Learn Me (unfortunately) Prostate Cancer

Yes, I know this isn't a medical board and none of you even play a doctor on TV, but I found out today my dad has been diagnosed with prostate cancer (or, as he will almost certainly call it, "prostrate cancer").  This is, unfortunately, my second round with cancer in the family in the past 18 months.  My mom passed from the same type of brain cancer John McCain had about a year ago.  Unfortunately, my experience with her is that nobody gives you a "straight answer" in the medical profession, at least when it comes to prognosis.  They tell you how they plan to treat it and that's about it.  They just assume you want the most aggressive treatment that's available.  Here's the thing: we, as a family, were collectively talked into treatment with mom that didn't really seem to prolong her life and cost her a great deal in terms of quality of life.   I don't want to make that mistake again.

So here's my current understanding, and I'm very much looking for correction/contrary information if it's out there.  Generally, assuming it's caught early, this is a relatively survivable form of cancer, with largely localized treatment that doesn't generally cause massive damage to other body systems.  

Two guys at my fire station had it. Both chose to have the thing completely removed. Both fully recovered and returned to work on the fire truck in 90 days or so. Both have full expectation that the problem is solved forever. 

(Unfortunately) I know something about this, but still no expert.  I was diagnosed with prostate cancer after several years of fluctuating PSA scores.  THe first biopsy missed it because the idiot only took six samples.  Second biopsy by a different doctor years later found cancer in 2 of 12 samples.  2 were pre-cancer and the remaining were normal.   THe doctor gave me information and a web site to visit.  I was not a candidate for radiation because I have Crohn's.  Radiation is hard on the gut.    I elected to have the surgery, because I didn't really want to keep having those damned biopsies.   Surgery went well and they fond no evidence that it has spread to lymph nodes.   He also got clean margins.  That was 7 years ago and my PSA scores are below detection.   BTW, the doctor offered no advice about surgery or not.  It was totally up to me.     

It is very treatable if it hasn't metastasized.  Also, some forms of PC are more aggressive than others.    Mine was the more aggressive type, so I felt better about the surgery afterward. 

The old saying is if you don't die from prostate cancer, you will die with it.    Typically it is very slow growing and depending on his age and health, your father  may just want to leave it be.                

Most of what little I know about prostate cancer is a result of reading a few articles about the recently revised guidelines for prostate cancer screening, which also delve into the reasoning.  It seems that in many (most?) cases, the prostate cancer treatment can be worse than the typically cancer itself, as its growth rate vs their age mean that they don't actually end up ultimately dying from the cancer anyway. Apparently monitoring it is often all that is really required.

https://www.cbsnews.com/news/new-prostate-cancer-screening-guidelines-focus-on-patient-choice/

My father was diagnosed 15 years ago, or so. He was in his seventies at the time and "leaving it alone" was one option. However, he chose to have his prostate removed and it worked. He'll be coming to Michigan from BC for a visit next week and is as healthy as any 90 year old can ask. When he was initially diagnosed he shared the news and his concerns with his curling buddies. Some of them laughed because virtually every one of them either had beaten it or were in the midst of going through it. If you live long enough you will get prostate cancer apparently. If your Dad has caught it early it shouldn't be a problem.

My dad was diagnosed about ten years ago; he always was sure he would die of it as his father and all of his uncles died of it. They gave him the treatment options and he chose the radiated beads; basically install radiated beads around the prostate to kill the cancer. It worked and he has been cancer free since. It had weird side effects and none of the kids could be near him for a certain amount of time and definitely couldn’t sit on his lap. Good options and if caught early they can beat it. Good luck.

In reply to spitfirebill :

How old is your father? What's his General State of health?

Ovid_and_Flem said:

In reply to spitfirebill :

How old is your father? What's his General State of health?

I had the cancer, not my father.  My father died many years ago from too much Jim Beam.  

There is an option to have it treated with implanted radioactive "pellets" that supposedly attack the cancer cells.

Radioactive seed implants are a form of radiation therapy for prostate cancer. Brachytherapy, or internal radiation therapy,

If you happen to be an electrician who occasionally gets called to work at a nuclear power plant, don't go this route...you can get into the plant to cause no one checks. But there is no process to get you out once you try to leave and set off the detectors. Might have trouble crossing the border also.

Pete

My dad had it almost 7 years ago, fortunately caught very early because he had a PSA screen after my uncle had it a year or so prior. Not sure on the details of my uncle's treatment but I know he had it removed. Dad went the lathroscopic surgery route and was more or less back to normal within a few weeks. Both were early-mid 50s, caught early, and in otherwise very good health. No issues since for either.

My grandfather got the radioactive implants when he got the diagnosis. He was 70ish at the time, died at 94 without ever having a another problem with it. 

I'll chime in for those just following along to learn something about prostate issues. I had a friend who died  (in his late 50's) from prostate cancer but never got tested myself figuring a heart attack would probably kill me first anyway based on family history. Here's my story.

I had a heart attack as expected @ 58 but knowing the mistakes my dad and other family members made thinking they just weren't feeling well and would lay down a while or whatever (they all died), I got a ride to the ER, slowly walked up to the counter, and told them I was probably having a heart attack but had no insurance. 15 minutes later I was in surgery getting stents installed.

Once out of the OR and back in intensive care I couldn't pee so they gave me a catheter, still couldn't pee later on so they gave me a Foley catheter which I was told I'd have until released from the hospital and went to a urologist.

Several days after being released I went to urologist $300.00 who removed the Foley. Now had the opposite problem and couldn't hold pee, so another Foley gets inserted and I'm sent home and told to get blood work. Blood work is $100.00 a pop. 

Couple weeks go by and blood work is back, I go for another office visit $300.00 to get results and another attempt at getting off Foley. Doc takes me in private office for "the talk"  and tells me in very sad tone my score is 14 and should be like 3-4. I tell doc I've always had "small bladder" and urgency issues and probably was a good thing in some ways since almost all my high school buds became alcoholics. Beer made me pee so frequently I never drank much, I'd nurse a beer all night at shows etc.   Anyway doc says wait a month and get blood retested, another $100.00. Here's some catheters in case ya can't pee again nurse will teach ya how to install.  I think "Great..., giant hootus straws, just what I always wanted". Sucks getting old but I guess it beats the alternative.

Next visit $500.00  doc says score down to 11 but in his "pretty sure you've got cancer" voice he says first thing to do is ultrasound. Having had them for other things like busted spleen I wasn't expecting this was going to be a magic wand up the butt experience, but, gotta do what ya gotta do right? Doc is shocked at the size of my prostate and says it's huge. I'm a small guy @ 135 lbs so this doesn't sound good. Then in his solemn "pretty sure you got cancer" voice he says I need biopsy to be sure and that'll be $800.00.

So I'm told it's no big deal and others who've had it done tell me no big deal, back to normal a day later. However in my case 2 days before a hurricane I had the biopsy from hell all the way from the pre biopsy enema that had me wishing I could reach a phone to call 911, through things crashing in the examination room during the procedure (while they're snipping my insides) to a week of recovering feeling absolutely miserable while preparing for hurricane, getting bashed by it, and the aftermath (I got hit pretty hard by Irma).

I was feeling so bad after the procedure I thought I should go to hospital but figured they were prepping for hurricane. Called doc & left message because office closed for hurricane. He called back from airport because he was bugging out. He said peeing blood clots is normal "if ya keep peeing blood and feel really bad go to hospital, your choice, I'm outta here".  A week later I started feeling better and kept feeling better, took a few weeks though. Lost a lot of roof shingles on my house, ins refused claim.

Meanwhile next office visit $300.00 the biopsy results are back with no signs of cancer, yay! But I get a lab bill for $1500.00 I wasn't expecting because I thought the 8 bills for the biopsy covered everything, wrong. Then they told me they wanted me to go back for blood work again within a year and make an office visit. The whole biopsy thing was sooo bad I've been avoiding going through the whole ordeal again so I haven't gone for the blood work yet, I'm overdue. It was worse than having a heart attack & heart surgery, but not worse than busted spleen.  I still haven't caught up on the mountain of bills from the previous heart stuff and urology issues so that's helping my procrastination also.

 Now I'm on Tamsulosin to help peeing but have had to use catheters 7 times since last urology office visit. I expect it'll only get worse with age and eventually I'll end up using Foley catheters. Foley is semipermanent with a bag strapped to your leg.

You'd never know the health issues by looking at me. I'm very active and in great shape for a 60 YO. Not overweight, balding or even gray. Today I worked, played basketball for a while, and push mowed 1/4 acre lawn. If I came ripping past your house on my 20 BMX bike in the dark you'd think I was a 14 year old trying to get away from the cops.

My next door neighbor (late 60's) has had prostate cancer for years, been on some kinda meds but I don't know what.

My dad found it early, did the beads, no problem. A really good buddy of mine faound it early, did the beads, did the surgery, did chemo, it metastasised into his bones, and he spent the next 3 years dying  horribly and painfully. Cancer sucks. Get tested. 

There is a frequently overlooked option called cryotherapy. They freeze it. 

Its completely non-invasive. My Dad had it done about 10 years ago- it worked brilliantly. He walked into the office and walked out same day- has never had a problem since.  He is like a poster child for cryotherapy.

At that time it was really rare in the US- almost only done in Canada. 

It is never recommended because it’s cheap- doctors, hospitals, and pharmaceutical companies all make less money.

Make sure you look into it. 

All I can add is this. My mom's fiance was recently diagnosed with Prostate Cancer, he is choosing to have it removed. Even though it hasn't spread to his lymph nodes or anything.  

He's also one of the top oncologists in the country.

Take from that what you will.