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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2008

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Califchief - 26 Jan 2008 07:00 GMT
Visited a new uro in December -- standard "new patient" exam that
consisted of a DRE, PSA, weight, height, pulse, BP, breathing, etc.

When he saw the Lidocain patches on the right leg, he asked, "How do
you know your pain isn't caused by metastasis?  We may need a biopsy."

I answered, "Because I've had the pain for 20 years before Dx'd with
PCa and I'm still recovering - slowly - from recent THR surgery."

He finally got to my chief complaint/question --- peeing.  The daily
quantity swings from 24 ounces to 72 ounces to 33 ounces to 51 ounces
to 29 ounces to 75 ounces, etc. etc. etc.  He remarked that this is
normal. In other words, there is no "average" quantity.  He ran an
ultrasound of the bladder and I was holding 3 ounces about 45 minutes
after filling that cup you get every time.

He wrote a lab request for X-rays.  I didn't know how many until I
got to the lab and lost track after counting the first dozen.  <g>
I phoned his office for the PSA result - it was 10.8.

2nd appointment yesterday (Thursday) and he admitted that there was no
cancer in the bones per the X-rays.  I brought in a very rough chart
recording my PSA since 1st Dx's in May 2001 -- 10.5, 11.1, 10.7, 11.0,
10.6. 11.3, 10.4, 11.1, 5.6, 6.1, 10.3, 10.9, 11.2, 11.4, 10.8 (his
test in December).  He stated that this was pretty good news -
basically a FLAT plot in 7 years with an unexplained drop in 2005.

No more talk about PCa.

Ran an ultrasound of the prostate, then concentrated on the bladder.
I emptied my bladder, then he used a catheter to fill it with a known
quantity. Had to hold it for a minute or 2, then pee into a receptacle
that plots quantity against time.  My chart was FLAT and LOW - it
should have risen quickly at the start, peaked, then fallen off pretty
fast.  BUT the ultrasound of the bladder showed that it was empty.
I had already told him that it takes me 4, 5, 6, 7 minutes to feel
EMPTY.   (And on average, I get up at night 6 times a week.)

He next began talking about Prolieve, and gave me an info packet with
literature and a CD. I gather from a brief reading of the literature
that Prolieve treats symptomatic BPH -- not cancer.

Questions: Will an enlarged prostate - BPH - feel like PCa with a DRE?

Will BPH cause a high PSA?

Is this what urologist #1, nurse #1, urologist #2, and urologist #3
felt between 2001 and 2006 and assumed (or told me) was PCa and tried
to bully me into radiation?

Joe N.
___ Blue Wave/QWK v2.12
I.P. Freely - 27 Jan 2008 07:32 GMT
>  He finally got to my chief complaint/question --- peeing.  The daily
>  quantity swings from 24 ounces to 72 ounces to 33 ounces to 51 ounces
>  to 29 ounces to 75 ounces, etc. etc. etc.  He remarked that this is
>  normal. In other words, there is no "average" quantity.

I can go all day without needing to pee, or need to pee every couple of
hours, depending on my activity and fluid intake levels. It's my (and
your) choice.

Guess which is healthier, dehydration (dark urine) or good hydration
(looks like drinking water)?

I.P.
ronju99 - 27 Jan 2008 11:45 GMT
Let me guess? hydration

Ron S

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callalily - 28 Jan 2008 01:20 GMT
>  Questions: Will an enlarged prostate - BPH - feel like PCa with a DRE?
>
>  Will BPH cause a high PSA?
>
>  Joe N.

===> Chief:

Don't understand the first part of your message (limitations of being
a woman?), but I tried to answer the second.
From Endotext.org:

(1) "In historical series, up to 50% of palpable masses were
attributable to prostate cancer."

That means that the other half were not.  Guessing it all feels the
same.

2)  "Re: Non-prostate cancer contributors to increases in PSA"

Benign prostatic hyperplasia (BPH)
Ejaculation (both free & total) up to 48 hours
Bacterial infection of prostate
Prostatic massage
Instrumentation (including catheterisation) of prostatic urethra
Prostatic biopsy

Leah

prostatecancerblog.net

* NOTE:  Latest Post, "Remembering Harry Pinchot, the Romantic,"
includes a photo dedicated to firefighters.  (A friend who knew Harry
sent me the speech. )
Califchief - 28 Jan 2008 08:00 GMT
Leah wrote:

> From Endotext.org:

> (1) "In historical series, up to 50% of palpable masses were
> attributable to prostate cancer."

> That means that the other half were not.  Guessing it all feels the
> same.

> 2)  "Re: Non-prostate cancer contributors to increases in PSA"

> Benign prostatic hyperplasia (BPH)
> Ejaculation (both free & total) up to 48 hours
> Bacterial infection of prostate
> Prostatic massage
> Instrumentation (including catheterisation) of prostatic urethra
> Prostatic biopsy

Thank you for the references.  I'll be going over them tonight.

Joe N.
___ Blue Wave/QWK v2.12
 
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