatment using what they've learned or do today. You're looking at numbers based on the level of medicine 5, 10, and 15 years ago.
 
Well that was a piece of cake.

I had my first chemo treatment and before I get into the details I must say that the great people at Kadlec Clinic Hematology and Oncology clinic are absolutely top notch. On a scale of 1 to 10 I'd give all of them a 15. No waiting to be seen, everyone was VERY friendly, everything was explained thoroughly and all my questions were answered completely. Nice job gang.

The actual treatment went pretty much as I expected. Lots of pills ahead of the infusion to head off nausea caused by the chemo treatment, the infusion itself along with saline solution. The whole procedure including the Q&A time before the procedure was about 3 hours.

One thing that surprised me is that I won't likely feel any ill effects for a couple of days. So instead of being tired and nauseous today and tomorrow, it likely will be Thursday and Friday. More on that later.

So there will be a total of 6 treatments 3 weeks apart. The day before each treatment I have to go to the local lab to have blood drawn and the day following I have to go to the Kadlec clinic for an injection and that visit won't take more than about 10 minutes.

At this time we only have 4 chemo treatments scheduled. As each treatment is completed another will be scheduled until all 6 are completed. At that point the doc will do an assessment to determine what treatment will be administered going forward.

So that's about it. At this point I'm feeling NO ill effects from the chemo. That likely will change on Thursday as this stuff works its way through my body.

Thanks for all the positive comments and prayers. They mean a lot. I never thought I'd be in this position (who does?) and it's a nice feeling to know there are people out there who care.
 
GFC, best wishes of course.
Be extra careful around sick people during your treatment especially right now with this covid thing.
 
Thanks for the heads up. I'm turning 60 this year (WTF?!!?) so will look into this further. Speaking of further, my doctor stuck his finger in a tad further than...oh, never mind.

Your optimism and scrappy attitude will add years to your life. Wallowing in potentially bad tangents is a total waste of time! Next time I gather a bunch of villagers to slay a dragon in its mountain lair, I'll give you a call.

Mind if I add a heads up? I'm of British/Irish stock, so have a more than a few moles. Some have been cut out over the years and tested for cancer...so far, so good.

It seemed like my doctor hadn't checked for a while, so I made an appointment and told him it was time for a mole check. He checked, and made an appointment for me at a clinic in Vancouver. Again, so far, so good. I'm supposed to go back every two years.

It pays to be proactive :thumb:
 
Yep, especially with melanomas, it is important to identify these diseases early on. As has been said here already there has been excellent advances in treatment, and these advances are ongoing.

Good to hear GFC, that all things considered, you are traveling well.

In a way we are very fortunate, medically speaking, that we are living in this time of human history, provided of course you are in a position to access the benefits.
 
Yep, especially with melanomas, it is important to identify these diseases early on. As has been said here already there has been excellent advances in treatment, and these advances are ongoing.

Good to hear GFC, that all things considered, you are traveling well.

In a way we are very fortunate, medically speaking, that we are living in this time of human history, provided of course you are in a position to access the benefits.

Andy, yes, I feel like I am traveling well. We are fortunate in our area to have two excellent cancer centers which are both connected to each other and also with the Cancer Alliance in Seattle which is comprised of the Fred Hutchinson Cancer Center, the Univ of WA Medical School and a couple of other cancer treatment centers.


I'm another light skinned Irishman who gets checked every 6 months at my dermatologist for squamous cells. They usually seem to find one or two, do the biopsy then excise them. Better safe than sorry.

Murray, I'm always up for a good dragon slaying party. I might even be tempted to have an adult beverage or three to celebrate the successful hunt.
 
Nausea?


100.webp
 
Mr. RTF, we're fortunate to live in a state where all those fun pot and CBD products are legal. We're ready for the nausea to start. Not hoping it will, but we're ready.
 
Mr. RTF, we're fortunate to live in a state where all those fun pot and CBD products are legal. We're ready for the nausea to start. Not hoping it will, but we're ready.

Wifey B: Hubby just talked to a long time friend undergoing an extreme unconventional cancer treatment and experiencing real pain. She's taking huge quantities of Tylenol and Ibuprofen but at night taking Tramadol. She can't take Opioids as they make her very sick. In a medical marijuana state but only sublingual and drops and both burn her mouth terribly. Her daughter to the rescue though with medicinal gummy bears. Last night the best sleep she's had in ages. :D
 
I feel as though I've been wrung through the wringer....several times. Last night was the worst night so far and this morning it isn't getting any better. I feel like my body has been through the flu. The bones in my body are sore as hell and it hurts to even move. This afternoon things started to pick up a bit though I'm still sore. I feel as though I've passed the worst part of it and hopefully tomorrow will get better. I wouldn't wish this on my worst enemy..
 
I feel as though I've been wrung through the wringer....several times. Last night was the worst night so far and this morning it isn't getting any better. I feel like my body has been through the flu. The bones in my body are sore as hell and it hurts to even move. This afternoon things started to pick up a bit though I'm still sore. I feel as though I've passed the worst part of it and hopefully tomorrow will get better. I wouldn't wish this on my worst enemy..

I'm aware how horrific it must feel, but to say I understand would be false as I don't think anyone can fully understand until they're there. I talked at length yesterday afternoon to a long time friend undergoing cancer treatment. Her problem was pain at night and she can't take opioids as they make her very sick so been taking Tramadol at night with little luck. She's in a medical marijuana state but the forms they give it in (sublingual and liquid) burn her tongue and mouth. The first relief she'd had was the night before when her daughter brought her some gummy bears. Four of those and she slept well.

I hope you find things to help you reduce the pain as you go through this. Doctors tend to concentrate on the disease but make sure they also help you with pain and nausea.
 
Tonight was the yacht club's St. Patrick's party. Needless to say we couldn't go but Tina did go down and pick up two corned beef and cabbage dinners and brought them home. It really hit the spot and it's the most I've had to eat in 3 days. Now if I can just keep it down I'll be in good shape. I took a shower this afternoon and that felt good. I think maybe I've turned the proverbial corner and am headed on an uphill run. I'm ready for this crap to be done with but it's one down, five to go.
 
Well Happy St. Patrick;s Day to all of you real and honorary Irishmen.

Yesterday I was feeling pretty good so later in the afternoon we joined some neighbors around their fire pit. I didn't drink anything but several bottles of wine were consumed, lots of jokes and stories told and everyone was having a great time. One unusual thing about our neighborhood is that generally, fences are not allowed. That has allowed us to meet and get to know all the neighbors around us quite well. And this is a bunch that likes to socialize.

So we sat around until about 7:30 swapping lies and enjoying lots of laughter. It started to get cold as the sun went down and I didn't realize how chilled I had gotten. By the time we walked home I was shivering. We ate dinner and I went upstairs and sat in the sauna (~120*) for about 20 minutes until I was thoroughly warmed up. I came downstairs and was going to read awhile but decided to head right to bed....about 8:00.

I was exhausted and didn't stir until about 3:00 when I rolled over, then got up to drain the radiator about 5:30, then slept solidly until 8:00 when Sailor let me know it was time to go for our morning walk.

I feel great this morning, about 100% but only have a couple of things to do so will take it easy. I taught myself a lesson and won't forget it. Until the next time.

I have to head out to a doc's appt but will tell you later what we planned last night while sitting around the fire pit.

Top' o' the day to ye all..
 
Wifey B: I had no idea there were neighborhoods that didn't allow fences. I've seen many that required fences. :)
 
WifeyB, it's fenced all the way around except the south side that faces the Columbia River. There are only 2 entrances/exits, narrow curving streets, 15mph speed limits, three traffic circles, 9 or 10 cul-de-sacs and it's VERY quiet in here.

We pretty much know all the neighbors within a 1/4 mile so if there's strange vehicle traffic we take note of it.

We're one of the few homes that has a fence and that's only because we have a pool. That's about the only reason the HOA will allow a fence. We've been here 12 or 13 years and it would take a huge load of dynamite to blast us out of here.
 
The neighborhood gathering around the fire pit a couple of nights ago was fun. While we were talking about the surreal living conditions we're going through with the virus and all the curtailments to our freedoms. Nobody was griping about what has been happening, but rather how fortunate we all are to be where we are.

We're all retired so we don't have to travel. One of the couples just returned a month ago from a month long trip through South America and returned safely with no virus symptoms. We live in a fairly secluded neighborhood where there is almost zero vehicle traffic except for those who live here.

The conversation then turned to how grateful we are to be at this position in our lives and how much we have to be thankful for, especially in these turbulent times. That then turned into the notion that we should have a Thanksgiving dinner to celebrate our good fortune. So, next Thursday we're going to do exactly that. A Thanksgiving dinner for about 20 or so of our closest friends. One couple is buying the turkey, we're doing the stuffing, others are bringing cranberry dishes, salads, potatoes, etc. It's going to be a very informal, outdoor event and should be a good time to reflect on our good fortune.

More to follow.
 
I'm too lazy to go back through these posts and check but I think I mentioned earlier how humbling this experience has been for me. I'm usually the one stepping up and helping others out, not the one being helped.

Tonight some good friends from the yacht club brought us a complete BBQ dinner including chicken, brisket, beans, 2 other sides and sauces. All from one of the restaurants that specializes in BBQ.

I am again humbled. Thanks, Mike and Kerry.
 
Hi there all, and especially GFC. Great post GFC, and thank you for launching it, as it is a really important subject, even though not boating related per se. I realise I'm coming in a bit later than I'd have liked, as it started back on the 1st, but I only just came across it. However, the speed with which it grew legs says a lot about the relevance of it, for sure.

Being not only a newly retired family doc, but also someone who in 2017 diagnosed himself with Ca prostate, while at the same time having quite a large number of men in whom I also diagnosed the condition over the last few years, and observing how they all went with their various modes of treatment, I thought I might be able to add to this discussion from the medical and personal standpoint, and with a certain degree of validity.

You say...
Of all the threads I’ve started on here this is by far the most difficult I’ve written. The reason? I have prostate cancer. Well, actually I have Metastasized Prostate Cancer.

About 2 months ago a long time friend of mine that I’ve met for coffee every Thursday for the past 25 or so years told me he had prostate cancer and was going to have his prostate removed. I’m 73 and he’s several years younger than I am. He asked me when the last time I had my PSA checked and I couldn’t honestly tell him.

A quick call to my local VA medical center disclosed that I had my last PSA test done when I was 70. I asked them why they didn’t do it every year when I had my physical done and they hid behind the recommendation of the CDC that says something about not doing them for men over 70. I asked them why and they said they didn’t know, that’s just what the CDC recommends.

Quite frankly, I feel like they let me down. I assumed (Yeah, I know…) they did that every year as part of my blood work. Had they told me they didn’t routinely screen for PSA after a certain age I’d have requested the test be done.

So, I had blood drawn and had a PSA test done and the results were sky high. High enough that they rushed through an approval for the VA to pick up the tab for me to see a urologist. I did, they did another PSA test and confirmed the reading and scheduled me for a CT Scan and MRI so they could determine the extent of the spread of the cancer cells.

So now that we know the cancer cells have spread throughout my body, attaching itself to bones at several locations in this otherwise perfect male specimen, they scheduled me to see an Oncologist.

So here I sit, writing this thread which took several beers before I could bring myself to do it. I’m facing 6 months of chemo treatments, one every 3 weeks. Nobody is predicting this is going to end my life early, in fact the only thing they are predicting at this point is that at the end of the 6 months they’ll reassess how things are going and likely put me on another type of treatment......

I didn’t write this thread looking for sympathy. That’s now how I roll. I wrote it with the hopes that some of you old farts out there who don’t know when you last had it tested will get your butt in gear and go see your doctor. Smooth waters, light winds and fair skies.

And therein lies the conundrum...
While the statistics might suggest that often a Ca prostate will not affect a man over say 70 all that much, and he may die with it, but not from it, each and every one of us do not think of ourselves as just a statistic..!


David makes a great point here when he says...
....But lots and lots of prostates were removed over the years, maybe including mine that would have been fine if left alone. That is why the CDC recommends and I am sure did not do it casually, not to do routine PSA exams anymore. It is a crap shoot for sure: If PSA is high, do the surgery and face quality of life reduction or do nothing and bet that you will be fine. The CDC apparently determined that on balance not doing routine PSAs was better than doing unnecessary treatment. The rub is that you never know if you will be the one like yourself who would have been helped by early detection and treatment.

And FWIW even if detected at the age of 70 which apparently was not for you, CDC recommends no treatment, because you will die from something else than prostate cancer. (But we don't think of ourselves as a statistic like this, do we? - my edit)

I am a little puzzled by the recommendation to start chemotherapy. Usually the treatment for someone in your condition is hormone therapy- reduce testosterone in your system because testosterone is necessary for cancerous cell growth.*** It works for a lot of people, but unfortunately not for all.

***The use of chemo straight up was because there were metastases, so testosterone deprivation therapy alone, in itself not enough in this case.

The other thing that began to concern me was that there is still an over-reliance on the surgical option, of radical prostatectomy, and often it became apparent to me that unless one knew (like I did) about the other options, like radiotherapy, and now even focussed ultrasound, folk were not being told about these options. It hinted at being a bit like the workman whose only tool is a hammer, would like every problem to look like a nail. So Syjos comment below is so right...
Wow, sorry about your prostate issue.
I get a PSA test yearly since my dad had prostate cancer.

10 years ago my PSA went up quickly. Went to an Urologist who performed a 12 sample biopsy that didn't find anything. I got an infection from the biopsy that took months to heal. The Urologist was sure my prostate was cancerous and wanted to do another 12 snip biopsy after I healed. I told my Doctor no way would I go back to the quack. He sent me to another Urologist who used a pee pee camera to look at the prostate. He found a golf ball sized tumor on the outside of my prostate. The Urologist removed the tumor through my urethra, had it tested and found it not cancerous. My PSA dropped to normal within 6 months.

Moral of the story, GET A SECOND OPINION! (I would add, especially including a radiation oncologist)

Thanks Tom. The whole notion behind this thread was to get guys to call their doc for a PSA test. I'm really pissed at my VA Physicians Assistant for not telling me they didn't routinely do a PSA test. Had she told me, I'd have requested that it be done. By not telling me, like WifeyB said, she was playing God and I don't like that.

Yes, I can understand how you feel, but about that time the US College of Urologists came out very strongly about not doing the test unless specifically asked, or symptoms suggested trouble. As did other colleges round the world. Problem is most patients aren't that pushy, and in many cases, (my own included) there are no real symptoms. Already since the surge of cases of metastatic ca prostate being diagnosed, these recommendations are changing back to more active surveillance..!


Many tests are indicators. That's why we do labs. Even things like echocardiograms are very limited diagnostic tools, but tell doctors places they should perhaps look.

It should proceed like this:

Dr. Mr. Patient, you are 70 years old and PSA's are no longer recommended for those your age. First, they may give inaccurate impressions. Second, it's felt at your age, the favored course of action, even if positive, is to do nothing. Would you like a PSA test done?

Patient: Yes, I prefer to have any possible information.

Then later.

Dr. Your PSA is elevated. There are now several courses of action. We can do a biopsy. We can do nothing. Or, if you're more concerned about other parts of your body, we can do some scans to see if we find signs of cancer.

Then pursues a discussion of each option and patient decides. Patient, not CDC, not Doctor, not Insurer, Patient.
Absolutely right. That is how it should go, but more importantly, nowadays, as one urologist has stated, "to do a prostate biopsy without first doing an MRI, is tantamount to malpractice". Actually, he used even stronger language. He said barbaric. And, like the poster Syjos mentioned above, I have had a friend actually die from septicaemia caused by trans-rectal biopsy, so I insisted on it being done (under GA) trans-perineal, (ie from clean skin between the scrotum and anus), and only after MRI showed where to aim..!

So, in summation I would just say as diplomatically as is appropriate, bugger those who say, you don't really want a PSA do you..? Or, if diagnosed, like I was told, "if you do nothing Pete it probably won't kill you till you're 80ish". I was only 69, and did not want to live what could be another 20 years with a ticking time-bomb down there, and I'm not a statistic, I'm me..!

So, I had just stereotactic (highly focussed) radiotherapy, declined the androgen deprivation therapy, as PET CT showed no spread, and I needed to keep working as a GP, and I never missed a day's surgery through the 25 weeks of treatment sessions, most of which were able to be done in the evening. My PSA went from 20 down to now, 3 years later, barely measurable at 0.04.

I explain this so others can know there are options other than surgery, and the sooner it is found, the more options are open, and the more effective the treatment will be. So, like GFC said, "ask for those PSAs and don't take no for an answer, as long as you're prepared to deal with the result of course - interestingly, some are not...

I'll finish by re-quoting from GFCs last post...as this is the sort of thing we need to hold onto when times are tough, for whatever reason...

The neighbourhood gathering around the fire pit a couple of nights ago was fun. We plan (sic)...A Thanksgiving dinner for about 20 or so of our closest friends. One couple is buying the turkey, we're doing the stuffing, others are bringing cranberry dishes, salads, potatoes, etc. It's going to be a very informal, outdoor event and should be a good time to reflect on our good fortune.

More to follow.

:flowers:
 
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Pete, thank you for your well laid out response to the various posters. I appreciate that it comes for your many years as a surgeon as well as a CA survivor.

As I said early on, my original thought was to post this (embarrassing as it was) to encourage others to get a PSA test done. If your doc doesn't specifically mention doing it, ask him/her about getting one done. Do NOT take anything less than a "YES" answer to that request then follow up to find out what the result was.

I made that original post on 3 different boating forums that attract boaters from 3 widely varying sectors of the boating community. Thus far I am able to count 9 men who have gotten a PSA test done as a result of what I posted.

I consider that not only a success story, but one of my life's greatest achievements. Let's hope the count increases.

Thanks again, Pete
 
GFC
What a wonderful and informative thread. Timely too and informative vs what we are accustomed to seeing on so many websites today. And good for you and your friends in having the fire pit get together in light of the doom and gloom currently running rampant.

Upon your experience I went to the Urologist last month. He was happy with the exam and always low PSAs I've enjoyed. He said at my age the PSAs are no longer needed. Since they are easy to do and paid for I'll continue them anyway.

Hang in there buddy and we look forward to seeing you in AZ.
 
Good luck with your treatment. I was diagnosed with prostate cancer in 2006 at 48 years old and had it removed.

As a way of encouragement, a good friend of high school, was diagnosed with Metastasized Prostate Cancer at the same time. He has been on hormone treatment ever since and is still kicking!
 
GFC
Hang in there buddy and we look forward to seeing you in AZ.

Tom, we're not sure at this time if we'll be coming down. We really need to get the condo closed up, patio furniture put away, and we'd like to bring our Whaler back up here when we return.

Given my medical condition (age, diabetic and chemo patient) I'm not sure I can talk my Galley Wench into letting us make the trip. She has me on a VERY short leash and a tight choke chain.

We are going to take the boat out for a few hours on Sunday. It's a good excuse to get out of the house and our self-imposed quarantine. Also a good excuse to blow out some of the cobwebs from the Cats.
 
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