Prostate Treatment

[rott]

Hoping you can help Cheryl, a friend of mine is awaiting the results of a PSA test and fearing the worst. 

 

Last time I heard (but it is 13 years ago and more) Radiotherapy was not readily available in Thailand and the implant much less if at all. 

 

I am hoping you can say that things have moved on and they are available options.

He is insured but any ideas on costs.?

Thanks.

[Sheryl]

Radiotherapy using implants (Brachiotherapy) has been avaialable in Thailand for many years now. Not difficult to find, but not all patients are candidates. I don't know the cost, but would certainly vary with the hospital and be cheapest at government hospitals, though these would usually not have direct payment arrangement with insurer.

 

Note that cancer cannot be diagnosed on PSA alone. PSA is increased in many conditions including benign prostate hypertrophy. If the PSA is extremely high, or if there has been a rapid rise in PSA (for which would need a baseline to compare to), or if manual exam indicated irregular shape etc then biopsy would be the next step. Preferrably MRI guided.

 

I am not sure whey he fears the worst, but if PSA is being done because of symptoms like difficulty urinating odds are it is BPH not cancer.

 

 

 

 

[rott]

18 minutes ago, Sheryl said:

Radiotherapy using implants (Brachiotherapy) has been avaialable in Thailand for many years now. Not difficult to find, but not all patients are candidates. I don't know the cost, but would certainly vary with the hospital and be cheapest at government hospitals, though these would usually not have direct payment arrangement with insurer.

 

Note that cancer cannot be diagnosed on PSA alone. PSA is increased in many conditions including benign prostate hypertrophy. If the PSA is extremely high, or if there has been a rapid rise in PSA (for which would need a baseline to compare to), or if manual exam indicated irregular shape etc then biopsy would be the next step. Preferrably MRI guided.

 

I am not sure whey he fears the worst, but if PSA is being done because of symptoms like difficulty urinating odds are it is BPH not cancer.

 

 

 

 

Thanks Sheryl and sorry for getting your name wrong. 

Yes he has a long way to go yet just looking ahead and considering the worst possible  outcome. His problem is frequent urination and the bladder not emptying properly. 

I had radiotherapy in London 13 years ago, my comments were based on comments from the BNH and Bumrungrad at that time. 

Edited November 10, 2021 by rott

[Sheryl]

Just now, rott said:

Thanks Sheryl and sorry for getting your name wrong. 

Yes he has a long way to go yet just looking ahead. His problem is frequent urination and the bladder not emptying properly. 

I had radiotherapy in London 13 years ago, my comments were based on comments from the BNH and Bumrungrad at that time. 

Odds favor it being BPH not cancer.

 

Friend of mine had brachotherapy in Thailand more than 20 years ago. it has been here for quiet a while.

 

 

[Will B Good]

It can be stressful for sure........I have a PSA every 3 months at Bumrungrad.......little bit of a money spinner for them I feel.

 

Results have steadily come down though, so feeling much more relaxed now.

[thaibeachlovers]

Never go by the PSA alone if it is positive for cancer. Must have a biopsy to confirm.

Edited November 10, 2021 by thaibeachlovers

[BritManToo]

11 minutes ago, rott said:

His problem is frequent urination and the bladder not emptying properly. 

I have that ....... almost certainly BPH ........ mostly solved by a pill or two every day.

@Will B Good PSA test at my local government hospital 250bht, I'm supposed to have my yearly one next month.

I've had results from 0.5 to 1.2 ..... supposedly over 4 may indicate something wrong.

Although as I don't believe in cancer treatment I'm not sure why I have them ..... easier than fighting the system I guess.

Edited November 10, 2021 by BritManToo

[Boomer6969]

9 minutes ago, Will B Good said:

It can be stressful for sure........I have a PSA every 3 months at Bumrungrad.......little bit of a money spinner for them I feel.

 

Results have steadily come down though, so feeling much more relaxed now.

Huan-kin may be of some help though...

 

But we should keep in mind that the primary use of the PSA test was to detect recurrence of cancer following treatment such as prostatectomy, radiotherapy and other.

 

There is a lot of debate regarding its use as a tool to early detection of PCA. The medical community agrees that is has led to hundreds of thousands of unnecessary treatments, which have led to epidemics of incontinence and impotence.

Edited November 10, 2021 by Boomer6969

[Will B Good]

1 minute ago, BritManToo said:

I have that ....... almost certainly BPH ........ mostly solved by a pill or two every day.

@Will B Good PSA test at my local government hospital 250bht, I'm supposed to have my yearly one next month.

I've had results from 0.5 to 1.2 ..... supposedly over 4 may indicate something wrong.

Got up to 8.6, which caused a panic ......MRI report indicated level 4 cancerous lesion.....but the biopsy gave me an all clear!!!!!!

 

Drifted back down to 1.5 now.......fingers crossed.

 

 

[Will B Good]

2 minutes ago, Boomer6969 said:

Huan-kin may be of some help though...

I have read it does genuinely reduce your risk......if not, I wouldn't do it........

Edited November 10, 2021 by Will B Good

[Rampant Rabbit]

30 minutes ago, Will B Good said:

I have read it does genuinely reduce your risk......if not, I wouldn't do it........

The  key  is  WHEN in your  lifespan youve been  doing it  and  up to 49  years  of  age then its a  20%  less  chance if  21  times a  month after 49 yrs  old seems  it doesnt  matter how  much.............so if  youre  over  49  you can give it a  rest.

 

[Will B Good]

40 minutes ago, BritManToo said:

I have that ....... almost certainly BPH ........ mostly solved by a pill or two every day.

@Will B Good PSA test at my local government hospital 250bht, I'm supposed to have my yearly one next month.

I've had results from 0.5 to 1.2 ..... supposedly over 4 may indicate something wrong.

Although as I don't believe in cancer treatment I'm not sure why I have them ..... easier than fighting the system I guess.

Is it an alpha blocker that you take?

[Will B Good]

Just now, Rampant Rabbit said:

The  key  is  WHEN in your  lifespan youve been  doing it  and  up to 49  years  of  age then its a  20%  less  chance if  21  times a  month after 49 yrs  old seems  it doesnt  matter how  much.............so if  youre  over  49  you can give it a  rest.

 

OMG....all that time wasted....16 years.....555

[rott]

39 minutes ago, BritManToo said:

I have that ....... almost certainly BPH ........ mostly solved by a pill or two every day.

@Will B Good PSA test at my local government hospital 250bht, I'm supposed to have my yearly one next month.

I've had results from 0.5 to 1.2 ..... supposedly over 4 may indicate something wrong.

Although as I don't believe in cancer treatment I'm not sure why I have them ..... easier than fighting the system I guess.

It was also my problem and the first indication of prostate cancer although I was initially misdiagnosed as having an enlarged prostate. 

The last appointment I had before my treatment started the specialst/consultant said "you never had an enlarged prostate, when the physical was done he must have been touching the bladder. An easy mistake to make." 

[Rampant Rabbit]

x

Edited November 10, 2021 by Rampant Rabbit

[Will B Good]

Just now, rott said:

It was also my problem and the first indication of prostate cancer although I was initially misdiagnosed as having an enlarged prostate. 

The last appointment I had before my treatment started the specialst/consultant said "you never had an enlarged prostate, when the physical was done he must have been touching the bladder. An easy mistake to make." 

OMG..........nightmare!

 

Did you have PSA tests?

[Rampant Rabbit]

4 minutes ago, Will B Good said:

OMG....all that time wasted....16 years.....555

What a Huan-ker

[rott]

5 minutes ago, Will B Good said:

OMG..........nightmare!

 

Did you have PSA tests?

Initially 4.8. But for 6 months at least I was on medication for an enlarged prostate which I didn't have. The top man at Bumrungrad told me - those pills artificially reduce the PSA you need a biopsy, which eventually the London GP sorted. Then a series of tests including a scan before the treatment. Which happily was successful. 

[BritManToo]

9 minutes ago, rott said:

Initially 4.8. But for 6 months at least I was on medication for an enlarged prostate which I didn't have. The top man at Bumrungrad told me - those pills artificially reduce the PSA you need a biopsy, which eventually the London GP sorted. Then a series of tests including a scan before the treatment. Which happily was successful. 

Assuming the BPH diagnosis was wrong, and the cancer diagnosis was right.

The funny thing about cancer, you only know you have it because the doctor says so.

Then you go through a lot of painful and debilitating treatments, and usually die anyway.

[rott]

3 minutes ago, BritManToo said:

Assuming the BPH diagnosis was wrong, and the cancer diagnosis was right.

The funny thing about cancer, you only know you have it because the doctor says so.

Then you go through a lot of painful and debilitating treatments, and usually die anyway.

Not painful or debilitating. Bit of a nuisance having to go for 37 treatments but not a serious problem and in 13 years I haven't died once for which I am grateful. 

Bob Monkhouse was not diagnosed till too late and was quoted as saying "prostate cancer is not a good thing to be dying of." Something I am happy to have avoided. 

I was happy to take the Doctor's word for cancer as he had the result of the biopsy. 

[BritManToo]

20 minutes ago, rott said:

I was happy to take the Doctor's word for cancer as he had the result of the biopsy. 

My doctor told me I had a serious gall bladder problem and I'd die if he didn't cut it out.

I didn't have it cut out and 8 years later am still alive.

 

Another doctor told me my 3 year old son needed his appendix removed immediately or he would die.

I didn't allow it, and 7 years later he's still alive.

(He was treated by another doctor for constipation though)

 

I don't have much confidence in doctors,

If you get well it was due to their (expensive) treatment (even if you didn't need any treatment), if you die it was going to happen anyway.

 

Edited November 10, 2021 by BritManToo

[KhunLA]

1 hour ago, BritManToo said:

I have that ....... almost certainly BPH ........ mostly solved by a pill or two every day.

@Will B Good PSA test at my local government hospital 250bht, I'm supposed to have my yearly one next month.

I've had results from 0.5 to 1.2 ..... supposedly over 4 may indicate something wrong.

Although as I don't believe in cancer treatment I'm not sure why I have them ..... easier than fighting the system I guess.

Have you gotten an ultrasound of prostate / lower or full abdomen ?  I'd highly recommend that.  As I also have an enlarged prostate.  Originally just large, then PSA #s doubled to 4 something, then the ultrasound show my prostate size had also doubled, and no masses noticed, so explained the higher # due to size and age, as it apparently increases with age.  Though usually not at that rate, without a size 'growth'

 

At least it's growing outward, instead of inward .... flow is still the same, just more often ????

[rott]

22 minutes ago, BritManToo said:

My doctor told me I had a serious gall bladder problem and I'd die if he didn't cut it out.

I didn't have it cut out and 8 years later am still alive.

 

Another doctor told me my 3 year old son needed his appendix removed immediately or he would die.

I didn't allow it, and 7 years later he's still alive.

(He was treated by another doctor for constipation though)

 

I don't have much confidence in doctors,

If you get well it was due to their (expensive) treatment (even if you didn't need any treatment), if you die it was going to happen anyway.

 

I have sympathy for your bad experiences. 

Goes to prove the adage, in Thailand always go for a second opinion. 

[BritManToo]

23 minutes ago, KhunLA said:

Have you gotten an ultrasound of prostate / lower or full abdomen ?  I'd highly recommend that.  As I also have an enlarged prostate.  Originally just large, then PSA #s doubled to 4 something, then the ultrasound show my prostate size had also doubled, and no masses noticed, so explained the higher # due to size and age, as it apparently increases with age.  Though usually not at that rate, without a size 'growth'

 

At least it's growing outward, instead of inward .... flow is still the same, just more often ????

Why would I?

At 65 I've already had my life, and entirely satisfied with the outcome.

I'm OK with death when it comes.

[rott]

4 minutes ago, BritManToo said:

Why would I?

At 65 I've already had my life, and entirely satisfied with the outcome.

I'm OK with death when it comes.

 

65, you haven't even started the fun yet.

Bet you haven't had arthritis, discomfort when rising from lying or sitting, the joy when the jelly works, trying to remember the word for............? 

Give over lad. 

 

There's always something new, just as of today I'm now on blood pressure tablets. 

A whole new world awaits you. 

[BritManToo]

14 minutes ago, rott said:

Bet you haven't had arthritis,

Had mild arthritis since age 45 (knuckles and knees from riding a m/c in the freezing UK year round).

Went away at age 52 when I moved to Thailand, knuckles have been hurting again since age 63 in Monsoon.

Oddly enough no further problems with the knees.

[rott]

5 minutes ago, BritManToo said:

Had mild arthritis since age 45 (knuckles and knees from riding a m/c in the freezing UK year round).

Went away at age 52 when I moved to Thailand, knuckles have been hurting again since age 63 in Monsoon.

Oddly enough no further problems with the knees.

You have had your share of suffering. 

Before the prostate played up I had only seen a doctor once in 30 years, for shingles. Not fun but didn't last too long. 

[rott]

Good news for him, PSA, fiery finger and ultrasound all showed clear. Still peeing like good 'un but whatever the cause it's not the prostate. 

[KhaoYai]

On 11/10/2021 at 5:14 AM, rott said:

Hoping you can help Cheryl, a friend of mine is awaiting the results of a PSA test and fearing the worst. 

Buddy, tell your friend not to fear the worst. A high PSA is quite often Prostate Cancer (PC) but as Cheryl said - there are other causes.  The main thing is to get the right diagnosis and treatment as soon as possible. Almost 7 years ago I was diagnosed with highly agressive PC, my PSA level was very high at 189, I had treatment and I'm still well. 

 

PC is very treatable if its caught early enough and much depends upon the grade of cancer.  If the tumours are contained within the capsule of the prostate, there is a very good chance of a full cure and recovery.  Even if the cancer has broken through the capsule there is still potentially much that can be done.  When it spreads to other parts of the body its is more difficult to treat but in most cases it can be slowed down with hormone therapy etc. - sometimes for many years.

 

Yes, such a diagnosis is scary, I remember being given the news - I felt like I'd been shot in the head.  However, with good oncologists and the right treatment its often not the curse its said to be. I had hormone therapy (HT) to shrink the tumours and give the next step - Radio Therapy (RT), a better chance.  My PSA went down to almost 0 and It took six years for it to start rising again (March this year).  PET scans revealed some low level activity which probably means the RT didn't quite get it all.  However, I've just had a course of High Dose Rate Brachytherapy (HDR) which although it wasn't suitable as a primary treatment in my case, it is now. I'd had the maximum dose of RT previously - more could cause damage to surrounding tissue whereas HDR can be targeted directly into the areas of activity after they are mapped out by scans and biopsies, hence, little to no effect on surrounding areas.

 

I have also been accepted for High Intensity Focused Ultrasound treatment should the HDR fail - so as you can see, the most important thing is to get checked.  If it is cancer the earlier they treat it, the more options there are.

 

A lot of blokes are scared of treatment because they have heard it affects your ability to perfom in the sheets.  It does but that's often temporary and there's much they can do to help nowadays.  The alternative may be the 'sheets' being replaced by a wooden box.

 

RT is virtually painless and is given for a few minutes every day for a few weeks depending on the oncologists recommendations.  HDR is a little more involved and does cause some discomfort and problems with your plumbing for a while (I'm fine after 5 weeks) but the treatment itself is usually carried out under a general anaesthetic. I've got to be honest and say that the HT that I had (there are different types) was bloody awful - not painful and it affects everyone differently but I had a few issues with it, it was necessary.

 

Please try to re-assure your friend that if it is PC, he has plenty of options but its up to him to find the right people to advise and then drive things forward - I've been lucky so far.

 

 

Edited November 25, 2021 by KhaoYai

[rott]

Thanks for that KY see the post immediately above yours all is OK. 

Good to hear that you are on top of yours I wish you well for the future.