confused and scared

Fear
Don't feel stupid. We've all gone through what you're going through. You've done the right thing to ask for input. 4.0 seems to be the magic number, however, the velocity (per cent of increase over time) is significant. It's normal to feel a sense of panic, especially before test results are known. If you have PC, it is generally slow growing. There are options available to treat it. Most on this board have had it, treated it, and continue to live "cancer free". I also thought the end was near. I felt a sense of urgency to get my affairs in order. My wife and I had a conversation about my "pending death" -- Did she want to continue to live where we are now, or move back home? What should I sell? Will my illness consume all our savings? Then, there was the gut-churning waiting. Waiting for test results. Waiting for a doctor's appointment. And then searching for the "right" answer. Seeds? Radiation? Watchful waiting? Surgery? If surgery, open or robotic?

I had surgery during August, 2006 (I was 60 at the time). On top of that, another surprise -- they found I had bladder cancer in 2007. I had surgery for PC and BCG treatments for the bladder cancer. I have been living cancer free since the treatments. Of course, I have to undergo testing periodically to see if there are any surprises.

If PC is in your cards, I would imagine you caught it early which is in your favor. In battling this monster, you can choose your team (doctors), choose the place (hospital), and choose your "weapons" (treatments). You're in control. Everything is in your favor.

Good luck and keep us informed.

Tom

Anxiety, Large Prostate and 61
Like you I had all three. Like Trew recommends, I did up my med (Clinopin ... and old friend). A year and a half later I am rolling right along with a non-detectable PSA.

I found it helped my anxiety to focus on one step at a time. First I worried about the biopsy, then I worried about the biopsy results, then based on the results I started worrying about my treatment options.

IF you have PCa(and thats not for sure), you'll most likely have plenty of time to look at your teatment options. I rushed it a bit and all I wanted was the prostate removed. Don't do this ... take your time and do your research. Many of the guys on this site can be very helpful, and welcome your questions.

Best wishes.

Trew said:

More or less I think many of
More or less I think many of us had some of that fear when we first hear our psa was elevated. Take a deep breath, and maybe a Xanax and know that your psa is not that high.

In the waiting time- go do a little research on proton therapy- just in case. Proton therapy will probably give you the fewest complications after treatment.

In fact, do as much reseach now just in case you do have a positive biopsy. having done the research now, you will be in a better position to make a decision about treatment then while the emotional impact of a positive biopsy hits you.

Proton Therapy
Trew, I know that you are an avocate of proton therapy for any man that has been diagnosed with prostate cancer... please show unbiased documentation to indicate that it is better than other treatments.

confused and scared
We have all been there. Reading and sharing in this discussion group are good ways to get perspective about dealing with prostate cancer. My first advice - slow down and don't rush into decisions. Second, start learning as much as you can about pc. I see this disease in distinct stages, each with its own information and decision. After you get your biopsy results take weeks, maybe months, to understand everything about the terms and numbers in your biopsy report. Get a second opinion to interpret the results. Post your results in this forum and consider the responses.

Don't rush into a decision about further treatment, don't even consider further treatment until you feel you completely understand your biopsy report. If the report indicates you have pc, and we all hope it doesn't, you face the next decision: what to do. That opens up a whole new area of learning, asking questions, weighing options. But don't get wrapped up in those decisions and anxieties until you have to.

Good luck and keep us posted.

Over Cautious?
Hi, Kimber. We all understand your anxiety but I really wouldn't bo losing sleep over worrying about dying in the next few years...at least not from prostate cancer. PSA naturally increases with age and the BPH you described with your enlarged prostate is the most likely cause of an elevation. Frankly, I think your urologist is being overly cautious in moving forward with a biopsy. Besides, even if the biopsy comes back negative, it doesn't mean you don't have cancer...it just means that the needle missed it. From a urologist point of view I know many doctors want to err on the side of caution and it certainly helps their business development program as he is likely going to bill your insurance company about $5K for the procedure.

Even if they do find cancer it will most likely be the early stage cancer that is treatable by many options that all have 90%+ liklihood of getting it.

If you do decide to have a biopsy, you may want to look at having it done via the perineum instead of transrectally and the pain will be less and the probability of infection almost nil. Transrectally is easier for the doctor and it can be done in his office but, in my case at least, I found it very painful (even with a local sedative), and there was blood in my urine for about a week and in my ejaculate for about six weeks. Other than that, recover is pretty quick provided there isn't an infection but you'll be taking anti-biotics for that so it's not that big a deal.

Odds are very much in your favor that the biopsy will be negative and that your PSA is caused by an enlarged prostate which can be treated in a variety of ways,

Keep us posted.

Trew said:

More or less I think many of
More or less I think many of us had some of that fear when we first hear our psa was elevated. Take a deep breath, and maybe a Xanax and know that your psa is not that high.

In the waiting time- go do a little research on proton therapy- just in case. Proton therapy will probably give you the fewest complications after treatment.

In fact, do as much reseach now just in case you do have a positive biopsy. having done the research now, you will be in a better position to make a decision about treatment then while the emotional impact of a positive biopsy hits you.

CyberKnife vs. Proton Beam Therapy
Actually, after considerable research, I think CyberKnife (CK) is currently a better treatment for early PCa than Proton Beam Therapy (PBT). Kongo recently had CK treatment w/no complications whatsoever and I am going to have CK treatment w/in a month.

IMHO, CK is better than PBT for the following reasons:

1) CK only takes 1-2 weeks of 4-5 daily (or every other day) treatments vs 8-9 weeks of daily treatments for PBT;

2) you don't have to have to be fitted for a body cast to prevent movement during treatment for CK as you do for PBT;

3) you don't have to have a balloon inserted up your butt before each treatment for CK as you do for PBT; and

4) CK is less likely to have ED effects than PBT because it better targets the prostate and avoids the vascular bulb (which along w/nerves is critical to erectile function).

CK is a little more expensive than PBT if you have to pay for it out of pocket, but insurance coverage for CK and PBT is available, depending on your carrier. PBT has a longer track record with minimal side effects, but people do have some problems w/urinary incontinence or retention, ED and rectal bleeding w/PBT. CK may have some of the same effects over time, but anecdotal evidence suggests that it is less harmful than PBT.

So, if you're considering PBT for treatment, you should also looking into CK.

hopeful and optimistic said:

Proton Therapy
Trew, I know that you are an avocate of proton therapy for any man that has been diagnosed with prostate cancer... please show unbiased documentation to indicate that it is better than other treatments.

Take a look at the
Take a look at the Newsletter for tose who have finsihed proton therapy at LLU. Look at the lack of serious side effects most of these men lack.

here is a lik to the current newsletter:

http://www.protonbob.com/newsltr.asp

Other than that, what I beleive about the adventages of proton therapy is my opinion reinforced by many graduates of the program who are still shoot bullets instead of blanks, if they can even get that far. Nope not a perfect treatment, but the end results look far better to me than surgery.

Great book to start with
I can certainly understand where your mind is at this moment. While it may seem stressful, you have the odds on your side.

I would recommend Dr Patrick Walsh's book "Guide to Surviving Prostate Cancer".

After my biopsy results came back positive my head was swimming with what do I do now. I spent a great deal of time searching the net only to become more confussed with advice and articles promoting one option over all others. I came across Dr Walsh's book by accident and found it to be very well written and covers all stages from basic understanding PC to positive biopsy and what do I do now. It will help you understand where you are now and what you could expect along with many statistics. Surprisingly, a small number of men with above average PSA have positive biopsies. Of course, over time, the figures are much higher with 1 in 6 men getting PC during their lifetime.

Best of luck to you. You are not alone.

ProfWagstaff said:

I'll second that book recommendation
Dr. Walsh's book is a must have. I'll echo mtguy's recommendation heartily. The best feature is that there are chapter summaries at the start of each chapter so you can get quick answers to most questions and then read the "meat" of the chapters at your leisure. I found it very helpful.

Kimber, I understand where you're coming from. I'm the most laid-back guy I know. I'm so laid back that I make Perry Como look like he's on PCP but my diagnosis even kept ME up nights. It's easy to say "relax" but harder to do. Please remember that we're all here for you and this IS very survivable. Key step is early detection - and you're right where you need to be. Keep us posted when the biopsy results come back. I'm keeping my fingers crossed that you're one of the 12 out of 13 biopsies that comes back negative.

I'll second that book recommendation
Hi, kimber45. I'll third ProfWagstaff's recommendation. Be sure you have the newest edition; last year it was the 2nd, c2007. I'll add a much smaller "PC 101 survey course:" 100 Questions and Answers about Prostate Cancer, 2nd ed., which my urologist gave me. Again, there may be an updated version. But my hopes are, of course, that you won't have to crack either book. John in Seattle.