[Leica] Elder prostate wisdom

[Charlie Chan]

George,


I am very sorry to hear of your predicament. Whilst I don’t personally treat prostate cancer, as as surgical oncologist, one gets to know the basics about this. PSA testing is not a particularly reliable diagnostic test for prostate cancer (it is however good as tumour marker to monitor the disease in people who have already been diagnosed).

If your PSA is rising, it would be sensible to see an urologist. You will probably end with some more scans, such as an ultrasound and possibly MRI. Also you may end up having some needle biopsies taken of the prostate (a day or office procedure) for the pathologist to check. Many people having these tests for a rising PSA will have no abnormality after assessment.

If a high grade prostate cancer (using the Gleason score) is diagnosed, this needs taking seriously and will require treatment (surgery, radiotherapy or medical therapy depending on the stage of the disease). However, many men have low grade prostate cancer, which MAY not progress during your lifetime. In fact one will find that 50% of men who have died in their 80s will have an undisclosed, biologically insignificant prostate cancer, if a routine autopsy is performed.

I have enclosed a couple of articles below, which look at the conundrum of low grade prostate cancer.

http://www.health.harvard.edu/blog/prostate-cancer-lives-as-it-is-born-slow-growing-and-benign-or-fast-growing-and-dangerous-201308146604

http://www.bjuinternational.com/bjui-blog/is-gleason-6-really-cancer/

http://cancerres.aacrjournals.org/content/73/16/5163.abstract?sid=6c0fb31f-fc58-4bbf-ad44-ae9e67eaf77f


Feel free to email me off list and Good Luck!

Best wishes,

Charlie

www.charlie-chan.co.uk
Cheltenham UK


On 22 Feb 2015, at 11:58, Bernard Quinn <bjq1 at mac.com> wrote:

> 
> George,
> 
> I do not have any knowledge or wisdom to contribute to this conversation at all other than to wish you well on this journey. 
> 
> The bus metaphor may have another useful meaning here, namely that with the help of our friends and loved ones the best thing we can do on these journeys is to make our way forward as best we can a say at a time. 
> 
> Barney
> 
> Barney Quinn, WK3Z
> C: (301) 775-1386
> H: (301) 654-0938
> 
>> On Feb 20, 2015, at 6:06 PM, George Lottermoser <george.imagist at icloud.com> wrote:
>> 
>> So I had a PSA blood test at the request of my new "primary care" doctor.
>> First time I've ever had one of these PC doctors.
>> He ordered a blood test for PSA, Cholesterol, Blood Sugar
>> 
>> First PSA test was 4.1 in April, 2011
>> When enlarged prostate was diagnosed with digital exam.
>> All the usual symptoms you'd expect with an enlarged prostate.
>> 
>> Now, Second PSA test was 7.8 in February, 2015
>> 
>> My new young Doctor wants me to see a Urologist.
>> 
>> I'd appreciate any and all opinions re: current state of the art
>> for Screenings et al re: Enlarged Prostates, Pre Cancer, Cancer, etc.
>> 
>> I know we must have a lot of experience among these OLD LEICA NUTS
>> 
>> On or off list as you see fit.
>> 
>> Thanks,
>> 
>> Regards, 
>> George Lottermoser 
>> 
>> http://www.imagist.com
>> http://www.imagist.com/blog
>> http://www.linkedin.com/in/imagist
>> 
>> 
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> 
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