What 9 Types of Men Should Do About Prostate Cancer Screening

Prostate Cancer

The debate about prostate cancer omits an important consideration; a condition known as Peyronies Disease (PD). According to Johns Hopkins University, (Prostate Cancer Update, Vol 5 Winter 2000) men who have prostate cancer surgery have a 1000 fold greater risk of developing this disease as compared to the general male population. There is no satisfactory treatment.

PD is a disorder whereby a man develops scar tissue in his p---s, causing it to curve when erect. This often makes intimacy impossible and can be accompanied by excruciating pain.

Until I developed PD, I never heard of this condition. In frustration about the lack of objective information, I started an informational website. www.curepeyonies.net

Each email I receive describes a man, and often his partner, in a desperate situation with nowhere to turn. This medical condition should be factored in when discussing any issue related to prostate cancer.

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To screen or not to screen for Prostate Cancer

I was 74 when routine blood tests revealed that my PSA had risen to 7. A subsequent test showed a further increase to 11, so a biopsy was ordered. This revealed that the Prostate was cancerous on one side, had a Gleason of 7, but had not spread. Four of my maternal male cousins have Prostate Cancer, two have died so far. My maternal grandfather "probably" had prostate cancer but in 1940, there was no money to pay for tests so we never knew for sure. He broke his hip in fall, and died in the hospital.

I underwent 42 External beam radiation treatments. Six months after the conclusion of the radiation, a PSA was recorded at 19. Bone, and MRI scans showed a "suspicious" lesion on the L3 Lumbar vertabra, which was concluded to be metastatis. It was suggested that I start on Hormone Therapy (Zoladex 10.8 mg) to curb the flow of testosterone and bring down the PSA. It worked, the PSA immediately dropped to 2.5, and six months later was zero, where it stayed for two years. During these two years, I kept asking if there were some way to verify the suspicious lesion. Finally, a bone biospy was performed in May 2007. The result even surprised the surgeon - the lesion was non cancerous sclerotic bone probably caused from an injury. Two years of my life were influenced by the specter that I was inflicted with an incurable and fatal condition. That was tough.

On my last visit to the Urologist who was treating me with the Quarterly Zoladex injections, commented that he didn't think the lesion was ever metastis yet he continued to order the injections and was prepared to continue them.

I am thankful for the screening, and hope that all men after a certain age should be allowed learn of their conditions. PSA screening and even biospies are not as expensive as unecessary Zoladex injections.

I am a healthy 79 year old, now. My mother is 101 and still going strong. Lives in her own home and is sharp mentally, has a good memory. I'd like to do as well.

Good luck to all you guys who are concerned about your health. Get any test that might alert you to a possible adverse health condition.

George Jacobs

CA-125

To Frank of CA: So sorry to hear that this happened to you.

Your second from last comment is very true...the article does give the wrong message. It is the same thing with the CA-125 (cancer antigen) test for ovarian cancer in women. This test was once thought to be a standard for ovarian cancer, but it is now only used in patients who actually have ovarian cancer.

Apparently the CA-125 can be elevated when you have other types of cancers and even some other non-cancerous conditions so it is not a good indicator for ovarian. Since cancer is so prevalent and many are silent killers, why aren't we all screened with the CA-125 test on a yearly basis just as a precaution even if we are asymptomatic? What difference does it make that it catches other types of cancers, or other non-cancerous conditions (in men and women alike)? It is a sign that something is wrong with your body that warrants further testing. I'm sure the answer to this will involve the words "cost" and "insurance"!

TO TEST OR NOT TO TEST

NEVER IN MY LIFE DID THE DIGITAL EXAMINATION INDICATE THAT I HAD A PROSTATE PROBLEM. ALSO, I NEVER HAD A PROBLEM PEEING.

ABOUT 1990, I READ AN ARTICLE SUGGESTING THAT ANY MAN OVER 50 SHOULD HAVE THE NEW PSA TEST.I WAS 64 AT THE TIME.

I MENTIONED THIS TO MY DOCTOR AND WAS INFORMED THAT THE TEST WAS ONLY RECOMMENDED IF ONE ALREADY HAD A PROBLEM. THE DOCTOR, IN AFFECT TALKED ME OUT OF HAVING THE TEST.

IN 1994, A FRIEND OF MINE WAS DYING FROM PROTATE CANCER. WITH A NEW DOCTOR I LIED AND INDICATED THAT I HAD A PROBLEM. HE ORDERED A PSA WHICH CAME OUT 17.6 WITH A GLEASON OF 8.

SUBSEQUENTLY, MY UROLGIST DID A BIOPSY WHICH INDICATED THAT I HAD PROSTATE CANCER.THE UROLOGIST SAID THAT HE THOUGHT THAT THE CANCER WAS ALL CONTAINED WITHIN THE PROSTATE. I LEARNED THEN THAT THE GLEASON OF 8 MEANT THAT THE CANCER WAS AGGRESSIVE.

I WAS 69 AT THE TIME. MY FATHER LIVED TO BE 100. THIS WAS DEFINATELY NOT A CASE OF WATCHFUL WAITING.

AFTER THE SURGERY, IN JANUARY 1995, TO REMOVE MY PROSTATE, THE UROLOGIST SAID THAT HE WAS SORRY AND THAT THE CANCER WAS NOT ALL CONTAINED.

AFTER A COUPLE OF YEARS, THE PSA BEGAN TO RISE.I UNDERWENT A SERIOUS OF RADIATION TREATMENTS WHICH BROUGHT THE PSA BACK TO 0.

THE PSA HAS SINCE RISEN TO .04. I AM IMPOTENT. I AM NOT INCONTINENT. HOWEVER, I AM 81 YEARS OLD AND ALIVE.

THAT FIRST DOCTOR, IN 1990 DID ME A TERRIBLE DISERVICE. THAT IS WATER UNDER THE BRIDGE AND BEST FORGOTTEN.

HOWEVER, THE ABOVE ARTICLE GIVES THE WRONG MESSAGE ESPECIALLY TO MEN WHO ARE RELUCTANT TO HAVE ANY TESTS INCLUDING A PSA.

MY ADVICE TO ANY MAN WHO OVER 50 IS MAKE DAMN SURE THAT HE KNOWS ALL THERE IS TO KNOW ABOUT HIS OWN HEALTH AND ESPECIALLY THE CONDITION OF HIS PROSTATE. NEVER RULE OUT THE PSA.

Prostate cancer screening

Adam Voiland's article about nine types of men at least puts some reasonable decision points into the mix. Following the more superficial articles and deciding not to get screened is like playing Russian Roulette with your health. And since many of us men would rather not interact with any doctor, articles questioning PSA screening are invitations for us to continue to neglect our health.

There are more sophisticated PSA tests available, and some good ways of interpreting the old one. For instance, a more-than .7 yearly rise in PSA (called PSA velocity) should be a cause for further tests - in fact, a very good argument for a biopsy. That's how John Kerry's cancer was found - he never got above the threshold of 4.0. If your internist or urologist doesn't know about more sophisticated tests or PSA velocity, change doctors. If you're diagnosed and your doctor recommends surgery - and has little experience with nerve-sparing - change doctors. Nerve-sparing surgery is one way to prevent erectile dysfunction.

I would recommend that all men get a digital exam and PSA test by age 45 (40 if African-American or with a family history) as a baseline.

Metastatic prostate cancer can be treated but not cured. There are some palliative measures to reduce pain and delay the spread, but side effects are nasty. In fact, the progression toward inevitable death can be very nasty - pain, broken bones, and more. "Watchful waiting" of early stages can turn out to be a cruel joke.

Yes, some men with early-stage cancer are treated unnecessarily. But tests are getting better. And if we keep our heads buried in the sand, who knows what is going on with the rest of our bodies?

Personal data: Prostate cancer survivor after surgery. Journal is at www.menletter.org/articles.htm.

What actions can change your risk of prostate cancer

As an example, if a woman breast feeds her children, vs bottle feeding, her risk for breast canced drops significantely. A use it or loose it syndrome.

Can the freequency of sex change risk of prostate cancer. Say someone that has sex daily, vs someone that has sex weekly or monthly. In the later example sperm and semen that is generated has to be reabsorbed by the body, while the first case the substance is naturaly voided from the body as designed. I've never heard a discussion of this topic.

Selecting a doctor

As a 74 year old caucasion with no known history of prostrate cancer in my family: when I began having prostrate problems in the mid-forties I found a urologist with a good surgical reputation for prostate cancer. About 30 years later, with a PSA reading around 10 for most of those years but with a negative biopsy, I recognize I would have been better served by a urologist with a good diagnostic reputation. As a result of my decision, I suffered for many years from prostatitis. I can see from reviewing the track record, prostatitis was simply out of my urologist's field.