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Cancer: Prostate Message Board

Cancer: Prostate Board Index

I'd like to welcome you to this site...but I see you are no stranger to HealthBoards! Nonetheless, I hope that I can provide some responses based on my experiences that will help you understand where you are at.

I'll insert some comments in [COLOR="DarkOrange"]orange[/COLOR] text below

[QUOTE=accessn12;4150326] I am gathering information regarding my husband's prostate cancer so that we may make the difficult decision regarding which treatment option to pursue.

It all started several years ago with a rising PSA level combined with a negative DRE. For several years, the PSA level rose slightly and then went back down at which point, the concern sorta got put aside for a couple years.[/QUOTE]
[COLOR="DarkOrange"]This would be a sign of likely infection. Infection will cause PSA to go up and down. Cancer makes it go nowhere but up. Cancer cells, as you probably know, double, then double again. Prostate Cancer (PC) cells produce PSA at at about 20X the rate of normal prostate cells.[/COLOR]

[QUOTE=accessn12;4150326]About a month ago, I asked our gp to test his PSA again. There weren't any symptoms but since he was going anyhow, it just sorta popped into my mind that it had been several years. It came back at 10.7 so it was off to the urologist. Again, a negative DRE but this time it was accompanied by an u/s and biopsy. The urologist was quite pleased with the u/s results and said that the rise in PSA was evidently due to some calcium deposits that were most likely due to an infection that had come and gone without him much noticing and that he expected the biopsy results to come back clear. [/QUOTE]

[COLOR="darkorange"]Hmmm... I've read a fair amount, but would have to say I've never heard of "calcium deposits" causing PSA to rise. I am currently vacationing and away from my key PC reference books (Walsh's book and Strum's book), but I went online to [B] [/B]and did a search on "calcuim deposits" and "PSA" and it did not return [B][U]any[/U][/B] medical research papers with these key phrases. Anyhow, it probably doesn't matter now because a small amount of cancer was found, as your next sentence reads...[/COLOR]

[QUOTE=accessn12;4150326] They didn't. One sample out of 6 showed 10% with a gleason score of 3+3. His bone scan and ct are clear. [/QUOTE]

[COLOR="DarkOrange"]Other than finding no cancer, finding only one sample with cancer shows it's not widespread, and the Gleason score of 3+3 is essentially the lowest possible score once cancer is found.[/COLOR]

[QUOTE=accessn12;4150326] We were presented the 4 treatment options of surgery, radiation, the seeds or, as not recommended due to his "young" age (65), AS. We were also told not to jump into a decision but were to take our time, research it and talk to others but in no event, should we put off a decision for more than a month or so.[/QUOTE]

[COLOR="darkorange"]Well, with these findings, you certainly do NOT need to rush into anything. Moreover, I absolutely do not know why AS was discounted so readily. I'm not going to try to steer you one way or the other, but as you do your research in the upcoming weeks, I would not discount this from your search, especially in light of some of the other factors you wrote below.[/COLOR]

[QUOTE=accessn12;4150326] The urologist called this a low grade cancer. I did ask him if it was possible that a portion of the PSA level that causes it to be above the magic 10 could be due to the calcium deposits. He said he didn't know. First question - Is there any way to know? It just seems that the PSA level doesn't seem to fall in line with any of the other results. Or does it? [/QUOTE]

[COLOR="darkorange"]I previously commented about my knowledge of "calcium deposits". Also, you didn't provide the "other results" here, so hard to say where the true low point is. That notwithstanding, it is absoluely possible to have a prostate infection simultaneous with PC, which would cause PSA to be even higher than a non-infected prostate. By the way, there isn't anything magic about 10ng/ fact 4ng/mL is the typical threshold for triggering an investigation into why PSA is high, although there are also race- & age-adjusted values which are +/- from this value.[/COLOR]

[QUOTE=accessn12;4150326]We have been married for 29yrs. I wouldn't describe him as being in the best of health (a smoker with copd and a few other minor health problems) but he's still active and able to enjoy life. He's pretty scared. I'm not so much scared, being the daughter of a prostate cancer survivor, a double breast cancer survivor, a laryngeal cancer survivor and a double skin cancer survivor. It's almost like my folks were in the cancer club of the month there for a while but they're both still alive and kicking now cancer free at 80. I also know that any cancer treatment is not easy and I hate to see him have to go thru this. I'm also facing surgery after the holidays for possible ovarian cancer. Ok, I haven't told him that part yet. I just found that out and it's right after he found out his best friend is dying of congestive heart failure, following the death of another very close friend from prostate cancer. This might put a huge monkey wrench in any decision we might try to make so I'm trying to gather as much information as I can as quickly as I can cause he's going to try and put me first no matter what once he finds out.

My main concern is with waiting. If it weren't for the PSA of 10.7, I'd feel a little easier about it. I'm also concerned because he's a vietnam vet and was often sprayed by flyovers with agent orange. That brings up another question - Is prostate cancer that might be linked to agent orange any different or more aggressive than pc that has no known cause? Has anyone around here had experience with this? [/QUOTE]

[COLOR="darkorange"]Sorry, my I don't have direct experience, but have read that there is a link. In fact, there may be some disability status directly related to agent orange and PC...sorry I can't help more here, but use Google for more info.[/COLOR]

[QUOTE=accessn12;4150326] We live in a very isolated, rural area. That too plays into part of the treatment equation. Radiation treatments would be very difficult due to the distance but not impossible if it were the best route to go. The one person that he's spoken with that had surgery now regrets his decision due to the impotence and other problems he's had. I told him that that doesn't mean surgery's not an option, only that it means he probably shouldn't use that particular surgeon. My dad had radiation a couple years back. He has not told me exactly why but was adamant that it isn't a good idea to rush into radiation when I told him about the elevated PSA. We haven't spoken since the biopsy results came back but I got the impression he was pretty unhappy with his decision. So, basically we know of a death from no treatment and have heard from two unhappy souls with their treatment.

I'm also trying to figure out if AS is a safe option for the time being. There's going to be a good 6wk recovery time following my surgery and being as we have no one else to do it, one of us needs to be able to take care of the business, the house, the horses and all the things that need to be done. We're going to have to stagger this somehow. I'd almost like to see another PSA level to see if it maybe has gone down or whether it's still rising. How early can that be tested? [/QUOTE]

[COLOR="darkorange"]This seems like a prudent approach...but there is little reason to believe that an infection would go away by itself. In other words, if there is an infection contribution to your husband's PSA, if it's not being treated with antibiotics then it would probably also be present in the follow up test.

It would be good to know if the low point is below 10. Other than the PSA of around 10, you husband sounds to me like an ideal AS candidate.[/COLOR]

[QUOTE=accessn12;4150326]I'm just sorta spinning right now and looking for some words of wisdom and experience. Does anyone have any input? [/QUOTE]

Hope this helps you down your journey of learning...

I mentioned two books, which are both available within days via internet bookseller orders; I would highly recommend both. The first is by Dr Stephen Strum: "A Primer on Prostate Cancer: The Empowered Patient's Guide", and the other is by Dr Patrick Walsh "Guide to Surviving Prostate Cancer."

Hope this info helps...

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