# prostate cancer checkup + elevated PSA reading - ? **URL:** \ **Category:** Factual Questions\ **Created:** [June 28, 2012, 6:08pm UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611 "2012-06-28T18:08:25Z")\ **Posts on this page:** 6\ **Page:** 2
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [June 29, 2012, 9:45am UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/21 "2012-06-29T09:45:21Z")
> [@Senegoid](#): > > What is the downside of having a prostatectomy? > > I mean, since so many older males have prostate trouble of one sort or another, why not just do a total prostatectomy (ETA: or at least offer the option) on ALL males at the FIRST hint of any problem, and save them all the hassle and horror that _may_ come later? Is there some reason an older male _needs_ a prostate? Is a prostatectomy an especially complicated or expensive operation? > > Why even wait? Why not give any male, age 60 or older, the option to have a completely proactive prostatectomy on request? The prostate secretes a fluid which is necessary for ejaculation. Even older men sometimes have sex (or often :)). In addition, all surgeries involve risk, such as noted by DrDeth. ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [June 29, 2012, 5:04pm UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/22 "2012-06-29T17:04:41Z")
The prostate secretes a milky, slightly acidic fluid, containing citric acid used by sperm for ATP production via the Krebs cycle. It also secretes proteolytic enzymes, such as PSA, pepsinogen, lysozyme, amylase, and hyaluronidase, that break down clotting proteins from the seminal vesicles, and seminalplasmin, an antibiotic. [source: _Anatomy and Physiology from Science to Life_, John Wiley & Sons, Inc., Jenkins, Kemnitz, and Tortora (2007) ---
**Author:** ![Digital\_is\_the\_new\_Analog](https://avatars.discourse-cdn.com/v4/letter/d/a88e4f/32.png) [@Digital\_is\_the\_new\_Analog](https://boards.straightdope.com/u/Digital_is_the_new_Analog)\ **Post date:** [June 30, 2012, 10:21pm UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/23 "2012-06-30T22:21:34Z")
> [@Senegoid](#): > > What is the downside of having a prostatectomy? My father is pretty much incontinent after his surgery. Once reason they haven’t done radiation yet is they are hoping he regains some control. Apparently the odds of that happening are much lower after the radiation. This doesn’t happen to everyone who has the surgery, but it is a very real risk. -D/a ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [July 1, 2012, 2:59am UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/24 "2012-07-01T02:59:34Z")
Re: My question of the downside of radical prostatectomy: > [@Digital\_is\_the\_new\_Analog](#): > > My father is pretty much incontinent after his surgery. Once reason they haven’t done radiation yet is they are hoping he regains some control. Apparently the odds of that happening are much lower after the radiation. > > This doesn’t happen to everyone who has the surgery, but it is a very real risk. > > -D/a And how should we compare, or try to evaluate the risks, of this versus other treatments (for cancer or even BPH for example)? I have a friend, age ~65 at the time, diagnosed with prostate cancer. He got radiation therapy, and apparently it was a disaster. His urethra apparently got irreversibly scarred and he now has a chronic and painful cyctitis of the bladder. His friends whisked him to ER repeatedly, begging and writhing in pain, to be catheterized because he couldn’t pee; he had catheter trouble (or maybe he got sick and tired of it); ended up with a permanent catheter from his bladder coming out a hole in his abdomen, to a bag. And he is still in great pain all the time from the bladder cyst, which he says they can’t operate on or otherwise treat for whatever reason. After 5 or so years, this is apparently what it’s going to be like for the rest of his life. I gather that the radiation therapy somehow torched part of his bladder too. (Bad aim?) As he puts it, just about everything that could have gone wrong did. At that age (~65), would it have been better just to have a radical prostatectomy in the first place and skip the risks of all that happening? It’s not like we was ever at risk of ever getting laid again. ---
**Author:** ![Rhaegar](https://avatars.discourse-cdn.com/v4/letter/r/51bf81/32.png) [@Rhaegar](https://boards.straightdope.com/u/Rhaegar)\ **Post date:** [July 2, 2012, 3:24am UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/25 "2012-07-02T03:24:29Z")
People are confusing the use of PSA as a screening tool vs using the PSA in someone who has already been diagnosed with prostate cancer. A rising PSA in someone who has already had a prostatectomy is indicative of the prostate cancer recurring. Depending on the age of the patient, the Urologist can opt to do nothing and let nature take its course. Usually this is the option for patients who have a limited life expectancy based on age or other medical conditions. The other option is what they are doing with your friend, Which is namely hormonal suppression with shots and oral pills. This does not “cure” anything, but it will let your friend live out the rest of his life by suppressing the cancer. He should be glad of the shots. In the old days the usual treatment was castration. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [July 2, 2012, 5:51am UTC](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611/26 "2012-07-02T05:51:47Z")
> [@Senegoid](#): > > Re: My question of the downside of radical prostatectomy: > > And how should we compare, or try to evaluate the risks, of this versus other treatments (for cancer or even BPH for example)? > > I have a friend, age ~65 at the time, diagnosed with prostate cancer. He got radiation therapy, and apparently it was a disaster. His urethra apparently got irreversibly scarred and he now has a chronic and painful cyctitis of the bladder. His friends whisked him to ER repeatedly, begging and writhing in pain, to be catheterized because he couldn’t pee; he had catheter trouble (or maybe he got sick and tired of it); ended up with a permanent catheter from his bladder coming out a hole in his abdomen, to a bag. And he is still in great pain all the time from the bladder cyst, which he says they can’t operate on or otherwise treat for whatever reason. After 5 or so years, this is apparently what it’s going to be like for the rest of his life. I gather that the radiation therapy somehow torched part of his bladder too. (Bad aim?) As he puts it, just about everything that could have gone wrong did. > > At that age (~65), would it have been better just to have a radical prostatectomy in the first place and skip the risks of all that happening? It’s not like we was ever at risk of ever getting laid again. The risks with a radical prostatectomy include permanent catheter from your bladder. [http://www.prostate-cancer.com/prostatectomy/side-effects/prostatectomy-side-effects.html](http://www.prostate-cancer.com/prostatectomy/side-effects/prostatectomy-side-effects.html) [Previous page](https://boards.straightdope.com/t/prostate-cancer-checkup-elevated-psa-reading/626611.md?page=1)