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Thread: prostate personality change

  1. #1
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    prostate personality change

    My brother recently had a prostatecomy and has never been the same since. I am a Clinical Psychologist and have noticed the significant changes. Of course I am aware of the environmental and social factors but these in no way account for this personalty change. He has become more hardened and less empathic and only interested in one desire, to build an aeroplane. This I do not object to, but it is his lack of human concern which worries me. I don't know if anybody else has experienced anything similar, but I would like to know.

    Robert Wojciechowski B.Sc. M.Sc. C.Psychol. A.F.B.P.S
    Consultant Chartered Clinical Psychologist

  2. #2
    Quote Originally Posted by derbyrobert View Post
    My brother recently had a prostatecomy and has never been the same since. I am a Clinical Psychologist and have noticed the significant changes. Of course I am aware of the environmental and social factors but these in no way account for this personalty change. He has become more hardened and less empathic and only interested in one desire, to build an aeroplane. This I do not object to, but it is his lack of human concern which worries me. I don't know if anybody else has experienced anything similar, but I would like to know.

    Robert Wojciechowski B.Sc. M.Sc. C.Psychol. A.F.B.P.S
    Consultant Chartered Clinical Psychologist
    Welcome to the Forum, Robert. If the surgery was recent and for prostate cancer, is it possible it was dealing with the cancer that has brought about this change and not the surgery itself? Have there been consequences from the surgery that are troubling him? It takes time to learn what the final outcome will be regarding ED and/or incontinence. Do you think those are factors in play? Have planes been a long-time hobby or is this something new? Perhaps you can use your skills to get your brother to talk about things.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg., then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day retest)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015
    08-28-19 (2 yr. ) 0.016
    Avg. = 0.013

  3. #3
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    Robert--
    I imagine he's feeling bitter about getting cancer and reflecting that outward.

    Some more info might help. Is he the older brother? Only one to get prostate cancer in the family? Was his treatment successful? Are you sure? How about side effects? Is he continent? Has he come bounced back from ED? Both side effect can be emasculating if not worked through.
    Age at Dx 57
    PCa History: Father, Uncles, Grandfathers

    Oct 2016 Biopsy 12 core: Adenocarcinoma, Gleason 4+3=7 Grade Group 3) w/PNI
    Left Lateral Base: Suspicious
    Left Lateral Mid: PIN
    Left Base: 4+3=7 (60% pattern 4) Core involvement 30% (5mm)
    Right Base: Suspicious
    Right Apex: 3+3=6 Core involvement 60% (7mm) discontinous
    Right Lateral Mid: 3+3=6 Core involvement 10% (1mm)
    Right Lateral Apex: 3+3=6 Core involvement 10% (1mm)

    Jan 2017 DaVinci - Dr. Grant Taylor - Pathology = pT2c or pT3a; Gleason 4+3=7; Weight: 42g

    Jun 2019 AMS800 installed - Dr. David Rapp - Jul 2019 activated

    ED: Light to moderate

    (Note: All PSA tests prior to Jun19 were done by LabCore)
    PSA_TESTS

    Apr 2016=5.1
    Jul 2016=4.7
    Aug 2016=5.13

    ----Surgery----

    Mar17<0.01
    Jul17<0.01
    Oct17<0.01
    Jan18<0.01
    May18<0.01
    Nov18<0.01
    Jan19<0.01
    Jun19<0.02

  4. #4
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    Quote Originally Posted by derbyrobert View Post
    but it is his lack of human concern which worries me.
    Robert Wojciechowski B.Sc. M.Sc. C.Psychol. A.F.B.P.S
    Consultant Chartered Clinical Psychologist
    What does that mean, "his lack of human concern". Was he involved in volunteer programs and now he is not? Or is he just not expressing the same feelings of concern that he had before?

    He just went through a life changing experience. Mortality is now very real and the brevity of life comes into sharp focus. I don't think anyone goes through this without some change.

    And it probably is not yet over in his mind. You are not certain of a cure for years. You might have to give him some time to get it sorted out.

    Most guys would say that the experience though has made them a better person overall. Strange but true.
    DOB 1955

    3/31/17 PSA 15.1
    4/5/17 DRE Negative
    4/7/17 PSA 14.1
    4/19/17 TRUS Negative
    5/1/17 Biopsy 12 cores
    RLB 3+4 30%
    RM 3+3 6%
    RLM 4+3 90%
    RLA 4+3 5%
    Left side negative
    5/26/17 Cat scan Negative
    6/7/17 Full body bone scan, Negative
    Decipher score .62 high risk
    RALP scheduled 6/28/17

    Final pathology report 7/28/17
    Prostatic adenocarcinoma with mucinous differentiation
    Gleason score 4+3 involving both lobes limited to the prostate
    Percentage involved by tumor 5%
    EPE -, SVI -, LVI -, LN -, PNI+, Margins -
    Pathologic stage pT2 N0
    PSA 8/4/2017 <0.1
    PSA 10/27/2017 <0.1
    PSA 1/26/2018 <0.1
    PSA 4/27/2018 <0.1
    PSA 10/25/2018 <0.1
    PSA 2/12/2019 <0.1
    PSA 8/25/2019 <0.1
    PSA 11/27/2019 <.006

  5. #5
    To the OP: I have no idea and nothing to contribute as far as your brother's cancer experience, but as someone who was a hang glider pilot for 13 years and also was involved, unfortunately, with the fatality side of kit airplanes and the Experimental Aircraft Association, building your own aircraft of any sort is an incredibly dangerous undertaking. Does your brother have years of experience building and flying aircraft already, or did this passion arrive with the prostate cancer? If the answer is the latter, then what your brother is attempting is the equivalent of him getting to the controls of a particle accelerator and trying to use it to cure his own cancer. I apologize for the drama, but building an aircraft is an incredibly complex and demanding project, and then attempting to learn how to fly ON a homebuilt aircraft is essentially suicide. The only good news here is that you are a psychologist, so at least you have a background to help your brother, provided he wants help. If you have any details about what he is attempting to build, you can PM me with the details, and I have a source that is still in the EAA side of aviation. My hopes and best wishes that your brother can recover from whatever psychological damage the cancer did to him.

    Best regards, DMW
    05/6/16 pre-op physical for surgery show low WBC & RBC
    5/22/16 [Birthday] Results of BM biopsy: AML 25% blasts with inv t(3:3) mutation, HIGH risk
    5/30/16 Undergo 3+7 chemo, but it doesn't touch AML, infections nearly kill me. Blasts 65%
    7/04/16 Diagnosis now Refractory AML. [:tombstone:]Six cycles of azacitidine, 21 shots over 7 days w/ 1.5" needle into gut + below navel.
    11/05/16 Move to NOLA - Infusion center 4 minutes away. 15 shots for 5 days with 5/8" 25 ga. needle Huge increase in quality of life.
    12/28/16 BMB shows blasts 12%
    4/16/17 BMB shows CD34 16%, cycles dropped to 4 weeks
    7/20/17 Diagnosis changed to "indolent leukemia", aka MDS
    7/27/17 BMB shows CD34 17%
    8/15/17 Venclexta chemo in PILL form added Onc estimates survival time now 2 - 4 YEARS.
    10/26/17 BMB results show 17/20 metaphases with inv(3:3) mutation-low blood cell counts - transfusions ineffective
    12/4/17 Diagnosis: Uncontrolled refractory AML

  6. #6
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    with reference to my brother

    I am immensely thankful for your reply. I suppose what I want to know is can physiological changes such as this bring about such personality changes. I haven't done an extensive search of the literature, but I don't think there is very much covering this. That is why I value every response I get. And I dearly thank you.

    Robert.

  7. #7
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    I cannot say how thankful I am for every persons reply. I will try to answer just some of the replies I have.

    I am a psychologist and not a medic. From what I know there are continuing issues regarding continence. These are things which he will not talk about. I wish I could talk to him about such issues but he is totally closed.
    Planes run in the family. My father was an RAF pilot in the second World War.

    He is not the type of person to talk about things like that. Which makes it even more difficult

    I am pretty sure he is not continent. Prostate cancer does not run in the family. You question as to whether treatment was successful is I think highly pertinent. I am not sure of the statistical facts but whatever, it must have a bearing on ones perception of mortality.
    Psychologically, I think this might be root of the problem.

    He always was the most caring, giving person you could wish to meet. Now he cares more about spanners and sanding machines than any human being. No contact with friends or anybody else.
    Yes I agree, I think that the realization of mortality has had a profound effect.
    Yes, building your aircraft is a very dangerous hobby, he has only taken it up since the surgery.
    He has always been obsessed with flying. He does not have years of experience in building aircraft and yes it does correlate with his prostate.
    Dear DMW. I am not sure whether or not to let him carrying on building his airplane or not. It is quite an obsession and I am sure he will get up into the air, for how long I don't know, but that might be enough for him.

    You can only help people if they want to talk to you, and he doesn't.


    So, where do I go?

    Robert

  8. #8
    Hi Robert,
    I rely dont think tbe procedure cod vause him problems. But the side effects from it could be getting to him. Incontnance and impotence are tough to deal with plus just having the cancer itself is hard to grasp early on for sure.

    I have had big changes in myself from hormone therapy and have been on it for seven years. The side effects of mood swings, depression and ED. Still gets to me. Its kind of like the new normal we have to live with.

    You would think after 7 years i would be an old hand at this stuff but in october i had a psa spike which in january ill have another psa done and scans. if it rises again their talking chemo. Actually this second time around is is no easier than the first. This crap aint easy.
    Thomas

  9. #9
    Moderator Top User HighlanderCFH's Avatar
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    Welcome, Robert.

    First, your father was (is) a wonderful man, a war hero. As with his associates over here that fought in WWII, he is a member of "The Greatest Generation."

    As for your brother, if there are profound physical side effects he is dealing with (such as the incontinence), it could be really freaking him out and causing him to react like this.

    I would tend to suggest that he receive counseling to help with potential psychological damage that he incurred as a reaction to his physical situation. How long has it been since the surgery?

    Continence almost always returns, but can leave a man really upset in the meantime. It can take months, or even longer than a year for urination to return to normal. So, perhaps there is a light at the end of the tunnel for him -- and that the easing of this problem might bring his personality back to normal.

    Wishing him the best -- and also reminding that as a direct relative, YOU might also be as risk for the disease. So be sure to have regular checkups to stay up on your PSA. HINT: Always have a PSA test BEFORE allowing the doctor to perform a digital rectal exam.

    Good luck to BOTH of you,
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  10. #10
    Quote Originally Posted by derbyrobert View Post
    My brother recently had a prostatecomy and has never been the same since. I am a Clinical Psychologist and have noticed the significant changes... but these in no way account for this personalty change.
    The changes that result from prostate cancer and more importantly cancer treatment certainly changes ones outlook on life. However, I had an experience that began long before my diagnosis and treatment.

    I started having some troubling prostate symptoms nearly four years ago, and had a biopsy a few months later which was negative, but turned out later to be a false negative... in other words, the biopsy completely missed the tumor.

    That was the beginning of a very rough year, and for the next two years I was prone to episodes of crying and my wife frequently told me that I was depressed. I have never had any psych or emotional problems, but spoke with my doctor and he pretty much dismissed the symptoms that I presented to him.

    Two years later another biopsy identified the tumor and I had a prostatectomy, was started on Lupron and the antidepressant Effexor, had a urinary implant and underwent two months of radiation. My life has definitely changed as a result of the treatments, but mentally I feel far better off than I did two or three years ago.

    I believe now that during those two years between the negative biopsy and the positive one and subsequent treatments that I actually did have a tumor growing in me and that it affected my personality and my mental and emotional state, perhaps chemically. I have never heard anyone else mention this, but what I experienced was real.

    Perhaps your brother is obsessed with his new project as an item on his bucket list. But maybe the cancer growing in his prostate actually affected his personality by means of a physical process.
    Last edited by RobLee; 11-23-2017 at 09:20 AM.

 

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