Biopsy

[Guest Ruben]

I learned today that I need to have a biopsy for prostate cancer. It seems my PSA jumped enough in one year to have certain guidelines kick in.

 

I'm 62 this month, with my birthday coming one day after the biopsy. This is not exactly the kind of birthday present I might want to have, but that is the way things are.

 

Question: Have any of you on this thread had a prostate biopsy? Do you have any advice for me?

 

Ruben

[eastbayguy]

>I learned today that I need to have a biopsy for prostate

>cancer. It seems my PSA jumped enough in one year to have

>certain guidelines kick in.

>

>I'm 62 this month, with my birthday coming one day after the

>biopsy. This is not exactly the kind of birthday present I

>might want to have, but that is the way things are.

>

>Question: Have any of you on this thread had a prostate

>biopsy? Do you have any advice for me?

 

Yes, as a matter of fact. Turns out I had a chronic prostate infection, requiring months of low level antibiotics.

 

My biopsy wasn't the worst thing ever. Went to a modern urologist with good tools. They used a little gun gizmo. They stick it up your ass, with lots of lube and fire four little tubes, one at a time, in to different parts of the prostate. Produces four little core samples, sort of like a geologist might get. They gave me a general sedative, I don't think any other anesthetics were used. I was awake but relaxed. Afterward, I had to sit around for an hour for the sedative to wear off, then someone else had to drive me home. The experience seemed to get either the prostate or the infection a bit riled up, but it calmed down in no time. Two weeks after the antibiotics kicked in, the prostate was much happier.

 

The old way was to do this with an evil device called a cytoscope that goes up your urethra via your penis. They use instruments to clip some tissue. My urologist said this is rarely used in the US any more.

 

It was all over in no time.

 

Afterward, the results were in pretty quickly. I've actually been through this twice now. Had the doctor been hotter, I might have been willing to pay more for the experience.

 

You asked for advice: My only advice would be to read up, ask questions and make sure you're seeing a modern, well trained urologist with all the latest tools and techniques. Access to the latest methods and surgical tools is essential.

 

--EBG

[+ Oliver]

"Question: Have any of you on this thread had a prostate

biopsy? Do you have any advice for me?"

 

Yes, I have. Four different times over a period of about seven years. With the last one, over four years ago, it was confirmed that I had prostate cancer (I was 64 at the time). Because of the ongoing checkups in that time, early detection was key. The cancer was totally contained within the prostate, and I, therefore, had several options on how to treat it. I saw more than one doctor for opinions and read everything I could to make the decision. I was also fortunate to be in a major university medical environment. (I would have liked to have had someone say, “Do this”, but I ultimately had to decide for myself.) I decided on removal of the prostate. It is now more than four years ago that it happened and I am happy to say I am cancer-free today (last checkup a week ago). Without the early detection, I might not be here to say that.

 

Did I like having the biopsies done? No! The procedure has been described by EBG. Each time it was done to me, seven or eight “shots” were taken from me. And I was counting down the whole time. There was a split second of pain for each one. Afterwards there was only a minimum of discomfort and some blood in the urine, but that ceased within a day. With a competent and compassionate urologist you will have the results quickly, to dispel the anxiety.

 

Advice? Be comfortable with your doctor and ask any questions you can think of. You must do it. It will save your life!

 

Oliver

[ValleyDwellerNorth]

Hello Ruben,

 

Oliver's last piece of advice is SO crucial! Talk to your doctor and ask questions. My father, age 72, just had a biopsy to see if he had prostrate cancer. The good thing about getting the biopsy is it puts a period to the end of that sentence. His PSAs were irregular and high. The biopsy ruled out cancer and he will get blood work every 3 to 6 months to monitor.

 

Now he shared with me the procedure wasn't painful. Outside of the unnatural setting where that part of your body is on full display there is minimal physical discomfort. The days following had time where sitting wasn't always comfortable. However, these discomforts are not out of the limits of tolerable discomfort.

 

My prayers are with you. If it is cancer it is one of the most treatable forms. If you have faith in your doctor then you are in good hands. Keep us all posted.

 

And just a suggestion - buy some of those moistened wipes to use for a week or so after the procedure when you need to do #2. They made the difference for my dad and he still uses them today. In other words, pamper your ass and don't be ashamed or embarrassed to do so!

 

VDN

[ValleyDwellerNorth]

>the prostate. It is now more than four years ago that it

>happened and I am happy to say I am cancer-free today (last

>checkup a week ago). Without the early detection, I might not

>be here to say that.

 

THAT IS WONDERFUL NEWS OLIVER! May you continue to experience great health and be cancer free forever. Many men need to follow your example and do early detection.

[OneFinger]

Ruben,

 

Sorry to hear that a biopsy is needed but feel you've been given great advice.

 

My recommendation, if it turns out you have prostate cancer, is to carefully consider your options. Prostate cancer is a fact of life in my family. (My father and all of his 6 brothers have prostate cancer.) I'm the only male in my generation NOT to have it (yet).

 

Prostate cancer is a very slow growing cancer and some in the family opted for very aggressive surgeries. Others (based on their age) decided to do nothing. It's not my place to make a recommendation in your particular case. But, be sure to get a second opinion on your options and perhaps join a prostate cancer support group. I've found that groups can provide specific info on how it's affected their lives and what they would have done differently.

 

Good luck.

[Guest zipperzone]

>I learned today that I need to have a biopsy for prostate

>cancer. It seems my PSA jumped enough in one year to have

>certain guidelines kick in.

 

Please don't panic and jump to conclusions. False positives are not infrequent with PSA tests. And if there is a problem, it sounds as if you have detected it in plenty of time.

 

>Question: Have any of you on this thread had a prostate

>biopsy? Do you have any advice for me?

 

The biopsy with today's methods is almost totally painless. The scope that is inserted in to your butt doesn't hurt at all and the actual taking of sample tissue by way of shooting a needle into the prostate can best be described as feeling like someone kicked you in the ass. No lingering pain at all. As you can probably tell - I've been there, done that.

 

One thing you should be aware of is that your ejaculate for the next few days will probably contain a fair amount of blood. Just mentioning this as it can freak your partner out (and you too) if you're not expecting it.

 

Once again - don't panic and I wish you well.

>

>Ruben

[swallows22]

Ruben, this might be long and drawn out, but I hope it helps you and maybe another bloke ot two.

I grew up in a family, in which colon cancer was rife. So I was diligent with my colonoscopies. This included blood tests. Much to my surprise, my results indicated a more than average PSA. It rose to the point that a biopsy was needed. As in previous messages, they go in from behind. It was uncomfortable, but tolerable. My diagnosis was that there was something there, but the surgeon wasn't sure. There is another type of biopsy where you go under a general and they enter between the scrotum and bum. Here, it was determined that CA was present but I was on a low level. There is a thing called the Gleeson scale. If you are between one and three, no worries. Just monitor. Above that, watch out. In December of last year, I hit four.Time to have it out, which I did in March.

What is the outcome? The prostate dictates ejaculate, not sexual drive. However, the removal can reduce the probability of a decent erection. This can be assisted by pills[viagra, etc.], vacuum pump or injection. I have to use the injection method. I swore I would never do that, but the needle is so thin, it actually doesn't hurt.

So where do I go now. My surgeon said there is no problem with being a top or bottom. Go for it.

I digress. I have been seeing Cameron #2 in Sydney for the past three years. I explained my situation and he said " no problems" He came to see me twice in the hospital. Now when we meet, he helps me with the injection and FUCKS me stupid. My orgasm is better than before. Just no ejaculate. As one of my mates says-Finally, you can get the black satin sheets out again.

So, mate, don't be afraid. I forgot to mention that I have a few years on you. Monitor this or IT IS A LONG SLOW PAINFUL DEATH.

What are my plans for the future? I leave Sydney mid-October for an ATW trip. I have lads lined up in London, Brussels[no not the inveterate poster, he declined to answer], DC, New Orleans, Portland, San Diego, LA and SFO.

And I would like to quote a statement from Alex in Portland when I explained my situation. He said- No worries. I have been with two other clients in that situation and it was great sex.

So, for God's sake, get on with it. There is life after a radical surgery, IF THE SURGERY IS NECESSARY.

Funny, I never thought that I would share this with anybody other than close mates. I am sitting here crying my eyes out-NOT because it happened but because I am still alive and hopefully can help someone else survive.

Disclaimer-I am not a medical practioner and with the tears, I can't see spell check. If you don't like it, get stuffed.

[HardnThick]

What an important thread! I uncomfortably squirmed reading it but I needed the info.

 

Just knowing there are newer techniques for doing the biopsy enables us to be better-informed health care consumers.

 

For the other guys who have had their prostates removed….has it changed your sexual activity? That would be the scary party for me.

 

P.S. to Swallow: Thank you for your hopeful sharing!

[+ Charlie]

My partner went through this process last year because his younger brother had just had his cancerous prostate removed. A test showed my partner had an elevated PSA, so he had a biopsy. Although his prostate turned out to be fine, they discovered that he had the early stages of bladder cancer, something totally unexpected, which would have gone on developing undetected if it weren't for the prostate biopsy. Luckily, the bladder cancer was removed, and treatment has prevented a recurrence. So, although no medical test is pleasant (well, maybe the manual examination of the prostate is an exception), it is always better to find out as much as possible, as soon as possible, about the state of your body.

[Guest Merlin]

My doctor did not use a sedative. He smeared the prostate area with novacain with his finger. Helps to take some Tylenol just previous to it--no aspirin, advil or aleve, they may increase bleeding. Most doctors take 6 or more biopsies now. To know what each feels like, thump your arm with the opposite middle finger--just a dull thump.

Don't rush into surgical removal. Study the available material. Surgery does not produce statistically better results than radiation, and with surgery there is a high probability you will be impotent and/or incontinent. It is a terrible operation which requires months of recovery. Radiation by implantation of seeds alone is a one day procedure with no hospitalization. Little chance of impotence or incontinence. Radiation by external beam requires daily treatments over a 5 week treatment (there are variations. No pain at all. Again, little chance of impotence or incontinence. Statistically, your chances of a cure with radiation are equal to surgery, and actually superior if it happens that the cancer has spread into adjacent tissues, which cannot be determined with certainty prior to surgery. There are some truly excellent source of information on the internet to help you decide, and there is a gay group on yahoo.

[jack]

Much good advice. Here's my take based on a PSA that had been 4 for years, suddenly went to 5.2. Referred to a Urologist who gave me a book and said 1)let me know which of the three routine choices you want to do and, 2) if one little cancer cell gets out into your body, you could be in big trouble.

 

The Prostate Cancer Book concluded that each choice resulted within three or four years with incontinence and erectile dysfunction. Being sexually active with platoons of Campus Escorts, I was challenged by this information and set our immediately to find out which Dr. or Clinic did the best "nerve sparing" in either the radical removal of the prostate, or with radiation, the best between the conformal with those daily treatments five weeks or more, or the one time seed implant (which I would favor if need be for the reasons already given above).

 

I started interviewing Drs and Clinics for the best "nerve sparing". John's Hopkins, a clinic in Atlanta, another in Philadelphia, amongst others since I have the resources to go any place for the best in the world.

 

Conclusion to my search for the best: Nobody cared a hoot if I actually needed an operation. They all wanted my business. Why: for their income and to keep their surgical teams in top shape. That must be why the Urological Association of the USA declared last year in the WSJ that they were going to review themselves to see if the tests were productive and how productive were their surgeries or implants in ruining men's lifestyles needlessly. In my opinion, most urologist are opportunitist and scare patients into procedures they don't need. In other words, in my opinion, they are unethical to us and their oath.

 

Along with your PSA number (and the velocity withwhich it changes from year to year) is the Gleason score achievd from the biopsy. You need the biopsy to get this Gleason score. Don't fret about it. It doesn't hurt. Its quick and simple. And, if you have a PSA under 10, which does not represent cancer, though 30% of the guys will get cancer, and if your Gleason score is 6 or less, you are very very very low risk candidate for prostate cancer.

 

Here's the math, guys, which you probably have never seen from your own Doctor and which I had to find out for myself at a University and nationally reputable Prostate Cancer Clinic will have:

 

T1c: the prostate gland feels normal on DRE (ie. no nodule) but the PSA level elevated

 

T2a, b or c: a nodule is felt on DRE (the letter a or b is given if the nodule is or on one side of the gland, c if it is felt on both sides.

 

T3: there is suspicion of cancer spread outside of the prostate capsule based on DRE

 

Risk Groups:

Low Risk: T1c or T2, PSA<10, Gleason sum of 6 or lower

Intermediate Risk: T1c or T2, PSA 10-20, Gleason sum of 7

High Risk: T3 or PSA>20 or Gleason sum of 8 or higher

 

So, when your family friendly Dr stands there and says it'd be best to get this done as soon as possible because it is a slow horrible death, and you find out you are popular with all Urologists who may have a kid going to college or wanting a new Mercedes, take a deep breath and get to a place that actually practices medicine in your behalf. My Dr. certainly didn't tell me I was low risk or how the Gleason worked (its an index of how fast the tumor is likely to grow) in the Risk Groups, though he did say my Gleason 6 was good, and that 7 would be bad. He wanted to knife his way in under my balls with my legs up and go for it causing me incontinence and erectile dysfunction when I didn't need it.

 

Enough already. Prostate cancer is horrible. My basic question for the author of this thread is how come he's asking about the biopsy without having been told by his Doctor how fundamental the results are next to his PSA score in what to do next. In my opinion, his Dr is as opportunistic as all the others. How come a lot of radical operations have been done on guys with PSA's under 10 who never heard about "Gleason". That's an outrage to me for the damage done to the lifestyle, that of being and feeling like a man, unnecessarily because the Dr withheld information.

 

There's a lot of medical information on prostate cancer. Watch out for your Doctor and get it.

[+ newatthis]

>Don't rush into surgical removal. Study the available

>material.

 

For sure. You've got lots of input already on where to find it. However, the statement that

 

>It is a

>terrible operation which requires months of recovery.

 

is contradicted by the recent experiences of 2 of my colleagues, who were back at work relatively quickly with few or no ill effects and little complaint about the surgery. I'd guess there are too many individual variables here for any one person's experience to be predictive of another's.

[jack]

My biopsy took less than forty five minutes. I drove home. That is really not important to the issue.

 

The essence is how the results of the biopsy are fundamental to what you decide to do next . . . . I humbly invite you to read my previously submited post here. You have to know what your Gleason score is that you get from the biopsy, along with your PSA to make decisions.

 

Here is a reference you should all get, that I failed to enter in my previous post: Prostate Cancer, Treatment Guildelines for Patients, published by National Comprehensive Cancer Network. Get that. Its got all the information your Doctor never told you and that you should know.

[Guest Merlin]

There are some mistakes in Jack's long post above. He says that with a Gleason score of less than 6, there is low risk of prostate cancer. Wrong. The Gleason score comes into play only if there is cancer. The pathologist looks at the cancer and determines which type of cells are most prevalent. A score of 6 or less indicates that the cancer is less agressive and slower in growing. Also, a PSA of 10 or less does not indicate there is no cancer. If it is less than 4 most Doctors will not recommend a biopsy, but over 4 they will.

[Guest alanm]

I had an operation for prostate cancer eight years ago and have been cancer free since then. My experience was different from others on this site. I never had a high PSA. My problem was near total wipe out after cuming. I was extremely tired for hour afterwards. I did get help from a decent urologist who proscribed antibiotics for a common prostate problem. When things did not get better, I asked for the biopsy to rule out cancer. Much to my surprise, the biopsy did show cancer, but was confinded to the prostate. I knew there was something very wrong and told the doctor, thus the biopsy. In this case, my body (and mind) was more valuable than the PSA. Moral: If you believe there is something wrong pursue it strongly, whatever your PSA shows.

[Guest Tristan]

Ruben, I had a prostate biopsy about two years ago. Luckily, it was negative. I just had local sedation and was able to drive home. The doctor used a high speed gun instrument. I found each sample taken increasingly painful (more like pressure), but this may be due to the fact that I had local sedatation only. At least one person in this thread mentioned not having much pain with more than local sedation. I was given an antibiotic to take along with the procedure to prevent infection from going thru the rectal wall to the prostate.

 

[b/]This is very important![/b]. If you have a biopsy, make sure you get a 12-sample test. Some urologists only do a 6-sample test or even less. That makes it easy to miss cancer cells. The 12-sample has an extremely high degree of confidence - I believe at least 99%. My brother had a 6-sample test, and the test was negative. He later had a 12-sample test, and the test was positive.

 

I hate this whole thing with PSA scores. It's a crap shoot. You can have a PSA between 4 and 10 from benign prostate enlargement (BPH) or other reasons. We need a better more accurate test than the PSA. Once you go to the urologist, he'll almost certainly want to do a biopsy on anyone over 4. Many urologists are trigger happy.

 

On another issue, note that most of the fluid when you ejaculate comes from the prostate. So if the prostate is removed, there goes most of the fluid.

 

Best of luck,

 

- Tristan

[Guest Ruben]

I want to thank all of you for your advice and words of encouragement. The worst part at the moment is the waiting, and I am not good at waiting. The procedure will not take place until August 27, and then I need to wait 3-5 business days for the results, which will be reported by telephone. Since I live alone, bad news by phone will probably be quite stressful at the time. On the other hand, I am told that I can drive myself to and from the clinic on the day of the biopsy. This will be helpful because the clinic is about an hour's drive away. What little family I have is a long way away, and friends are also either a long way away or will be working.

 

I have what I believe to be an excellent urologist who is young enough to have the latest training and experienced enough to be no greenhorn. We get along well. I saw a TV program on prostate cancer about four years ago. It was awful, just awful, and the treatments of the disease, or at least some of them, seemed more like mutilation than medicine. I'm sure the producers of the program intended no harm, but the impact on me was deeply negative. I mentioned this program to my urologist--I was being treated for prostate infection, successfully as it turned out. He was upset because I was so upset.

 

I live in a condominum. One of my retired friends here got prostate cancer about 4-5 years ago when he was about 75 years old. He did a survey of his retired friends from work to see how many, if any, had prostate cancer. Answer: 9 out of 11! Can you believe that? 9 out of 11. This man seems to have beaten the disease, however, and seems to be okay today.

 

Thanks again to all, and Jack, I'll start looking into that Gleason number you mentioned.

[eastbayguy]

>Conclusion to my search for the best: Nobody cared a hoot if

>I actually needed an operation. They all wanted my business.

>Why: for their income and to keep their surgical teams in top

>shape. That must be why the Urological Association of the USA

>declared last year in the WSJ that they were going to review

>themselves to see if the tests were productive and how

>productive were their surgeries or implants in ruining men's

>lifestyles needlessly. In my opinion, most urologist are

>opportunitist and scare patients into procedures they don't

>need. In other words, in my opinion, they are unethical to us

>and their oath.

 

Curiously, when my PSA score was funny and I reported some pain, the first words out of my doctor's mouth were "do not let anyone talk you in to an operation with seeing me first." There is much wisdom in the writing of the above poster. Lots of doctors operate needlessly. The reasons can be two-fold. Many patients push their doctor for an absolute cure and surgery seems to offer just that.

 

All the medical jargon, equipment, fancy offices and so forth can be daunting and intimidating. My message would be this: No one cares more about your body, your health and your overall goals than you. Align yourself with a doctor who can advise you of all possible courses of action, risks and so forth. Above all, don't let them scare you. Insist that the doctor answer your questions, spend the time with you that you need and so on.

 

These guys can be like those sleazy mechanics who imply that your car isn't safe to drive and insist that your vehicle requires expensive (and unnecessary) repairs that must be done RIGHT NOW in their shop. Excellent medical care does exist. It is your life and your body.

 

--EBG

[jack]

Ruben, you made my day when you said you were going after the Gleason score information.

 

Remember, that score together with your PSA, will give you a hint at what Risk Group you are in. This is crucial. See the layout of the Risk Groups in my Reply #9.

 

Make sure you get a copy of the NCCN's (National Comprehensive Cancer Network) publication, Prostate Cancer, Treatment Guidlines for Patients. That's where the Risk Groups are set up which your Doctor has to answer to you before he cuts you up under your ball sac in the middle of your perinium. Anyone with a PSA under 10, and a Gleason Score of 6 or less should really do these things before allowing any DR. to do anything to them to stimie their scare tactics and play on emotions. Prostate cancer has been around a long time. A lot of research and development is going on. Many Doctors ignore referring patients to the logics and sensibity of the facts in order to sometimes, in my opinion, take unnecessary radical procedures to simply make a buck and keep their surgical teams warmed up, at the expense of your lifestyle (incontinents and erectial disfuction) and wallet. x(

[jack]

Ruben, you made my day when you said you were going after the Gleason score information.

 

Remember, that score together with your PSA, will give you a hint at what Risk Group you are in. This is crucial. See the layout of the Risk Groups in my Reply #9.

 

Make sure you get a copy of the NCCN's (National Comprehensive Cancer Network) publication, Prostate Cancer, Treatment Guidlines for Patients. That's where the Risk Groups are set up which your Doctor has to answer to you before he cuts you up under your ball sac in the middle of your perinium. Anyone with a PSA under 10, and a Gleason Score of 6 or less should really do these things before allowing any DR. to do anything to them to stimie their scare tactics and play on emotions. Prostate cancer has been around a long time. A lot of research and development is going on. Many Doctors ignore referring patients to the logics and sensibity of the facts in order to sometimes, in my opinion, take unnecessary radical procedures to simply make a buck and keep their surgical teams warmed up, at the expense of your lifestyle (incontinents and erectial disfuction) and wallet. x(

[Guest Ruben]

Jack,

 

I've been away from the computer for a day or so, hence the delay in my responce to your last post.

 

I have found the NCCN's web site, and, as you said, it has already been very useful with the information it provides, even if much of this information is soooo depressing to read. I have also found a site for that prostate clinic in Atlanta you mentioned.

 

I have two questions for you. Based on your research, do you have an opinion about the Mayo Clinic in Minesota/Arizona as a prostate treatment center? And, if this is not too personal to ask, what did you finally decide to do with your own prostate cancer and where did you finaly seek treatment? I gather you did not have surgery and opted for seed implants. May I ask how long ago this procedure was done and how things are with you today? If you did have seed implants, would you elect to have implants again, knowing today as a veteran of the prostate wars, what you now know about your own case?

 

Thanks again to you and to all posters for your help.

[jack]

Ruben, this place is at its best when you review your thread and see how you are taking charge of your life through expanded intelligence. Just compare your original questions to yesterday's -- truly remarkable. You make me proud and happy along with the hopes that more men will be better informed, better instructed, better schooled to make practical decisions about themselve transcending the slip-shot emotional scare technique that seems to proliferate in the Urology industry in my opinion. Your questions:

 

1)In addition to the resources of the NCCN website, I was refering to NCCN's booklet entitled, Prostate Cancer, Treatment Guidlines for Patients, Version III / October 2002. That booklet contains outlines of the Risk Factors applicable to the numerous calculations of various Gleason and PSA scores. It gives you an idea of where you stand in the race. Ruben, try to get this -- there may be an updated printing too.

 

2)That Atlanta Clinic, remember, became a part of the chorus of people and medical entities that I discovered were all the same as each other -- just wanting to do anything regardless of what I needed. However, I'm sure they would be good at their jobs after you have medically decided what to do and that their services would be useful.

 

3)The Mayo Clinic has a superb reputation and I would have confidence in it. Nonetheless, at NCCN's website check out NCCN Network Hospitals. You'll see the consortium of clinics that work together throughout the United States. To me these people are unanimously practicing medicine and pursuing reaseach in the fight against prostate cancer. They are building and sharing reseach and conducting clinics.

The enlightenment I have had (including all the above) came after I got an appointment at the NCCN Roswell Park Cancer Institute in Buffalo,NY. The difference between their practicing medicine and the predatory tactics of many many urologist and their clinics is the difference between a Hurrican5 and a lite dew.

 

4)My case, that my local urologist wanted to geld me for, was PSA 5.2 and a Gleason 6. Now, Ruben, look that up in the Risk Factors. The Roswell recommendation (and from whence all this information on the NCCN,et aL) was to not do anything -- to wait. Since that time, two years ago, the PSA has moved some, up and down. My case is before a committee of five doctors. I don't want to do anything stupid, but, I feel very comfortable, based on the facts, that I am surviving and my sexuality is surviving along with me, trust me on this.

 

On what to do, that decision will be based on the then current situation. The seeds seem to be the least invasive approach. But, Ruben, buddy, while I've been on hold, I see the Cyberknife Society (CKS)proposes the new Stereotactic Radiosurgery System (see CyberKnife Overview ) may represent the most nerve sparing technique so far. Someday, it'll be a pill.

 

In conclusion, I hope this helps. We all start this thing with the guy playing with our balls with one hand (I should have sent him a bill) and with a knife in his other hand. As you now know, there is a tremendous amount of information available to us that helps in doing the right thing.

 

All I know, Ruben, is that if I get gelded, it will be because I needed it and not because they wanted to do me just because.

[Guest Ruben]

Jack,

 

How wonderful that your doctors recommended that you wait and watch. This sure beats surgery, though I imagine there is considerable stress every time you get a new PSA readout.

 

May I ask why you selected the hospital in Buffalo? Was it a matter of convinient location or some other consideration? How hard/easy was it to get an appointment with the hospital? Was there a long waiting period? I am definately not good at waiting, especially when I have something to be anxious about.

 

I have already read portions of the Treatment Guidelines put out in the NCCN's publication, though I have not yet ordered a copy for myself. After all, I still do not know that I actually have prostate cancer. I only know now that I'm at "high risk." Funny, but I learned that I am at "high risk," not through my urologist, but through the NCCN web page. My PSA is 1.8, but the previous reading was .99 and that gives me a "velocity" problem.

 

One more question. Are you familiar with Proton Radiation treatment for prostate cancer? If I do have this disease, my first move will be to contact the three hospitals in the country that provide Proton Radiation and pray that my case is suitable for this type of treatment.

 

Thanks, Jack

[jack]

Ruben, the guideline for Prostate Risk Group is:

 

Google: NCCN practice guidlelines

 

Next Click the second selection: NCCN Physicians Guidlines index

 

Next Click on Prostate Cancer and,

 

you'll see in two pages or so Staging Workshop. Your home.

 

 

I picked Roswell Park because I have friends there. The Roswell Park Prostate clinic is called: Buffalo Niagara Prostate Cancer Consortium. 717-845-3173 fax 845-7616 [email protected]

 

Would you believe I've heard some guys have PSA's of 150 or 200 or 18 or 25. They'd love to have a 1.8.

 

Hitherto, anything under 10 isn't cancer yet although 30%will turn into caner. A biopsy, it seems, would be very helpful -- and there is nothing to it, I promise.

 

What you say they say about velocity is true and new and requires real expertise. My PSA was 4. for years and years, then it bounced up to 5.2. I would not feel in imminante danger with your current PSA. At least you've had a chance to educate yourself and today you are a lot safer than you were a month ago.

 

It is true I feel some anxiety about each annual PSA but I also feel a sense of victory each year that goes by and each year that I am whole, and each year that new discoveries are discovered.

 

And, when you asked about the Proton . . . you made me very happy . . now we are equal in the crusade. Let me know. Good luck.