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Need Guidance What is this ?

 
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macomberk
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Joined: 22 Jul 2008
Posts: 1
Location: MA

PostPosted: Fri Jul 25, 2008 11:29 am    Post subject: Need Guidance Reply with quote

I am new to this forum and could really use some guidance and quite honestly comforting. I am 44 and was utilizing Flomax until it began working less effectively. I had blood work and a urine specimine taken last week and was notified my PSA was at 5.0. That was a disappointing shock and the reality kicked in. I have a biopsy scheduled, but I would like to know the top five questions I should be asking my doctor and/or myself. I'm scared quite honestly and don't know who talk to besides my doctor. Thanks for any guidance you can give me.
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ksplat
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Joined: 26 Apr 2007
Posts: 575
Location: Brisbane, Australia

PostPosted: Fri Jul 25, 2008 5:13 pm    Post subject: Need Guidance Reply with quote

Hello Macomberk

Welcome to the cancerforums. So sorry you have had to seek us out under the cloud of your health.
I am not familiar with your symptoms, I have a Bro with brain cancer. I have moved your post to the Pancreatic Cancer forum & can assure you you will receive the support, advice & comfort you are seeking.

Cheers, Angie.
_________________
Brother diagnosed with GBMIV Feb 07
Treatment: Radiotherapy, Temodal, Gliadel Wafers, Dexamethasone, Keppra, Dilantin, Clexane
Went to our Heavenly Father after a 19mth battle,, 47 years young.
23 Sep 2008
http://cancerforums.net/viewtopic.php?p=19227

"Without Faith We Have Nothing"
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Replicant
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Joined: 01 Nov 2006
Posts: 271

PostPosted: Fri Jul 25, 2008 5:58 pm    Post subject: the top 5 questions! Reply with quote

First, there's no need to assume you have prostate cancer! You have been on Flomax for something--BPH, I assume? That can elevate PSA. So can inflammation or infection. If your biopsy is normal, (negative for cancer) your doctor might try a course of high-dose Motrin and/or a powerful antibiotic, to see if that lowers the PSA.

IF your biopsy is positive for cancer, I would go straight to the bookstore and buy "Patrick Walsh's Guide to Surviving Prostate Cancer" (2007 ed.) That book will answer a lot of questions you didn't even know you had! Actually, even if you don't have cancer, it's a great guide to the prostate and what can go wrong with it.

IF your biopsy shows cancer, you will want to know these things:

* What was the Gleason score (something plus something)? This is the most important piece of information.

* What is the clinical stage (T1c, T2a, etc.)

* What percentage of cores were positive?

* What zones of the prostate were involved?

Write all this down at the appointment, or you won't remember. And get a copy of the pathology report.

With this information, your doctor can consult the Partin tables, and so can you. They're in Walsh's book and they're online. ***If you tell your doctor you've been reading books by Walsh and Scardino, he will know that he can give you more information than the guy off the street who thinks the name of the gland is "prostrate"!***

Partin Tables will give you an idea of the odds of localized cancer. Localized prostate cancer is highly curable by surgery or radiation.

Then you can start mapping out your course of action, and there won't be any rush. IF you have prostate cancer, it's been growing for years, and a few weeks to do some research and make an informed decision won't hurt at all.

Here are the treatments I know of:

*Surgery (open, laparascopic, or robot-assist lap)

* Radiation (external beam photons, external beam protons, protons AND photons, brachytherapy, combo brachy/external beam)

* Cryoablation (not done very much, by the way)

* HIFU (ultrasound treatment not yet available in the U.S.)

* Expectant management/watchful waiting--won't be a viable option for a young man, most likely


IF your biopsy is positive, research the above using books and authoritative websites like PubMed, Mayo Clinic, Johns Hopkins, Prostate Cancer Foundation, etc. Consult with physicians besides the diagnosing urologist. DO NOT rely on anecdotes ("this worked great for me, it will surely work great for everyone!"). Sketch out, on paper, the pros and cons of each treatment and what's important to you. Then make your decision and move forward with confidence.

But again, no reason to overly worry at this point! No reason to believe you have PCa, and IF you do, there's every reason to think it would be localized and curable.


I wish you well.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com
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