Prostate Cancer (Merged)
 

I am age 63 and flew for 30 years mostly longhall.
I have just been diagnosed with prostate cancer (PSA 8.1 and biopsy result 2 cores out of 8 Gleason score 3+3=6). MRI scan indicates cancer confined to the prostate. I had an uncle (my father's brother) who died from this cancer age 74.
I have decided to go for a Robot-assisted Laparoscopic Radical Prostatectomy. This is comparatively new in the UK but has been used for some time in the US.
I would welcome comments from anyone who has first hand information on this operation.

Mike,

I can't comment on the robot assisted aspect, but I had a radical prostatectomy just over 3 years ago at age 52, (which is young for prostate cancer), with a Gleason also of 3+3, and it was confined to the prostate. I've not been flying professionally, but held a class 1, and was able to get that renewed last year when there was a possibility of flying.

I was in hospital for just over a week, and off work for close on 6 months, but that wasn't helped by a massive flood at our home just before I went into hospital, and at the time I was working on the ramp at Dublin, so I had to be 110% sure that I was completely fit before returning to what I knew would be a demanding job, the doctor was very cautious, and with all the things that had to be done to sort out the house after the flood, I wasn't going to argue.

Three years down the line, I'm not working on the ramp any more, though that was nothing to do with the prostate issues, but I am still working full time, with no problems.

I have a PSA check done every six months, and I'm due one now, the last one was still undetectable. From a day to day point of view, I have very few problems, the only one worth even mentioning is a very minor stress incontinence, certain positions will provoke a very minor urine leak, but it's very easily managed and contained by very lightweight pads.

Thr first few weeks at home were tedious, in that I was catheterised for 3 weeks, and the theory and practise of catheters are somewhat different. Mine was a nuisance, both from a comfort view and operationally. It also leaked, despite being checked several times. Mobility wise it wasn't too bad, I was up and about walking within 3 days in the hospital, not too far at first, but once the catheter was out, then further afield, to get the strength back. Driving was not allowed for a number of weeks after surgery.

No way can any encounter with the big C be dismissed lightly, but looking back over what's been happening, it could have been a lot worse. I can still do 99.9% of the things I used to, without problems, and so far, there's no indication of anything else to worry about.

OK, depending on how the surgery goes, there are some "personal" issues that you'll be facing, but an open forum is not the place for that level of discussion, if you want to PM me, I can give you some more specific pointers to books that are helpful, or other comments that might be appropriate.

Hope that helps a little, best of luck with the operation and recovery.

Cheers

Mike,

Can only wish you the best and tell you of my two friends from the airline biz who tackled this problem and are today fit as a fiddle after the surgery. It is one of the most cureable cancers as I'm sure you know ( 98% the last I heard...I'll take those odds any day ). The "cure" might be a bit of a tough go, but one does come out the other end cured.

Coming back here to bring us all up to date would be a service to us all if you feel up to it.

Best of luck.

Mike:
No firsthand experience here, I do women, not men (!). However, my urological friends tell me that the robotic assisted prostatectomies go extremely well. Rising in popularity here in the US, probably because you can spend a pile of cash on the "DaVinci" machinery and we like expensive stuff like that. However the payoff comes in the ability to operate more precisely in tight quarters, and thus decrease the odd of damaging nerves while still removing the bad bits. That's the key to lessening the odds of those "personal problems" alluded to.
If I needed it, and it was available, that's the way I'd go.
___________
Graham MD

Hi guys!

I think that the topic of prostate cancer is a big issue among 50+yr old men. My father recently went through a tissue-taking proceedure for biopsy... Right now he has an enlarged prostate although cancer is not ruled out.

This is the first time that my dad going to have a major surgery (if ever) and the family would like to be ready with the aftershocksthe operation might bring. After the proceedure he's now wearing a diaper to make sure he doesn't leak. :sad: Hope to hear more insights from you guys. Let's help each other out; we never know when we will have it too.

Long live!

RQ

Mike6567

Having almost identical levels to you of the prostate nasties about 12 years ago (no personal noticeable effects with a PSA of 9) and at age mid 60s, I was initially given 3 choices.
1. Radical prostatectomy
2. 6 weeks session of radiography
3. Watch for further developments.

None appealed so full blown research revealed CRYO (freezing) Surgery with one only surgeon experiened in Oz. Hollow probes inserted into the prostate under Ultra Sonic monitoring enabled the injection of liquid nitrogen which formed frozen tissue around the tips of the probes. This process can be very nerve sparing in the region and it rid me of the problem. This process has been considerably improved/refined and a better mix of cryo gases now used.

Brachy process seems to be the current popular way to go where by the prostate is mapped for the nasties and again hollow probes inserted under computer control to enable high radiation pellets to be inserted for very short periods and evidently resulting in very satisfactory zapping. Hear tell that this process can be all over and done in outpatients in a morning or afternoon session.

Meanwhile two of my compatriots have suffered terribly during their last few years on the planet and all because they were diagnosed too late.

Pre start check lists should include "Recent PSA test confirmed"

Great topic lads
 

Prostate problems are more commen than people realise and they do not just affect 'old' men. If you are suffering from any type of urinary problems please read on.

There are three common disorders:

Prostatitis: - Inflammation or infection of the prostate. This can affect men at any age of their adult life. Although this is not a life-threatening condition it takes a significant toll on the quality of life of those afflicted. As well as urinary problems it is also characterised by symptoms of pain and discomfort around the anus, scrotum and the area in between (the perineum). Can also affect your sex life!! Experts do not know how to cure/control this.

Benign Prostatic Hyperplasia: BPH is a non-cancerous enlargement of the prostate. The gradual enlargement of the prostate gland in middle-aged men can cause problems by constricting the urethra, pinching off drainage from the bladder and hence interfering with urination. BPH is most common in men over 50 and about half of all men will have BPH by the age of 60.

Prostate Cancer: This is rare before middle age, with very few cases occurring in men under 50. Most prostate cancers are slow growing and many can be treated effectively or cured, especially if they are caught early. Prostate cancer is the second most common form of potentially lethal cancer to affect men


Only 1 in 7 men know what the prostate is, and fewer know of the three disorders. "Ignorance is not bliss"


Couple of great links:

http://uk.groups.yahoo.com/group/bps-assoc/ (support group for Prostatitis)

http://www.prostate-research.org.uk/

A couple of additional thoughts, based on experience
 

Just to clarify a few things that have been mentioned here.

First is that in some cases, mine included, there can be no symptoms what so ever, but cancer can be present.

I was extremely fortunate that when I went to renew a class 1, the medical examiner in Denver decided that my prostate needed checking, if he'd not done the gloved finger check, I might well not be sitting here typing this. A few months later, my prostate was being removed with Gleason 3 + 3 cancer, which was close enough to being a more serious problem. As far as I know, it was caught in time, before anything nasty escaped.

Radio therapy, and associated treatments.

I looked very carefully at the options, as I had time, and talked to a leading radio therapy consultant here in Ireland. He would have done it if I'd insisted, but he made it very clear to me that radiotherapy was not the best choice for me, given my age and other circumstances. He put it like this. "We can't guarantee that we can place the radio therapy needles close to every area of cancer, or that they will be completely effective, and the same is true for external beam radiotherapy. Therefore, there is a possibility that we won't get it all. If you have radiotherapy, there is no surgical option at a later date, there will be too much scar tissue in the way for a surgeon to be able to get the accuracy that's essential. If you have surgery and at a later date we see a recurrence, we can then use radio therapy to attack the remnants".

That was a pretty convincing argument for me. OK, I was (relatively) young, and fit, so major abdominal surgery was not so much of an issue as it would be for an older man. the other factor was that radiotherapy is relatively new, so they don't have long term survival statistics yet, and my potential survival period after surgery is longer than they can predict yet. Another convincing argument!

Yes, there are "issues" either way. That's the hard call, and I can't make it for anyone else, but for me, surgery was the best option, and so far, nearly 3 years later, I'm not seeing any problems with the PSA, which is as good as it gets.

The important things.

If there is any history in the family of problems with the prostate, get it checked from age 45 onward. Unbeknown to me, my father had problems with his prostate in his 40's, and it was treated. I still don't know exactly what was wrong with it, but he's still alive at 80, albeit with some problems again showing up now. He doesn't talk about it even now, and knowing what I've had to go through, and regrettably, many men have the same attitude.

Any symptoms, get it checked, and don't delay. Caught early, it's VERY treatable, left too long, and it's extremely nasty!!!!

I'm not going to go into more personal details in an open forum message, but if anyone is reading this and is concerned about anything that they've seen here, PM me, and I am prepared to discuss in a lot more detail if it will help. Either way, DO NOT IGNORE prostate, the cost of doing so can be deadly.

Usual disclaimer, I'm not a medic, but having been there, and done the research big time before the surgery, I have more than a passing knowledge of what's involved, and yes, I'm prepared to talk about it if it means I save someone else from a very painful end. Nuff said

Mike, I've got nothing to add on the medical sid of things. I just want to wish you the very best for which ever treatment you decide to go with.

Take care,
Steve.

Excellent thread Mike and best of luck. I got picked up on a routine medical three years ago at 59 with a PSA of 8.1. Had a biopsy and, thank goodness, it came back clean for cancer, but did show I had an infection - that can have the effect of raising your PSA. Anyway, PSA is back down and holding steady around 4 and I am now on 6 monthly checks, finger and blood, and welcome it. I can only advise any male from 55 on to take this seriously and start getting regular checks if you aren't already.
Cheers
Rick

PSA and Cancer
 

My husband is having the robotic surgery on June 21. He is a commercial pilot based in the USA. His Class 1 is currently invalid, we are anticipating the best with this type of surgery. He did take the time to visit 5 different doctors before deciding on MD Anderson Hospital in Houston.

Hello Mike
check here for previous discussions
http://www.pprune.org/forums/search.php?searchid=355013
cheers
H.

Robotic Surgery
 

Surgery is over for my husband. He is doing well. In the hospital for 2 nights. Still has the catheter but that comes out in a couple days. Still in Houston and will come home when he is able. All in all he says it went well. Day 1 and 2 were painful.

Prostate Cancer Forum
 

Thanks for all the replies and advice.
I have recently found a site giving a large amount of feedback on the robotic operation.

http://www.healingwell.com/community/default.aspx?f=35

This may be useful for others.
Mike

:hmm:

This appeared on today's BBC web page. Perhaps it might be interesting to some?

http://news.bbc.co.uk/1/hi/health/5132546.stm

:)

To all the Brits: The ladies have long claimed the right to specific medical checks such as breast and cervix ( With total justification) but the poor guys dying from prostate cancer have taken a back seat when it comes to having regular screening.

Any male should be regularly screened (I hear from age 50). All it takes is a blood test that you can tag on to your cholesterol check. Just ask your surgery for a PSA check. (Prostatic Specific Antigen).

I once had a urologist tell me that he didn't believe in PSA checks. No problem: I told him not to bother in his case but in mine I was going to have one!

Amusingly I first read about it in the BALPA Log many years ago. I took a copy into my local surgery where the staff all took copies for their husbands/boyfriends.

Unfortunately, all the data is not in on the value of the PSA, Lou, and your urologist friend's opinion is still a valid one. This is an area of medicine that is "in flux" shall we say. Much more needs to be learned about how to predict the course of the disease in a given patient.
I agree with you that it is a disease that has not, until recently, had it's proper share of research attention.
__________
Graham, MD

Cancer and Flying
 

Not sure about prostate cancer but I had a right lung upper lobectomy 18 months ago due to squamous cell carcenoma. I was given 3 months to live and only 35% chance of surviving sugery!. Lung came out easy with the tumor, had no narcotic meds after and got Class 1 medical back after 6 months. Now FAA want pathology reports etc 18 months later!!!!!, anyway surgeon says all is well. Moral is, if you want it bad enough, go for it. I am flying corporate in middle east and having a blast...Cancer can be the end, but also the beginning...never give up. Fight and Fight, then when you have no fight left.....fight again...you can win.:ok:

MD Anderson
 

My lobectomy was at Scott and White in Temple, Texas. Surgeon was William Smythe of MD Anderson. Did a great job and I got my Class 1 back and am flying again.

As a man of 67 I keep an eye on these things and have read the above thread with great interest. I happened to pick up a booklet re Prostate Cancer in my local hospital and I was interested to see that one of the possible ways forward is referred to as "Watchful Waiting". Now it may be that the NHS (UK) is trying to save money by suggesting that, on balance, observing the progress of a cancer (if there is any progress) is cheaper for them and more beficial for the life quality of the patient than radical and invasive surgery? Please may I know what members who have posted earlier think of where Watchful Waiting might fit into a sensible and realistic cancer treatment regime? Thank you.

As I understood it at the time, watchful waiting is used where the cancer has been detected, but (as far as they can tell) it's stage of progress does not represent a significant threat to the patient.

Unlike many cancers, prostate cancer is usually extremely slow growing, so while it may be present in the prostate, in it's very early stages, it does not represent a threat to other areas or organs, so keeping a close watch on the progression of development is deemed acceptable.

Unlike other cancers, which grow at very rapid rates, the majority of prostate cancer develops over a timescale that can well be 10 years or more. A high profile politician here in Ireland was diagnosed with prostate cancer in 1995 at age 69, and it is only this year that he succumbed to it. It was not deemed treatable 10 years ago, which suggests that he has been suffering from the early stages for considerably longer.

The other thought is that there is a lot of research at last being done on prostate, so if a patient is not in urgent need of treatment, there is a possibility that newer techniques for treatment may well be available before treatment is essential. In some cases, the development is slower than anticipated, so a rush to what may be major surgery can be avoided.

Equally, if the patient is not fit, or a smoker, or has other health issues, postponing surgery may be worthwhile if it is going to allow changes of lifestyle that will assist the recovery from surgery.

The emphasis is on watchful, it's not a case of the patient being long fingered, or to be specific, it should not be, the emphasis is most definitely on watching, and then making informed decisions at the point where it is necessary to intervene.

At the age of 67, and please don't misunderstand me here, if a routine scan detects cancer, it is very possible that you will be watched, and depending on other health issues, you may die with prostate cancer rather than as a result of prostate cancer.

My father in law is 83, and has had prostate cancer for a number of years, and as a result of other health issues, it's almost certain now that he will die before the prostate cancer becomes a serious threat.

Radical prostatectomy is by no means minor surgery, at the age of 51, and being relatively fit, I was able to cope with the surgery and recovery. There is no way that my father in law would be capable of surviving such surgery because of other health issues. He might be offered radio therapy if the need arose, but to be honest, from what I've seen reported, even that is not an easy option.

This isn't a medical opinion, just the thoughts of someone that's been there, and had to stare this one down and then take definitive decisions at relatively short notice. So far, it's been the right decision, 3 years down the line the PSA is still undetectable, which is as good as it gets.

Hope that helps a little

Regards

Prostate Cancer - Again
 

Hi all,

Didn’t particularly want to start a new thread on this but the previous one has been closed and it’s about time it was flagged up again. Talking to colleagues there is very little awareness of Prostate Cancer and, coupled with men’s general reluctance to discuss such subjects means that many are missed until it’s too late. Well, it’s out there and it got me. :uhoh:

My father, 67, was diagnosed with Prostate Cancer in April 03. Put the frighteners on me as he’d not had much in the way of symptoms but had been for a PSA test recommended by his GP which came back with a score of 128!! I happened to see a magazine article at the Barbers a month later which made me decide to go and have a similar test. GP happy to oblige and the blood was duly taken. Quite a shock when the result came back “out of range” – The limit for someone my age, 43 at the time was 2.5 – my result was 2.6. I was assured that there was nothing to worry about yet but I should keep an eye on it. My AME agreed and for the next 4 years we watched as the scores slowly went up. This year it got to 3.2 and I was referred to a consultant. My options were to do nothing yet, (just keep having the tests) or have a Biopsy and find out one way or the other. No contest as far as I was concerned. As my PSA was still relatively low, a 10 point biopsy was required and 4 weeks later I had a result – 2 out of the 10 cores were positive. PSA 3.2, Gleason 3+3. An MRI and Bone scan confirmed that it was Prostate Cancer but that it had not spread anywhere else.
Having been diagnosed at an early age, 47, and an early stage of the disease meant I had the full range of treatments available together with the option of doing nothing – yet.

After talking it over with wife and consultant the do nothing approach was ditched and, of the various treatments on offer, High Intensity Focussed Ultrasound or HIFU was selected. Basically, this uses the same technology as used in the biopsy to map the prostate but the power is turned up to very high levels and the affected area is "zapped" to destroy the tumour. There are fewer side effects with this technique and those which do occur are more easily treated.

On the appointed day I was wheeled into theatre and came to some 4 ½ hours later. An overnight stay was required due to the length of time I’d been under the anaesthetic. That was last Saturday.

I’m now off work for the next 6 weeks at least whilst I recover. I feel very bruised and sore but I can walk and move around. I have a catheter sticking out of my lower abdomen to ensure I can still empty my bladder which is a very sore process but improving.

The good news – My employers, my AME and the CAA have been very supportive and kept me flying until the day before my op. My father, still with us, is now 71, has a PSA score in the teens and is enjoying life to the fullest extent possible.

Hopefully, the recent TV campaign in the UK by the late Bob Monkhouse will have moved the subject a bit higher in everyone’s conscience and more cases will be diagnosed at an earlier stage before it gets chance to spread. I’m due back in hospital for tests on Monday and if all is well then catheter will come out.
Will keep you informed.

In the meantime, if you think it can’t get you, if you think it can get you or you simply don’t know, here’s a good place to start. http://www.prostate-cancer.org.uk

Happy to take pm's on this.

Thanks for the post Fortyodd, I think that it is fantastic that you bring into the open, a subject clouded in ignorance and general embarrasment, and its great to hear that you are progressing well.

The current message is to get to the doc as soon as you notice any urinary symptoms, and get checked out.

I've got to throw in a word of warning re: the PSA test- it's just not that reliable at picking out what we hope it would- the science isn't that brilliant, so , as far as I'm aware, the use of the test alone as a "screening" tool is limited.

Thanks Gingernut,

I would agree that, from all the comments I've heard that the PSA test alone is not clever enough to be used as a screening tool but there are some new developments which could improve things. Having a test done, even if it proves negative, still puts a dot on a chart that can later be used to plot a trend and that's what helped my case. I didn't have any obvious symptoms and only went to the doc in the first place due to "Family History". Chances are that my dad developed it at about the same age as me but didn't get picked up till much later in life.

I still count myself as very lucky.

Update:
 

Went back to the hospital yesterday for “tests”. Basically to see that my bladder & waterworks system were capable of managing without the extra installed plumbing. Passed said tests which meant that I could have the catheter removed – as a result, I now have 2 belly buttons and my bladder is grateful for being returned to its original capacity. Still feeling a little bruised but improving – I won’t be riding my pushbike for some time.
The consultant is happy with progress so far. I have another progress check in 2 weeks time and then it’s a case of allowing natures repair process to get on with it. In the meantime I need to be getting plenty of gentle exercise and avoiding sitting for too long. Next appointment with the consultant will be at the end of November by which time I will have had a further blood test. If all is well at that point then he will write me up to the AME/CAA to get my medical back. If I had a “Normal” job, I could go back to work next week.

http://www.prostate-cancer.org.uk

A thank you to those who have been in touch for your words of support.

A couple of themes have emerged which I think are worth mentioning. From some others who have been diagnosed, they initially were reluctant to report the symptoms they were experiencing as they feared it would be diabetes which would see them grounded immediately/permanently - (like me, mostly single pilot, helicopter types). The other is a general ignorance of/lack of available information on the disease and its symptoms. The website link on my earlier posts is a good place to go for more information and there is always the option of talking to your GP/AME.
As I said in my first post, had my father not been diagnosed I would probably not have been picked up as I was not suffering from any of the common symptoms. In fact, the only thing I had become aware of in the last couple of years was that my bladder had become very intolerant of ground coffee. One cup would see me visiting the loo about 3 times in the following hour!

PC3A Test for Prostate Cancer
 

http://www.channel4.com/news/article...+cancer/826962
Will not be given on NHS unless there is a very strong family history of the disease. Costs between £200 and £400 depending on which report you read. Test involves giving a urine specemin after the gland has been 'massaged' via a DRA. Result in 7 to 10 days, the test reveals the presence of genetic 'markers' indicative of the cancer.

Update
 

All well at the progress check today and I have been cleared to drive again as the "wound" where the catheter was removed has healed nicely. Now have to wait until the end of November for the next checks which will decide if I can get back to flying. Again, thanks to all Pruners who have been in touch for your support. :D

Wishing you a quick recovery and I hope you'll get back to flying soon.

Many thanks for being so open about what some perceive to be a taboo subject. I'm in the RAF and as aircrew, we take an annual medical. It was only by accident that a colleague (also over 50) informed me that once you'd reached 50, you could request the extra blood test screening for this. I've had it checked now for the last 2 years, nothing to worry about I've been told. However, is the blood test for this sufficiently accurate or should I be slightly more concerned?

Wishing you a full and speedy recovery! :)

Yes well done Fortyodd for bringing this not-often-enough-talked-about-man's-subject out again...

Being a bit more anatomically aware than some, and not too shy to talk to sundry GPs, I have had concerns about my prostate on and off throughout my forties having felt that it was sometimes enlarged (and being proved right), and having sometimes less than ideal bladder function (sometimes needing to go two or three times during the night, and noticing sometimes small leaks of a drop or two after returning to bed, but nevertheless still able to drink beer in respectable UK quantities and company without being the first to the toilet...:ok: )

I nevertheless have had a pervading image in my mind from a US made movie I saw two or three years ago (can't remember the name) in which the lead actor's father suffered from prostate cancer, could not afford the medical bills, and as it got worse, found himself sitting lady's style on the toilet, straining in pain to empty his bladder...I wouldn't wish that upon anyone...least of all me...

Despite two or three visits to specialists after renewed 'episodes' of things 'not seeming quite right' over the last ten years, including recently an endoscopy under local anaesthetic (not as uncomfortable as I imagined and quite interesting to watch on tv:{), plus PSA and flow tests, I have been given no adverse feedback. I haven't been told that there was nothing to worry about, just not told anything informative at all basically. I do rate the head of practice at my GP's surgery too ... but the low key approach seems to be the UK way unless you make a nuiscance of yourself. Not necessarily good in my opinion. Seems to fit with an old-fashioned 'work until you drop' type culture, but doesn't seem to sit well with 'planning a long leisurely retirement' kind of thing...

My view is that disorders of the Prostate gland are amazingly still very much a cloudy subject in the United Kingdom if not worldwide, and only remain so because UK GPs and specialists are not ready to get into the oncosts of pro-active preventative regimes at the moment. Probably eats far too far into their precious budgets.

Having seen this thread, whilst also recognising that simple PSA tests are notoriously rough and ready indicators, I think I'll call my GP in the morning and just check to see what the numbers actually are for my tests.

Best wishes to Fortydd with the recouperation, and thanks A2QFI for the link to the report about the new test.

S&T , check your pm box.

Bumped to the top again.
In the meantime, I'm continuing to heal, getting very bored and strangely looking forward to the blood test in 3 weeks time.

The big question.

Suppose you have an old bloke, say 68 years old. He's told that he has a nodule on the right side of his prostate and he asks the doc if it's likely to be anything else but cancer. 'No' is the answer.

Well, given that it is indeed the case of almost certain probability, then one of the options at this age is to play the waiting game. Monitor and wait.

Firstly, what is the risk factor of playing that game like at this particular age?

If deciding to monitor only, is there any point in going through the tedious ritual of a biopsy? I mean, what will it profit you to be sure of something you're not going to do anything about?

Just wondered.

The biopsy result (tumor aggressiveness, etc) might influence whether or not to continue the "watchful waiting" plan.
Best discussed by urologic oncologists. More than one.
_______
Graham

If deciding to monitor only, is there any point in going through the tedious ritual of a biopsy? I mean, what will it profit you to be sure of something you're not going to do anything about?

Are you saying you will not seek treatment on a bad biopsy result?

My 2 cents worth on Loose rivets question. An elderly relation of my wife has been diagnosed - current PSA of 7.8. He's 86 and his doctor has said that if he hasn't died of anything else before he's 120 then to come back and see him. The drop in quality of life and the upheaval caused by surgery at his age would not be worth it. So he's having injections once every 3 months to keep it quiet and he's enjoying the rest of his life.

As for me - blood test on Thursday - watch this space.

Fortyodd, the management of your relatives case appears reasonable, (most men over 80 have prostate cancer) but caution, LR's situation is slightly different.

LR, it sounds like your current situation with your prostate, is causing you some confusion. Watchful waiting is a reasonable strategy in some cases, but it sounds like that you havn't had a firm diagnosis (via needle biopsy), yet?

As already expressed by obs g, you will need to take specialist advice on this, it's unlikely your GP will have access to the tests, and interpretation of the results, that they will have.

Keep us posted, ginge.

That's right.

The specialist seemed fairly certain that the lump would be cancer and said there was no point in putting the (squeezed )drops into the jar...we'd past that stage because of what he'd felt.

He wants to do a biopsy, but given the possibility of me 'doing nothing' for a while, this seems that an unpleasant procedure could be delayed.

I asked him what the risks were of a biopsy freeing cells globally. He said that it was not an issue. I wish I could be sure of that.

I can't see the point of a biopsy unless there is a wide scale of findings from such a procedure. In other words, giving a guideline as to the urgency factor. Right now it seems that he is just going to confirm what he already knows.

What I haven't had is a Free PSA analysis. What I read is that this gives a very good indicator of the likelihood of malignancy.

He seemed quite certain that the biopsy was the only way to go now, but he is also the owner of the clinic, and in a cynical moment I wondered if he was drumming up business. Having said this, he does seem a nice guy that knows his stuff...but having said that, I see some figures that indicate that a fair proportion of lumps can be benign. That counters what he said.

So, does stabbing it release deadly cells globally?

And does the biopsy tell more than just yes or no?

As for playing the waiting game, well, my back pain was so bad yesterday that when he told me about the lump I didn't give the proverbial toss. But then, if I followed my own beliefs, the pain was probably psychosomatic.

I guess I could flick a coin.

Hi Loose rivets,

I'm not a doctor but for me personally I would have a biopsy if it was recommended to me. Don't worry about whether the Dr also owns the clinic. In the overall scheme of things, that shouldn't be a deciding factor in my point of view.

Gingernut and obgraham always seem to give sound advice from my observations and they seem to be suggesting that consulting a specialist is the way to go at this point.

Good luck with it all.

VH-MLE