Prostate-screening perspectives shared as another nears
Republic 1/8/10
Last fall I announced a prostate screening offered by Scottsdale healthcare. Robert Diepenbrock of Scottsdale sent me this follow up email.
“I had made appointments for a PSA test and a Cholesterol & Glucose tests, but was also able to have my skin checked for skin cancer, a test for osteoporosis, a fat percentage and waist circumference test and a review and evaluation of my test results by a physician.
During the event I was administered a Glucose test (the prick your finger blood test). I tested high. Based on this test result I have seen a physician and discovered I have Type 2 Diabetes. I'm treating it with a change in diet, exercise and medication (no insulin shots). If it hadn't been for the screening my condition could have gone on undetected and gotten worse.
I am truly fortunate to have attended this event and urge other men to attend the next event,” said Diepenbrock.
Phil Anderson responded as well.
“I had the robotic surgery in September, 2008 and I spent only one night in the hospital. I never had to wear more than a pad. That was for only about a month. My personal life with my wife has changed very little due to the fact with robotic surgery many of the nerves are able to be spared. I opted for the robotic way as I have a bleeding disorder, and this is much less invasive. I am a 70 year old man in fairly good health. My latest PSA test was in the negative zone. I know there are many options for prostate cancer and everyone must make their own decisions, but this robotic option, I feel is one of the best.”
Jack Szatkowski wrote me in September too late to get his comments in my column so I checked on him a couple of weeks ago.
“I had the seeding procedure in April, it has been and continues to be the most painful, miserable, and uncomfortable experience a person would want to go through. I am doing somewhat better; it is down to penis and urethra pain spasms and urinary retention. I just have to plan ahead when leaving the house.”
Hal Cope offers an interesting perspective.
I have been living under the ax of prostate cancer for years. In brief my PSA in 1992 was 2.5. Since that time it has climbed and climbed and climbed during which time I had biopsies upon biopsies.
Finally in 2001 with my PSA at 14.1 and with all biopsies and the Digital Rectal Examination [DRE] negative, I had the seed implant.
My PSA dropped to 1.4 then began its steady climb to 40.7 in April of 2008. It dropped to 34.4 in August, 2009. All DRE's were clear of cancer including the granddaddy of all biopsies 29 punctures with no visible sign of cancer. My doctor wanted to give me hormone shots to lower the number which I declined.”
Cope has his next check up this month. For many like Hal Cope, watchful waiting may be an option but you have to have regular check ups.
The next prostate cancer screening is January 23, 2010 from 8 AM to Noon in the US Airways Center at 201 E. Jefferson. Call (480) 964-3013 or 800-828-6139 to schedule your FREE Screening. Appointments required.
If you cannot get to this screening, schedule an appointment with your personal physician.
For both men and women, a regular physical examination with your physician is a good way to start this new decade.
Helpful sources:
Go to http://prostatecheckup.com to read other stories and learn more.
Go to my blog at http://prostatecancersupport.blogspot.com for previous columns and stories.
Sunday, April 25, 2010
Prostate cancer 4/9/2010
PSA testing for prostate cancer debated; disease remains a killer 4/9/10
There have been a lot of scary stories in the media about the role of PSA testing for prostate cancer. One writer told a health magazine that he wanted his cancer back. He had read the two studies published in the New England Journal of Medicine and wrongly concluded that routine screening is not necessary. Hidden near the end of the article is this statement, “Nobody wants to die of it. So I guess it was a good thing my prostate was taken out.”
The greatest risk factor for prostate cancer is age. This risk increases significantly after the age of 50 in white men who have no family history of the disease and after 40 for black men and men with a close relative with prostate cancer. About two-thirds of all prostate cancers are diagnosed in men age 65 and older. About 80 percent of men who have reached 80 have prostate cancer. Medicare will only cover men over 50.
My concern is that older men, particularly those who do not like the PSA [prostate-specific antigen] test and DRE [digital rectal exam], will see these stories and say why bother testing. We should do less treatments but better screening.
National Public Radio interviewed a staff member, Richard Knox, under the title: Prostate Test: Lifesaver or Big Mistake? Knox talked to Richard Ablin, M.D. from the University of Arizona. Ablin discovered the PSA or prostate-specific antigen and now says the PSA test has become a public health disaster.
Ablin uses the analogy of the prostate gland as a box with no top. Aggressive cancer, the rabbit, can jump out of the box and spreads. The nonaggressive cancer, the turtle, just crawls around and goes no where. He is correct that the PSA test cannot tell you which cancer it is or even if you have cancer.
The April issue of the Johns Hopkins Prostate Disorders Health Alert discussed the quality of life issues after Prostate Cancer Treatment.
“Because prostate cancer progresses more slowly than other types of cancer, men can take some time to carefully consider the various prostate cancer treatment options. A man should talk with his doctor about the relative risks and benefits of each treatment and consider consulting physicians from different fields [urologists, radiation oncologists, and medical oncologists] to get a broader spectrum of opinions.”
The New England Journal of Medicine published two now famous studies a year ago, one American and one European. They are still being cited to suggest that PSA testing is not that important. Dr. Ruth Etzioni in Biostatistics of the Division of Public Health Sciences at the Fred Hutchinson Cancer Research Center pointed out several issues that put the research in the proper context.
The interpretations of the results of these studies are incorrect. Etzioni says, “The American trial is not a study of true screened and not screened as was the European trial.” That is because nearly one third of the supposed “not screened” did have tests so the American cancer death rates cannot be compared to the European results.
“There was too much focus on the American trial. You cannot just look at the number of deaths from prostate cancer, since not that many die from the cancer. You have to look at the percentage drop in the number of deaths for those who were screened. The European results showed a 20% drop in cancer deaths which I think is significant,” said Etzioni.
One PSA test is insufficient to recommend additional tests.
In early March, The American Cancer Society revamped its recommendations for prostate cancer screening. In new guidelines released the Society says that men who choose to be tested should get an annual screening if their level of prostate-specific antigen, or PSA, is 2.5 nanograms per milliliter or higher. But men whose PSA is under that threshold can be safely screened every two years. Men with a PSA level of 4.0 or higher should consider getting further evaluation, such as a biopsy. Previous guidelines had suggested that men with a PSA of less than 4.0 should be screened annually.
Next week: What should you do about prostate cancer screening?
Resources:
http://content.nejm.org/cgi/content/full/NEJMoa0810696?query=TOC
This is the American study.
http://content.nejm.org/cgi/content/full/NEJMoa0810084?query=TOC
This is the European study.
http://www.nejm.org/perspective-roundtable/screening-for-prostate-cancer/?query=TOC
Go to this website for the physicians’ discussion of the studies.
There have been a lot of scary stories in the media about the role of PSA testing for prostate cancer. One writer told a health magazine that he wanted his cancer back. He had read the two studies published in the New England Journal of Medicine and wrongly concluded that routine screening is not necessary. Hidden near the end of the article is this statement, “Nobody wants to die of it. So I guess it was a good thing my prostate was taken out.”
The greatest risk factor for prostate cancer is age. This risk increases significantly after the age of 50 in white men who have no family history of the disease and after 40 for black men and men with a close relative with prostate cancer. About two-thirds of all prostate cancers are diagnosed in men age 65 and older. About 80 percent of men who have reached 80 have prostate cancer. Medicare will only cover men over 50.
My concern is that older men, particularly those who do not like the PSA [prostate-specific antigen] test and DRE [digital rectal exam], will see these stories and say why bother testing. We should do less treatments but better screening.
National Public Radio interviewed a staff member, Richard Knox, under the title: Prostate Test: Lifesaver or Big Mistake? Knox talked to Richard Ablin, M.D. from the University of Arizona. Ablin discovered the PSA or prostate-specific antigen and now says the PSA test has become a public health disaster.
Ablin uses the analogy of the prostate gland as a box with no top. Aggressive cancer, the rabbit, can jump out of the box and spreads. The nonaggressive cancer, the turtle, just crawls around and goes no where. He is correct that the PSA test cannot tell you which cancer it is or even if you have cancer.
The April issue of the Johns Hopkins Prostate Disorders Health Alert discussed the quality of life issues after Prostate Cancer Treatment.
“Because prostate cancer progresses more slowly than other types of cancer, men can take some time to carefully consider the various prostate cancer treatment options. A man should talk with his doctor about the relative risks and benefits of each treatment and consider consulting physicians from different fields [urologists, radiation oncologists, and medical oncologists] to get a broader spectrum of opinions.”
The New England Journal of Medicine published two now famous studies a year ago, one American and one European. They are still being cited to suggest that PSA testing is not that important. Dr. Ruth Etzioni in Biostatistics of the Division of Public Health Sciences at the Fred Hutchinson Cancer Research Center pointed out several issues that put the research in the proper context.
The interpretations of the results of these studies are incorrect. Etzioni says, “The American trial is not a study of true screened and not screened as was the European trial.” That is because nearly one third of the supposed “not screened” did have tests so the American cancer death rates cannot be compared to the European results.
“There was too much focus on the American trial. You cannot just look at the number of deaths from prostate cancer, since not that many die from the cancer. You have to look at the percentage drop in the number of deaths for those who were screened. The European results showed a 20% drop in cancer deaths which I think is significant,” said Etzioni.
One PSA test is insufficient to recommend additional tests.
In early March, The American Cancer Society revamped its recommendations for prostate cancer screening. In new guidelines released the Society says that men who choose to be tested should get an annual screening if their level of prostate-specific antigen, or PSA, is 2.5 nanograms per milliliter or higher. But men whose PSA is under that threshold can be safely screened every two years. Men with a PSA level of 4.0 or higher should consider getting further evaluation, such as a biopsy. Previous guidelines had suggested that men with a PSA of less than 4.0 should be screened annually.
Next week: What should you do about prostate cancer screening?
Resources:
http://content.nejm.org/cgi/content/full/NEJMoa0810696?query=TOC
This is the American study.
http://content.nejm.org/cgi/content/full/NEJMoa0810084?query=TOC
This is the European study.
http://www.nejm.org/perspective-roundtable/screening-for-prostate-cancer/?query=TOC
Go to this website for the physicians’ discussion of the studies.
Prostate cancer 4/16/2010
Prostate cancer is treatable; 27,000 men don’t have to die 04/16/10
Routine PSA screening a must despite advice from cancer society
Prostate cancer warning
While Prostate Cancer in its early stages may not have any symptoms, you should honestly ask yourself if you are experiencing any of the following:
• Difficulty starting to urinate
• Less force to the stream of urine
• Dribbling after you finish urinating
• Frequent urination, especially at night
• Blood or pus in the urine
• Blood in the semen
• Pain while urinating
• Pain with ejaculation
• Hip and lower back pain that does not go away over time
• Pain in the lower part of your pelvis
• Unintended weight loss and/or loss of appetite
______________________________________________________________________
Bob King about 61 years old became concerned when he was making four nightly trips to the bathroom. His dosage of Flomax was not working so went for a biopsy. One positive finding and a suspicious second spot raised concern for prostate cancer.
The Scottsdale resident did not rush to surgery but discussed his options with several urologists and friends who had had surgery.
Ultimately Bob had the surgery with this thought, “if your body tells you that there is a problem, then you have to deal with it.”
Gary Cruz also of Scottsdale, at age 57 found that he has several positive biopsies.
“My options were to do nothing, radiation, hormone therapy, radioactive seeds, conventional surgery or robotic surgery. I hated knowing that cancer was in my body and after some emotional conversations with my wife and son and my urologist. I decided to undergo the robotic surgery to remove my cancerous prostate,” said Cruz.
“Was I in a life and death situation? The simple answer was no but as I stated, I couldn't mentally deal with the fact I had cancer growing in my body, regardless of how slow it may have been and there is no evidence that it was or was not growing rapidly.”
Cruz said early detection saved his life. “Almost 27,000 men die from prostate cancer every year. It drives me crazy that most of those deaths could have been prevented with early detection. I'm a firm believer that men should start getting tested at age 40 on an annual basis,” he added.
What should you do about prostate cancer screening? If you are over fifty and you get an annual physical, add the PSA test to your blood work if it is not already included. They use the same blood sample for the cholesterol test.
The test that most men do not like is the digital rectal examination [DRE]. It probably saved Scottsdale resident David Tucker’s life.
“My case was simple. DRE revealed a lump, PSA went from 2.8 (for 3 years straight) to 3.6, biopsy had 3 hits in 10, and I was just 62.”
He elected surgery and has been cancer-free for four years.
Rabbi Ed Weinsberg writes a blog on prostate cancer and notes “Prostate Cancer screening has NOT been overtly encouraged by the American Cancer Society [ACS] for the past 15 years. Now the American Cancer Society has gone even further by asking patients and doctors to consider the danger of routine prostate cancer PSA screening, since the ACS implicitly claims such testing can easily lead to over-treatment.”
His conclusion is the same as mine.
“Even though at least 80% of prostate cancers are found early, scientists have yet to figure out which are likely to become aggressive. Is the ACS asking men to avoid treatment and simply assume they won’t be among the 27,000 prostate cancer patients who die every year in the US alone? It’s true that the odds of survival are in our favor. But prostate cancer remains the second leading cause of male cancer death after lung cancer.”
“Whatever its limitations, until a more precise biomarker is discovered, routine PSA screening is a must for most men, followed by a biopsy when indicated to determine if a man has prostate cancer. We men have a right and an obligation to ourselves to know what’s happening inside our bodies,” Weinsberg said.
So get regularly testing and keep good records. Doing nothing may make you a statistic.
Prostate cancer resources:
http://conquerprostatecancernow.typepad.com/
Rabbi Ed Weinsberg’s blog
Conquer Prostate Cancer: How Medicine, Faith, Love and Sex can renew Your life, by Rabbi Ed Weinsberg with Dr. Robert Cary
http://prostatecancersupport.blogspot.com My blog
Routine PSA screening a must despite advice from cancer society
Prostate cancer warning
While Prostate Cancer in its early stages may not have any symptoms, you should honestly ask yourself if you are experiencing any of the following:
• Difficulty starting to urinate
• Less force to the stream of urine
• Dribbling after you finish urinating
• Frequent urination, especially at night
• Blood or pus in the urine
• Blood in the semen
• Pain while urinating
• Pain with ejaculation
• Hip and lower back pain that does not go away over time
• Pain in the lower part of your pelvis
• Unintended weight loss and/or loss of appetite
______________________________________________________________________
Bob King about 61 years old became concerned when he was making four nightly trips to the bathroom. His dosage of Flomax was not working so went for a biopsy. One positive finding and a suspicious second spot raised concern for prostate cancer.
The Scottsdale resident did not rush to surgery but discussed his options with several urologists and friends who had had surgery.
Ultimately Bob had the surgery with this thought, “if your body tells you that there is a problem, then you have to deal with it.”
Gary Cruz also of Scottsdale, at age 57 found that he has several positive biopsies.
“My options were to do nothing, radiation, hormone therapy, radioactive seeds, conventional surgery or robotic surgery. I hated knowing that cancer was in my body and after some emotional conversations with my wife and son and my urologist. I decided to undergo the robotic surgery to remove my cancerous prostate,” said Cruz.
“Was I in a life and death situation? The simple answer was no but as I stated, I couldn't mentally deal with the fact I had cancer growing in my body, regardless of how slow it may have been and there is no evidence that it was or was not growing rapidly.”
Cruz said early detection saved his life. “Almost 27,000 men die from prostate cancer every year. It drives me crazy that most of those deaths could have been prevented with early detection. I'm a firm believer that men should start getting tested at age 40 on an annual basis,” he added.
What should you do about prostate cancer screening? If you are over fifty and you get an annual physical, add the PSA test to your blood work if it is not already included. They use the same blood sample for the cholesterol test.
The test that most men do not like is the digital rectal examination [DRE]. It probably saved Scottsdale resident David Tucker’s life.
“My case was simple. DRE revealed a lump, PSA went from 2.8 (for 3 years straight) to 3.6, biopsy had 3 hits in 10, and I was just 62.”
He elected surgery and has been cancer-free for four years.
Rabbi Ed Weinsberg writes a blog on prostate cancer and notes “Prostate Cancer screening has NOT been overtly encouraged by the American Cancer Society [ACS] for the past 15 years. Now the American Cancer Society has gone even further by asking patients and doctors to consider the danger of routine prostate cancer PSA screening, since the ACS implicitly claims such testing can easily lead to over-treatment.”
His conclusion is the same as mine.
“Even though at least 80% of prostate cancers are found early, scientists have yet to figure out which are likely to become aggressive. Is the ACS asking men to avoid treatment and simply assume they won’t be among the 27,000 prostate cancer patients who die every year in the US alone? It’s true that the odds of survival are in our favor. But prostate cancer remains the second leading cause of male cancer death after lung cancer.”
“Whatever its limitations, until a more precise biomarker is discovered, routine PSA screening is a must for most men, followed by a biopsy when indicated to determine if a man has prostate cancer. We men have a right and an obligation to ourselves to know what’s happening inside our bodies,” Weinsberg said.
So get regularly testing and keep good records. Doing nothing may make you a statistic.
Prostate cancer resources:
http://conquerprostatecancernow.typepad.com/
Rabbi Ed Weinsberg’s blog
Conquer Prostate Cancer: How Medicine, Faith, Love and Sex can renew Your life, by Rabbi Ed Weinsberg with Dr. Robert Cary
http://prostatecancersupport.blogspot.com My blog
Wednesday, September 9, 2009
SECOND PSA READING POST SURGERY
The second reading remains as good as the first. I will be writing a column on Prostate cancer that should be published in the next three weeks and will be posted here.
Wednesday, April 15, 2009
First PSA checkup since surgery
On 4/14/09 I had my PSA checked. There was a negative amount. I return in 3 months. I continue to make progress on every front without any ED drugs.
Sunday, March 29, 2009
Prostate cancer screening
TESTING FOR PROSTATE CANCER IS ADVISED DESPITE STUDIES
Watch. Wait. Should I test or not test? Last week the results of two studies on prostate cancer screening were part of the headlines in The Arizona Republic. [3/19/09]
I read those studies, and I am concerned that men might get the impression that it is OK not to be given a prostate specific antigen test [PSA] and digital rectal examination [DRE].
The article concluded with this thought. “The two studies were designed to give a definitive answer about the value of such screening.” Not all researchers agree that the studies do this.
Overall one of every six men will get prostate cancer during their lifetime, most physicians recommend the PSA and DRE after age fifty. It is usually slow growing but it ranks as the fifth leading cause of death among men. At 50, your chances are 1 in 476 of having the cancer.
WHAT THE STUDIES MEAN
Dr. Ruth Etzioni in Biostatistics of the Division of Public Health Sciences at the Fred Hutchinson Cancer Research Center pointed out several issues that put the research in the proper context.
“The interpretations of the results of these studies are incorrect. In the American study, there were as many men who where screened in the non-screened groups as were in the screened group. In treatment research, one group gets the treatment and the other does not. You can then compare your results.”
In the American study, the figures are almost identical for the screened and not screened. 34.6% of the screened had a PSA test in the past 3 years and 34.3% in the not screened had the PSA test. The results of the DRE examination were 32.8% for screened and 31.9% for the not screened.
Etzioni says, “The American trial is not a study of true screened and not screened as was the European trial.” That is because nearly one third of the supposed “not screened” did have tests.
“There was too much focus on the American trial. You cannot just look at the number of deaths from prostate cancer, since not that many die from the cancer. You have to look at the percentage drop in the number of deaths for those who were screened. The European results showed a 20% drop in cancer deaths which I think is significant.”
PROSTATE CANCE IS SLOW-GROWING
Most prostate cancer is a very slow growing cancer that could take 15 years. The U.S. Preventive Services Task Force suggests that men over the age of 75 not bother with testing since life expectancy is shorter than the time it would take for prostate cancer to be your cause of death.
Most men who are diagnosed with prostate cancer are likely to die from something else before they die from that cancer.
When I was diagnosed with prostate cancer last November, only one biopsy of twelve actually contained cancer. After surgery, my surgeon told me that more than 90% of my prostate contained cancer. He also informed me before surgery that it was my decision to choose an approach. I could have chosen watchful waiting.
What you do not see in the media reports about the two large research studies, but is included in the New England Journal of Medicine, is that about 95% of male urologists and 78% of primary care physicians who are 50 years of age or older report that they have had a PSA test themselves, a finding that suggests they are practicing what they preach.
While I do not recommend that you read the two studies, I do recommend that you read the discussion by two physicians about the studies. The research may have been reported too soon. In the European trials, the researchers plan to continue beyond the current ten years.
MY PROSTATE CANCER EXPERIENCE
The results of my prostate surgery so far are very positive. One week with a catheter was followed by a full diaper pant for 2 weeks. An absorbent pad was needed for four weeks. Now there is no leakage. I took no drugs and have not experienced erectile dysfunction.
What I do not know and may not know for some time is whether I am cancer free. I will continue to be screened on a regular basis.
You must decide for yourself whether you wish to be screened and then whether to seek treatment. I made my decisions after a lot of study and consultation with friends who were diagnosed with prostate cancer.
Do not let headlines alone persuade you.
More Resources:
American study: http://content.nejm.org/cgi/content/full/NEJMoa0810696?query=TOC
European study: http://content.nejm.org/cgi/content/full/NEJMoa0810084?query=TOC
Physician Discussion of studies: http://www.nejm.org/perspective-roundtable/screening-for-prostate-cancer/?query=TOC
My blog on prostate cancerhttp://prostatecancersupport.blogspot.com/
Watch. Wait. Should I test or not test? Last week the results of two studies on prostate cancer screening were part of the headlines in The Arizona Republic. [3/19/09]
I read those studies, and I am concerned that men might get the impression that it is OK not to be given a prostate specific antigen test [PSA] and digital rectal examination [DRE].
The article concluded with this thought. “The two studies were designed to give a definitive answer about the value of such screening.” Not all researchers agree that the studies do this.
Overall one of every six men will get prostate cancer during their lifetime, most physicians recommend the PSA and DRE after age fifty. It is usually slow growing but it ranks as the fifth leading cause of death among men. At 50, your chances are 1 in 476 of having the cancer.
WHAT THE STUDIES MEAN
Dr. Ruth Etzioni in Biostatistics of the Division of Public Health Sciences at the Fred Hutchinson Cancer Research Center pointed out several issues that put the research in the proper context.
“The interpretations of the results of these studies are incorrect. In the American study, there were as many men who where screened in the non-screened groups as were in the screened group. In treatment research, one group gets the treatment and the other does not. You can then compare your results.”
In the American study, the figures are almost identical for the screened and not screened. 34.6% of the screened had a PSA test in the past 3 years and 34.3% in the not screened had the PSA test. The results of the DRE examination were 32.8% for screened and 31.9% for the not screened.
Etzioni says, “The American trial is not a study of true screened and not screened as was the European trial.” That is because nearly one third of the supposed “not screened” did have tests.
“There was too much focus on the American trial. You cannot just look at the number of deaths from prostate cancer, since not that many die from the cancer. You have to look at the percentage drop in the number of deaths for those who were screened. The European results showed a 20% drop in cancer deaths which I think is significant.”
PROSTATE CANCE IS SLOW-GROWING
Most prostate cancer is a very slow growing cancer that could take 15 years. The U.S. Preventive Services Task Force suggests that men over the age of 75 not bother with testing since life expectancy is shorter than the time it would take for prostate cancer to be your cause of death.
Most men who are diagnosed with prostate cancer are likely to die from something else before they die from that cancer.
When I was diagnosed with prostate cancer last November, only one biopsy of twelve actually contained cancer. After surgery, my surgeon told me that more than 90% of my prostate contained cancer. He also informed me before surgery that it was my decision to choose an approach. I could have chosen watchful waiting.
What you do not see in the media reports about the two large research studies, but is included in the New England Journal of Medicine, is that about 95% of male urologists and 78% of primary care physicians who are 50 years of age or older report that they have had a PSA test themselves, a finding that suggests they are practicing what they preach.
While I do not recommend that you read the two studies, I do recommend that you read the discussion by two physicians about the studies. The research may have been reported too soon. In the European trials, the researchers plan to continue beyond the current ten years.
MY PROSTATE CANCER EXPERIENCE
The results of my prostate surgery so far are very positive. One week with a catheter was followed by a full diaper pant for 2 weeks. An absorbent pad was needed for four weeks. Now there is no leakage. I took no drugs and have not experienced erectile dysfunction.
What I do not know and may not know for some time is whether I am cancer free. I will continue to be screened on a regular basis.
You must decide for yourself whether you wish to be screened and then whether to seek treatment. I made my decisions after a lot of study and consultation with friends who were diagnosed with prostate cancer.
Do not let headlines alone persuade you.
More Resources:
American study: http://content.nejm.org/cgi/content/full/NEJMoa0810696?query=TOC
European study: http://content.nejm.org/cgi/content/full/NEJMoa0810084?query=TOC
Physician Discussion of studies: http://www.nejm.org/perspective-roundtable/screening-for-prostate-cancer/?query=TOC
My blog on prostate cancerhttp://prostatecancersupport.blogspot.com/
Friday, January 9, 2009
More stories of prostate cancer and survival
Rusty Dennison wrote:
Saw your article this week and wanted to check in with you. Removing the catheter was such a relief in one way for me though those first few weeks after its removal were a challenge too. At least at that point I felt like I was beginning to move forward and I knew I needed to honor my body’s need to have time to heal. Walking and yoga both helped a lot, especially after the first three weeks or so. It was not a linear process but the water works subsides. Best wishes and trust that it does get better.
The waiting game was hard for me at first and now that I am on a six month cycle instead of three month cycle, it is a lot easier but not still not easy. The first three month cycle I was convinced that based on my pathology report (nearly 100% positive surgical margins and Gleason 7) that I would need radiation right away. I was nearly sick to my stomach waiting for the results and cried with relief when the doc told me the PSA was undetectable. The second three month cycle was equally hard because I couldn’t believe I could be so fortunate to get two in a row. For these first two cycles, I started getting anxious about half way through the three months and built to a peak at the time of the test. It didn’t help that I got my blood work two days before the doc visit each time and had to wait. Those 48 hours were just miserable for me the first two times. Then, by talking to the lab tech at Mayo, I learned that the blood results were in the computer record within 2 hours of the blood draw and that the Physician Assistant would call me that very night if I wanted. That helped me so much because I knew I only had to wait a few hours and could get myself pulled together well to actually ask questions by the time I met with the doc. Now, I’ve refined it even better and schedule my blood and doc visit on the same day with only three hours in between the two appointments. Works well and cuts down on the waiting tremendously.
Lastly, I don’t know about your personal style but my general approach to the doctor was to try to be a good patient and not ‘bother’ him in between appointments. Dumb idea. Once I learned that the Mayo docs didn’t consider it a bother, I did much better at calling the Urology office, leaving a detailed message and asking either the doc, the resident or the PA to call me back. I would always get a call by the early evening of the same day and they always answered every question patiently. I learned that so many of my new ‘symptoms’ were quite normal and some required intervention but were not abnormal. It was so much better than psyching myself out that everything was some new cancer symptom. I limited the drama on the calls, but I was clear about my fears too. It was a new behavior to learn to call more readily but well worth it.
Take care, be patient with yourself, and on a daily basis find things for which you are grateful (some days for me it was as basic as ‘one pad instead of three’!).
Mike Martinelli wrote:
I have read your article on Prostate Cancer in the Chandler Republic and found it very informative. PSA Results should be scrutinized carefully and utilized in conjunction other tests and rectal examinations. .
In early 2000 my PSA went from 1.6 to 4.2 which was a dramatic increase in only one years time. NOTE; I never had any of the usual signs of Prostate Problems. My Physician told me to wait a couple of months and then have it checked again. Because of the anxiety, I decided to have it checked sooner, and the results were 2.3. Although I initially viewed this decrease as good news, something told me that it didn't make sense. I waited a couple of months and had it checked again; however, this time it showed 9.7.
I immediately went to a Urologist who scheduled me for a biopsy. He took eight biopsy's which showed Cancer in four of the tissues. I was 63 years old at the time and decided to have "Radical Surgery" for the removal of the Prostate. The post-operative biopsy showed a Gleason of 6. After only three weeks after surgery, I was driving, playing golf and doing light workouts at the gym. Two weeks after surgery the catheter was removed and I never had a problem with incontinence. It has been over 8 years since my surgery; my PSA has remained at close to
"0". PSA is only part of determining Prostate health and after age 50, semi-annual rectal examinations is certainly recommended.
Dave Rushlo of Scottsdale:
HI I AM ONE OF THE 35000 IN THE SELECT CANCER PREVENTION TRIAL WE WERE USING VITAMIN E& SELENIUM PLUS A MULTI- VITAMIN. THREE YEARS INTO THE STUDY MY PSA WENT FROM .5 TO 4.5 IN SIX MONTHS. AFTER TWO PSA TESTS & ONE BISOPY I MADE THE DECISION TO HAVE SURGERY USING THE ROBOT. I WAS IN THE STUDY AT MAYO CLINIC SO I WAS REFERRED TO DR. ROBERT FERRIGNI WHO DID MY SURGERY AFTER ABOUT A FOUR WEEK WAIT TO GET ON HIS SCHEDULE. THINGS WENT VERY WELL UP & WALKING NEXT MORNING & OUT OF HOSP. & HOME ON SECOND DAY. HOWEVER ONE WEEK LATER RUNNING A HIGH TEMP. WITH INFECTION IN AREA OF SURGERY BACK INTO HOSP FOR FOUR DAYS FINALLY HOME AND ONE WEEK LATER BACK INTO HOSP WITH SAME PROBLEM & 104 TEMP. AFTER FIVE DAYS FINALLY HOME. THINGS WENT FINE FROM THERE. THIS FEB. WILL BE FOUR YEARS WITH A PSA OF .0 AND THE ONLY PROBLEM IS MINOR BLADDER LEAKING WHEN I LIFT TURN REALLY SHARP OR SQUAT & LIFT. I GUESS AT 75 YEARS OF AGE IF THAT IS THE ONLY PROBLEM VS CANCER I CONSIDER MYSELF VERY LUCKY. THE STUDY WAS A DOUBLE BLIND STUDY SO WILL NOT KNOW FOR THREE MORE YEARS WHAT I WAS TAKING. HOWEVER THE STUDY HAS BEEN STOPPED BECAUSE "THE DATA TO DATE SUGGEST, BUT DO NOT PROVE, THAT VITAMIN E MAY SLIGHTLY INCREASE THE CHANCE OF GETTING PROSTRATE CANCER, AND THAT SELENIUM MAY INCREASE THE CHANCE OF GETTING DIABETES MELLITUS. WE WANT TO EMPHASIZE THESE FINDINGS ARE NOT PROVEN."
Saw your article this week and wanted to check in with you. Removing the catheter was such a relief in one way for me though those first few weeks after its removal were a challenge too. At least at that point I felt like I was beginning to move forward and I knew I needed to honor my body’s need to have time to heal. Walking and yoga both helped a lot, especially after the first three weeks or so. It was not a linear process but the water works subsides. Best wishes and trust that it does get better.
The waiting game was hard for me at first and now that I am on a six month cycle instead of three month cycle, it is a lot easier but not still not easy. The first three month cycle I was convinced that based on my pathology report (nearly 100% positive surgical margins and Gleason 7) that I would need radiation right away. I was nearly sick to my stomach waiting for the results and cried with relief when the doc told me the PSA was undetectable. The second three month cycle was equally hard because I couldn’t believe I could be so fortunate to get two in a row. For these first two cycles, I started getting anxious about half way through the three months and built to a peak at the time of the test. It didn’t help that I got my blood work two days before the doc visit each time and had to wait. Those 48 hours were just miserable for me the first two times. Then, by talking to the lab tech at Mayo, I learned that the blood results were in the computer record within 2 hours of the blood draw and that the Physician Assistant would call me that very night if I wanted. That helped me so much because I knew I only had to wait a few hours and could get myself pulled together well to actually ask questions by the time I met with the doc. Now, I’ve refined it even better and schedule my blood and doc visit on the same day with only three hours in between the two appointments. Works well and cuts down on the waiting tremendously.
Lastly, I don’t know about your personal style but my general approach to the doctor was to try to be a good patient and not ‘bother’ him in between appointments. Dumb idea. Once I learned that the Mayo docs didn’t consider it a bother, I did much better at calling the Urology office, leaving a detailed message and asking either the doc, the resident or the PA to call me back. I would always get a call by the early evening of the same day and they always answered every question patiently. I learned that so many of my new ‘symptoms’ were quite normal and some required intervention but were not abnormal. It was so much better than psyching myself out that everything was some new cancer symptom. I limited the drama on the calls, but I was clear about my fears too. It was a new behavior to learn to call more readily but well worth it.
Take care, be patient with yourself, and on a daily basis find things for which you are grateful (some days for me it was as basic as ‘one pad instead of three’!).
Mike Martinelli wrote:
I have read your article on Prostate Cancer in the Chandler Republic and found it very informative. PSA Results should be scrutinized carefully and utilized in conjunction other tests and rectal examinations. .
In early 2000 my PSA went from 1.6 to 4.2 which was a dramatic increase in only one years time. NOTE; I never had any of the usual signs of Prostate Problems. My Physician told me to wait a couple of months and then have it checked again. Because of the anxiety, I decided to have it checked sooner, and the results were 2.3. Although I initially viewed this decrease as good news, something told me that it didn't make sense. I waited a couple of months and had it checked again; however, this time it showed 9.7.
I immediately went to a Urologist who scheduled me for a biopsy. He took eight biopsy's which showed Cancer in four of the tissues. I was 63 years old at the time and decided to have "Radical Surgery" for the removal of the Prostate. The post-operative biopsy showed a Gleason of 6. After only three weeks after surgery, I was driving, playing golf and doing light workouts at the gym. Two weeks after surgery the catheter was removed and I never had a problem with incontinence. It has been over 8 years since my surgery; my PSA has remained at close to
"0". PSA is only part of determining Prostate health and after age 50, semi-annual rectal examinations is certainly recommended.
Dave Rushlo of Scottsdale:
HI I AM ONE OF THE 35000 IN THE SELECT CANCER PREVENTION TRIAL WE WERE USING VITAMIN E& SELENIUM PLUS A MULTI- VITAMIN. THREE YEARS INTO THE STUDY MY PSA WENT FROM .5 TO 4.5 IN SIX MONTHS. AFTER TWO PSA TESTS & ONE BISOPY I MADE THE DECISION TO HAVE SURGERY USING THE ROBOT. I WAS IN THE STUDY AT MAYO CLINIC SO I WAS REFERRED TO DR. ROBERT FERRIGNI WHO DID MY SURGERY AFTER ABOUT A FOUR WEEK WAIT TO GET ON HIS SCHEDULE. THINGS WENT VERY WELL UP & WALKING NEXT MORNING & OUT OF HOSP. & HOME ON SECOND DAY. HOWEVER ONE WEEK LATER RUNNING A HIGH TEMP. WITH INFECTION IN AREA OF SURGERY BACK INTO HOSP FOR FOUR DAYS FINALLY HOME AND ONE WEEK LATER BACK INTO HOSP WITH SAME PROBLEM & 104 TEMP. AFTER FIVE DAYS FINALLY HOME. THINGS WENT FINE FROM THERE. THIS FEB. WILL BE FOUR YEARS WITH A PSA OF .0 AND THE ONLY PROBLEM IS MINOR BLADDER LEAKING WHEN I LIFT TURN REALLY SHARP OR SQUAT & LIFT. I GUESS AT 75 YEARS OF AGE IF THAT IS THE ONLY PROBLEM VS CANCER I CONSIDER MYSELF VERY LUCKY. THE STUDY WAS A DOUBLE BLIND STUDY SO WILL NOT KNOW FOR THREE MORE YEARS WHAT I WAS TAKING. HOWEVER THE STUDY HAS BEEN STOPPED BECAUSE "THE DATA TO DATE SUGGEST, BUT DO NOT PROVE, THAT VITAMIN E MAY SLIGHTLY INCREASE THE CHANCE OF GETTING PROSTRATE CANCER, AND THAT SELENIUM MAY INCREASE THE CHANCE OF GETTING DIABETES MELLITUS. WE WANT TO EMPHASIZE THESE FINDINGS ARE NOT PROVEN."
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