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What happens after a prostate cancer diagnosis? Aug 24, 2022 | By Jennifer O'Hara (@jenohara)Comment receiving replies
@tonyinm From your photo, you look like a young man, I am 77. After my fatherr-in-law passed I asked my primary care DR why no prostate exams and PSA tests. The extent of a medicare wellness exam is driven by medicare and I suspect maybe the insurance industry. He made it sound like there are too many false and misleading readings. The risks associated with doing a biopsy of the prostate are quite high.
I definitely want to know if there is something going on there. At my age, I would probably have it removed before cancer could spread. I request the tests.
Replies to "@tonyinm From your photo, you look like a young man, I am 77. After my fatherr-in-law..."
@mazeppabob My understanding is that the PSA blood test is a crude measure for prostate cancer. The Digital Rectal Exam (DRE) is a better test for the cancer. The doctor feels for abnormalities or areas of hardness. My PSA was increasing with each annual exam so I was referred to a urologist. My PSA increased to 8.6 when I went back to the urologist. I had an ultrasound but that did not indicate a problem so I'm good until next year. The last PSA was 6. something. I've been taking Saw Palmetto on a daily basis. I'm actually looking forward to the next PSA to see if it has gone down even further.
Tony in Michigan
@mazeppabob Good afternoon. I am trying to recall the "discovery process" that my life partner, Jay went through at 70. How much information did the PSA test reveal? Enough to want to schedule a prostate biopsy which was done locally and revealed areas of concern. He chose to seek additional analysis and information from Mayo Clinic. That process was quite thorough and an MRI was used to determine if the cancer was contained in the prostate or had spread to other areas. At that time options were presented, one of which was chosen by Jay and that was surgery. He had to factor in the genetic reality that both his father and grandfather had prostate cancer.
Once the decision for surgery was made for much the same reasons as you outlined, he was included in a shared decision-making process as to how to proceed. He chose to reduce the testosterone with Lutron prior to surgery to hopefully ensure that the spread would be contained. After surgery and recovery, everything stayed positive for a couple of years only to reappear as his PSA climbed.
Further tests indicated that a small section of the cancerous tissue was accidentally dropped in the prostate bed. They chose photo beam therapy....30 days of it.....to remove the affected tissue. That was almost three years ago and he has had intractable PSA scores since that time. Early on, he went for a complete check-up every six months. Then it was extended to a year. And now....he doesn't have to return to Mayo for 2 years......just sends in his PSA scores every 3 months.
Hopefully, this recounting of another way to do things......will be helpful.
Do you have a genetic history of prostate cancer in your family?
May you be safe and protected from inner and outer harm.
Chris
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Hi Bob -
My primary described the Medicare "physical" as a hands-off wellness check. I have to schedule an actual physical to get complete exam. My husband has the annual prostate exam & PSA during one of his 4x a year diabetes check-ins.
If I was in Texas right now, I would poll the guys at Saturday morning coffee...hmm, I wonder how many would answer? FWIW, Medicare is great for some things like managing chronic conditions - asthma, diabetes and blood pressure - not so good for others like routine cancer screenings.
Sue