Your Prostate Will Kill You! Basic Advice About Prostrate Cancer

   Prostate cancer will kill more men in the U.S. than breast cancer will kill women!

Prostate cancer is so serious and since over the last few months we have heard more of it with our friends we feel necessary to repeat this July 2015 entry so our male friends around the country will get checked and treated. Make getting checked your   New Years resolution

WARNING…WE DO NOT advocate or support any advertisements that are automatically placed on this posting for ANYTHING having to do with supplements or any treatment, plan or way to control prostate situations. Read the post as it is and come to your own conclusions and do your own thing! But if you are 50 or more–you should be checked if you value your own life.

This post will hopefully help you some in determining what you might do to keep from killing yourself through inaction. Here is the deal. It is pretty well accepted that most men will develop some level of cancer in their prostrate. Don’t let that scare you!

A light blue ribbon is the symbol for prostate...

A light blue ribbon is the symbol for prostate cancer (Photo credit: Wikipedia)

First, if you don’t know what your prostate is or where it is in your body then search that at on the Internet. Assuming you know or have searched let’s continue.

Now nothing of what we say here will be of any use to you if you are one of those folks who doesn’t want to hear potential bad news. If you go through life with your head in the sand like the ostrich or viewing your life through rose colored glasses–this is not the blog posting you should read. 

This information is somewhat academic if you have not reached your late 40s or early 50s. But some forewarning does not hurt; popular author Vince Flynn died (July 2013) in his 40s of prostate cancer after fighting it for three years.

We won’t not going into great detail on this because initially it is pretty simple and we are not doctors. It gets much more complicated when or if you develop serious prostrate cancer or indicators of it but do not let that scare you–just deal with it medically.

Once you get much past the age of 45 you should have a regular checkup each year. Part of that exam should (will) consist of having a doctor physically examine (feel) your prostate and that means a finger up your rear! It is called a digital rectal exam (DRE) and when past 50 you should do this each year.

Probably more important–a simple PSA (Prostate-Specific Antigen) blood test. You need not have your doctor do this as your doctor can call in to a clinic to draw the blood and then report back to him the results which he should then notify you of. If your doctor does not get back with you within a week, you contact him and you get the PSA number and his opinion.

Write the PSA “score”and the date and keep it somewhere for each year (it will also be in your doc’s records), but you too should keep it. Some doctors will not freely give the number–they will just say you are fine.  bull crap! Get the number and YOU save it–you will see why shortly–read on.

NOTE: For three (3) days prior to getting your PSA blood test done DO NOT have sex of any kind, row a boat, ride a bike or motor cycle or do anything else like any exercise that might put pressure on your crotch or anything that makes your junk move/work (you get the idea)–this can skew the PSA numbers. Come on, you can hold off for three days, you are a big boy!

Digital rectal exam; drawing shows a side view...

Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate. (Photo credit: Wikipedia)

About the rectal digit exam. It is not fun! Done best, the doctor should bend you over his office exam couch, have you rest your chest flat (not on your arms) and then he will insert his gloved and lubricated finger into your rectum and will feel your prostate–it is not fun but do your best to relax. A proficient doctor can do this with relatively  low discomfort but this is one uncomfortable exercise you want him to do well–your life or health depends on it.

Resistance is futile in this exam, try not to tense up!  I always ask my doc (between my whining, bitching and climbing up the wall) if he has found his damn golf set yet? But the doc is feeling for bumps, lumps, ridges on the front, side and rear of the prostate and if he is really good with lots of experience he may be comparing the firmness on each side of the prostrate. If it is hard or extra firm on one side or both and/or has lumps, bumps and or ridges there may be a problem and he should advise you of this immediately–because he knows of it immediately.

Part two is the PSA blood test mentioned earlier. A few docs (getting much fewer nowadays) do not favor this test and that is flat out crap! It is one quick blood sample from your arm that pulls about two tablespoons of the red stuff into a syringe and takes all of 30-seconds and with today’s needles, is painless so man up you sissy boys–BTW I am scared shiftless of needles.

NOTE: We will say it again…To AVOID false (inaccurate) results in the PSA test it is important that 3-4 days PRIOR to the PSA test you do NOT have sex of any kind, ride a bicycle or motorcycle, conduct weight lifting or involve yourself in other events or do things that can affect the prostrate by pressure, exertion or function. You want and need accuracy so don’t mess up the test.

Years ago the PSA test was not so great and perhaps that history has stuck with many old thinking doctors. But the new PSA tests are geared for prostate cancer and are very reliable. The test results will apply a number from 0 to well above 20. We do not want to quantify the numbers and their meanings because we are not doctors, but the literature indicates a little of the following and this is NOT in stone.

Generally (consult your doctor) for guys under 50 a PSA under 2 or 3 is okay and for most guys a PSA past let’s say a PSA of 5 regardless of age is something to at least note (again, consult your doctor). And generally as you age the number may tend to rise but it should rise gradually and that NOW is the rest of the story.  Also and again we advise YOU keep PSA numbers for yourself for your own comparison over the following years–just do it!

Here is where the PSA can save your life! If you (or your doctor) see a significant rise (to be determined) n your PSA numbers that indicates a potential problem. 

ANECDOTAL STORY–BUT A REAL LIFE THING…

We know of one case where a friend of our in his mid-60s who in October 2012 had a PSA of 5.0. Not such a big deal. However, and pretty quickly he noted his pee stream was weak and kept getting worse and at times he had to force himself through exertion to pee and he had to pee much more often.

That coupled with the fact he was uncomfortable with his “recent” 5.0 PSA number as just two years prior it was a 3.0 (he kept his own records like we recommend). Doctors may NOT go through your chart to see what your past PSA numbers were–they may just report the latest one.  this is why YOU should keep your number and run comparisons–get it? He saw the jump, his doc did not (see above for reason). So he got with his doc. with his concerns.

Over his doctor’s polite objections he insisted on another PSA in three months; it was now 5.4. So he repeated in two months and it was a 6.0. Once more and again over his primary doctor’s polite objections he insisted on another in 2 months and that one was 6.54.

In a period of under JUST seven months it jumped 11/2 points, and that to him (and anyone with a brain) was (is) in his case an indicator of things going south-very quickly! He was correct!

His primary care doc tried to say it was nothing much and to do some “watchful waiting” (this is not unusual with some docs) but because it ramped up so quickly he ordered his doc to get him a needle biopsy-which is a real pain in the ass and not anything you casually want.

For this test you go to a urologist. Urologists are also (prostate) surgeons, that is how they make their living, keep that in mind as we go along, they remove prostates as part of their way of making a living.

After getting locally anesthetized and infection preventing drugs taken, a fat a cigar (no jokes please) sized device is inserted into the rectum guided by ultrasound image into generally a dozen (sometimes 18) specified areas of the walnut sized prostrate.

A very tiny spring loaded (sucking) needle quickly extracts a really tiny part of the prostate, it really is pretty painless and at the worse a split second tiny pinch will be felt. These samples from various precisely specified areas of the prostate are put on glass slides, noted where they are taken from the prostate and sent to a lab for a biopsy.

My friend’s results arrived in a few days and he learned he had prostate cancer in eight of the 12 specified sample areas of the prostate at 100 percent fill and two other areas were 70 percent filled-not good news.

Additionally this needle test also provides a Gleason score. About the Gleason Score. The Gleason score is derived only from the needle biopsy samples and this test IS considered by ALL experts as a highly-significant test! His Gleason was a 7. Coupled with his quick ramping up PSA, the content of his prostate, and his Gleason, he had bad stuff going and going on quickly.

English: Micrograph showing prostatic acinar a...

A H&E stained slide from the needle test showing Micrograph prostatic acinar adenocarcinoma (the most common form of prostate cancer).This is the type of thing the Gleason test will show and it is this type of slide image as well as the locations from the needle test that will ultimately quantify and determine how serious things are. This kind of information is only determined from the needle test. (Photo credit: Wikipedia)

Again we can’t go into great detail because we only know some generalities. However, after a bit of research we learned that the bottom line is after a needle test if your Gleason is a 6 or above you your doc and your urologist need a heart to heart talk of various options such as watchful waiting (ugh-can get you killed!); or depending on the score you may need to get treatment.

But it is all your choice and you should do your own research on the treatment best for you if your test should prove positive. When a Gleason gets into 6 you should be concerned. At 7 you better get really serious, an 8 or 9 and you MUST ACT IMMEDIATELY–now, a 10 is pretty much the worse news you might imagine but with lots of work…

After the urologist was finished our friend said he was sent to the hospital for a CT and bone scan to see if the cancer had spread through the walls of the prostate into the bones or lymph nodes–this is the danger; it hadn’t. He went into 45 days of proton radiation treatment and caught this mess in the nick of time.  Now it is done and his PSA (he gets one or two every year) is like that of a newborn and has been so for three years.

  So what happened here of significance?

The PSA has caught far more prostate cancer than the digit (finger feel) exam. Regardless, get both-why gamble?

We learned of a guy with just a 4.5 PSA but his 70 year old doctor (lots of experience and smart) during his once a year doctor visit felt a ridge on his prostrate. His doc had him immediately take the needle procedure and it found him to have a Gleason of 9; he just barely caught the problem in time.

Our friend in the first example noted the rise in his own PSA levels and he insisted on the monitoring with additional PSAs. Prostate cancer is generally slow-growing, you have the time if caught early. If caught too late it may have spread to the bones and lymph nodes. The key is he became his own best advocate and kept his own numbers! If you aren’t, who will be?

<<<<<<<<<<<<<<<<  PAY ATTENTION DUMMIES!  >>>>>>>>>>>>>>>>>>

Insist (and you can and should) your doctor give you your PSA results and the date every time you have the test. YOU  also keep track of this information. If things start to or appear to be going south then take matters into your own hands–this is your life.  Again, first get the PSA and DRE every year. If things appear weird then get the PSA check more often to see if it is going up. If it looks like you may have a problem, get the needle test soonest. Then you will know. If your Gleason is 6 or above your doc may order the soft tissue and bone scan to see if any cancer has spread. Then the treatment of your choice with your doc’s recommendation can begin–and remember you can also ignore your doc’s best treatment recommendation based on your research and always get a couple of second and third opinions–which you should do, but don’t fiddle around.

Again, our friend above became his own best advocate and so should you and in his case he insisted and got PSA tests over a few months and after things indicated a problem he got the needle biopsy and the results from that revealed the cancer and he moved quickly.You MUST be your own advocate!

If you do not care to be your own advocate whether it is your car’s oil change, pick of food in a restaurant, your choice of booze or cigars, your dealings with your accountant or your affirmative involvement with your own health, then you will get what you get! You get to run the show!

Last, if you discover you have prostate cancer do not let worry ruin your life (it can). Caught early enough there are several courses of action available and you should exhaustively research and examine each for what YOU think is best for you and go to a couple of different doctors in different locals and offering consultations about what my work best for you: Surgery (statistically it has been shown it has a 15% incidence where they do not get it all and you may still have to have the full radiation treatment), IMRT (radiation and there are several types), radioactive seeds (they can migrate), proton treatment (what our friend got and which we prefer–but much more expensive), freezing and more. The most utilized are surgery and IMRT radiation (due to cost).

Regardless of your choice, get the most experienced doctor and facility you can locate and ask a ton of questions–lots of questions and concerns are expected by consulting doctors. Research the hell out of this.

And last, it helps to get at least two different consultations from different facilities and different doctors in different hospitals using the same or different techniques (they will “must” share the slides showing your cancer (Gleason score however). Our friend went to two urologists, two IMRT docs and facilities and one proton facility. Believe it or not, the insurance companies actually like you checking things out.

Again, what you don’t know may kill you and in a very unpleasant way. Don’t be stupid. And certainly once past 45-50 get the digit exam and the PSA every year and then watch for indicators of problems.

We would like to have you back at our blog with us for a long time and while this blog is a guy thing for manly men we also  mean for it to be SMART men NOT macho and heroically stupid; not a guy thing; that is dead guy thing.

It is your life and ultimately your responsibility! and with the advent of the Internet and some great books on this subject (one is Dr. Patrick Walsh’s guide to Surviving Prostate Cancer, 3rd, ed.) there is little or no excuse for non-action on your part.

Take care of yourself damn it!

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2 comments for “Your Prostate Will Kill You! Basic Advice About Prostrate Cancer

  1. Thomas
    September 21, 2015 at 11:10 am

    I have prostrate cancer. Have urologist but want to have 2nd opinion (to make sure i have the best Doc) i am going for a prostatectomy (robotic) followed by radiation. How do i find the best Doc, radiologist & hospital in Raleigh NC area for my treatment.
    Thanks
    Tom

    • September 21, 2015 at 2:28 pm

      Hi,

      This is tough because we are not in your area. We advise you check with your local HMO/insurance to see who they recommend; talk with your PRIMARY doctor and get some referrals for the operation and radiation from him and of course Google cancer treatment facilities/hospitals that do this (daVinci and IMRT) in your area–if you MUST stay in your area). Get and retain copies of your exam info, your diagnosis info, and get a couple (discs) of copies of your soft tissue and bone images your hospital did–they will give them to you. Armed with this stuff you can speed up the second opinion thing. Also good cancer docs may want to see the ACTUAL needle test slides (and they are available for the docs to transfer for second and third opinions–you do NOT get them-they send them to the various docs). These slides show your cancer which resulted in your Gleason score that forms the severity opinion for the docs. Basically you are after second opinions for how you are to be treated. Bear in mind that Urologists are also surgeons–they may recommend radiation but do not generally do that–but they do do the surgery-which in a few cases can skew their recommendation.

      What we get From your question, The only justification for your having BOTH the operation and radiation is that your cancer has spread out from the prostrate–otherwise not sure why you need both. A statistical fact is that about 15 percent of people who get the operation (And it can be a real bitch! Complicated and with some nasty potential side effects–make sure your doc tells you of all of them!.) will not get all the cancer and will have to have some radiation (typically IMRT). It seems docs try to avoid radiation on younger men (say below 40 or so) because the radiation goes right through and may affect other organs over the many years left in their lives. Senior types (guys in their mid/late 50’s and up) may be better for radiation since as we get old-operations of this type can be a real problem. However, that too may not hold true depending on you, your prostate, the risk, the problem and so much more. So ALSO scheduling an appointment with a radiation oncologist who has worked a lot with prostate type cancers and has an up to date IMRT unit is another opinion

      I would get–and radiation has some drawbacks too so ask them that question. And if your insurance can and will handle it I would really check into proton. Regardless, if your cancer must have treatment, the treatment side effects are much less than a miserable death. Hope this helps.

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