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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2007Newbie Here...
I'm a 45 year old male with a lousy family history with regard to the prostate (both Grandads had prostate cancer and my Dad currently suffers from it). My PSA in 3 years has gone from 2.8 to as high as 4.7 after which 30 days of Levaquin lowered it to 3.6. A subsequent 30 days of Uroxatral and my PSA was at 3.3. My doctor has recommended a biopsy, to which I am prepared to undergo. He has also recommended a prostatic block (numbing agent) which unfortunately isn't covered by my insurance but I gather is well worth the price of admission. The part that bothers me the most is being the "baby" in a waiting room full of guys with 20 years on me.... Any advice on what to focus on would be apppreciated. > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently > suffers from it). My PSA in 3 years has gone from 2.8 to as high as > 4.7 after which 30 days of Levaquin lowered it to 3.6. A subsequent 30 > days of Uroxatral and my PSA was at 3.3. Too high, *IF* the cause is not related to prostatitis, infection, or BPH (benign prostatic hyperplasia). > My doctor has recommended a biopsy, to which I am prepared to undergo. > He has also recommended a prostatic block (numbing agent) which > unfortunately isn't covered by my insurance but I gather is well worth > the price of admission. Is that aka anesthesia? I've never heard of an anesthetic not being covered. Demand it. Nothing to be gained by being macho and gambling on pain. > The part that bothers me the most is being the "baby" in a waiting > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. Everyone here has been a newby. There is no dishonor in ignorance; it is curable. Beyond us amateurs, I recommend the authoritative and objective Prostate Cancer Research Institute: http://prostate-cancer.org/index.html For a start, see the section "Undiagnosed." Regards, Steve J "Empowerment: taking responsibility for and authority over one's own outcomes based on education and knowledge of the consequences and contingencies involved in one's own decisions. This focus provides the uplifting energy that can sustain in the face of crisis." --Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled "The Empowered Patient's Guide." > Is that aka anesthesia? I've never heard of an anesthetic not being > covered. Demand it. Nothing to be gained by being macho and gambling on > pain. I think that anesthesia or any kind pain treatment during a prostate biopsy is unusual. Partially quoting me: >> Is that aka anesthesia? I've never heard of an anesthetic not being >> covered. Demand it. Nothing to be gained by being macho and gambling on >> pain. He wrote: > I think that anesthesia or any kind pain treatment during a prostate biopsy > is unusual. I'm unsure just exactly what James means by "unusual." Rarely done? Done less than 50% of the time? Never done? Guesswork? What is his source? To clarify, if he and Mikey Freely need it, "covered" means "covered by insurance." And they can learn about the subject, starting with "A double-blind, randomized, controlled trial of topical glyceryl trinitrate (GTN) for transrectal ultrasound guided prostate biopsy." by Rochester et al. on PubMed. ID number 15643191. The conclusion: "Topical GTN paste is an effective and well tolerated method of decreasing pain associated with transrectal ultrasound guided prostate biopsy. It is safe and easy to use, and it should be offered to patients undergoing this procedure." There are many related articles on the site. There might be hope for James. Mikey won't be interested in mere facts. Regards, Steve J "What are the facts? Again and again and again -- what are the facts? Shun wishful thinking, ignore divine revelation, forget 'what the stars foretell,' avoid opinion, care not what the neighbors think, never mind the unguessable 'verdict of history' -- what are the facts, and to how many decimal places? You pilot always into an unknown future; facts are your single clue. Get the facts!" --Lazarus Long > I'm unsure just exactly what James means by "unusual." Rarely done? Done > less than 50% of the time? Never done? Guesswork? It means that since it is not covered by most insurance plans, it is unusual that someone would pay for it on their own. Quoting me: >> I'm unsure just exactly what James means by "unusual." Rarely done? Done >> less than 50% of the time? Never done? Guesswork? He replied: > It means that since it is not covered by most insurance plans, it is unusual > that someone would pay for it on their own. What is the evidence in support of the allegation re: lack of insurance coverage? Regards, Steve J "Facts are stubborn things; and whatever may be our wishes, our inclination, or the dictates of our passions, they cannot alter the state of facts and evidence." --John Adams > Quoting me: > [quoted text clipped - 12 lines] > > Steve J You are real smartass (or a.shole). I am not the one who asked for evidence. It was Ron who asked and I responded. But to answer your question (apparently you are blind), the OP said "He has also recommended a prostatic block (numbing agent) which unfortunately isn't covered by my insurance but I gather is well worth the price of admission." I never said the OP did not have insurance, I said it was not covered by his insurance. On February 6, James replied to me: (snip James's trifling attempts to be insulting) > I never said the OP did not have insurance, I said it was not covered by his > insurance. Well, no he didn't. What he wrote was, "it is not covered by most insurance plans..." *Paul* wrote that his insurance would not cover the anesthetic. It is apparent that James is unable to present evidence to support his allegations, choosing instead to attack one who asks for it. It is useless to continue with this. Regards, Steve J "Judge, and be prepared to be judged." -- Ayn Rand >On February 6, James replied to me: > [quoted text clipped - 18 lines] >"Judge, and be prepared to be judged." >-- Ayn Rand Sorry to stir up an argument, but I am gleaning some knowledge from it so thanks. To be clear about it, I do have insurance, and although it is not the greatest plan in the world, its not the worst. That said, when the doctor told me a biospsy was in order, he mentioned the numbing agent and said that I should know up front that the insurance companies cover the procedure, but not the numbing agent. He also went on to say he doesn't recommend it to the older candidates, but that it works well for the younger guys. > Sorry to stir up an argument, but I am gleaning some knowledge from it > so thanks. To be clear about it, I do have insurance, and although it [quoted text clipped - 4 lines] > on to say he doesn't recommend it to the older candidates, but that it > works well for the younger guys. Paul, this is completely anecdotal and impressionistic, but my impression is that most people on this forum have had the biopsy without anaesthetic. It's really not bad. I've had much worse medical procedures. You have the usual unpleasantness of having an object in your rectum, and then the actual penetrations are like a rubber band being snapped against the inside of the rectum. My uro didnt even suggest an anesthetic, and if I had had to have it done again, I wouldnt have sought one. Granted, I don't read every post, but I can't recall anyone complaining about how painful it was. On the contrary, most people in this forum over the 5 years I have been reading it, have reassured worried guys that it's not that bad. But once again, like everything else in PCa treatment, it's up to you. Claude > Sorry to stir up an argument, but I am gleaning some knowledge from it > so thanks. To be clear about it, I do have insurance, and although it [quoted text clipped - 4 lines] > on to say he doesn't recommend it to the older candidates, but that it > works well for the younger guys. No need to be sorry, it is not your fault that some other people on this newsgroup are a.sholes. I have had biopsies under two very good insurance plans, and the numbing agent was not covered on either. The urologist did not suggest that I pay for it myself, and I don't think it is needed for most people. >> I'm a 45 year old male with a lousy family history with regard to the >> prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 4 lines] >Too high, *IF* the cause is not related to prostatitis, infection, or >BPH (benign prostatic hyperplasia). Levaquin only took it down to 3.6 and the Uroxatral (which I understand to be a Flomax like drug) did not help with the PSA or my new founds habit of waking up one a night to urinate. I also feel tightness upon ejaculation which is new. >> My doctor has recommended a biopsy, to which I am prepared to undergo. > [quoted text clipped - 5 lines] >covered. Demand it. Nothing to be gained by being macho and gambling on >pain. He called it a numbing agent, his literature calls it a prostatic block. Anesthesia to me is being put out, so I'd say no to that question. >> The part that bothers me the most is being the "baby" in a waiting >> room full of guys with 20 years on me.... Any advice on what to focus >> on would be apppreciated. > >Everyone here has been a newby. There is no dishonor in ignorance; it >is curable. Inspiring words, thank you. >Beyond us amateurs, I recommend the authoritative and objective Prostate >Cancer Research Institute: [quoted text clipped - 11 lines] >--Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled >"The Empowered Patient's Guide." > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 10 lines] > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. Being Dx'd at 45 is no longer as unusual as it once was. Getting the word out, and better techniques have lowered the age at diagnosis a great deal. Be thankful that it was caught now and not some time in the far distant future. -Gordy > My doctor has recommended a biopsy, to which I am prepared to undergo. > He has also recommended a prostatic block (numbing agent) which > unfortunately isn't covered by my insurance but I gather is well worth > the price of admission. I gather your doctor has never had a biopsy. Most men barely notice them with nothing more than a dab of numbing salve. Our colons can't perceive being cut, and few prostates feel more than a weird, slight twitch with each needle jab. If my doc hadn't kept saying, "and here's another poke", I would not have realized he was taking his core samples. I might have wondered why the heck he was up my rear end so long, but given that there were nurses and a receptionist observing the procedure as part of their office show and tell day, I figured everything was above board. My doc said one of his patients arrive at -- and carefully left -- his drug-free biopsy on his bicycle. Bottom line? The whole procedure should hurt less than the average tooth cleaning. If I had taken a Tylenol before mine, I really don't think I would have perceived any of my dozen (16?) core samples or the slight ache at home that evening. To be honest, a few men feel pain. The key word is "few", and is the reason insurance won't fund the block. If your first poke hurts, a) I'd be surprised and b) tell the doctor to stick you with a shot of his favorite local anesthetic before continuing. > The part that bothers me the most is being the "baby" in a waiting > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. The trophy babe on your arm comes to mind. Or the cucumber in your pants just to show the old geezers who's the alpha male in the room. Or make a date with the hot receptionist. Or just sit there quietly drinking two 64-oz Big Gulps while they go to the bathroom three times. Maybe a few one-armed pushups? Complain about your nightly wet dreams. Or if you *really* want to knot up their shorts, ask 'em how long this PC takes to cure, so you can get on with the next 50 years of your life. There's a point in my irreverence: you're worrying about totally inconsequential trivia. If you're worried about being the youngest guy in a room now, how are you going to feel when a gray-haired lady you hardly know asks after your PC treatment some day, "How's your continence and sexual ability?", as one did me. Or when a 40-something neighbor asks you and your wife several direct questions about your sex life after you've given your neighbors a PC talk? Or you have to change diapers in a crowded gym locker room? Answers to these and most subsequent questions about it: frank, candid, and "who cares?" You probably cured your cancer, and few other hassles remain as important as, say, "American Idol" is right now. I.P. >> My doctor has recommended a biopsy, to which I am prepared to undergo. >> He has also recommended a prostatic block (numbing agent) which >> unfortunately isn't covered by my insurance but I gather is well worth >> the price of admission. > >I gather your doctor has never had a biopsy. Last night reflecting on the day I actually wondered "how many urologists get prostate cancer". >Most men barely notice them >with nothing more than a dab of numbing salve. Our colons can't perceive [quoted text clipped - 14 lines] >To be honest, a few men feel pain. The key word is "few", and is the >reason insurance won't fund the block. Along time ago I had this conversation with my Dad and he said it wasn't all that painful. I'm not telling him about my recent events because quite frankly, the man has all to worry about to get by from day to day and I see no reason to burden him with my new found problem. >If your first poke hurts, a) I'd be surprised and b) tell the doctor to >stick you with a shot of his favorite local anesthetic before continuing. I'll keep that in mind, thanks for your comments. >> The part that bothers me the most is being the "baby" in a waiting >> room full of guys with 20 years on me.... Any advice on what to focus [quoted text clipped - 24 lines] > >I.P. > On Tue, 06 Feb 2007 17:30:23 -0800, "I.P. Freely" > [quoted text clipped - 68 lines] > > >I.P. ">I gather your doctor has never had a biopsy. Last night reflecting on the day I actually wondered "how many urologists get prostate cancer". " When my uro ( now referred to as Quack) proposed a biopsy, and I expressed some fear, he told me "it's not that bad". I then asked him if he'd ever had one, and he answered "no". He first injected an anesthetic (I felt the pinch) and, before waiting for it to take effect, started taking his samples. The first 7 or so were excruciatingly painful, and then I surmise, the anesthetic kicked in, because the last 4 or 5 were just about painless. One of my PCa books, written by a doctor - sorry can't remember which, says he would never submit to a biopsy without anesthetic. -Gordy I would opt for an oral anesthetic like Vicodin. I had the injected numbing agent and it was not enough. The procedure was tolerable, but unpleasant. >> On Tue, 06 Feb 2007 17:30:23 -0800, "I.P. Freely" >> [quoted text clipped - 4 lines] >> >> unfortunately isn't covered by my insurance but I gather is well worth >> >> the price of admission. Having read some of the comments on discomfort with a biopsy, I consider myself very fortunate to have a well qualified urologist. I was given a shot in the rump as an antibiotic for infection. I was then prepared for the biopsy with a local directly into the prostate. That followed with the sonogram being set up and the needle biopsy started. One short pinch on the first one, and each following one he told me it was happening. I felt no further "pinches" (12 removed) and no discomfort. I was sent home with a prescription for a 3 day antibiotic to take. I peed some blood for about 4 days, and that was it. The results of the biopsy came back in about 4 days, the result: prostate cancer. I opted for the seeding, based on discussions with the urologist and the radiation oncologist. That was accomplished on 29 December. The real shock was when I got my bills from the hospital. Since I was not "yet" eligible for Medicare, I have to pay 10% of the bill: $3600. Had I been on Medicare I would have owed the hospital $0.00 I may have waited until I became eligible in June of this year, but no one advised me about this. Me bad, cause I should have educated myself on the benefits of Medicare hospital coverage versus my company insurance coverage. Or should have the hospital staff/oncology office/urology office made me aware of these insurance options? (getting off track here. sorry) >>> On Tue, 06 Feb 2007 17:30:23 -0800, "I.P. Freely" >>> [quoted text clipped - 24 lines] >should have the hospital staff/oncology office/urology office made me aware >of these insurance options? (getting off track here. sorry) Hardly getting off track, healthcare coverage is every bit a part of the process unfortunately. Last year I was scoped for a hiatal hernia and the anesthesist billed separately but did not take my (or any other) insurance. Unfortunately the release forms were provide to me ten minutes before the procedure that I signed in the procedure room ( a lousy thing to do to someone IMO) and I had to successfully fight my insurance company to get them to cover that part as if it were in network blah blah blah. That's one thing my Dad is great at, he lives for spending hours on the phone going at it with insurance companys over coverage etc. Many people just pay these folks regardless of the bill.... Hello, Paul: I'm a few years older than you (51), and recently went through the same sort of thing you're going through now. Others in the group have said that they hardly noticed a thing during the biopsy, but mine was quite uncomfortable, though tolerable. Knowing what I know now, had someone offered me a numbing agent or a local anesthetic, I would have taken it. But that's one of the things that happens in this group a lot; you'll hear different men report very different experiences with the same procedure. And, as you've seen, it leads to some 'spirited' discussions. But most of the time, there's not much of that useless name-calling and nastiness here. If it turns out that you do have prostate cancer, you're very young and that's a huge advantage. You'll probably be able to treat it aggressively with surgery or radiation seeds and kill the beast. Some of those old guys you'll be sitting with in the waiting room are not so fortunate. When I go to my urologist, I am usually the youngest man in the room, and I mostly feel sorry for the older men around me who clearly have fared much worse than I. And the fact that my stunningly beautiful wife is sitting next to me helps, too. ;-) Good luck, Paul. And please let us know how it turns out. --charlie >Hello, Paul: > [quoted text clipped - 4 lines] >someone offered me a numbing agent or a local anesthetic, I would have >taken it. I'm pretty certain that I'll go for it, plus I've blown 225 on stupider things in life than this. >But that's one of the things that happens in this group a lot; you'll >hear different men report very different experiences with the same >procedure. And, as you've seen, it leads to some 'spirited' >discussions. But most of the time, there's not much of that useless >name-calling and nastiness here. And from that I learn, so it's all good. >If it turns out that you do have prostate cancer, you're very young >and that's a huge advantage. You'll probably be able to treat it >aggressively with surgery or radiation seeds and kill the beast. I've yet to pose the surgery vs. radiation question, only because I'm not at that point yet and I don't want to put people out needlessly. > Some >of those old guys you'll be sitting with in the waiting room are not >so fortunate. My Dad's one of those guys unfortunately.... > When I go to my urologist, I am usually the youngest >man in the room, and I mostly feel sorry for the older men around me >who clearly have fared much worse than I. Interesting point of view. >And the fact that my stunningly beautiful wife is sitting next to me >helps, too. ;-) You touch an interesting point. My wife knows this is all going on but I've basically gone to the Dr. myself. She's made it clear that she *is* going with me for the biopsy, which is fine as I think now's a good time to actively involve her. >Good luck, Paul. And please let us know how it turns out. > >--charlie Will do thanks so much Charlie. > I've yet to pose the surgery vs. radiation question, only because I'm > not at that point yet You _are_, however, to the point of curling up with a good prostate cancer book, IMO. > My wife knows this is all going on but > I've basically gone to the Dr. myself. She's made it clear that she > *is* going with me for the biopsy, which is fine as I think now's a > good time to actively involve her. Good for her! The public announcement for my last public talk on PC specifically invited women along with the men. But not just *any* women . . . explicitly, those who loved anyone with a prostate over 40 years old. Why? Because as we've seen right here and in our private lives, most men are idiots when it comes to their health care, especially when it involves anything their Speedos cover. My audience in that talk was primarily women, and I urged them to know the PSA numbers of those prostates they loved. I.P. >> I've yet to pose the surgery vs. radiation question, only because I'm >> not at that point yet > >You _are_, however, to the point of curling up with a good prostate >cancer book, IMO. Any recommendations? >> My wife knows this is all going on but >> I've basically gone to the Dr. myself. She's made it clear that she [quoted text clipped - 7 lines] >most men are idiots when it comes to their health care, especially when >it involves anything their Speedos cover. Heh, I'm not that vain about appearance and I have been going for PSAs and DRE's since I was 41. Believe me I'm trying hard not to be an idiot about my health as I've been watching my Dad being eaten away by PC and Chemo treatments... >My audience in that talk was primarily women, and I urged them to know >the PSA numbers of those prostates they loved. > >I.P. >>> I've yet to pose the surgery vs. radiation question, only because I'm >>> not at that point yet >> You _are_, however, to the point of curling up with a good prostate >> cancer book, IMO. > > Any recommendations? Scardino, Walsh, Bubley, Lange (PC for Dummies), Strum (off the internet unless you live near Portland, OR and Powell's Book Store), Oesterling, Marks, the American Cancer Society . . . they're all good. IMO, each of them paid for itself by offering insights the others didn't. But, then, I had already flunked my biopsy, so I was motivated. Given your family history alone, I'd borrow or buy any one of the first 5 or so, and if you ever flunk a biopsy, you won't need our encouragement to read several chapters of each of them. > Heh, I'm not that vain about appearance I was surprised that my onc warned me that hormone therapy might cost me my hair. Heck, hair's a nuisance, IMO. It runs about 137th in my priorities . . . right below going bald with no vote in it. > I have been going for PSAs and DRE's since I was 41. Yup . . . I prefer my position on the table over those of my urologist and proctologist. > Believe me I'm trying hard not to be an > idiot about my health as I've been watching my Dad being eaten away > by PC and Chemo treatments... Some men learn from that, some don't. I.P. >>>> I've yet to pose the surgery vs. radiation question, only because I'm >>>> not at that point yet [quoted text clipped - 30 lines] > >I.P. Thanks IP for the good info. >I'm a few years older than you (51), and recently went through the >same sort of thing you're going through now. Others in the group have >said that they hardly noticed a thing during the biopsy, but mine was >quite uncomfortable, though tolerable. Knowing what I know now, had >someone offered me a numbing agent or a local anesthetic, I would have >taken it. FWIW: my experience was the same and I agree with above. >But that's one of the things that happens in this group a lot; you'll >hear different men report very different experiences with the same >procedure. And, as you've seen, it leads to some 'spirited' >discussions. But most of the time, there's not much of that useless >name-calling and nastiness here. What's usenet without name-calling and nastiness :-) I'd imagine that your anxiety is taking its toll with the PSA numbers and the family history you have. They are not sky high but guys like us (I was 52 when diagnosed) need to take action with the low end of high numbers. If I remember, in that younger pCa diagnosed patients tend to have more aggressive Gleason's, you want to dive into this unfortunate morass sooner than later. Mine clocked in at 4.6 when I had my biopsy. I had a Gleason of 8. The prior PSA was clocked at 3.2 18 months earlier. The biopsy procedure lasted about 2 maybe 4 minutes, was uncomfortable like sitting in a broken chair where the broken part is right where your butt is, and moderately painful for only seconds at a time while they take the cores, usually 10. Good luck dude, we're here for any questions you have, or any time you need to vent. WSF >I'd imagine that your anxiety is taking its toll with the PSA numbers >and the family history you have. They are not sky high but guys like [quoted text clipped - 11 lines] > >WSF I'm concerned for sure. My father's father made it to 79, my Dad's 72 and has been diagnosed since age 61 and now I'm starting at 45, but will be grateful to know at an early age if I am loaded for bear so to speak. Thanks for the support! > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 10 lines] > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. My daughter is a nurse and assisted on literally hundreds of biopsys. She told me to ask for complete anesthetia. I did. My memory of the biospy is: I was lying in bed, talking to my wife, a nurse came in with two syringes, and said: "Here comes the little hammer, and now here comes the big hammer." The next I knew, I was looking at wife, and she was saying, "How do you feel?" It was great. Better living through chemistry. j. >> I'm a 45 year old male with a lousy family history with regard to the >> prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 34 lines] > >j. Sounds like a scene right out of the movie "Jacob's Ladder" > My daughter is a nurse and assisted on literally hundreds of biopsys. > > She told me to ask for complete anesthetia. > > Better living through chemistry. Umm, hmmm . . . and in the UK it's banned by law because of its SEs for some dentistry procedures that hurt more than most prostate biopsies. It never ceases to amaze me how many people will use mind-altering drugs with an appreciable risk of whole-body SEs for recreation or to escape a very modest discomfort. I.P. >Umm, hmmm . . . and in the UK it's banned by law because of its SEs for >some dentistry procedures that hurt more than most prostate biopsies. [quoted text clipped - 4 lines] > >I.P. Like those who frequent the pubs... > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 5 lines] > He has also recommended a prostatic block (numbing agent) which > unfortunately isn't covered by my insurance but I gather is well worth I may have been lucky to have my biopsy at the first visit, before I had any time to research or think about it. It was at worse, a little uncomfortable. Like being shot with a rubberband on your butt. No pain at all. As for your plight, keep in mind that this is not a death sentence. If in fact you have PCA, at your age you have a better chance than most of a cure and recovery. Sure your life will need some adjustment, but it's not nearly as bad as dozens of other cancers, or getting crippled in an auto accident. Hang in there!  SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 10 lines] > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. I was 46 when diagnosed with prostate cancer. During all my visits, in teh last 6 years, I've never considered that I was the 'baby' in the room. >> I'm a 45 year old male with a lousy family history with regard to the >> prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 13 lines] >I was 46 when diagnosed with prostate cancer. During all my visits, in teh >last 6 years, I've never considered that I was the 'baby' in the room. Every time I go to the urologist, the waiting room is full of men that I give 20 years to easy. That was the foundation for my comment, no offense meant to anyone. >>> The part that bothers me the most is being the "baby" in a waiting >>> room full of guys with 20 years on me.... Any advice on what to focus >>> on would be apppreciated. Tell 'em you're considering a penis reduction so you can walk more comfortably. Nobody cares how old we are anymore. I spend 8 months a year hanging out at the beach with scores of people from 50 years younger to 15 years older than I, and we'd be hard pressed to tell each other apart after the wrinkles, gray hair, nose rings, tats, and clothing disappear with the setting sun. I.P. >>> I'm a 45 year old male with a lousy family history with regard to the >>> prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 18 lines] > I give 20 years to easy. That was the foundation for my comment, no > offense meant to anyone. No offense taken. Indeed I see I was confusingly brief. My experience is that when I go to the urologist, I am often with men and women of all ages who are obviously there for all urological issues. But, even when I was in line for EBRT, I had what really was the unfortunate experience of sitting with much younger, and some much older, men, boys, women.... Cancer doesn't discriminate.... 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 PSA <0.04 Non Illegitimi Carborundum I am NOT trying to be insensitive, but I am starting to suspect that there MIGHT be some difference between the North American system of PSA Measurements used, to those in the United Kingdom. I Mean - what Paul writes as being alarming - top level of 4.7 - would seem low to my own 140+ at diagnosis. So - IS there a difference in measurement units - I KNOW there IS a difference in Diabetic Units. (ie - dcl/mml)in UK that gives WILD figures when translated from UK to US units that makes us in UK think you guys are just wimps - but in reality - just different measurement units that - in the end - equal us all out at even. - Someone explain for us all please? Thankyou. And regards to Paul... and best wishes for his on-going good health. Thanks. Hugh. > I'm a 45 year old male with a lousy family history with regard to the > prostate (both Grandads had prostate cancer and my Dad currently [quoted text clipped - 10 lines] > room full of guys with 20 years on me.... Any advice on what to focus > on would be apppreciated. >I am NOT trying to be insensitive, but I am starting to suspect that there >MIGHT be some difference between the North American system of PSA [quoted text clipped - 10 lines] >Thanks. >Hugh. Thanks Hugh, best wishes to you as well. Hi Paul - your reply was a bit confusing and concerning to me. (As was your Original post - concerning NUMBERS) I really do hope you did NOT think that I was in ANY way demeaning you or your concerns. I was quite simply confused about measurement units being used and as to whether there was a difference between the UK and the US measurement systems- as there is in Diabetes. THAT issue has already been cleared up from private e-mails. I would be happier if you accepted that I had NO intention of me trying to upset or annoy you. THAT was NOT intended at all. We are ALL in this battle together - let's sort out any mis-understandings right now and fight this on an agreed, United Front. Thanks. If you **WANT** a 'sorry' - you have it - freely and sincerely given. HUGH >>I am NOT trying to be insensitive, but I am starting to suspect that there >>MIGHT be some difference between the North American system of PSA [quoted text clipped - 14 lines] > > Thanks Hugh, best wishes to you as well. >Hi Paul - your reply was a bit confusing and concerning to me. (As was your >Original post - concerning NUMBERS) [quoted text clipped - 11 lines] >given. >HUGH No appology necessary I was just thanking you for the well wishes. I didn't comment on the numbers you speak of because I am ignorant on the subject but not too arrogant to admit it :) >>>I am NOT trying to be insensitive, but I am starting to suspect that there >>>MIGHT be some difference between the North American system of PSA [quoted text clipped - 14 lines] >> >> Thanks Hugh, best wishes to you as well. > I am NOT trying to be insensitive, but I am starting to suspect that there > MIGHT be some difference between the North American system of PSA > Measurements used, to those in the United Kingdom. There is a European measurement system using "mols," pronounced "moles." No, not the furry kinds. But I believe that the Brits use the same system of measuring PSA as we Yanks: ng/mL (nanograms per milliliter). When I correspond with Brit PCa patients, our PSA measurements are on the ng/mL system. I reckon that the confusion arises from the fact that 2.5 ng/mL has become pretty well accepted as the upper limit of what is acceptable. Until a few years ago, it was thought to be 4.0 ng/mL. See the Prostate Cancer Research Institute (PCRI) at: http://prostate-cancer.org/index.html A PSA of 140 ng/mL is not uncommon and is ugly. But not a death sentence. Also: Paul asked upthread for a book recommendation. Here's mine for a thorough basic course on prostate cancer: _A Primer on Prostate Cancer_ 2nd ed., by medical oncologist and prostate cancer specialist Stephen B. Strum, MD and prostate cancer warrior Donna Pogliano. It's available via the PCRI website as well as other PCa-oriented sites, and at bookstores. And, FWIW, my anecdote: I believe that learning from that book and from Dr. Strum's response to my plea for help on the P2P (Patient to Physician) website quite likely saved my life. It certainly saved additional misery. Regards, Steve J "Never -- never -- never give up! Never go gently. There will be plenty of gentle after we die, so until then, fight! Control the rhythms and tempo of the dance, even when you have to let the PCa dancing bear lead for a while -- even when you have to wear the lead suit as you dance -- never let the bear set the rhythm and tempo of your dance with life. When the bear finally takes control, it will be a very hollow feeling for him, because I will be gone -- dancing in a better place." --E. B. (Burns) Mixon, PCa survivor, June 14, 2005 on The Prostate Problems Mailing List Thank you, Burns. Live long and prosper. >I am NOT trying to be insensitive, but I am starting to suspect that there >MIGHT be some difference between the North American system of PSA >Measurements used, to those in the United Kingdom. > I Mean - what Paul writes as being alarming - top level of 4.7 - would > seem low to my own 140+ at diagnosis. Not trying to be insensitive in the answer, but the fact is, 4.7 is a concern in that normal people have PSAs of less than 4. Your 140 is extraordinarily high. Out of 474 people here who have reported their PSA at diagnosis (since I've kept track), only 16 have been higher than yours. Not that yours is high relative to some others. We have had then as high as 4900! 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 PSA <0.04 Non Illegitimi Carborundum > My doctor has recommended a biopsy, to which I am prepared to undergo. > He has also recommended a prostatic block (numbing agent) which > unfortunately isn't covered by my insurance but I gather is well worth > the price of admission. The replies here are the living proof that "your mileage may vary". My uro told me that the biopsy needles would feel like "the pinch you feel when you extend a ballpoint pen against your skin. Not pain, just minor discomfort" so he didn't normally recommend any anaesthetic. WRONG!!!! For me, the pain was excruciating! Even though I don't seem to be particularly pain sensitive in other situations. I'd recommend some numbing agent just in case! Fred |
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