Wait and Watch Urged in More Prostate Cases

[Nelson Vergel]

I recommend for everyone to read this really well written article. It’s pretty eye opening.

Too Many Older Men Are Still Screened for Prostate Cancer

Most have low-risk cancers and rarely benefit from treatment, a new study finds. Actively monitoring the condition is often the best choice.

www.nytimes.com

 

[henfab]

I am 57 years old and I take daily 5mg tadalafil and I don't have any problems with my prostate. Three years ago I was taking tamsulosin and it was not very helpful.

 

[SoxsRocks]

I am 61, was diagnosed with Prostate Cancer back in 2001 at that time my PSA lever was only 2.8 usually they don't start doing anything until it is 4.0. My father had prostate cancer for 30 years finally passed at age 92. Anyways when I was diagnosed my Gleason score was reading 3+4=7 I monitored my cancer every 3 months for a year then my PSA registered at 3.3 (still not alarming) but my Gleason score changed from 3+4 (7) TO 4 +3 (7) same score but more aggressive, so I weighed out the odds and took action. I wanted it out and it was still confined only to the prostate (had not spread) August lat year (2022) I removed it via nerve sparing Radical prostatectomy (robotic)
Long story short a year later PSA = 0 (Non-detectable)
I had 0 effects of incontinence after surgery but am dealing with the side effect of ED. Working on that with the PDE5's (Ceialis, Viagra) but not to happy with those, I Have ordered PT-141 in hopes that will do the trick
Anyways thanks for reading and keep in mind the PSA level is not 100% a guarantee accurate to if or if not you have cancer

 

[George9]

I could not read the NYT article since I don't have a subscription. Would you briefly summarize the results?

 

[tcmi]

I am 61, was diagnosed with Prostate Cancer back in 2001 at that time my PSA lever was only 2.8 usually they don't start doing anything until it is 4.0. My father had prostate cancer for 30 years finally passed at age 92. Anyways when I was diagnosed my Gleason score was reading 3+4=7 I monitored my cancer every 3 months for a year then my PSA registered at 3.3 (still not alarming) but my Gleason score changed from 3+4 (7) TO 4 +3 (7) same score but more aggressive, so I weighed out the odds and took action. I wanted it out and it was still confined only to the prostate (had not spread) August lat year (2022) I removed it via nerve sparing Radical prostatectomy (robotic)
Long story short a year later PSA = 0 (Non-detectable)
I had 0 effects of incontinence after surgery but am dealing with the side effect of ED. Working on that with the PDE5's (Ceialis, Viagra) but not to happy with those, I Have ordered PT-141 in hopes that will do the trick
Anyways thanks for reading and keep in mind the PSA level is not 100% a guarantee accurate to if or if not you have cancer

I had similar path, with RP done at 51. My PSA was only 2.6 yet the tumor was sized at about 20% of the prostate gland, and immediately adjacent to one of the two nerve bundles. A decision to watch and wait at 70 is a lot different than if you’re 50.

 

[tcmi]

Good article overall, and active surveillance can make sense in many men. But be careful about the details of their “argument,” that mortality in the “treatment group” was no better than the “surveillance,” group, while acknowledging that the cancer in the surveillance group is more likely to metastasize. Ask someone with metastatic prostate cancer about the quality of their life, and the side effects and pain they’ve experienced during a succession of treatments. Focusing the argument only on mortality misses an important point. So, yes, you can still live many years with metastatic prostate cancer due mainly to the many treatments available. But quality of life should remain an important factor. And even with all of the “over treatment” of PCA suggested by the article, we still have more than 100,000 men in the US die from metastatic prostate cancer each year.

 

[Marcel]

Quick question, more like opinion seeking or pointing to the right studies.

Testosterone doesn't cause prostate cancer, I think that's pretty clear now days. However they say if you have it could accelerate its growth(?) I've also heard that if you have prostate cancer testosterone might accelerate it. I've also read that most men have prostate cancer, some will die (not from prostate cancer) but in autopsies they found it. After considering all these, where does it leave trt? Will it accelerate it? Will it protect the prostate? How do the risks increase?

 

[tcmi]

Quick question, more like opinion seeking or pointing to the right studies.

Testosterone doesn't cause prostate cancer, I think that's pretty clear now days. However they say if you have it could accelerate its growth(?) I've also heard that if you have prostate cancer testosterone might accelerate it. I've also read that most men have prostate cancer, some will die (not from prostate cancer) but in autopsies they found it. After considering all these, where does it leave trt? Will it accelerate it? Will it protect the prostate? How do the risks increase?

I was on TRT until two days prior to my surgery. I resumed TRT six weeks after surgery (following a great pathology report and undetectable PSA).

 

[Marcel]

Wow! That's great stuff. Did the trt make it worse ? Or did it speed up the cancer? ( I know.. hard to tell)

 

[tcmi]

Wow! That's great stuff. Did the trt make it worse ? Or did it speed up the cancer? ( I know.. hard to tell)

I think it was relatively indifferent. My surgeon was well informed on TRT and had no issues with resuming as long as surgery went as expected (it did). A small part of my decision to have surgery vs other treatment options was a desire to restart TRT as soon as possible. When you have RP, your sensitive PSA result after surgery should be undetectable- if it’s not, there is cancer somewhere inside. With other treatments where the prostate is not removed, you can’t rely on the PSA test in the same way as a screening for reoccurrence. So I can now remain on TRT and I’ve got a very simple, yet highly accurate way to test for any recurrence.

 

[tnap]

I am 57 years old and I take daily 5mg tadalafil and I don't have any problems with my prostate. Three years ago I was taking tamsulosin and it was not very helpful.

Same here

 

[Systemlord]

Same here

My GP won’t allow daily Cialis, says it’s not intended for daily use. Maybe I’ll just take my blood pressure medicine twice weekly. I hate these dumba** Kaiser doctors!

Cialis reverses endothelial dysfunction, improves insulin resistance and lowers blood pressure.

Takeaway, daily Cialis is as needed.

 

[tropicaldaze1950]

My GP won’t allow daily Cialis, says it’s not intended for daily use. Maybe I’ll just take my blood pressure medicine twice weekly. I hate these dumba** Kaiser doctors!

Cialis reverses endothelial dysfunction, improves insulin resistance and lowers blood pressure.

Takeaway, daily Cialis is as needed.

I was in Kaiser Mid-Atlantic through my wife's policy after we married in 1995. I began to realize it was mediocre medicine when I started having more health issues in 2005, spending more time arguing and filing complaints. Left in 2012 when I qualified for Medicare from Social Security Disability. Then went on a Medicare Advantage plan.

 

[Systemlord]

spending more time arguing and filing complaints.

It’s definitely an uphill battle to get anything resembling quality care. Kaiser is the insurer and the provider, you’re fighting the insurance company who has it’s doctors on a short leash.

After 2000, something at Kaiser changed, for the worse.

 

[tropicaldaze1950]

It’s definitely an uphill battle to get anything resembling quality care. Kaiser is the insurer and the provider, you’re fighting the insurance company who has it’s doctors on a short leash.

After 2000, something at Kaiser changed, for the worse.

My wife loved Kaiser and still misses it. My former primary there left in frustration and went into private practice.

Are you going to an outside doctor for TRT? I know Kaiser won't prescribe T if you're even one point above 240, as told to me by other men who had to deal with their severely restrictive clinical standard.

 

[SoxsRocks]

I think it was relatively indifferent. My surgeon was well informed on TRT and had no issues with resuming as long as surgery went as expected (it did). A small part of my decision to have surgery vs other treatment options was a desire to restart TRT as soon as possible. When you have RP, your sensitive PSA result after surgery should be undetectable- if it’s not, there is cancer somewhere inside. With other treatments where the prostate is not removed, you can’t rely on the PSA test in the same way as a screening for reoccurrence. So I can now remain on TRT and I’ve got a very simple, yet highly accurate way to test for any recurrence.

I have had 3 PSA tests since my surgery and all have come back at 0.0000 or Nondetectable, I have resumed my TRT protocol to try and assist with my Erectile Dysfunction. An earlier post indicated that IF you already have prostate cancer Dr's will take you off it believing it does speed up the cancer, my cancer was contained to the prostate and removing it got it all and only eith that did the Dr allow me back on TRT

 

[Guided_by_Voices]

Wow! That's great stuff. Did the trt make it worse ? Or did it speed up the cancer? ( I know.. hard to tell)

The work of Dr Samuel Denmeade suggests that periodic pulses of high Testosterone actually fight prostate cancer. I think Madman posted something on this a while back. The obvious question is whether this would be helpful as a preventative. I don't know but I have started doing my split weekly dose as a single dose once every few months just in case. It shouldn't hurt and might help.

 

[Keepfit1]

I think it was relatively indifferent. My surgeon was well informed on TRT and had no issues with resuming as long as surgery went as expected (it did). A small part of my decision to have surgery vs other treatment options was a desire to restart TRT as soon as possible. When you have RP, your sensitive PSA result after surgery should be undetectable- if it’s not, there is cancer somewhere inside. With other treatments where the prostate is not removed, you can’t rely on the PSA test in the same way as a screening for reoccurrence. So I can now remain on TRT and I’ve got a very simple, yet highly accurate way to test for any recurrence.

By simple accurate way do you mean PSA.?

 

[Keepfit1]

I recommend for everyone to read this really well written article. It’s pretty eye opening.

Too Many Older Men Are Still Screened for Prostate Cancer

Most have low-risk cancers and rarely benefit from treatment, a new study finds. Actively monitoring the condition is often the best choice.

www.nytimes.com

It seems only prescribers can read the article?

 

[Jon H]

It seems only prescribers can read the article?

I think this link will show the same version of the article; just from the Yahoo site instead of NYT. Too Many Older Men Are Still Screened for Prostate Cancer