Justification for "routine" psa testing in males >50yrs.
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Guess I'll stand by my earlier post that psa screening in asymptomatic men doesn't work.
That's a high-ish Gleason for the PSA, so at my age and with that rate of development I can be pretty certain that within the next five years it would have metastased - which is another ball game.
Routine screening for men over 50 - you bet. Sorry if it's not scientific, but it may have saved my life, and as the carer for an MS sufferer, it's saved her quite a bit too.
Psychophysiological entity
a a
I'm not sure about this, but cells in the blood or lymphatic system are not what kills most people with prostate cancer. I'd gathered the danger to be a contiguous formation reaching the lower spine. I guess the difference is somewhat academic to the sufferer.
With those findings, and at your age, what did you do - or what are your intentions?
Those were my Gleason figures, and a surgeon in Texas said get on with it . . . "two, maybe three months, no more." And I was 17 years older than you at diagnosis.
The thing is, that 4 + 3 is borderline for Brachytherapy, and you may well want to consider what is a very easy option with regard to treatment.
Taking the figures from the NHS brochures handed out at the time, and the consultant's verbal briefing, the 5 year results for Brachytherapy are now equal to external beam.
As mentioned above, this was in the UK.
I can be pretty certain that within the next five years it would have metastased
With those findings, and at your age, what did you do - or what are your intentions?
Those were my Gleason figures, and a surgeon in Texas said get on with it . . . "two, maybe three months, no more." And I was 17 years older than you at diagnosis.
The thing is, that 4 + 3 is borderline for Brachytherapy, and you may well want to consider what is a very easy option with regard to treatment.
Taking the figures from the NHS brochures handed out at the time, and the consultant's verbal briefing, the 5 year results for Brachytherapy are now equal to external beam.
As mentioned above, this was in the UK.
Red On, Green On
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With those findings, and at your age, what did you do - or what are your intentions?
Psychophysiological entity
I had the dye/X-ray and an MRI within a few days. The former seemed pretty important in the decision making. Have they covered that in briefings?
Good luck with the results.
Good luck with the results.
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Airborne Artist
With those findings, and at your age, what did you do - or what are your intentions?
I'm waiting for the MRI results to ensure that it is still contained, and I anticipate opting for brachytherapy.
When I was leaving Hospital after my Radical Prostatectomy in April 2009, the nurse who was taking me to my car stated the following:
Her husband had the Brachytherapy Procedure 7 years earlier. He had since found out that the Prostate Cancer had come back. She told me that it is not possible to have Radical Prostatectomy after a Brachytherapy Procedure because the Brachytherapy creates a lot of 'scar tissue' and thus surgery is nigh impossible. She was not at all confident about his future because of the return of the Ca
Please carefully consider all your options.
Mike
With those findings, and at your age, what did you do - or what are your intentions?
I'm waiting for the MRI results to ensure that it is still contained, and I anticipate opting for brachytherapy.
When I was leaving Hospital after my Radical Prostatectomy in April 2009, the nurse who was taking me to my car stated the following:
Her husband had the Brachytherapy Procedure 7 years earlier. He had since found out that the Prostate Cancer had come back. She told me that it is not possible to have Radical Prostatectomy after a Brachytherapy Procedure because the Brachytherapy creates a lot of 'scar tissue' and thus surgery is nigh impossible. She was not at all confident about his future because of the return of the Ca
Please carefully consider all your options.
Mike
Psychophysiological entity
You'll note that I mentioned the burning of bridges in an earlier post.
I really wouldn't want to try to bias anyone towards a particular procedure. In the UK, there is free dedicated counseling and unbiased advice. It's odd, I didn't really like the counseling, I think to make a 'command decision' like this, one needs to listen to the surgeons (in my case two plus one specialist doctor) then decide what's better for that particular set of circumstances.
Even 7 years ago the positioning and power of the radio iodine 125 'seeds' was notably less accurate. The Volume Studies is a fairly complex procedure, and I guess this is the crux of the matter.
The claim that the 5 years figures are the same as external beam is something I've bet the farm on, but to some extent I took a line of least resistance cos of a slew of personal issues.
I was offered a radical procedure both here and at home. Here it was offered at $23,000 for the compete hospital package. They were to use the da Vinci machine.
The kind young surgeon that did my biopsy, refers most, if not all of his patients now, to a colleague that uses the robotic machine. He said that after seeing the accuracy, he would not do the conventional surgery again.
At home, the surgeon said that he would do the conventional procedure, but if I wanted, I could opt for the da Vinci. A longer wait, and more travel in my case. It became academic, but I would have had a problem telling him that I didn't want him to do it. Seems like a vote of no confidence.
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I really wouldn't want to try to bias anyone towards a particular procedure. In the UK, there is free dedicated counseling and unbiased advice. It's odd, I didn't really like the counseling, I think to make a 'command decision' like this, one needs to listen to the surgeons (in my case two plus one specialist doctor) then decide what's better for that particular set of circumstances.
Even 7 years ago the positioning and power of the radio iodine 125 'seeds' was notably less accurate. The Volume Studies is a fairly complex procedure, and I guess this is the crux of the matter.
The claim that the 5 years figures are the same as external beam is something I've bet the farm on, but to some extent I took a line of least resistance cos of a slew of personal issues.
I was offered a radical procedure both here and at home. Here it was offered at $23,000 for the compete hospital package. They were to use the da Vinci machine.
The kind young surgeon that did my biopsy, refers most, if not all of his patients now, to a colleague that uses the robotic machine. He said that after seeing the accuracy, he would not do the conventional surgery again.
At home, the surgeon said that he would do the conventional procedure, but if I wanted, I could opt for the da Vinci. A longer wait, and more travel in my case. It became academic, but I would have had a problem telling him that I didn't want him to do it. Seems like a vote of no confidence.
Google Image Result for http://www.drewprops.com/graphics/article_photos/2009/mysurgery_003.jpg
Last edited by Loose rivets; 10th Aug 2010 at 05:31.
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Please carefully consider all your options.
Equally there are risks with RP - it's not simple.
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Back in spring 2007 I was in France and got gout. Went to the GP in the village..gout treated and OK..but he said "You need the following tests" and listed several, which I had already had, plus a PSA test. I'd been peeing a bit more often in recent months, and had started taking Saw Palmetto..so when back in the UK I had a PSA test at my usual GP. He gave me the "false positives" story...but the result came back at 26. So, no question, biopsy etc...T3a Gleason 9 (5+4). Since then I have had hormone therapy with 12 weekly Zoladex implants, a daily bicalutamide pill, Intensity Modulated Radio Therapy and a Trans Urethral Resection of the Prostate. My PSA is now 0.17 and I am asymptomatic, going back to the Royal Marsden every 6 months for a howgozit. Prof. Dearnaley tells me I am the Worlds Most Irradiated Man!! Whatever, it all seems to be working OK at the moment, so I'm quietly optimistic.
I feel that routine PSA blood tests would be a life saver..agreed the results need careful interpretation, but if it wasn't for my gout I probably wouldn't have had the test and not be here now. As for Saw Palmetto and Flomax...they will kill people, sure as eggs. If you have any suspicion of these sort of urinary problems, bite the bullet and get tested. Things can be done to cure/treat them nowadays.
I feel that routine PSA blood tests would be a life saver..agreed the results need careful interpretation, but if it wasn't for my gout I probably wouldn't have had the test and not be here now. As for Saw Palmetto and Flomax...they will kill people, sure as eggs. If you have any suspicion of these sort of urinary problems, bite the bullet and get tested. Things can be done to cure/treat them nowadays.
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The PSA test may not be a very good indicator of Prostate cancer but it appears to be all we have -I believe that soon there will be more effective blood or urine tests.In my case I had no symptoms but had a medical checkup for a Philippine residence visa and this showed elevated PSA levels,a biopsy showed cancerous cells.I was given the option of surgery or radiotherapy,I took the surgical option as it appears on the information given to be the best of the two in my case. Without the PSA test the cancer would have progressed until I had symptoms and by then possibly it would have been too late for effective treatment. After two years of routine tests all seems to be well - it was not a very pleasant experience especially the biopsy but it is better than being dead!
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bcgallacher
The PSA test may not be a very good indicator of Prostate cancer but it appears to be all we have -I believe that soon there will be more effective blood or urine tests.
...
Without the PSA test the cancer would have progressed until I had symptoms and by then possibly it would have been too late for effective treatment.
Agreed - the PSA Test is only an indicator - its the trigger to be become alert.
In my case, it concerned my GP just how quickly the PSA numbers increased and it was his absolute insistence I see a Urologist.
I had the Radical Prostatectomy in April 2009 and my last PSA Test last week (17 August) was <0.04!
Mike
The PSA test may not be a very good indicator of Prostate cancer but it appears to be all we have -I believe that soon there will be more effective blood or urine tests.
...
Without the PSA test the cancer would have progressed until I had symptoms and by then possibly it would have been too late for effective treatment.
Agreed - the PSA Test is only an indicator - its the trigger to be become alert.
In my case, it concerned my GP just how quickly the PSA numbers increased and it was his absolute insistence I see a Urologist.
I had the Radical Prostatectomy in April 2009 and my last PSA Test last week (17 August) was <0.04!
Mike
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Bryan G
As you say - the PSA test is just an indicator.A high PSA reading as I understand it can only show you may have a prostate problem,not neccessarily cancer. A biopsy is usually required to try to diagnose the problem - this may or may not indicate cancerous cells. Even if cancerous cells are found there is as yet no way to tell if this is the relatively benign slow growing cancer which requires little or no treatment or the more aggressive type that requires rapid attention as it is capable of being fatal in a relatively short time. In my case there was no doubt that my prostate was cancerous and only the decision as to treatment was required. It appears to me that all we can do at present is to make assessments and decisions on probabilities - having a good urologist who gave me honest and precise information on what he could and couldnt do made it a lot easier. I was just fortunate that I was diagnosed when it was in the cureable stage - a few months later and it may only have been treatable.
Psychophysiological entity
A biopsy is usually required to try to diagnose the problem - this may or may not indicate cancerous cells. Even if cancerous cells are found there is as yet no way to tell if this is the relatively benign slow growing cancer which requires little or no treatment or the more aggressive type that requires rapid attention as it is capable of being fatal in a relatively short time.
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Prostate - Gleason Scale
Here is an explanation of the Gleason Scale which has an association with a Prostate biopsy.
Mike
How the Gleason Score is Calculated
The scale (1-5) is made up of a Gleason grade (1, 2, 3, 4, 5) from your prostate biopsy.
1 being the least aggressive and looking mostly like normal prostate cells, and 5 being the most aggressive and looking mostly like irregular prostate cancer cells.
Your Gleason score is based on combining the grades of two differant biopsy sections (primary and secondary).
- The primary section (at least 50% of biopsy).
Graded from 1 to 5.
- The secondary section (5% to 50% of biopsy).
Also graded from 1 to 5.
Therefore your Gleason score consists of 2 Gleason scale grades.
1 to 5 (primary) + 1 to 5 (secondary) = 2 to 10 (your Gleason score).
i.e. 4 + 3 = 7. A Gleason score of 7.
Gleason Score for Prostate Cancer Levels
- Low Grade (well differentiated): 4 or less.
- Intermediate Grade (moderately differentiated): 4 to 7.
- High Grade (poorly differentiated): 8 to 10.
Low Gleason Score: 4 or Less
Your biopsy test results indicate prostate cancer cells that still look like regular prostate cells and will tend to spread slowly. Intermediate Gleason Score: 4 to 7
Your prostate cancer cells look somewhat like regular prostate cells but there are noticable differances, and may tend to spread at a faster rate. High Gleason Score: 8 to 10
Your prostate cancer cells have clear indications of irregular shape and size, and may spread at a fast rate. Prostate Cancer Treatments
Which treatment you and your doctor decide upon will depend on both your Gleason scores and stage of prostate cancer. The factors of whether the prostate cancer has spread outside your prostate gland and it's rate of growth, are the major determinants for the best treatment approach.
Mike
How the Gleason Score is Calculated
The scale (1-5) is made up of a Gleason grade (1, 2, 3, 4, 5) from your prostate biopsy.
1 being the least aggressive and looking mostly like normal prostate cells, and 5 being the most aggressive and looking mostly like irregular prostate cancer cells.
Your Gleason score is based on combining the grades of two differant biopsy sections (primary and secondary).
- The primary section (at least 50% of biopsy).
Graded from 1 to 5.
- The secondary section (5% to 50% of biopsy).
Also graded from 1 to 5.
Therefore your Gleason score consists of 2 Gleason scale grades.
1 to 5 (primary) + 1 to 5 (secondary) = 2 to 10 (your Gleason score).
i.e. 4 + 3 = 7. A Gleason score of 7.
Gleason Score for Prostate Cancer Levels
- Low Grade (well differentiated): 4 or less.
- Intermediate Grade (moderately differentiated): 4 to 7.
- High Grade (poorly differentiated): 8 to 10.
Low Gleason Score: 4 or Less
Your biopsy test results indicate prostate cancer cells that still look like regular prostate cells and will tend to spread slowly. Intermediate Gleason Score: 4 to 7
Your prostate cancer cells look somewhat like regular prostate cells but there are noticable differances, and may tend to spread at a faster rate. High Gleason Score: 8 to 10
Your prostate cancer cells have clear indications of irregular shape and size, and may spread at a fast rate. Prostate Cancer Treatments
Which treatment you and your doctor decide upon will depend on both your Gleason scores and stage of prostate cancer. The factors of whether the prostate cancer has spread outside your prostate gland and it's rate of growth, are the major determinants for the best treatment approach.
Last edited by Bad medicine; 24th Aug 2010 at 21:20. Reason: Removed link to commercial website
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er husband had the Brachytherapy Procedure 7 years earlier. He had since found out that the Prostate Cancer had come back.
I'm having a robotically-assisted RP now. My prostate is too small (27ml) and too diseased (about 65-70% tumourous cells) for radio-based therapies. Highly likely that it's an aggressive sort, I gather. If I hadn't had the PSA test this year or next I'd probably not have seen 60, my man tells me.
Psychophysiological entity
As always, good luck, and let us know how you get on as soon as possible after the procedure.
mmciau Thanks for your post. It would be nice to have something we might call a Prostate Specific Sticky - filtered to contain posts like yours.
mmciau Thanks for your post. It would be nice to have something we might call a Prostate Specific Sticky - filtered to contain posts like yours.
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Loose rivets
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mmciau Thanks for your post. It would be nice to have something we might call a Prostate Specific Sticky - filtered to contain posts like yours.
Loose rivets
I agree.
As you well know, my experiences are included in Jet Blast - Bugger, I've got Cancer. It can get buried in other issues in that Jet Blast Category
I believe it would be appropriate if a "Prostate Specific" category was included as a permanent subcategory of Medical and Health as I believe it would serve as a reminder that the Prostate's condition is a matter every male must consider as their lives progress .
Would you be kind enough to make representaions to the Moderators for such a sub category to be created?
Regards
Mike
...
mmciau Thanks for your post. It would be nice to have something we might call a Prostate Specific Sticky - filtered to contain posts like yours.
Loose rivets
I agree.
As you well know, my experiences are included in Jet Blast - Bugger, I've got Cancer. It can get buried in other issues in that Jet Blast Category
I believe it would be appropriate if a "Prostate Specific" category was included as a permanent subcategory of Medical and Health as I believe it would serve as a reminder that the Prostate's condition is a matter every male must consider as their lives progress .
Would you be kind enough to make representaions to the Moderators for such a sub category to be created?
Regards
Mike
Moderator
We can certainly merge any new threads regarding prostatic disease into one (probably this one if the members think this would be useful). It is already done with some of the other major topics, but this does generate both positive and negative feedback.
Cheers,
BM
Cheers,
BM
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Prostate Specific Issues
Bad Medicine,
Yes I believe a sub-category called Prostate Specific Issues would be appropriate.
The Prostate in males has had elevated interest over recent years as a potentially critical male health issue.
I'm a lucky one as my Ca was identified at an early stage and treated.
Mike McInerney
Yes I believe a sub-category called Prostate Specific Issues would be appropriate.
The Prostate in males has had elevated interest over recent years as a potentially critical male health issue.
I'm a lucky one as my Ca was identified at an early stage and treated.
Mike McInerney
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Bryan G
In the last week or so articles have appeared in the press about some research that recommends a PSA test at 60 - studies show that prostate cancer will appear in 90 % of those with high PSA levels which will need treatment,the majority of those tested with slightly high or normal PSA will require no further action. Those with high levels will be in a minority. This seems to be the best procedure that we can hope for at present as in theory it will minimise the number of those being treated unneccessarily