I voted like, and then saw the update.
Do not like.
“Good news! You no longer have to save for retirement!”
I’m coming to the thread rather late, but it struck a chord.
My two brothers and I were diagnosed with prostate cancer within the past four years. My older brother opted to “wait and keep track,” while my younger brother opted for implanting the radioactive “seeds.” I was 66 YO at the time.
My own urologist told me that I had a 99% chance of 20-year survival with a complete prostatectomy. My wife and I discussed this, since there were obviously some potential side effects (e.g., ED and urinary incontinence). We went with the total prostatectomy…just to be absolutely sure. My PSA is absolutely unmeasurable now. Do I have ED and incontinence issues? Yes, to some extent.
Was it the right choice? Well, my own late wife had died at the age of 44 and I was a widower when I married my current wife. Her late husband had died at the age of 42 and she was a widow with two teenagers when we married. In spite of the potential issues, we were totally committed to the goal of me having the best chance of living as long as possible. Prostatectomy was really the only possible choice for us to make.
My wife and I are often a bit surprised when other people don’t seem to understand that we both lost spouses at an early age and in horrible circumstances, and that we, therefore, have strong views about our own survival as a married couple. My wife won’t even let me mow the lawn or go up on the roof to fix minor problems because she is worried that she might be widowed again. Seriously. (I also have an ascending aortic aneurysm and some vertigo problems.) When we met with my urologist, her only question was, “What treatment promises the longest survival, even at the expense of ED or other issues?”
Holy cow, all three brothers in four years get cancer? Wow, that’s awful and I’m so sorry.
I also chose radical prostatectomy, it seemed like the surest thing, and mine was a medium aggressive cancer - waiting wasn’t an option and I wasn’t going to screw around with it. It took 3.5 years for my ED to go completely away. Continence is pretty good though it took years to fully learn to clench up if I got, say, a sneezing fit, otherwise I’d feel that awful dribble down my leg, ugh. But if I hadn’t done the surgery I’d be dead or dying right now.
I heard back from my oncology/urology group. Since my PSA is mildly elevated (.06ng/ml), they just want to test again in 3 months. If it reaches .2ng/ml, they’d refer me to radiation therapy to discuss treatment. I have a short call scheduled w the NP to discuss this today.
Damn, a lot of me wants then to do a PET scan RFN and figure out what my body is up to. I don’t see how any detectable PSA couldn’t be cancer. Let’s see what the NP says.
This link is more about surgery for an enlarged prostate, but it does say that the organ can grow back. Maybe they left behind some BENIGN tissue, and that is producing the PSA?
Laser surgery for enlarged prostate is no more effective than TURP.
And this link says that luminal cells can revert to a more stem-cell like form.
New Discovery Explains How the Prostate Gland Regenerates Itself.
Now, that’s something I learned today! Did not know that before.
OK, I talked with the NP at the urology/oncology group. Takeaways:
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Waiting for .2ng/ml is basically their protocol for if this is a number to be taken seriously or not. There is the possibility this was a bad test result. There may also be a great deal of jitter in the numbers as I retest. What they most want to look for is velocity - are the numbers increasing slowly or quickly or not at all? If, say, I retested at .15ng/ml in 3 months, that would be a startling result and indicate high velocity, but again there may be a lot of jitter in the numbers (but that would be a big jitter).
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If I were referred to the radiation department, they’d do both imaging (PET scan) and a physical examination to look for changes since my 2018 surgery.
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The overwhelming case in a recurrence is that there’s some regrowing tissue (and this is important) in the original area of the pelvis that is still localized. If that’s the case
then they’d treat me with radiation and kill that tissue. She reassured me that treatment isn’t arduous.
I’m going to retest in December.
@nearwildheaven, thank you for the links.
I just had a biopsy and will meet with the doctor next week. The MRI hadn’t been very promising (4 out of 5) and they calculated the risk of cancer at 60% so they suggested an MRI fusion guided biopsy. They can’t do that locally so I had it done up in Taipei. My doctor suggested general anesthesia so we went with that.
I’ll find out Tuesday what the results are.
Since there isn’t anything else I can do in the meantime, I’ve been binge watching Breaking Bad now we finally have Netflix.
Are you looking for a prostate cancer diagnosis? The MRI guided was what finally found mine after nearly four years of ultrasounds and blood tests.
Yeah, that show really strikes a chord when you’re trying to get a diagnosis. I still style my annual birthday picture after that show after a doctor told me in 2014 I may have cancer based on PSA, right in the middle of my wife divorcing me.
Good luck with the biopsy.
You may want to do some research on the wide-spread misuse and abuse of what PSA levels mean.
You mean the controversy over whether men should be widely screened for prostate cancer via PSA testing? Yeah, I have. I was tested and had prostate cancer.
I mean, yes - over relying on PSA can cause unnecessary stress to someone who may be fine and just has high PSA for no particular reason that isn’t cancer. In my world we’d test men for PSA levels starting in their 20’s - not at age 50 - and establish their baseline PSA, then look for elevations as they age. We don’t do that now, and I don’t see a future where we would.
Well, looking for a diagnosis of no prostate cancer 
but yes, that’s where they jabbed all the needles
I have had one biopsy about 5 years ago because my PSA numbers are halfway old enough to drink, but the biopsy wasn’t guided and they didn’t find anything. This time, they did the MRI first and saw something that looked suspicious.
I only have a few days to wait, but damn, it’s not fun.
My PSA was right on the boundary, but it had been going up, so I went for an MRI and there it was. Not advanced, but there. I went with Brachytherapy. 3 years later my PSA is nice and low. It plummeted and kept on plummeting. No incontinence problems at all. Not sure ED was from that or from age, but even that went away. I get the PSA checked every 6 months, but that’s it.
I had a slowly climbing PSA number for years I was referred to a urologist. He did an exam and said not to worry. The number kept climbing and is now 5.9. The new urologist did an exam and felt “firmness” on one side. he ordered a free PSA % (it was 9) and an MRI. The day after the MRI he called me, said there were lesions on both sides to come in the next day for a consult. The urgency worries me a bit. That day is today and I’m out the door in five minutes. I know a biopsy will be ordered. I’m 65 and in excellent health, otherwise.
Assuming you do have a biopsy, you’ll be looking for a Gleason score - effectively a rating of how aggressive any cancer they find is. Low numbers are good. Many prostate cancers are effectively non-events. Good luck!
Don’t get frustrated with the biopsies. It took me four to finally get a diagnosis. Final biopsy was MRI guided, done in a hospital while I was unconscious. That one finally found the cancer. Gleason 7, 3+4. Good luck today.
I’m curious how @TokyoBayer’s diagnosis quest is going. Hope you’re doing okay!
Biopsy is scheduled for next week.14 cores to be taken. MRI had a PI-RADS number of 4. Good news its that lesions are limited to the prostate and there is no enlargement. I was looking through the treatment options and … wow. Between radiation and surgery there must be a dozen or more with no clear “winner”. At least, not until I get the Gleason number which might pare the choices down some.
My advice is to research the hell out of it when you get information. So many people seem to take surgery by default. I decided it was between radiation and brachytherapy, and I interviewed doctors who did both. I was luck in that I had a brachytherapy expert near me. I chose that path, and it worked out great. No side effects to speak of, one procedure and it was done. But it might not work for you.
Success rates for radiation and brachytherapy seem to be about the same, but we don’t have really long term (over 20 years) data since the procedure is too new.