Report on Surgery Relevant for Older Males

[rjtfroggy]

When talking about PSA's sometimes the numbers lie. During my ordeal with bladder cancer all of my prostate test were within normal ranges, never above .2. When the bladder had to go the surgeon said the prostate goes also because he didn't want to go back in in 6months to a year later to remove it. He is a urologist/oncologist, very experienced and highly regarded.
Upon removal it went to pathology, wait for it, it came back stage 4. My urologist still can't believe it because all the test showed nothing wrong with it.
I don't even try to explain it, all I tell guys over 40 is to make sure they get tested at least once a year.
My cancers were inevitable I was a firefighter for 21 years and an oil burner tech. for over 30 years, all that smoke and fumes took its toll.

 

[jxb]

Jeff glad to hear you're on the mend and caught it early.

I'm 4B prostate, completed my radiation in August and will complete my hormone therapy April 2027 (2yrs). Last weekend I had my first range session since early spring, I was pretty tired after but felt really nice to get back to the range.

I can't tell enough men, if you're 50+ get a yearly PSA test it's a simple cheap test that's a great indicator for most men. If you have anyone in your family male/female that's had any reproductive related cancer, start checking PSA at 40. Not only might it save your life, but it's far easier to simply remove the prostate than deal with metastasis and everything that goes with it. -- Jeff

 

[WayneShaw]

I went through the radiation treatment. I was getting blood work done every 6 months and PSA was included, so I saw the number creeping up. When it got over 5, I had the tests done and confirmed the cancer. Went through the radiation, which really was terrible, more uncomfortable than anything. After 4 years now, my PSA is at .25. Glad I didn't do the full removal.

 

[Fire Dog]

I went through the radiation treatment. I was getting blood work done every 6 months and PSA was included, so I saw the number creeping up. When it got over 5, I had the tests done and confirmed the cancer. Went through the radiation, which really was terrible, more uncomfortable than anything. After 4 years now, my PSA is at .25. Glad I didn't do the full removal.

The Slice & Dice option has a lot of risk of incontinence, your soldier never standing at attention again and other unpleasant side effects…

 

[JEFFPPC]

Since I started this I will give you an update. Nine days out never had any pain, never took a pill, some very minor discomfort first two days. Bladder 95%+ under control already. Go for pathology report next week and hopefully done. All you guys who don't, need to get regular blood testing and at least yearly physicals. Happy Thaksgiving Day to all, I have lots to be thankful about, and I am.

 

[JEFFPPC]

The Slice & Dice option has a lot of risk of incontinence, your soldier never standing at attention again and other unpleasant side effects…

First of, you sound like someone with normal fears, I had them. Now I realize at 78 I have a some what different perspective than if I was 40 but today most solve incontinence in less than a year . Everyone of the men I have talked to that have had Robotic Prosectemy had bladder control in 3 no or less. My airgin buddy who is 8 years younger than me was forced into the chemo / radiation/ hormone route due to his prostate being so large they would not evrn do the Open style surgery. So he has suffured through all the side effects of what CRH causes. Plus if you go that route to avoid surgery the radiation causes problems that makes open surgery if needed later a poor or even not an option.He even went to a name big city hospital for a second opinion.....No not a canidate for surgery. No unpleasant side effects for me or any of the men I know who have had my procedure. Do yourself a favour and see a surgeon with a good reputation. My guy has 5 stars in all the surveys, I had probably saw dozen options locally but I did my home work. Plus my 30 yr family Dr highly recommended him. Quit spreading bad informatio, it could kill someone.

 

[BW64]

Tuesday the 18th I had a Robatic Assisted Prostectemy. So now 2 days later still no pain. Twinge across the waist getting up or down but less each time. Was I apprehensive and nervous? Yes and no. I had a lot of friends praying for me and was comfortable just leaving everything in God's hands, the Great Physician. Don't wait, it won't go away but it will kill you. I had a double hernia fixed 6 months turning the 3 hr procedure into 5 hr, but all good. Mine was maximum size for this procedure to remove in 1 piece, Dr said it was larger than a tennis ball. I never had any issues but get a regular 6 month checkup. I'm 78 and started the checkups about 30 years ago, always been healthy. PSA number creeping up until my family Dr made me see a Urologist. I had a lot of choices, I went with my Drs pick, glad I did. So listen up guys, save your life. Only downside limited to 10lbs for 3 months, it will pass. I did it, so can anyone of you.

Had mine out in 2009. Still kicking at 80. They say prostate cancer can return in 10 years so I think I'm safe! Good luck with your rehab. That was the hardest part for me since I'm a golfer. Had to wait longer to get back to normal. Guess I had a bad dr though. Bladder is not normal & sex is non existent even with all the pills & stuff available. Oh well I'm alive & still married!

 

[Shooter13]

Get well and DO what the Dr. says!

 

[rjtfroggy]

The Slice & Dice option has a lot of risk of incontinence, your soldier never standing at attention again and other unpleasant side effects…

What is better being able to have sex or living?
I chose to live.

 

[Fire Dog]

What is better being able to have sex or living?
I chose to live.

I’m still here and have both…

 

[Jr solocam]

I cannot see I cannot pee
The golden years have come and passed
The golden years can kiss my ass.

Best wishes Jeff, both my dad and his brother had prostrate cancer, I suppose I will too. My PSA is very low, but I worry sometimes. At 60 now I can feel my type 1 starting to sneak up on me too.

I can still shoot, but right handed instead of left handed.....

Again, best of luck to you.

Jon

 

[itchyTF]

@JEFFPPC

JUST turned 79, PSA in July was 7.7. Saw urologist & suggested a biopsy - cancer. PET scan indicated still contained in prostate, hasn't spread. Trying to read/research to decide which method. Tough since all options have possible negative side effects. I've been told after 75 urinary continence is tougher to get back and some never do. Surgeon says to decide by mid December. Don't look forward to diapers till expiration date. Soldier hasn't been at attention for a while so that side effect is inconsequential. Decisions, decisions........................

 

[rjtfroggy]

I’m still here and have both…

Lucky you.

 

[Fire Dog]

@JEFFPPC

JUST turned 79, PSA in July was 7.7. Saw urologist & suggested a biopsy - cancer. PET scan indicated still contained in prostate, hasn't spread. Trying to read/research to decide which method. Tough since all options have possible negative side effects. I've been told after 75 urinary continence is tougher to get back and some never do. Surgeon says to decide by mid December. Don't look forward to diapers till expiration date. Soldier hasn't been at attention for a while so that side effect is inconsequential. Decisions, decisions........................

If you opt for the Nuclear treatment may I suggest to also inquire about a gel pack that goes in between the rectum and the prostate as that helps shield the bowel from the beam.
I had that done at the same time as the gold locating needles were inserted, not inexpensive but… No good being the richest person in the bone yard.
No incontinence, ever… A bit of urinary discomfort towards the end of treatment, and post for another month. PSA has been .012 -.013 for 5 years, checked every month first 6 months then a year of every 3 months and now at least twice a year.
Here is a link:

SpaceOAR™ Hydrogel | Prostate Cancer Hydrogel Spacer

SpaceOAR™ Hydrogel is a rectal spacer designed to minimize the side effects of radiation therapy for prostate cancer. Preserve quality of life with SpaceOAR.

www.spaceoar.com

 

[WileyG]

@JEFFPPC

JUST turned 79, PSA in July was 7.7. Saw urologist & suggested a biopsy - cancer. PET scan indicated still contained in prostate, hasn't spread. Trying to read/research to decide which method. Tough since all options have possible negative side effects. I've been told after 75 urinary continence is tougher to get back and some never do. Surgeon says to decide by mid December. Don't look forward to diapers till expiration date. Soldier hasn't been at attention for a while so that side effect is inconsequential. Decisions, decisions........................

I'm 68 and in a somewhat similar situation except my PSA went up from 3.9 to 4.7 in a year. Went to urologist in October. He felt 'something' on the left side and wanted a biopsy. 18 samples were taken and 8 had cancer cells. He then scheduled a PET with contrast and it showed the cancer contained within the prostate. The oncologist said that there was so little cancer that he recommended just monitoring every 90 days with PSA and PET every 6 months. He said that IF I wanted he would schedule me for 28 radiation treatments but that I didn't NEED them. All of my info was plugged into a survey of sorts that showed that I was in the top 95% of men my age and with all my medical conditions never need any kind of treatment. So, I have elected to wait and watch with my first PSA in February. And if there is a rise in the number I am going to request radiation ASAP.

Sending prayers for all of you guys who are dealing with this issue.

 

[SGK]

Anyone 50 and over should have an annual PSA test at an absolute minimum and I would suggest an MRI if any PSA reading comes in above 2. (Praying it doesn't happen to you isn't going to help. Screening and science will.)

I was diagnosed with prostate cancer at 58. The PSA threshold for elevation to a urologist is higher in the US (at 4.0) than in other countries (e.g. the UK it is 3.0). When mine touched over 4 just before COVID (55 years old) my PCP wasn't concerned and no alarm was rung. I was delinquent in following up until about 3 years later. 5.7 then triggered alarm bells. (My eventual treatment specialist told me a number much over 2 should have been reason for an MRI as it is PSA density that's more important - PSA levels relative to the size of the prostate.) A biopsy confirmed need for treatment (Gleason score 3-4.) It should have been caught and treated three years earlier.

Also, the US has been way behind the likes of Europe regarding treatment options, although it is slowly catching up. While robotic surgery, eg Da Vinci machine, has meant a radical prostatectomy causes less damage to the nerves surrounding the prostate gland, it can be reserved for the most aggressive of cases or those that have left things far too late (yet the cancer is still contained within the prostate). There are various focal strategies that are less, or non, invasive. I had High Intensity Focused Ultrasound to ablate the partial area of my prostate where the tumour was. No side effects from the treatment whatsoever. But unfortunately it appears I might be part of the 10% of patients that need a second treatment. My annual MRI now two and a half years after treatment has shown some signal that needs to be investigated and I have another biopsy scheduled for this coming Thursday.

(Other focal strategy treatment options include nano knife which use electrical signals to ablate bad tissue, cryotherapy and high-intensity MRI-guided radiotherapy which is typically a one and done procedure (a close friend of mine had this treatment a couple of months ago). Even though these treatment strategies were relatively common in Europe, and now increasingly so here, my original urologist in Miami then said to me "all I could tell you about those options is what I could Google" which is absolutely appalling coming from a guy who did radical prostatectomies with a Da Vinci robotic machine.)

Don't dick around with this fellas.

 

[JEFFPPC]

If you opt for the Nuclear treatment may I suggest to also inquire about a gel pack that goes in between the rectum and the prostate as that helps shield the bowel from the beam.
I had that done at the same time as the gold locating needles were inserted, not inexpensive but… No good being the richest person in the bone yard.
No incontinence, ever… A bit of urinary discomfort towards the end of treatment, and post for another month. PSA has been .012 -.013 for 5 years, checked every month first 6 months then a year of every 3 months and now at least twice a year.
Here is a link:

SpaceOAR™ Hydrogel | Prostate Cancer Hydrogel Spacer

SpaceOAR™ Hydrogel is a rectal spacer designed to minimize the side effects of radiation therapy for prostate cancer. Preserve quality of life with SpaceOAR.

www.spaceoar.com

It's great you have had good results firedog.

 

[JEFFPPC]

I hope the information in this post saves some guys from an ugly ending. No need to be afraid there are options and treatments. But to be unaware leaves you to have no choice and a quite possibly bad conclusion. Get checked, get it handled. Remember 80% of males world wide at some point in their life has prostrate cancer. It can be a death sentence if you ignore it. You choice.

 

[7887mm08]

The Slice & Dice option has a lot of risk of incontinence, your soldier never standing at attention again and other unpleasant side effects…

if you choose radiation, surgery is not an option afterwords if cancer returns But if you have surgery and cancer comes back you can go thru radiation treatment.
2 yrs for me in Dec. having my prostate removed, everything still works but it took some time. (I'm 62 now)

 

[Fire Dog]

….and high-intensity MRI-guided radiotherapy which is typically a one and done procedure

This is what my treatment was and my hospital has two of those German machines…
Varian TrueBeam proton machines.