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Cancer: Prostate Message Board

Cancer: Prostate Board Index

[COLOR="DarkGreen"]Hi jellybean, and welcome to the Board! :)

Baptista already suggested that you provide key information about the degree of seriousness of your son's case. Prostate cancer can range in seriousness from a case of dandruff to aggressive pancreatic cancer, but many cases are toward the milder side. The few clues you have so far are consistent with a milder case.[/COLOR]

[QUOTE=jellybean3009;4682532]Yesterday my 50 yo son told me he just found out he has prostate cancer. Needless to say I was devastated![/QUOTE]

[COLOR="darkgreen"]So many of us feel the same way when we get the news. However, prostate cancer is almost unique among cancers in its typical slow growth. In fact, virtually 100% of men with low-risk and intermediate-risk cancer are alive not only at the ten year point but live many years beyond that, often free of serious interference from the cancer for the rest of their lives. Researchers have now figured out pretty well how to tell who needs treatment and how aggressive that treatment should be, though there are open questions yet to be answered.[/COLOR]

[QUOTE]His PSA was 4 when he had his yearly physical in Dec/2010. The year before it was 3.8.[/QUOTE]

[COLOR="darkgreen"]Both the score of 4 and the rise of only .2 in a year are clues that the cancer could be low-risk.[/COLOR]

[QUOTE]... The dr is trying to schedule him for a CAT scan and bone scan soon as possible.[/QUOTE]

[COLOR="darkgreen"]That's too bad - the doctor trying to set up the scans, I mean. :( In 2009 the American Urological Association came out with guidelines discouraging CT and bone scans unless cases had certain high risk characteristics. They gave those guidelines because both scans are almost always useless unless certain higher risk features are present. Perhaps that's the case - discussed below. However, if your son does not mind pressing the point, he might tactfully ask if getting the scans, in his case, is consistent with the AUA's "Prostate Specific Antigen Best Practices Statement" of 2009. That guideline is available to us patients.

One of the problems is that neither scan rules out cancer. For instance, a bone scan does not pick up the cancer until 10% or more of a spot on the bone is involved. What that means is that, with low-risk characteristics, it's very likely that little if any of the bone is involved, and the difference between that amount and 10% is almost always very small. In other words, say that around 15% cancer metastasized to bone is the practical upper limit for any patient with a PSA of below 10. (I'm using 15% as an example, I'm not sure what the real value would be, but it is low.) If the patient has the rare bad luck to have a cancer with 9% bone involvement, it is unlikely to show up. That means the real value of the scan would be for a metastasis affecting 10% to 15% of the bone. It's extremely unlikely for that to occur. (My PSA was 113.6, with a Gleason score of 7, a rock-hard prostate, a stage III assessment, but my CT and bone scans were still negative. That's common even for higher risk cases, though in those cases the scans are worth doing.) [/COLOR]

[QUOTE]I need to be moral support for him but this news has made it difficult to do right now. I asked my son if he had any unusual symptoms and he said the only thing he had noticed was difficulty totally emptying his bladder and lower back ache. He attributed his back ache to the 120 miles he drives each day to work and back. NO other symptoms. Is this normal? What is he facing now?[/QUOTE]

[COLOR="darkgreen"]The lower back ache could be what triggered the urologist's decision to get the scans. However, your son's explanation is certainly plausible, and it is extremely unlikely that the ache would be due to metastasis with such a low PSA, unless the Gleason were high, in the 8-10 range, as I see it as a now fairly savvy layman but with no medical education. [/COLOR]

[QUOTE]ANY suggestions you have will be sincerely welcomed.

Thanks for listening.[/QUOTE]

[COLOR="darkgreen"]There are a couple of books that are wonderful aids for orienting a new patient and family. One is "A Primer on Prostate Cancer - The Empowered Patient's Guide, by Dr. Stephen B. Strum, MD, and Donna Pogliano (2005, 2nd edition). The other is "Invasion of the Prostate Snatchers," by Ralph Blum and Dr. Mark Scholz, MD, 2010. There are some other books that are very simple and also useful, such as "100 Questions And Answers About Prostate Cancer", or something like that. If you have a good library system, it is likely to have these. However, the Primer has many forms for recording key information and places to take notes, so it might be best to purchase a copy. It's a great location to centralize notes about the disease. I recommend you steer clear of "Prostate & Cancer," by Dr. Sheldon Marks, MD. The version I read way back in early 2000 was helpful, but his edition of a couple of years ago was obsolete - he had made little effort to update his knowledge, especially regarding treatments other than surgery, and the book has a strong bias toward surgery that has been undermined by research over the past decade. :(

I'm sorry your life and your son's have been upset with the diagnosis, but trust that the situation is much better than you now think!

Take care and keep your spirits up,

Jim :wave:[/COLOR]

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