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Cancer: Prostate Message Board

Cancer: Prostate Board Index

[COLOR="DarkGreen"]Hi Scub,

You've had some really fine replies from daff and Dale, so I'll just address a few points in green that you raised and that haven't been specifically covered yet, using an extract of your first post. Jim[/COLOR]

[QUOTE=Scub;3861093]... I'm 59 and was healthy (!) until the digital exam, when my Doc told me I have a "pea sized lump" on my prostate. My PSA was negligable and has been for years.

[COLOR="darkgreen"]A low and stable PSA is a good thing, of course! As Dale mentioned, it's nice to have a PSA of around 1 at your age as a suggestion that problems with BPH, prostate cancer or infection/inflammation are not present. Based on research involving Dr. William Catalona, MD, one of the foremost prostate cancer surgeons and researchers in the US, PSAs of .9 for men in their fifties and 1.4 for men in their sixties are the median (average) PSAs of men with no evidence of prostate cancer. (I assume that's based on biopsies and other evidence.) For men with PSAs for their age group at or below those values, the risk of prostate cancer is "very low." For you at age 59, I suppose the key value would probably be around the 1.0 to 1.1 range. For those men with PSAs above the median for each age, risk of prostate cancer is somewhat above average, though, if your PSA is close to the median, the risk, while above average for similar men, is still pretty low.

I've read some of the research advocating that a PSA of 2.5 is a better threshold of concern than the old 4.0. Dr. Catalona is the chief advocate of that viewpoint, and because he is so highly regarded (a regular featured speaker at urology conventions), his view has been influential. Personally, as a layman but a savvy layman, it looks to me as if lowering the threshold will pick up approximately another 2 1/2% or so of prostate cancer - significant, but not game changing in my view.[/COLOR]

I've had mild, typical symptoms ( slow pee, hard to start, night pees etc) for a few years but no indications during yearly check ups.

[COLOR="darkgreen"]While it's possible that cancer can cause those symptoms, by expanding and pressing on the urethra, it's a lot more likely they are due to BPH - benign enlargement.[/COLOR]

What I really wonder is, if the "pea" isn't cancerous, what is it ? I understand benign lumps occur, but am I deluding myself, hoping for this ?

[COLOR="darkgreen"]I see the likelihood as daff sees it. As to what the pea could be, there are a number of causes, such as benign calcium stones in the prostate.[/COLOR]

If my PSA shows nothing, does that count ?

[COLOR="darkgreen"]Yes, that is a good negative clue, but it is not the whole story. Much of the time a low PSA suggests the absence of cancer, or at least the presence of only a mild case of prostate cancer, caught early. Very rarely, less than 1% of the time as I understand it, there will be a strange type of prostate cancer that gives off very little PSA yet is very aggressive. It's hard not to think we are at ground zero when we have nightmares about the possibilities, but the odds are extremely high against such a scenario. Quite aggressive, more normal prostate cancers can also often give below average levels of PSA, but they still produce some and are not likely to fly below the radar.[/COLOR]

If a noticeable lump has developed over a year, is this a fast growing tumour ?

[COLOR="darkgreen"]While that's possible, it's far more likely that you are like the vast majority of men whose doctors find lumps where there were none the year before: something benign as described above, or a detectable but mild case of prostate cancer caught early.[/COLOR]

I must admit to being surprised at my situation and of having thoughts of my early demise. My Mum died of breast cancer complications and I've always feared some type of cancer would get me, too.

[COLOR="darkgreen"]Your reaction sure sound normal and typical! Fortunately, prostate cancer is one of the slowest growing cancers, and we have an abundance of ways of controling or curing it for almost all of us. Our situation is quite a bit better than that of breast cancer patients, in my opinion. Only about 3% of prostate cancer patients will die of the disease, and that figure is very likely somewhat high as it is based on history - it has a certain lag behind current understanding of the disease and tactics. Maybe some other type of cancer will get you, but it's unlikely to be prostate cancer. By the way, two respected urologists at major cancer-treating institutions told me in early 2000 that, because I had a challenging case (at the time looked like an extraordinarily challenging case), I would probably die in five years, after three good years and two declining years with the disease. (They sugar coated it some, but that was the bottom line.) Yet it's now 2009, and I'm going strong with the cancer under reasonably good control. (The doctors weren't negligent, but they were just not aware of certain new tactics, and to their surprise I turned out not to have widespread metastases (or any that were detectable). And, there have been substantial advances in knowledge of prostate cancer since then! :cool:)

Sometimes a little knowledge can really ease our anxieties. When I was in grade school, probably around age 10 or 11, I learned about appendicitis and I worried whether certain pains I felt might be it. Well, when I found out that the appendix was on the right side, I not only stopped worrying about supposed discomfort on my left side, but about all the discomfort. In fact, most of the discomfort vanished!

We may yet admit you to our exclusive club (prostate cancer survivors), but at the moment you just don't have the credentials! ;)

Good luck, take care, and keep your cool, :cool:


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