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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2006Waiting....
I posted about 60 days ago regarding my husband. He decided to go sky diving and beforehand wanted to buy an additional life insurance policy that would take him up through the age of 71. All his blood work came back great EXCEPT his PSA. It was 5.02. The previous year it had been 3.8. He had recently really got serious with his diet and excercise as he had to be a certain weight to jump out of the airplane...this is why his other bloodwork was better than it has been in many many years...his blood pressure low, pulse awesome, chlosterall good...but the damn PSA. They denied the insurance and that has sent us to this point. One other thing that he has yet to discuss with the Dr. He had started taking stinging nettle...to be blount...he thought his testicles were shrinking and he found some advice on line this might help...I guess he was worried about testerone. He would kill me if he knew I put this out here...but this is the one thing we wonder could have possibly effected his prostate too. Our primary Dr. sent him to a ur. The urolgoist was not available so the physcian assistant...a very young physcian assistant saw my husband. He did a DRE and reviewed bloodwork from the life insurance company and scheduled a biopst in 2 weeks. He did not explain the biopsy...my husband did not ask questions either. I asked my husband why they did not repeat psa and why not a free psa. He did not know. I called the physcian asst....he told me he did not see either warranted..but DRE seemed normal. I don't know I just did not feel real good about the real Dr. not making the call for biopsy. I know the outcome could be the same but I believe one has to be an advocate for their own care. Okay..moving on. A week before the biopsy my husband hurt his hand and had to go back to our primary Dr. and while my he was there he and the dr. spoke of the upcoming biopsy. Our primary Dr. said he did not want to step on any toes but my husband had a right to know why they did not repeat psa and had the given any consideration to an infection. In the mean time the UR office called and wanted to do another PSA. The nurse told me most likely after the Dr. reviewed the physcian asst. notes he called for another psa. My husband talked to nurse about repeat test and infection. She called back and Dr. decided to put him on 30 days of antibotics with a repeat psa/fpsa upon completion. Well, Friday he completed and had test and we wait. My husband has read and researched all he can in the last 30 days. So, we wait...they said it could be 7 to 10 days or it could be 3 before we get results back......We have been dealing with this since the end of May. It feels like you can't plan to far ahead because you don't know what the future holds....sometimes all feels a bit sureal. He did tell his boss at work but we have not said anything to the kids...grown kids until we know more. He is sort of sorry he told his boss at work because he is afraid it might effect his future with the company.....possible promotion....that is it...I just wanted to get it all out there. Husband is 51 years old He is in good health First psa @ 50 DRE every year Dad had prostate cancer Thanks, Lisa Lisa: I hear ya! All of my blood work came back great except that "damn psa". Mine was around 7. I was 53 when dx'ed and in great shape over all. A 5.02 could mean Pca or something more benign. Either way, he will be ok. I'm ok! I had surgury 12/04. Forget about GP's and physician's assistants and go to a Pca specialist now to rule it out. In other words, get a new PSA test, free PSA test, and if warranted, a biopsy from competent doctors/specialists. No one probably really cares at the office, (more likely they do not than do) especially his boss. They are watching out for their own "bottom" lines. You watch out for yours. If the antibiotics work and reduce his PSA to undetectable or almost undetectable levels, then all may be well in the Pca department. Waiting since May can be very stressful to the both of you, your jobs, and your relationship. You, as other have here, will get through this successfully. Pca, if it is, is cureable and not a death sentence! And, of course, all this may be a moot point too if the antibiotics work. The waiting to know is tough. B.A. >I posted about 60 days ago regarding my husband. He decided to go sky > diving and beforehand wanted to buy an additional life insurance policy [quoted text clipped - 43 lines] > company.....possible promotion....that is it...I just wanted to get it > all out there. I remember you posting mid-June. I believe then I agreed with the biopsy. I still do. But, antibiotics and re-test is not a bad way to go. Biopsies are easy for most, especially if given happy juice in advance. Don't cut yourself short on a quick diagnosis just because you're worried about a few needle pricks.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum On July 30, Lisa wrote, in pertinent part: > I posted about 60 days ago regarding my husband. He decided to go sky > diving and beforehand wanted to buy an additional life insurance policy > that would take him up through the age of 71. All his blood work came > back great EXCEPT his PSA. It was 5.02. At age 51 with a father who had PCa, Lisa's husband (what's his name?) is at risk for PCa. But the PSA test is not specific for PCa. The result could be from prostatitis, an infection (I'm very disappointed that the uro had to be *told* to initiate antibiotic therapy), stress to the gland from, frex, the DRE if it was performed within a day or so before the blood draw or sex within 48 hours, even bicycle riding. IOW, the PSA is more likely to result from something *other than* PCa. (snip) > He had started taking stinging nettle...to be blount...he thought his > testicles were shrinking and he found some advice on line this might > help...I guess he was worried about testerone. I don't believe in eye of newt and toe of frog magical medicine, but that's just me. One thing I am sure of: One should never, ever, dose oneself with anything without coordinating with the MD. There is a blood test for testosterone. > He would kill me if he > knew I put this out here...but this is the one thing we wonder could > have possibly effected his prostate too. > Seems doubtful to me, but asking a prostate cancer specialist would be best. Also: if the husband doesn't want the info posted, he'll soon learn better if he indeed has PCa. There are no secrets here, and no embarrassment, either. We're dealing with something that is far more important than shyness. And men are, unfortunately, much more shy than women. (snip) > Friday he completed and had test and we wait. > My husband has read and researched all he can in the last 30 days. So, > we wait...they said it could be 7 to 10 days or it could be 3 before we > get results back...... Amazing. I get my PSA results within three days directly from the lab -- because I asked for it. As for the biopsy, I recommend insisting upon an anesthetic. Pain relief is a patient's right, and the biopsy is no time to test one's macho-ness. Some men experience little or no pain even without medication, but how is the pt to know beforehand? It would be well to bear in mind that a uro is a surgeon. Therefore, if the dx is PCa, he is almost certain to press for surgery. Do not be rushed into any tx before studying all options. An excellent source of authoritative and objective information is the website of the Prostate Cancer Research Institute at: http://prostate-cancer.org/index.html Good luck. Let us know what happens. There is, if the dx is PCa, much to do. Regards, Steve J "The thing is to expect nothing in particular, but (to) be aware of the lack of enforceable guarantees or enforceable contracts with nature/god/entropy as to the condition or durability of our bodies." -- Brian Brunner, PCa survivor, December 12, 2005 on The Prostate Problems Mailing List Thank you, Brian. Hmm!! You posted about the travails of waiting about 60 days ago. Today you have no further info other than to tell us your hubby used something wierd for his perceived small testicles. Now you complain about waiting!!! Do something about this now. If the repeat PSA shows 5 or higher, get a biopsy. David I did not mean for it to come across as complaining about waiting...only I wanted to express how hard it has been to wait. I know as many things in life...waiting is necessary and as it has been said here and I believe not to RUSH into anything too quickly. But everyone is entitled to their opinion. As you might note....he took antiboics for 30 days. Once we got the lab work back, got in to the primary, got in to the UR, schedule for biopsy and then ask to take 30 days of pills....I hardly see how to avoid waiting. I do believe I have more to report....as all the things above have taken place and we are at the stage where a biopsy will most likely be next.....Again, I feel the last thing I want to do...is to get all freaked out and hurry....we are crossing each path as it presents itself and trying to make informed choices. > Hmm!! > [quoted text clipped - 9 lines] > > David Instead of waiting and worry do what you can control today, make like bunnies...... If it is PCa, then it will be a looooong time between...... :) >I did not mean for it to come across as complaining about > waiting...only I wanted to express how hard it has been to wait. I [quoted text clipped - 23 lines] >> >> David Update on our waiting. Paul had another psa and finally got the results. The number has gone to 5.3 from 5.03. We have scheduled a biopsy for August 21st..this is as soon as the current uro could get us in. There have been several incidents that have caused us to be a bit uneasy with current uro...nothing he has done but it is what he has not done. We spoke to my husband's exwife who is a nurse. I wish we would have called her sooner. She recommended us to another Dr. Dr. Frey. Paul has an appt. with him on the 15th. We are not canceling the biopsy with first Dr. for now but we are going to see how we like new doc. The new doc's office said if biopsy comes back positive for cancer they would send us to one of two docs in their group who deal primarily with prostate. They also do the Da Vinci surgery. So, that is where we are...taking one day at time. This is very new territory for us so we are trying to do the best we can. > I posted about 60 days ago regarding my husband. He decided to go sky > diving and beforehand wanted to buy an additional life insurance policy [quoted text clipped - 51 lines] > > Thanks, Lisa On August 9, Lisa wrote: > Update on our waiting. Paul had another psa and finally got the > results. The number has gone to 5.3 from 5.03. In and of itself, that change is in my non-expert opinion not likely to be significant. It very well could be within the margin of error of the test protocol. > We have scheduled a > biopsy for August 21st..this is as soon as the current uro could get us > in. There have been several incidents that have caused us to be a bit > uneasy with current uro...nothing he has done but it is what he has not > done. We spoke to my husband's exwife who is a nurse. I wish we would > have called her sooner. She recommended us to another Dr. (snip) If Paul is not confident in the uro he should change. It is his life at stake. FWIW I have fired two medics and am much the better for it. But Paul must do his homework, which is why I previously recommended the Prostate Cancer Research Institute at: http://prostate-cancer.org/index.html IMO an educated, empowered, patient is certain to have a better outcome than a patient who blindly relies upon his medic. As Dr. Strum has written, "MD does not mean 'Medical Deity.'" (snip) > Paul has an appt. with him on the 15th. We are not canceling the > biopsy with first Dr. for now but we are going to see how we like new > doc. The new doc's office said if biopsy comes back positive for > cancer they would send us to one of two docs in their group who deal > primarily with prostate. They also do the Da Vinci surgery. If the dx is PCa, surgery might be the appropriate tx. But it might not be. That's why I nag nag nag about doing homework. Examine all options and choose the one that is best for THIS patient at THIS time. It isn't easy. It certainly isn't fun. But doing it will at minimum give the patient confidence that he has done his best. Regards, Steve J "We must tailor the treatment to the nature of the disease. We must listen to the biology." -- Stephen B. Strum, MD Sorry about the PSA, but it is what we all expected. Don't worry about the days ticking by, it is extremely unlikely a few weeks more or less will make any difference to the final outcome. If the biopsy comes back positive, you would be well advised to send the samples for a second opinion. Bostwick Labs is often mentioned, I believe there are one or two others. The biopsy results are very material to treatment choices, so it is wise to be absolutely certain. You are entitled to take possession of all the samples and do whatever you want with them; don't let yourself be persuaded otherwise by the original lab/urologist. Whilst surgery is an appealing option for younger men, you should probably consult a radiation oncologist with strong experience dealing with PCa before making any final decision. Full disclosure: I didn't bother to talk to a rad onc before choosing surgery, but I had done a bunch of reading before I made my decision and had strong reasons for my choice which I did not feel would be altered by talking to a rad onc - your circumstances and set of values may be completely different to mine. SignaturePeter Headland > Update on our waiting. Paul had another psa and finally got the > results. The number has gone to 5.3 from 5.03. We have scheduled a [quoted text clipped - 10 lines] > is where we are...taking one day at time. This is very new territory > for us so we are trying to do the best we can. As I recall your appointment, switching doctors is a good idea. But, please do not make the mistake of liking a doctor for his manner. For a GP, a good diagnostician is best. For surgery, nothing replaces a good surgeon. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum |
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