PSA test

elektrified · May 16, 2017

3 hours ago, d4291797 said:

Again a very emotive subject!
What one is looking for ,is a spike in PSA levels, or a 'doubling' as the urologists say.
Critical if there is a spike , is to find the cause , which can be a big inflammation of the gland or it could be the start of cancer.
Yes biopsy does have risks and is bloody unpleasant ,unless you have a G/A! But critical again to catch this early.
A very successful treatment is Cyberknife, google ,and go to their forum.
Very informative. Every case is different, as is the result, every Dr or Urologist will 'push a barrow'!!!
Generally if caught early ,therefore requiring lower dose radiation, Cyberknife will be better at retaining normal body function.
However if high PSA and more than a T1 tumor, with a high Gleason score there can be issues with radiation damage to the urethra, causing a stricture.
Sorry this is a ramble, but one needs to be informed.
My PSA 12, T1 tumor , Gleason 8, which means very aggressive cancer.
After Cyberknife my PSA now 0.9, have has issues with urethral stricture.
But all body functions 100%.
Chairman of my local prostate cancer support group ,had the DaVinci robotic procedure, poor guy has not had an erection since!
Plus with surgery you do end up with a reduced length penis.
One can only do research and be guided by gut feelings.
Diet is critical, together with detox.
But catch this early in its infancy, and one has every chance of retaining quality of life.

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Often there is a spike or doubling and no cancer can be found... Many people have PSA of 10.0+ and no cancer.

xylophone · May 16, 2017

3 hours ago, d4291797 said:

A very successful treatment is Cyberknife, google ,and go to their forum.

Thank you for that information I have read it and put it in my bookmarks file in case I ever need it, which hopefully I won't.

I did post earlier on in the piece about the newest treatment for prostate cancer which involves introducing a modified type of bacteria into the blood which when activated by light introduced into the prostate by the da Vinci robotic system, actually attacks and kills cancer cells and this has been trialed with great success. Indeed I mentioned that an acquaintance of mine had just gone to Spain for this very treatment.

It would seem that there are some good and new treatment methods becoming available and that gives older folk is like me a lot of confidence for the future.

Thanks for sharing and may you experience ongoing good health.

cheeryble · May 16, 2017

Thank you for that information I have read it and put it in my bookmarks file in case I ever need it, which hopefully I won't.

I did post earlier on in the piece about the newest treatment for prostate cancer which involves introducing a modified type of bacteria into the blood which when activated by light introduced into the prostate by the da Vinci robotic system, actually attacks and kills cancer cells and this has been trialed with great success. Indeed I mentioned that an acquaintance of mine had just gone to Spain for this very treatment.

It would seem that there are some good and new treatment methods becoming available and that gives older folk is like me a lot of confidence for the future.

Thanks for sharing and may you experience ongoing good health.

About your light sensitive treatment......it, and also HIFU treatment....is very well described in the BBC's Inside Health podcast not so long ago. Just check the back episodes, they usually have three subjects each week. I remember HIFU is now accurate enough they can target a focal area the size of a grain of rice. I believe the excellent Royal Marsden Hospital in Fulham is a leader in it.

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xylophone · May 16, 2017

2 hours ago, cheeryble said:

About your light sensitive treatment......it, and also HIFU treatment....is very well described in the BBC's Inside Health podcast not so long ago. Just check the back episodes, they usually have three subjects each week. I remember HIFU is now accurate enough they can target a focal area the size of a grain of rice. I believe the excellent Royal Marsden Hospital in Fulham is a leader in it.

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Thanks also............however the FDA don't recommend it according to this article:

http://www.harvardprostateknowledge.org/fda-panel-rejects-high-intensity-focused-ultrasound-early-prostate-cancer

????

uhhh ohhh · May 17, 2017

So many choices in treating this disease and no one treatment fits all. One must do their DD and decide what is best for them.....watchful waiting, surgery, Brachytherapy, IMRT, Cyberknife and one I didn't see mentioned....Proton Therapy, although that can be very expensive. Many of these treatments are used in conjunction with drugs. The best advice is to do your research and find out what you think would be the best treatment for you. Certainly, in many cases, doctors in a particular field will tell you their treatment would work the best so one should consult with numerous doctors if they're diagnosed with Prostate Cancer. The PSA, IMHO, can be one useful indicator of a problem along with the DRE and if necessary a biopsy. This is a very treatable cancer if detected early but as one poster pointed out, if not treated in time a very unpleasant way to die. GOOD LUCK TO ALL!!!

JimGant · May 17, 2017

Quote

The new report still advises against PSA testing for men ages 70 and older. In this age group, the panel said, the evidence is clear: Looking for prostate cancer and treating the tumors that are found would do more to erode quality of life than to extend it.

http://www.latimes.com/science/sciencenow/la-sci-sn-prostate-cancer-screening-20170411-story.html

Probably a good call, if you're over 70.

They found my prostate cancer in 2005, when I was age 60. Then, the toughest part was deciding on treatment. With a Gleason score of 6, watchful waiting was an option, as this number suggests a less aggressive prostate cancer. However, many folks with Gleason scores of 6 have actually had very aggressive cancer, determined after surgery, when the entire prostate can then be analyzed (core sample biopsy is just that -- random samples -- so a Gleason 6 on each core doesn't necessarily speak for the entire prostate). And, since Dad had died uncomfortably of prostate cancer, I decided to be proactive.

Now what? Surgery or radiation? Found a radiologist specializing in brachytherapy (radioactive seeds) in the DC area (I lived in Alexandria), with 100's of procedures and an excellent reputation. Consulted with him. Then, I consulted with a noted surgeon in the area, who also was a pioneer with robotic surgery (which, in the right hands, had a better record than manual surgery). I'd already done tons of research (none conclusive, however), and knew that with surgery you had a better chance of getting it all out -- and, if not, could then fall back on radiation. However, once you go with radiation, surgery is not a followup option. But then you have to consider side effects. And all I read gave the nod to radiation. Then, the noted surgeon moved to Chicago, and his replacement on the robot didn't have enough procedures to give me any confidence. So, radiation it was. (Cyberknife had yet to come to the DC area; plus, it was so new, had it been available, I would still have to question experience levels. Thus, brachytherapy and the proven doctor was the call.)

Into the OR in the morning (Alexandria INOVA), then home by afternoon, complete with 119 seeds in my prostate -- and a card for the screeners at the airport as to why I glowed.

Anyway, fairly easy recovery. Some burning for a month, but no catheter ever required. And now, 11 years later, my PSA is <.01; only a minor drip -- and that's only when I wash dishes in the sink. And half a Viagra does the trick (or two). No regrets. But, boy, the decision process was murder. Nevertheless, when I read the horror stories of the side effects some have from surgery, I just thank that surgeon for moving to Chicago.

LannaGuy · May 17, 2017

6 hours ago, JimGant said:

Probably a good call, if you're over 70.

They found my prostate cancer in 2005, when I was age 60. Then, the toughest part was deciding on treatment. With a Gleason score of 6, watchful waiting was an option, as this number suggests a less aggressive prostate cancer. However, many folks with Gleason scores of 6 have actually had very aggressive cancer, determined after surgery, when the entire prostate can then be analyzed (core sample biopsy is just that -- random samples -- so a Gleason 6 on each core doesn't necessarily speak for the entire prostate). And, since Dad had died uncomfortably of prostate cancer, I decided to be proactive.

Now what? Surgery or radiation? Found a radiologist specializing in brachytherapy (radioactive seeds) in the DC area (I lived in Alexandria), with 100's of procedures and an excellent reputation. Consulted with him. Then, I consulted with a noted surgeon in the area, who also was a pioneer with robotic surgery (which, in the right hands, had a better record than manual surgery). I'd already done tons of research (none conclusive, however), and knew that with surgery you had a better chance of getting it all out -- and, if not, could then fall back on radiation. However, once you go with radiation, surgery is not a followup option. But then you have to consider side effects. And all I read gave the nod to radiation. Then, the noted surgeon moved to Chicago, and his replacement on the robot didn't have enough procedures to give me any confidence. So, radiation it was. (Cyberknife had yet to come to the DC area; plus, it was so new, had it been available, I would still have to question experience levels. Thus, brachytherapy and the proven doctor was the call.)

Into the OR in the morning (Alexandria INOVA), then home by afternoon, complete with 119 seeds in my prostate -- and a card for the screeners at the airport as to why I glowed.

Anyway, fairly easy recovery. Some burning for a month, but no catheter ever required. And now, 11 years later, my PSA is <.01; only a minor drip -- and that's only when I wash dishes in the sink. And half a Viagra does the trick (or two). No regrets. But, boy, the decision process was murder. Nevertheless, when I read the horror stories of the side effects some have from surgery, I just thank that surgeon for moving to Chicago.

wow congratulations you must have good karma lol

cheeryble · June 9, 2017

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elektrified · June 10, 2017

6 hours ago, cheeryble said:

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Good video. My approach...better safe than sorry. I have gone from checking PSA every 3 months to every 6 months.

Saraphee · June 10, 2017

1 hour ago, elektrified said:

Good video. My approach...better safe than sorry. I have gone from checking PSA every 3 months to every 6 months.

Same for me!

Bill97 · June 10, 2017

Good video. My approach...better safe than sorry. I have gone from checking PSA every 3 months to every 6 months.

Wouldn't every three months be safer?

What other tests do you do annually or more frequently?

elektrified · June 10, 2017

1 hour ago, Bill97 said:

Wouldn't every three months be safer?

What other tests do you do annually or more frequently?

The doctor told me that since the PSA number has stabilized (does not fluctuate up or down very much) that every 6 months is sufficient.

Twice a year...PSA and DRE. I've already done the biopsy which was negative.

thaibeachlovers · June 10, 2017

On ‎04‎.‎05‎.‎2017 at 3:40 PM, elektrified said:

I just saw on the U.S. news about a week ago...the U.S. has reversed their opinion and has gone back to their original recommendation for men to get PSA tests regularly.

Whether one gets the tests done regularly or not, just remember that there are always some false results on any test.

If the test is positive for prostate cancer, one should ALWAYS get a biopsy done to confirm.

Even if confirmed positive there are treatments that don't involve destroying your quality of life by having a surgical prostatectomy. I unfortunately made the wrong choice and regretted it every day since. Sometimes death is a better outcome.

thaibeachlovers · June 10, 2017

On ‎17‎.‎05‎.‎2017 at 11:08 AM, JimGant said:

Probably a good call, if you're over 70.

They found my prostate cancer in 2005, when I was age 60. Then, the toughest part was deciding on treatment. With a Gleason score of 6, watchful waiting was an option, as this number suggests a less aggressive prostate cancer. However, many folks with Gleason scores of 6 have actually had very aggressive cancer, determined after surgery, when the entire prostate can then be analyzed (core sample biopsy is just that -- random samples -- so a Gleason 6 on each core doesn't necessarily speak for the entire prostate). And, since Dad had died uncomfortably of prostate cancer, I decided to be proactive.

Now what? Surgery or radiation? Found a radiologist specializing in brachytherapy (radioactive seeds) in the DC area (I lived in Alexandria), with 100's of procedures and an excellent reputation. Consulted with him. Then, I consulted with a noted surgeon in the area, who also was a pioneer with robotic surgery (which, in the right hands, had a better record than manual surgery). I'd already done tons of research (none conclusive, however), and knew that with surgery you had a better chance of getting it all out -- and, if not, could then fall back on radiation. However, once you go with radiation, surgery is not a followup option. But then you have to consider side effects. And all I read gave the nod to radiation. Then, the noted surgeon moved to Chicago, and his replacement on the robot didn't have enough procedures to give me any confidence. So, radiation it was. (Cyberknife had yet to come to the DC area; plus, it was so new, had it been available, I would still have to question experience levels. Thus, brachytherapy and the proven doctor was the call.)

Into the OR in the morning (Alexandria INOVA), then home by afternoon, complete with 119 seeds in my prostate -- and a card for the screeners at the airport as to why I glowed.

Anyway, fairly easy recovery. Some burning for a month, but no catheter ever required. And now, 11 years later, my PSA is <.01; only a minor drip -- and that's only when I wash dishes in the sink. And half a Viagra does the trick (or two). No regrets. But, boy, the decision process was murder. Nevertheless, when I read the horror stories of the side effects some have from surgery, I just thank that surgeon for moving to Chicago.

I was similar. Waited 3 years till I couldn't pee any more and had surgery. Unfortunately green laser wasn't suggested till too late.

Biggest mistake ( other than getting married ) of my life.

They wanted to give me post op radiation, which I refused due to potential side effects and that was a very good decision. No recurrence of cancer in 12 years.

thaibeachlovers · June 10, 2017

On ‎17‎.‎05‎.‎2017 at 8:42 AM, uhhh ohhh said:

So many choices in treating this disease and no one treatment fits all. One must do their DD and decide what is best for them.....watchful waiting, surgery, Brachytherapy, IMRT, Cyberknife and one I didn't see mentioned....Proton Therapy, although that can be very expensive. Many of these treatments are used in conjunction with drugs. The best advice is to do your research and find out what you think would be the best treatment for you. Certainly, in many cases, doctors in a particular field will tell you their treatment would work the best so one should consult with numerous doctors if they're diagnosed with Prostate Cancer. The PSA, IMHO, can be one useful indicator of a problem along with the DRE and if necessary a biopsy. This is a very treatable cancer if detected early but as one poster pointed out, if not treated in time a very unpleasant way to die. GOOD LUCK TO ALL!!!

It's for that very reason that I support voluntary euthanasia.

I'd have preferred having green laser so I could pee and taking the pills when cancer actually did something to make me wish to die. Other than urination problems, I had ZERO symptoms of cancer when I had the op.

My quality of life has been s*** since the op. It's no way to live.

Some may disagree with that, but it's how I feel, and that is my right.

orang37 · June 10, 2017

1 hour ago, thaibeachlovers said:

... Sometimes death is a better outcome. ... it's how I feel, and that is my right.

Of course it is your sacred right to consider death, and, the limitations or problems you are experiencing must be very serious for you to be at this point.

However, perhaps you'll forgive another cancer survivor (me) for feeling a sense of brotherly concern that you may be very depressed now, and (as a former psychiatric social-worker who spent a life-time dealing with his own tendency towards depression) thinking that some form of therapy might help you to become less depressed.

The word/concept, "therapy," these days is such an overloaded semantic catch-all that it can mean everything and anything: something as simple as a work-out at the gym, or a daily walk, can, sometimes, make a big difference in the quality of life.

Sometimes depression, in combination with social isolation, stress, and other factors, can "feed on itself" ... become a vicious self-reinforcing spiral; Ernest Gruenberg (1972) called this the "social breakdown syndrome." imho, there are many ways to try and transform this journey (through what Hesse called "morbio inferiore") back to ... one's core, battle-hardened, sanity.

best wishes for your health in mind and body ... today and tomorrow ...

~o:37;

xylophone · June 10, 2017

On 5/11/2017 at 8:14 AM, LannaGuy said:

Good luck and hope you kill off that UTI very soon. Let us know how you get on.

BTW my friend tells me that the insertion of his catheter at Bangkok Hospital was painful every time but in UK was painLESS. Not sure why that would be.

Seems like a long time since I was posting on this thread, and you did ask me to let you know how I got on, and so far it's been a bit of a nightmare..............

The UTI that they were chasing around the place, and were for many, many months, has only just been cultured, this despite me asking for it to be done every time I gave the urine sample which would almost be in double figures now. Sure they said there was an infection and gave me yet another round of antibiotics and I have been on more antibiotics for two to three weeks at a time than I can recall, but at a rough guess, around seven or eight of them and nothing seems to have worked.

I think I may have mentioned somewhere that I went into hospital last November for a bladder neck incision and nothing has been going quite right ever since, with this recurrent UTI and many visits to the urologist, a couple of urologists in fact.

Well just three weeks ago I woke up feeling absolutely dreadful and running one hell of a high fever so I managed to drive myself to hospital and presented at emergency and they were very concerned and I was immediately put on a saline drip and the antibiotic levofloxacin (IV) and wheeled into a room.

The next couple of days were a bit of a blur but I had the antibiotic everyday and the saline, as well as having a catheter inserted. I was visited a couple of times a day by my urologist and after five days I was allowed to go home, yet no one really knew or really told me what the problem was although they did suspect it was a UTI (I saw that written on my records).

Three days after coming out of hospital I felt dreadful again and this time managed to collect the urine sample which looked something along the lines of cloudy hollandaise sauce so I was at a loss to know what to do. Eventually I decided that I would have to go back to Bangkok Phuket hospital because they had all my records and they were probably my best hope.

Sure enough they tested the urine sample and I had an infection and I stressed this time that I wanted it cultured, whereas I had stressed this so many times before and it hadn't been done, so I made it quite clear that was to be done. In the meantime I was sent home with painkillers and more antibiotics.

Four days later back into the hospital for the results and the good news was they had cultured something but the bad news was that it was E. coli-ESBL (a form of E. coli which is antibiotic resistant to most known and regularly used antibiotics) it was tested against a whole host of them and they were just four antibiotics which it was susceptible to!

Because this is quite a deadly bug I was put onto an infectious diseases Dr, and she was very good, and we tried the first drug, (all of which have to be administered intravenously I am sad to say) but that had started to seriously affect my kidneys after just three days when she took another test, because she thought that could be the case as it is a very potent antibiotic. So onto the next one and I have been going back to the hospital every day now for nine days for one hours worth of intravenous antibiotic and of course because I am an outpatient, I'm not covered by my insurance policy so it is quite expensive, but then again what price health?

Now here's the strange bit, or maybe not so strange, because I asked the two doctors in the hospital how on earth I had managed to get an E. coli-ESBL bacteria in my bladder and they both gave me the same "round about" answer – – that this particular bug lives in the faeces and it can find its way into the bladder. But this is mainly in women because of the nature of their anal and urethral openings, but almost impossible in men by the same route.

I thought long and hard about this and could not come up with a satisfactory answer and no amount of research on the Internet would solve the problem for me. However I mentioned this to a relative of mine in Canada whose husband has worked (in a medical capacity) in a major hospital over there for many many years and he asked around and came up with what I think is the answer – – this type of bacteria can be "hospital-acquired" in as much as according to some reports up to 5% of this type of infection will be caught in the hospital where surgery or catheter use is undertaken.

That seems to be the only thing I can think of because I had a cystoscopy, a bladder neck operation and two instances of indwelling catheters at that hospital and contracting this bug all points to that.

I know it's gone a little off track from the PSA test, but in another post I did say that my PSA score was just under 10 when it used to be under one and that I would get it tested again, however with all this going on and still not being 100% (five more days to go of this IV antibiotic and then more tests) it has taken a back seat because I don't think it would be meaningful testing it now, although I still intend to get it done once this is all over.......... and I really hope it is over soon because it has been a nightmare which started just after my operation last November.

If this antibiotic doesn't do it, there are two more to try and after that, I really am at a loss to know how things will progress.

cheeryble · June 10, 2017

9 hours ago, thaibeachlovers said:

It's for that very reason that I support voluntary euthanasia.

I'd have preferred having green laser so I could pee and taking the pills when cancer actually did something to make me wish to die. Other than urination problems, I had ZERO symptoms of cancer when I had the op.

My quality of life has been s*** since the op. It's no way to live.

Some may disagree with that, but it's how I feel, and that is my right.

Very sorry to hear of your suffering TBL

I think it;s important to remember that the rationale behind what the USPSTF originally recommended.....no PSA test for symptomless patients.....the rationale being bad outcomes of over treatment outbalancing risk of deadly cancer.....still holds.....it's just been adjusted so it's not fixed in stone and doctor will consult for best choice.

Also important to remember that the risk of death from PC is about 1 in 35 for Western men, and PSA tests will save.....what was it?......one life in a thousand visits?(please correct sounds wrong but it IS a very small number indeed)

thaibeachlovers · June 11, 2017

On ‎10‎.‎06‎.‎2017 at 5:17 PM, orang37 said:

Of course it is your sacred right to consider death, and, the limitations or problems you are experiencing must be very serious for you to be at this point.

However, perhaps you'll forgive another cancer survivor (me) for feeling a sense of brotherly concern that you may be very depressed now, and (as a former psychiatric social-worker who spent a life-time dealing with his own tendency towards depression) thinking that some form of therapy might help you to become less depressed.

The word/concept, "therapy," these days is such an overloaded semantic catch-all that it can mean everything and anything: something as simple as a work-out at the gym, or a daily walk, can, sometimes, make a big difference in the quality of life.

Sometimes depression, in combination with social isolation, stress, and other factors, can "feed on itself" ... become a vicious self-reinforcing spiral; Ernest Gruenberg (1972) called this the "social breakdown syndrome." imho, there are many ways to try and transform this journey (through what Hesse called "morbio inferiore") back to ... one's core, battle-hardened, sanity.

best wishes for your health in mind and body ... today and tomorrow ...

~o:37;

No need to be concerned. I am less depressed now than I was for most of my life, and at the moment pretty good. Probably as "normal" as anyone could hope for.

No, the problem is that this biological machine that carries "me" around is not very good at all, and I have accepted it isn't going to get any better. The prostate business while in itself traumatic was one of many problems.

I just don't want to be forced to exist once it really packs it in, and I have pain, and am completely dependent on others. We all know someone like that and probably said something along the lines of "if he was a dog he'd be put down".

The real problem is that good men like Kervorkian have been locked up or otherwise neutralized, and my country is not enlightened enough to allow the magic pill. Hopefully that will change, if only because the cost of forcing us all to live as complete dependents is going to become astronomical once all us baby boomers hit retirement age.

Sadly, I'm in LOS, but I spend every night in my room watching tv because my op destroyed my sex life. Bummer to the max.

Thanks for your concern, but I'm OK mentally.

LOUIS65 · March 20, 2018

I am writing because my husband had a PSA test at a well known hospital here in CM as part of his yearly check up. His friend also did the PSA. Neither have ever had any of the symptoms of prostrate cancer. They had both always had PSA levels of under 4. They are aged 73 and 75 .

The results for both of them came back as a devasting PSA 12.

My husband went to another hospital to have an MRI scan but it not possible as he has had a hip replacement.

So he was booked for a biopsy the following week , which is very invasive. The dostor who had examined him

noticed he had a soft prostrate , not hard, which was a good sign.

The day before the Biopsy operation we became very worried, especially because of the risk of infection. Plus my husband had no syptoms of prostrate cancer and was feeling very well.

We decided to have another PSA test at a different hospital. The PSA result was under 4, so we cancelled the Biopsy Op.

A couple of days later we went to a 3rd hosptal to check the PSA level, and it was still under 4.

Our friend had returned back to the US, worried he had Prostrate cancer, he he re- did the PSA test there and it was under 4.

The reason I am writing this is only to help others, and that it would be well advised to have several PSA tests

after our experience , before doing the MRI or the invasive Biopsy which carries a risk of infection.

LOUIS65 · March 20, 2018