GREG'S LEGACY

Specialising in the human experience of Living with prostate cancer – warts and all

Would PCa Screening Have Helped Me

with 2 comments


Prostate Testing and Screening

I have been a contributer to Greg’s Legacy for a short period of time. I was diagnosed in March 2012 with advanced prostate cancer, Gleason 9 graded T3/T4 with 18 out of 18 core samples positive at between 80% and 100% PCA cancerous tissue also involving the lymph system.

Scans taken in March indicated that there was no spread of the cancer to the bones, lungs or liver at that time.

I had been suffering urinary symptoms since August 2011 which increasingly worsened until finally in late January 2012 I sought help which finally led to my diagnosis in March. After diagnosis I was immediately put on ADT ( Hormone therapy) to stabilise the spread of the cancer. My urologist believes that he has a chance to cure this cancer for me using ADT , HDR Brachytherapy and External Beam Radiation.

Due to my urinary issues I had to undergo a TURP procedure in May 2012 to correct my urinary symptoms before I could undergo the radiation treatments. I am almost ready to proceed with the brachytherapy hopefully sometime in September 2012 and am awaiting word from the specialists in Brisbane to confirm the dates.

At diagnosis my urologist made a statement to me after some interrogation of my immediate past 15 years including the fact that I had not been tested for prostate cancer for the past 14 years. He stated the following:  ” You have most likely had this cancer for at least the past 10 years when you have been symptom free”. As I was 64 years old at diagnosis that meant that this cancer may have been picked up when I was 54 years old if screening was the practice.

After receiving this news I was at first upset that perhaps if it had been picked up early I would not be going through this advance stage and its implications that I am now dealing with. However more investigation and wider reading by me on the effects of prostate cancer, treatment, side effects and statistics have slowly changed my mind to be more open on this subject and I offer the following to any readers who may be interested.

There is much debate in the prostate cancer world at the present time as to the relevance of screening men over the age of fifty or forty if there is a family history of prostate cancer. Having now read fairly widely on this matter it appears most of the controversy centres around two main issues. The first issue is the aggressiveness of the cancer that may be diagnosed and the second issue is the debilitation of the side effects of any treatment given to these men.

It is a well known cliche that most men if they live long enough will test positive for prostate cancer. Prostate cancer is in most cases a slow growing cancer and many men who have this type of cancer will never experience any symptoms and may die with the disease rather than because of it. It is interesting to read a quote from the discoverer of PSA Dr Richard Ablin who made the following comment. ” The PSA reading as a test is hardly better than a coin toss. It cannot distinguish between the two types of prostate cancer. The one that will kill you and the one that won’t.

Another piece of information I came across which I found interesting is the yearly prostate cancer death statistics in Australia. Approx 2900-3000 men will die from prostate cancer in Australia each year. Of these 58%  are men aged 80 or over, 82% are aged 70  or over and just 2.8% are aged under 60.

The main debilitating side effects from treatment of prostate cancer is incontinence, erectile dysfunction and ejaculation reversal. If you go in search of statistical data related to these side effects you will be hard pressed to find results from different studies that correlate with each other. Rather you will see wide variance of results such as between 15% and 60% of men experience incontinence one year after treatment or between 20% and 70% of men experience sexual problems one year after treatment. All forms of treatment from surgery to radiology, brachytherapy and other forms have the same widely ranging data figures.

Since I became symptomatic back in August 2011 and following my TURP procedure I now have a small taste of what it can be like to have incontinence problems and erectile issues. I have been unable to have sexual relations for nearly a year now and since the TURP I am still wearing pads and experiencing pain on urination.  I still have nocturnal urination issues  sometimes several times throughout the evening. I now know quite a few prostate cancer survivors personally who have advised me of their issues after treatment. A quick read through any prostate forum will reveal that incontinence and sexual issues are very common indeed and debilitating for these men.

So here I am looking at my situation at the present moment. The question for me to answer is, do I regret not being tested earlier so my cancer may have been found and treated easier? If I had written this article two months ago you would have found that I was bitter toward the medical industry for not advising or carrying out any testing during my 50’s. I was bitter that I had to become symptomatic for the cancer to be diagnosed and when it was diagnosed it is advanced. My thinking then was that,  “Man if only I knew back then I could have had it fixed easily”

Education and information is a wonderful thing as it has the power to change opinions and actions. I have since given a lot of thought to the question of “would I have been better off fixing this cancer back when I was say 54 yrs old”? My answer is really my acceptance to myself that things have worked out as they have and cannot be changed. Throughout my fifties I enjoyed a satisfying sexual life, I had no urinary issues and led a good life. At 64 yrs this all changed but I now understand more and I think to myself that perhaps, the past 10 years could have been a lot more miserable for me if I had treatment for the cancer back then due to these side effects.

So would screening for prostate cancer have helped me. I don’t think so and in fact may have led to a loss of quality of life that I enjoyed throughout my 50’s.  I am now satisfied that things have worked out for the best given this cancer is a reality for me to deal with right here and now, for better or worse. If in the next five years I do not die from something else, chances are that this cancer will run its course. In five years and a bit I will be seventy years old which puts me nicely into the statistics for prostate cancer deaths in Australian men.

Further Reference Reading

http://ses.library.usyd.edu.au/bitstream/2123/6835/3/Let-sleeping-dogs-lie.pdf

Lee aka Popeye

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2 Responses

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  1. I reckon your choice of HDR Brachytherapy and External Beam Radiation is the right choice for you. We must hope it works and you can rid yourself of the cancer – for now at least. All my reading indicates it is less damaging than surgery (RP) to remove the prostate.

    The only urological problems I have had came from the TURP. I have no incontinence issues, I have ejaculation reversal and limited ED recovery with erection but no elongation. I guess I will never know if that would have been repaired. So, don’t be too quick to blame the radiation as you have had a TURP as well.

    Your last paragraph mirrors mine when I say that, at least, I lived those years rather than survived them. It makes you appreciate what you have left because we cannot turn back time. Keep on keeping on …

    Greg Naylor

    28 July 2012 at 11:10 am

    • “”All my reading indicates it is less damaging than surgery (RP) to remove the prostate.””
      Interestingly, all my reading has suggested that there is no real difference.
      CHOP or BURN, the results are pretty much the same after two years, and I DO believe that all doctors perpetuate the same untruth about the FINAL consequences.
      NO – I am not happy with my situation after the big CHOP.. The result was instant and pretty final..
      We can fool around, but that’s about all. The car’s only been in the garage once since..

      The interesting thing is that EVERY man I have confided in, who has had the same CHOP Job, has declared the same consequences.. We dumb men don’t talk about it.. Is it because we see loss of sexual function as a slight on US individually.. Would it not be better for doctors to be up front and say, “…and there is only a slim chance you will perform as you did prior…”

      At least THAT way, we would not be ALL thinking “WHY ME” or more correctly “WHY US”, because the Bride has a big response to all that happens..

      So – why CHOP and why BURN.. The results after 2 years are said to be the same..
      CHOP = Removes…… BURN = Destroy…. |:-{ … Is there a difference.?????

      BURN – will give you a period to wildly catch up, if you like, but according to the official NSW studies (if I remember correctly) 80% will be adversely affected , either way.

      I won’t repeat my previous comments on what RADIATION does, but suffice to say that the choice of 50yo should be different to that of an 80yo… IMHO…
      BUT – losing those 50’s years as a couple, would be soul destroying, even if you genuinely believe “…It’s better OUT with a 95% guarantee of success.., than IN with the uncertainty of just how dead, that cancer really is..”
      ..
      .

      Peter

      30 August 2012 at 10:26 am


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