Prostate Cancer: A Survivor's Point of View
Prostate cancer is a disease you have to literally take into your own hands with research that leads to making the right treatment decision - for you.
Prostate Cancer-#1 Male Disease
It's a fact - prostate cancer affects many men.
So many that it's the number two killer behind lung cancer. However, it's the number one disease among all men. Some say that sooner or later, every male will have to deal with prostate issues. That's not necessarily so. Others say that it's a slow-growing disease. Not exactly true in all cases, either.
Here, we'll explore some of the facts and express a few opinions along the way about prostate cancer. You'll find resources for treatment options (yes, most of them), although our preferred choice was surgical removal (a prostatectomy) with the aid of a robot called the da Vinci and a very gifted surgeon.
So, if you're newly diagnosed or are well into the process, have a seat and check back often for updates.
Here, we'll explore some of the facts and express a few opinions along the way about prostate cancer. You'll find resources for treatment options (yes, most of them), although our preferred choice was surgical removal (a prostatectomy) with the aid of a robot called the da Vinci and a very gifted surgeon.
So, if you're newly diagnosed or are well into the process, have a seat and check back often for updates.
The Prostate: What It's All About
It's a muscular gland, actually, that only males have. About the size of a walnut, it normally wraps around a part of the urethra, which attaches from the bladder and leads out of the body for urination and ejaculation. The prostate gland helps by secreting a liquid and providing contractions during ejaculation as well.
As men age, the prostate begins to show signs of wear, too. It may become enlarged and interfere with normal function. It can also attract bacterial or non-specific infections that cause issues. In one out of six individuals, cancer may occur. At that point, it's time to start making decisions. These include surgery, radiation, and newer proton beam therapies. Some individuals may be advised to "watch and wait," meaning no action is taken immediately.
When you're out there seeking answers, you'll find much advice. Visit a radiation oncologist and he or she will push that specialty. Visit a urologist who specializes in open surgery and you might be steered in that direction. It's sometimes difficult to find someone to offer a balanced opinion based on your case. The rest is up to you...
As men age, the prostate begins to show signs of wear, too. It may become enlarged and interfere with normal function. It can also attract bacterial or non-specific infections that cause issues. In one out of six individuals, cancer may occur. At that point, it's time to start making decisions. These include surgery, radiation, and newer proton beam therapies. Some individuals may be advised to "watch and wait," meaning no action is taken immediately.
When you're out there seeking answers, you'll find much advice. Visit a radiation oncologist and he or she will push that specialty. Visit a urologist who specializes in open surgery and you might be steered in that direction. It's sometimes difficult to find someone to offer a balanced opinion based on your case. The rest is up to you...
How it all starts - the PSA test
PSA stands for prostate specific antigens. They're produced by the prostate gland and help keep semen in a liquid form. Very generally, those are also proteins that escape into the bloodstream and bind together or float freely. They show up in a specialized test that is performed on men, usually beginning at the age of 50 or 55. However, for those males with a family history of prostate cancer, testing often (and should) begins at age 40.
Numbers for PSA counts can vary, but most physicians agree that any number over 4 (at any age) may be cause for concern. Even low numbers may arouse suspicion if they show a significant rise in a short period of time.
Numbers for PSA counts can vary, but most physicians agree that any number over 4 (at any age) may be cause for concern. Even low numbers may arouse suspicion if they show a significant rise in a short period of time.
Biosafe Prostate Test at Amazon
The Biosafe test is an economical choice if you're in watch and wait mode (or can't get your husband to go to the doctor as often as he should -shame on him!). It should not be relied on as a physician replacement. Also, it's not for use post-treatment. However, to give you an idea of where you are with rising (or stable) levels, this is a good backup. (Gift wrapping not available - well, think about it.)
Biosafe Prostate Test, Purple (1 test)
Amazon Price: (as of 10/06/2008)
Next: The Biopsy
You're already had the DRE, since that's what usually leads to a biopsy. This initial procedure stands for "digital rectal exam." That means the doctor has used a finger (his digit, in other words), to get a feel of the gland through your rectum. Not especially fun, but nothing, really, in the big scheme of things.
If the doctor feels a suspicious area, he'll likely recommend a biopsy (even if the PSA test returns an insignificant number). This is done in a doctor's office or day-surgery clinic. A tube is inserted into the rectum (once again) and needles are shot into the gland to gather tissue samples. There may be as few as 6 or as many as 24 (rarely). The median number is 12. Most men report the sound of a rubber band with varying levels of sensations or pain. The area can be numbed or you can ask to enter "la-la land," although some physicians just charge right in (ours did).
These samples are sent to a pathology lab and studied under a microscope. Here's where it gets a little complicated. You can read more about that here:
Prostate Cancer Staging Basics
If the biopsy comes back positive, now you have to begin shopping for answers and an eventual solution. Believe me, it won't exactly go away.
If the doctor feels a suspicious area, he'll likely recommend a biopsy (even if the PSA test returns an insignificant number). This is done in a doctor's office or day-surgery clinic. A tube is inserted into the rectum (once again) and needles are shot into the gland to gather tissue samples. There may be as few as 6 or as many as 24 (rarely). The median number is 12. Most men report the sound of a rubber band with varying levels of sensations or pain. The area can be numbed or you can ask to enter "la-la land," although some physicians just charge right in (ours did).
These samples are sent to a pathology lab and studied under a microscope. Here's where it gets a little complicated. You can read more about that here:
Prostate Cancer Staging Basics
If the biopsy comes back positive, now you have to begin shopping for answers and an eventual solution. Believe me, it won't exactly go away.
Dealing with a Prostate Cancer Verdict
Well - the freight train has passed and now you're lying on the tracks. That about sums it up. You may already have set images about drooling, sexless old fools and now you're faced with that prospect.
Not so fast.
Take a few days to gather your thoughts. Don't, however, assume you have a lot of time here. As you begin to share your news (if you do), you'll hear two main comments:
-If you have to have cancer, this is the good one.
-It's always slow-growing, you have plenty of time to decide.
Wrong on both counts. First, no cancer is a good one. That's fairly easy to understand, right? Second, prostate cancer is not always slow growing. It can explode (although that's less common).
The next steps? Research. You can't do enough of it. Once you start visiting specialists, they make it even tougher as they're pushing their own deal. At times, you'll feel like you're on a used car lot (with absolutely no offense meant - substitute your word of choice).
However, you'll narrow down the choices as you gain knowledge and information. One day soon, you'll reach that important treatment decision. That's just how it works.
Not so fast.
Take a few days to gather your thoughts. Don't, however, assume you have a lot of time here. As you begin to share your news (if you do), you'll hear two main comments:
-If you have to have cancer, this is the good one.
-It's always slow-growing, you have plenty of time to decide.
Wrong on both counts. First, no cancer is a good one. That's fairly easy to understand, right? Second, prostate cancer is not always slow growing. It can explode (although that's less common).
The next steps? Research. You can't do enough of it. Once you start visiting specialists, they make it even tougher as they're pushing their own deal. At times, you'll feel like you're on a used car lot (with absolutely no offense meant - substitute your word of choice).
However, you'll narrow down the choices as you gain knowledge and information. One day soon, you'll reach that important treatment decision. That's just how it works.
The 3-Step Prostate Cancer Priority Dance
Doing the 3-Step (cancer, incontinence, dysfunction)
When those words - "You Have Cancer" - come out of your doctor's mouth, you set dire predictions.
1. Dysfunction
2. Incontinence
3. Oh, yes, I could die
In the days or weeks ahead, those three priorities begin to shift. It's fairly normal, of course, but eventually, they'll be reversed in your mind. You deal with it and know that all the horror stories you're now hearing from friends and family are a thing of the past. In many cases, all of these issues are resolved within a few weeks or months to a year. Rarely, some incontinence and dysfunction may remain for a few months longer.
By this time, you understand it's a small price to pay for taking on the battle against prostate cancer.
When those words - "You Have Cancer" - come out of your doctor's mouth, you set dire predictions.
1. Dysfunction
2. Incontinence
3. Oh, yes, I could die
In the days or weeks ahead, those three priorities begin to shift. It's fairly normal, of course, but eventually, they'll be reversed in your mind. You deal with it and know that all the horror stories you're now hearing from friends and family are a thing of the past. In many cases, all of these issues are resolved within a few weeks or months to a year. Rarely, some incontinence and dysfunction may remain for a few months longer.
By this time, you understand it's a small price to pay for taking on the battle against prostate cancer.
Helpful Prostate Web Sites:
When you're starting the information gather stage, you may find these sites helpful.
- Team Prostate
- New, but growing site with prostate cancer articles.
- Prostate Cancer Foundation
- Find the latest news as well as basic information
- yanow.net
- At "You Are Not Alone Now," you'll meet mentors/survivors and discover a wealth of information on various cancer treatment options.
- Prostate Anatomy
- Illustration of the Prostate Gland and surrounding anatomy
- National Cancer Institute
- News and Information on Prostate Cancer
- Us TOO International
- Us TOO International is an informative site and support network
Prostate Cancer Treatment Options Overview
Brief information on the various treatment options available today
With any cancer, treatment decisions are tough. The docs push their particular trade while the generalists won't give you an answer - it's up to you. You go back and forth among them: surgery? radiation? an alternative plan? Sometimes, preexisting circumstances will rule out one treatment or another. More often than not, it's a barrage of facts and fallacies, much like tire-kicking and choosing a new or used car.
Emotions are high, which makes logical thinking even more difficult. Of course, there is no logic to cancer, is there? Here, you'll find a list of options, followed by a brief description of each.
Emotions are high, which makes logical thinking even more difficult. Of course, there is no logic to cancer, is there? Here, you'll find a list of options, followed by a brief description of each.
Surgical Treatments
-Cryosurgery
-Perineal Surgery
-Retropubic Surgery
-Robot-Assisted Laparoscopic Surgery
-Perineal Surgery
-Retropubic Surgery
-Robot-Assisted Laparoscopic Surgery
Radiation Treatments
-Brachytherapy
-External Radiation Therapy (almost outdated)
-Laparoscopic Surgery
-Intensity Modulated Radiation Therapy (IMRT)
-Proton Beam Therapy
-TomoTherapy
-External Radiation Therapy (almost outdated)
-Laparoscopic Surgery
-Intensity Modulated Radiation Therapy (IMRT)
-Proton Beam Therapy
-TomoTherapy
Alternative Treatments
-Active Surveillance
-Herbal Treatments
-High Intensity Focused Ultrasound (HIFU-not available in the U.S.)
-Hormone Therapy
-Watch and Wait
-Herbal Treatments
-High Intensity Focused Ultrasound (HIFU-not available in the U.S.)
-Hormone Therapy
-Watch and Wait
Prostate Cancer Articles
Prostate cancer articles that cover a variety of issues and provide basic information
- patients.uptodate.com
- A comprehensive overview of prostate cancer diagnosis and treatment options
The Best Prostate Cancer Forums
- Healing Well Prostate Cancer Forum
- If you're facing the potential for - or have been diagnosed with - prostate cancer, the Healing Well forum features a great group of people who can offer support and advice.
- Prostate Center of Austin Forum
- Join in at this new forum for discussion and encouragement.
- The Cancer Forums
- Another popular forum where you can go to for advice
- Google Groups-Prostate Cancer
- You'll find some very helpful information here.
- HealthBoards
- Prostate Cancer Message Board
A Few Prostate-Related Tips
Just a few things we've learned along the way
--Saw Palmetto: Has been linked to the potential for masking a higher PSA rating. Yes, it may in some cases ease the symptoms of an enlarged prostate, but could potentially lead to a delayed diagnosis of cancer.
--Pomegranate Juice: it tastes pretty nasty, actually. Plus, there are some findings that it may interact with some antidepressants. Little testing has been done on other potential drug conflicts. This pomegranate article will tell you more about the juice and its benefits. We suggest apple and grape juices (as long as they don't come from China). These have superior antioxidant benefits that certainly won't hurt you!"
-Experts estimate that prostate gland removal, with cancer contained, still leaves the patient faced with a 3%-11% chance of recurrence.
-According to some experts, when there is no change in the "non-detectable" PSA count for two years post-surgery, the chance of return drops dramatically.
--Pomegranate Juice: it tastes pretty nasty, actually. Plus, there are some findings that it may interact with some antidepressants. Little testing has been done on other potential drug conflicts. This pomegranate article will tell you more about the juice and its benefits. We suggest apple and grape juices (as long as they don't come from China). These have superior antioxidant benefits that certainly won't hurt you!"
-Experts estimate that prostate gland removal, with cancer contained, still leaves the patient faced with a 3%-11% chance of recurrence.
-According to some experts, when there is no change in the "non-detectable" PSA count for two years post-surgery, the chance of return drops dramatically.
Recommended Robotic Surgery Sites
- Prostate Center of Austin
- Dr. Randy Fagin of the Prostate Center of Austin addresses the benefits of robotic surgery
- da Vinci Surgery®
- And from the source itself with a list of doctors state-by-state who are trained in robotic prostatectomies
- Find a da Vinci® Surgeon
- Search here for a robotic surgeon in your area.
Robotic Surgery Articles
Specific Articles Relating to Robotic Prostate Surgery
- Robotic Prostate Surgery
- Discover the benefits of this robotic procedure that is a growing "gold standard" for prostate removal
- Science Daily
- Article from Science Daily on Robotics and Survival Rates
Prostate Cancer Reading
Our Recommended Book List
Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
Dr. Patrick Walsh is a pioneer in nerve-sparing prostate surgery. His book, while a touch outdated, covers all the bases of this dreaded disease. (There may be an updated version available now.)
Amazon Price: (as of 10/06/2008)
Prostate Cancer for Dummies
Wouldn't you know that the Dummies series would cover prostate cancer? Still, it gets high marks and we all have to start somewhere.
Amazon Price: $14.95 (as of 10/06/2008)
A Primer on Prostate Cancer: The Empowered Patient's Guide
A primer that will also get you started down this confusing path of prostate issues.
Amazon Price: $19.77 (as of 10/06/2008)
Understanding Prostate Cancer
A newer release that encourages men to be tested beginning at age 40.
Amazon Price: $19.95 (as of 10/06/2008)
You Can Beat Prostate Cancer
A survivor details the many treatment options (with a focus on proton beam).
Amazon Price: $18.00 (as of 10/06/2008)
Prostate Cancer Blogs
These are brave folks who have become outstanding proponents of getting the word out about prostate cancer. Their stories are inspirational as many of them continue to fight this dreaded disease.
- David's Blog
- David from Kansas details his continuing fight and the great heart he has through this grueling and horrifying battle.
- Prostate Cancer Information Board
- Meet IdahoSurvivor
- Tony's Blog
- Tony bravely continues the fight.
Prostate Cancer Glossary
Growing list of helpful terms
-Benign Prostatic Hyperplasia (BPH): A non-cancerous enlarged prostate that becomes more prevalent as men age.
-Brachytherapy: Prostate cancer treatment using radioactive seeding delivered directly to the gland.
-Digital Rectal Exam (DRE): The physical examination of the prostate in which the physician uses a finger to feel for size and texture.
-Gleason Score: A combination of numbers based on the biopsy results that helps determine the extent of cancer in the gland.
-Prostatitis: An infected or inflamed prostate gland.
-Proton Beam Therapy: A radiation procedure that is able to target specific areas of the prostate with higher concentration with less impact on surrounding non-cancerous tissue.
-Staging: A combination of testing, evaluation and historical perspective that helps a medical team decide on cancer treatment or alternatives.
-TNM Staging: This process with levels of T1-T4 is a system of judging the extent of prostate cancer. Also includes grading for extent of lymph node involvement, if any, along with whether cancer has spread to other parts of the body (metastasis).
-Watchful Waiting: The practice of frequent PSA testing when the cancer may be slow growing or other health conditions preclude treatment.
-Brachytherapy: Prostate cancer treatment using radioactive seeding delivered directly to the gland.
-Digital Rectal Exam (DRE): The physical examination of the prostate in which the physician uses a finger to feel for size and texture.
-Gleason Score: A combination of numbers based on the biopsy results that helps determine the extent of cancer in the gland.
-Prostatitis: An infected or inflamed prostate gland.
-Proton Beam Therapy: A radiation procedure that is able to target specific areas of the prostate with higher concentration with less impact on surrounding non-cancerous tissue.
-Staging: A combination of testing, evaluation and historical perspective that helps a medical team decide on cancer treatment or alternatives.
-TNM Staging: This process with levels of T1-T4 is a system of judging the extent of prostate cancer. Also includes grading for extent of lymph node involvement, if any, along with whether cancer has spread to other parts of the body (metastasis).
-Watchful Waiting: The practice of frequent PSA testing when the cancer may be slow growing or other health conditions preclude treatment.
Robotic Prostate Surgery in Action
Dr. Ash Tewari of the Cornell Department of Urology and renowned expert in robotic prostate surgery presents a robotic procedure. This is Part 1 of 6.
You can find Parts 2-6 here:
Prostate Cancer Videos
You can find Parts 2-6 here:
Prostate Cancer Videos
Weill Cornell Robotic Prostatectomy: Introduction (1/6)
For more information contact Dr. Ash Tewari: ash@theehealth.com or (212) 746-5638. www.theehealth.com
Runtime: 6:25
5271 views
0 Comments:
Please Feel Free to Comment
If you have questions or comments about prostate cancer, please feel free to respond. We're happy to discuss any aspect of this disease.
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RickBasset
Thanks for the excellent lens! My father had BPH which made me more aware of prostate conditions and the need for more attention to prostate disease. your lens is very helpful! Posted March 26, 2008 |
Gary H
I went through the radical prostatectomy in early 1/2006 and PSA testing post-op was fine until a test in March 2008 was reported at 0.2 - previoous one in 9/2007 was <0.1. Haven't been to the doctor yet to fully understand implications due to no appt available as yet. I was wondering if there are some good web sites to visit or blogs where people have experienced this reoccurrence.
Thanks for any insights you can provide. Any responses can be sent to gholtze@comcast.net.
Posted March 20, 2008
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KelleyEidem
Thank you for your site, K. With prostate cancer being the #1 cancer for men, you've provided some valuable resources for many. Posted March 01, 2008 |
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One Final Note
We're not experts and not giving medical advice. Please consult a professional if you're experiencing problems that may be related to male health.
Special Thanks
- Hope Blossoms
- Thank you Hope Blossoms for letting us place the blue ribbon at the top of this Squid lens.
