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Medical Forum / Diseases and Disorders / Prostate Cancer / June 2004Just got the "word"
I am 73 and have had an enlarged prostate for at least 10 years, but my PSA was always less than 1.0. This year, my PSA is "off the scale" at 25. I have two cancer sites with a total score of eight. I am just beginning the reading phase. The urologist I was sent to check me out by my family physician has found two cancerous areas both on the right side. He saw no blockage in my kidneys. He gave me a hormone shot and prescribed Casodex and Flomax. I was referred to an oncologist, the earliest date was ten days after the urologist saw me. His nurse told me she would call me if a cancellation occurs before my initial consultation. The urologist told me that the oncologist would probably begin with a bone scan and *then* choose a method of treatment. I have enlarged Prostate in my lineage (grandfather, father, one son) but none of them were diagnosed with cancer. I am open for suggestions -- especially ways to combat anxiety. I have turned this over to the Lord, but having to urinate every 15 minutes (for three hours) after taking LASIX for HBP, and about hourly the rest of the day, I am constantly reminded of the seriousness of the situation. God is truly testing my sincerity in accepting His Sovereignty. May God bless all of us as we face the inevitable in God's wonderful world. With christian Agapé, Marvin Blickenstaff > I am 73 and have had an enlarged prostate for at least 10 years, but my > PSA was always less than 1.0. This year, my PSA is "off the scale" at 25. [quoted text clipped - 26 lines] > > Marvin Blickenstaff The hormone shot should bring down the PSA and keep things under control for the moment. The oncologist will probably suggest a method of treatment which will keep you going for a considerable length of time. At your age, you may even die with this cancer rather than from it, as they say. Finally, keep in mind that there are some exciting new developments in prostate cancer research which may result in a cure even for quite advanced cases some time in the next 5 to 10 years. With that in mind, you might also ask the oncologist about any clinical trials which might be helpful in your case. We all wish you the best of luck in facing this. Welcome, Marvin. I guess "welcome" is not the right word, but you know what I mean. If I could just make the suggestion that you estimate what your longevity would be in the absence of prostate cancer. You know, based on your family history and general health. This will be a factor in your choice of treatment. The doctors may suggest that aggressive treatment is not warranted in a patient whose expected longevity is less than seven years or so, because the prostate cancer will not get him first. If I understand you correctly, your case has a Gleason score of 8. The bone scan will of course help determine whether the cancer is localized or metastacized. If it's localized, you're at the borderline age for surgery due to the higher risk of side effects in older men, but you might be offered surgery anyway, or radiation. Let us know what you find out. I recommend the book, Dr. Walsh's Guide to Surviving Prostate Cancer. jimhoney not a doctor My uncle was diagnosed when he was 76. He chose to have an RRP (surgery) and is doing well now at age, now let's see- he was born in May, 1920, so he is 84 now. Time flies. I was diagnosed at age 58 years 9 months, failed surgery, radiation, and hormones, chemotherapy seems to have worked. I assume you mean the right side of the gland. A Gleason score of 8 is aggressive, which explains the fast climb to 25. If the bone scan and CT are clear, surgery or radiation might be the way to go. Otherwise you need Lupron/Zoladex and Casodex, and/or maybe chemotherapy later on. I expected to die at age ca. 75 of stroke or heart attack, anyway, as my parents did. My doc thought I should live to age 85. If your family history or current health suggest you would probably live another 15 years or more, if free of cancer, you should treat it aggressively. Welcome, Marvin, to the club you never applied for. The good news is, at 73 years, prostate cancer is slow in growing. 25 is not really off the scale; the scale goes into the thousands. And there is a lot of medical advancements available in this millennium to almost guarantee you a much easier entry into His kingdom. There is a lot you haven't told us (probably because you didn't think it important), like the Gleason Score (e.g., 3+3=6, 3+4=7, 4+3=7) and the stage (T1a, T2b, T2c). You also mention to cancer sites (common), but then discuss kidney blockage. Has the cancer left the prostate and builing up outside it? And, probably most important of all.... How long did you expect to live if you did not have prostate cancer? These will all figure into your treatment decision. All this is important as you will find in your reading. We generally recommend Dr. Patrick Walsh's book called Guide to Surviving Prostate Cancer. I wish there were a newer book (that one was written in 2000), but it's considered the best there is right now by most of us. You can also visit www.phoenix5.org for a tremendous amount of information.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > I am 73 and have had an enlarged prostate for at > least 10 years, but my PSA was always less than [quoted text clipped - 35 lines] > > Marvin Blickenstaff I just read Jimhoney's post and realized you did give us your Gleason; probably 4+4=8. That probably reduces your options to radiation and/or hormone treatment. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > Welcome, Marvin, to the club you never applied for. > [quoted text clipped - 56 lines] > > > > Marvin Blickenstaff Hi, Marvin, Sorry to hear of your news. We have all been there at some point. I can certainly identify with the anxiety. It's a very normal reaction. If your bone scan is clear, your options will probably be radiation or hormones. Seed implants are a definite possibility. My father is 76. He was diagnosed at 72 and chose seeds. He is doing fine today. All may not be as bleak as it may seem. Try to think positive! There are many forms of treatment with new discoveries everyday! Take care... and lean on us as much as you need.... MikeH > I am 73 and have had an enlarged prostate for at > least 10 years, but my PSA was always less than [quoted text clipped - 35 lines] > > Marvin Blickenstaff *I am 73 and have had an enlarged prostate for at *least 10 years, but my PSA was always less than *1.0. This year, my PSA is "off the scale" at 25. *I have two cancer sites with a total score of *eight. I am just beginning the reading phase. * Well, you've found a good spot to get support. I'm certain some of the more senior folks here can make more experienced suggestions than I can. But glad you found this group! Al Please be quiet if replying via email, flames will be deleted promptly. I won't even read the whole message... Nice to meet you Marvin. Sorry for the circumstances. On the anxiety question, please note that you are dealing with a disease here that does not threaten your life in the short term future. No need to be frightened at this point. Concentrate on the research and education so you can make the most informed treatment decision that you can. Once you make that decision, move on and don't look back. I am not saying to delay making the treatment decision. With a Gleason of 8 you need to address this as soon as possible, but don't bother to update the will just yet. You have found a wonderful place to get support. In my opinion there is no better group of people to be found for information and support. Please note that this group does include humor, so don't be surprised when you run into that here. Some have been offended. Don't be. Best of luck to you. Keep up your normal activities. Do not let this take over your life. Thank you. David S. >I am 73 and have had an enlarged prostate for at >least 10 years, but my PSA was always less than [quoted text clipped - 35 lines] > >Marvin Blickenstaff One thing you should do right away is get a second opinion on your biopsy slides from a top-rated pathologist. Johns Hopkins is one. Bostwick Laboratories in Richmond, Virginia, is another. There are others. You'll find a good list (and a lot of other good info) at http://www.prostate-help.net/ Reading the slides correctly is apparently something of an art, and as accurate a reading as possible is critical to determnining your prospects and the treatment with the best chance of curing you. Good luck. > I am 73 and have had an enlarged prostate for at > least 10 years, but my PSA was always less than [quoted text clipped - 35 lines] > > Marvin Blickenstaff Let me just say that the suggestion for the second opinion is "seconded" here. Bostwick is world reknowned, and it should'nt be any trouble asking your physician to have the slides forwarded. Aside from that, Marvin, relax and take a deep breath. You will have decisions to make.....be sure they are *informed* ones. STUDY !!! jh > One thing you should do right away is get a second opinion on your > biopsy slides from a top-rated pathologist. Johns Hopkins is one. [quoted text clipped - 44 lines] > > > > Marvin Blickenstaff |
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