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Old 12-07-2011, 10:01 PM   #1
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More Prostate Info

We seem to discuss this a lot but here is another article that came out today in USA Today concerning the " low risk type"

http://usat.ly/sUuZfp

A few of the interesting points. On a 20 year study, only 5% of patients had died from it, with most have never been detected if the the PSA had not been invented. More than half of all prostate cancers are diagnosed as " low risk" with 90% of men preferring treatment immediately. Article mentioned that maybe the term cancer shouldnt be used with this type as it provokes action that may not be needed. Article suggests why so few chose watchful waiting is because the choice isnt offered to them. They just began a 1500 person study to determine why such few people choose " watchful waiting or serveillance".
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Old 12-07-2011, 11:13 PM   #2
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I think it's just hard to accept an alien thing growing inside of you. I'm sure now that would choose watchful waiting, but maybe if it happened to me I'd have the "Cut this thing out of me now" attitude.
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Old 12-08-2011, 07:11 AM   #3
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I agree that 'watchful waiting' would be a tough decision. A good friend was recently diagnosed with prostate cancer and chose to go that route, at least initially. The 'cut this thing out of me now' approach has a lot more appeal until you consider some of the side effects. My neighbor across the street (in his 50's) had his prostate removed a year ago and has a major problem with urinary incontinence.
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Old 12-08-2011, 09:15 AM   #4
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Although there are no guarantees with any surgery, the key to those two ugly side effects are to find a uro surgeon who has done more than 500, and learned from recognized experts.
The goal with prostate cancer treatment is to achieve the trifecta.
In order; 1. Eliminate the cancer, 2. Preserve urinary continence, and 3. Preserve sexual ability.

Also, when discussing prostate cancer, the pathological Gleason score is at least as significant as the psa. Gleason scores range from 2 - 10. Rarely do you hear of anyone with a Gleason of 5 or less. G 6 and G 7 are most common, and depending on several other factors watchful waiting can be an option.
Gleason 8 - 10's are a different cancer, and are very aggressive and dangerous.

I am not a physician, but I have more understanding of PCa than I would prefer.

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Old 12-08-2011, 09:39 AM   #5
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I think it's just hard to accept an alien thing growing inside of you. I'm sure now that would choose watchful waiting, but maybe if it happened to me I'd have the "Cut this thing out of me now" attitude.
That's why it is important to not screen populations where screening causes more harm than benefit in the first place. Once you have an abnormal PSA, it is very hard to do nothing.

It may be best to think of the slightly elevated (4-10) PSA as men's equivalent of a dysplastic Pap smear for women: follow closely, biopsy if advancing consistently etc. Not a perfect analogy but not too far off.
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Old 12-08-2011, 12:26 PM   #6
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That's why it is important to not screen populations where screening causes more harm than benefit in the first place. Once you have an abnormal PSA, it is very hard to do nothing.

It may be best to think of the slightly elevated (4-10) PSA as men's equivalent of a dysplastic Pap smear for women: follow closely, biopsy if advancing consistently etc. Not a perfect analogy but not too far off.
To a non medical person like me, I tend to run in circles on this. If I knew I would definitely not get prostate cancer, or it was the " low level" type, I would probably never get tested because there is no family history for it. Yet if I didnt test, and got the serious version, I would be kicking myself for not doing what I should have. Yet if I do get tested and it is the low level, then I sit and worry it may grow, but I dont want to be cut on because I dont want to risk the other side effects. Well, I got 2 and a 1/2 years to figure it out before 50.
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Old 12-08-2011, 12:30 PM   #7
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Not all prostate conditions are cancerous. Anyone have any suggestions on treating an enlarged prostate; seems like there are a lot of options in that area and I guess doing nothing other than monitoring is one of them.
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Old 12-08-2011, 12:41 PM   #8
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The key word is "watchful". This requires a lot of commitment from both the patient and the doctor.

Too many men avoid doctors like the plague (har!) and only get testing done when pushed by their spouses/partners. That is, unfortunately, one of the reasons why the cancers are caught so late, in many cases. PSA testing is a useful tool that indicates there is a problem - be it an infection, BPH, cancer or any other type of cause. It's up to the man and his doctor to find out what is causing an elevated PSA.

Diagnosis and treatment of prostate cancer is at about the level that breast cancer was about 15 years ago. More people are talking about it now, more funding is going to research, more men are getting their prostates checked.

Interesting factoid: 1 in 6 men over the age of 50 will face PCa in his lifetime. 1 in 80 people will face AIDS. Yet the funding for AIDS research in 2009 was 24.1 billion

The funding for prostate cancer was 293.9 million
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Old 12-08-2011, 01:00 PM   #9
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Not all prostate conditions are cancerous. Anyone have any suggestions on treating an enlarged prostate; seems like there are a lot of options in that area and I guess doing nothing other than monitoring is one of them.
it's a little complicated. With current technology it is not possible to know whether an elevated PSA is from cancer or some other disease, like prostatitis. So, often we wait, repeat and sometimes treat for infection before repeating.

The higher the PSA the more likely it is due to cancer especially over 15 or so. Still doesn't mean it's cancer, though, nor that early detection gained you anything.

As I have said before, screening is a patient driven decision without an absolute right or wrong answer. I have decided not to continue screening (had one or two very low PSAs in the past few years) but make your own case. The screening technology will improve, I am confident.
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Old 12-08-2011, 01:11 PM   #10
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Not all prostate conditions are cancerous. Anyone have any suggestions on treating an enlarged prostate; seems like there are a lot of options in that area and I guess doing nothing other than monitoring is one of them.

Check out this website: lots of useful info on BPH

Enlarged prostate - PubMed Health
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Old 12-08-2011, 06:02 PM   #11
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You can avoid those terrible side effects of impotence and incontinence, by having proton beam radiation. Also it doesn't wipe you out and damage surrounding tissue like xray(photon) radiation.
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Old 12-08-2011, 08:03 PM   #12
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I just talked to my doctor on this subject. He recommended and I agree with his thinking that we will continue to test annually, both PSA and the digital check. I've never had an abnormal reading and hope that continues. He says the testing is not wrong and the knowing that something might be wrong is better than not knowing. At my age (75), maybe we wouldn't do anything. However, we'll cross that bridge if and when we come to it.

As I posted a few weeks back, one of my golf buddies had his cancerous prostate removed eight years ago. The first of September the cancer was back (on the stem?). Don't understand all this. He's just finishing up eight weeks of radiation treatments and will be back to golf next Tuesday. His treatment was once a week (on our golf day) and it lasted about 15 minutes.
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Old 12-08-2011, 08:52 PM   #13
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Be very careful using psa as the only criteria. My psa was below 3, but other symptoms caused me to get a biopsy. My Gleason score was 4+5=9, which is a very aggressive form of PCa.
Another interesting bit of info is that the younger you are diagnosed with PCa, the more aggressive it tends to be.

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Old 12-08-2011, 09:11 PM   #14
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I was reading in Wikipedia that a study of autopsied men from various countries who died from illness other than prostate cancer cited that 30 % of all men in their 50's and 80% of all men who had died in their 70's all had prostate cancer.... Stunning if correct.
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Old 12-08-2011, 09:13 PM   #15
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Not all prostate conditions are cancerous. Anyone have any suggestions on treating an enlarged prostate; seems like there are a lot of options in that area and I guess doing nothing other than monitoring is one of them.
I had urinary problems, that turned out to be caused by BPH and was put on alpha blockers (single visit to a urologist). Worked great, and problems went away within a few months. That was 3 years ago and this last 2 years the annual checkup with the urologist has the prostate back to normal size. PSA tests have always been <1
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Old 12-10-2011, 01:10 PM   #16
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Check out this website: lots of useful info on BPH

Enlarged prostate - PubMed Health
Nuiloa,

Thanks for that link. I've been getting some BPH symtoms of late. I noticed in the PubMed site, that decongestants could cause enlargement. I've been fighting some fluid in the ear for a while now and have been taking Sudafed for over a month, possibly that may be triggering something. My PSA the past few years have been negligble. I guess I should stop the Sudafed and maybe get an antibiotic for the ear issue.
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Old 12-10-2011, 01:22 PM   #17
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Nuiloa,

Thanks for that link. I've been getting some BPH symtoms of late. I noticed in the PubMed site, that decongestants could cause enlargement. I've been fighting some fluid in the ear for a while now and have been taking Sudafed for over a month, possibly that may be triggering something. My PSA the past few years have been negligble. I guess I should stop the Sudafed and maybe get an antibiotic for the ear issue.
The fluid in the ear is a PIA! I had it hit out of the blue about 3 years ago. Bothered me almost daily, went to the doctor and he said there was nothing wrong. Thanks for the help, Doc! Then after about a year it went away. Hope it never comes back, as it made me want to try to set a record for furthest distance a QTip could be shoved down the ear canal.
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Old 12-10-2011, 04:16 PM   #18
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The fluid in the ear is a PIA! I had it hit out of the blue about 3 years ago. Bothered me almost daily, went to the doctor and he said there was nothing wrong. Thanks for the help, Doc! Then after about a year it went away. Hope it never comes back, as it made me want to try to set a record for furthest distance a QTip could be shoved down the ear canal.
It sure is. Had to fly a few weeks ago for a business trip and wow, did that ever hurt and it caused hearing issues that are still lingering.
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Old 12-10-2011, 11:41 PM   #19
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I was reading in Wikipedia that a study of autopsied men from various countries who died from illness other than prostate cancer cited that 30 % of all men in their 50's and 80% of all men who had died in their 70's all had prostate cancer.... Stunning if correct.
More men die with prostate cancer than from it. So my doctor told me.
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Old 12-11-2011, 10:32 AM   #20
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I think it's just hard to accept an alien thing growing inside of you. I'm sure now that would choose watchful waiting, but maybe if it happened to me I'd have the "Cut this thing out of me now" attitude.
Yep. My father started with "watchful waiting" but quickly moved to the surgery attitude.

Good thing, too... it turned out to be a stage IV tumor instead of the smaller problem they thought they were "watching".
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