tell me about prostate cancer

[jamsmu]

we heard the bad news last night. FIL will have chemo treatment 5 days a week for 6 weeks, as recommended by his doctor. I'm not ready to read the medical journals yet...but terrified (selfishly) because i don't know if its hereditary.

I do know its considered curable or controllable and MIL said she understands this treatment should give him 10-15 more safe years.

Anyone with experience care to share?

Thanks.

[jbowman]

Julie,

I'm going out the door, but will post about my father's experience later. My dad has fully recovered. Hugs to you and your family!

ETA: My dad was diagnosed three years ago. They caught it early and operated quickly. He did not need chemo, and he made a complete recovery--he has been routinely checked since then and it hasn't reappeared. Sorry if this is TMI, but he used a catheter for awhile. My dad was able to run errands and get out of the house just days after his surgery (but he has a "go-getter" personality). In fact, he had DH and my uncle take him to Costco for the free samples just a few days into his recovery-LOL!

Best of luck to you and your family, Julie.

[bcky2]

my father just had surgery for his prostate cancer but they didnt get it all because it had started to spread. he will have radiation treatments for 6 weeks starting in jan. i guess the chances of that getting it all are very good and you do have alot of safe years afterwards. it is a slow growing cancer from what i have found out. as far as cancer goes it is better to get then most, not that getting any type of cancer is good. i hope that his treatments go well and that he is cancer free for many more years to come :)

[MegND95]

I will fully admit that I know very little on this topic. My Dad had prostate cancer several years back, and has made a full recovery from that. I know he did not have chemo for the prostate cancer, though. He is now facing a rather grim diagnosis from bladder cancer. But from my limited knowledge, the two are not related.

As you mentioned, this form of cancer is treatable. My Dad has been routinely screened since his initial diagnosis, so any problems were noted quickly.

Best of luck to your family.

[tarabenet]

Grandfather had it. Surgery/treatment was no fun, I'm sure, 'though he didn't give me the details. But it is an extremely survivable disease. I have heard that the majority of (American, at least) men will get it, if they just live long enough, and that it is a disease that men die *with*, not *from*.

From what I learned when he was going through it, there is probably a lot more about it that is environmental than hereditary, although that info may have shifted by now. I suspect that even if hereditary, by the time your DH might be at much risk, they will have moved a lot further toward a cure, and with minimal after-effects, too.

So sorry your family is facing this.

[ribbit1019]

Hugs Julie! I hope your FIL is able to recover with treatment!

Christy
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[phirey]

I'm a Urology PA and up until recently (maternity leave) worked with one of the top prostate cancer specialists in the Southeast, if not the country.

I can't fully answer your question without knowing his age, PSA, "PSA velocity" and Gleason grade (a score from the biopsy).

The baby is starting to wake, but let me type quick. Forgive typos and I'll try to come back and fix later:

Prostate CA is diagnosed by a biopsy -- this provides a Gleason score to predict the aggrssiveness of the cancer. The PSA is just a measure of the *inflammation* of the prostate, therefore it can go up for many reasons other than CA. But the *speed* that it goes up over time can be a clue -- the faster, the more likely it is cancer.

The reason I need to know his age has to do with the treatment options. Treatment options are sort of divided up by life expectancy.

As a very general rule, men in otherwise pretty good health in their 50s or 60s are best treated with surgery. Here I am a bit biased. (The assistant in this article is me: http://www.northside.com/news/releases/july0705-01.htm) Surgery on a Gleason grade 6 or 7 Prostate CA is usually considered a cure. As long as it has not spread outside the gland, the chance that they got it all is in the high 90s. If it has spread outside thegland, surgery can still be followed by radiation and hormonal chemo. Side effects include incontinence and erectile dysfunction. This is where my brag factor comes in -- laparoscopic prostatectomies are far less likely to have these side effects. Robotic laparoscopic prostatectomies are even more successful.
http://www.davinciprostatectomy.com/

Men in their 70s usually do well with radiation seed implants followed by external beam radiation. The cancer is usually cure for decades with this method, which is usually longer than a man in his 70s has to live. If radiation fails, the tissue is too messed up -- surgery is not really an option, so the patient can only fall back on chemo or castration. Side effects include radiation burns to the area, which can range from painful urination to abscesses.

Chemo is usually reserved only for men in their 80s or so. It is essentially chemical castrration. Prostate cancer "feeds" on testosterone, so taking it away with Lupron or other drugs that shut down production of hormones is the chemo of choice. Side effects are very similar to menopause, plus the man can grow breasts and suffer severe osteoporosis.

That's the nutshell without copyediting. Please let me know his age and what his urologist has said so far and I can elaborate. But no, chemo would not be my first or even second choice for my Dad...

HTH

[kboyle]

I hate being the black cloud. I really do.

I will admit like other pp that I don't know much about this subject, I do on the other hand like pp have dealt with it. My FIL found out in 9/02 that he had type 2 diabetes. In 11/02 he was diagnosed with prostate cancer. It was mid-stage at the time, but not terrible. He went thru tons of meds, a run of chemo and I think 2-3 surgeries. He did well for a while, but by summer 03 he was having lots of kidney problems, which from what I've learned thru this and thru school is normal. He had a catheter draining his kidneys from then on. I'm not positive, but I think the cancer had spread to his kidneys. They did scans of his body on a regular basis just to make sure nothing had spread further. In 12/03 the scans were clean, in 1/04 the scan showed that the cancer had spread to his bones, which they then told us was pretty bad. After a cancer has spread to the bones, things go quickly. He was starting to get weak after the end of summer 03, so by 1/04 he was getting around with the help of a walker. When the family med doc (who happens to be the dr for my in-laws, (sorry, 1 handed typing now, i'm bfing)my family, my bil's family, and my mil's 2 sisters & their families)got the results, he called them in and pretty much told them that this was IT. They decided to come home and not admitted to the hospital. The next day a hospital bed was delivered & hospice showed up. My family was living there at the time because we were putting an addition on the house and there was drywall dust everywhere & no heat. My SIL had also moved in after a BAD break-up from an 8 yr relationship, so it was definately a FULL house. Pretty much after the bad news hit it was an open house. My in-laws ran a landscaping/snow removal business so many old & new employees, clients, family and friends were in the house at all times. UGH, I hate to bring an even blacker cloud on the subject but DH just walked in and he got a phone call that a friend's father just passed away tonight from prostate cancer. OK, back to the story, a nurse visited once a week and hospice came by twice a week to do anything that he wanted done, one day she'd shave his face and give him a manicure, another day she'd give him a bath, some days she just sat around with us while we talked about some great memories. She was great, the nurse that visited on the other hand had an awful bedside manner. Well, she was great to him, but AWFUL to the family. Anyway...my FIL was doing pretty well considering his situation. He was still able to stay up and talk to old friends that stopped in, or get out of bed (with help) and play cards with us when no one could sleep (which we pretty much didn't do.) We threw the diabetes out the window and had milkshakes with every meal and he fell in love with my sons Gerber Berry Baby lotion. DS and my FIL would sit staring at Sesame Street for episodes on end. DS would push, poke and kick (he was 7mo at the time) at every painful spot on my FIL's body, but not once did he every try and give him back. He would just bite his lip and keep on holding or playing with him. Finally there came a time when he didn't have enough strength to get out of bed & then back in, it was just too much on us to get him around. By this time, yes only 4 weeks later, it was February and their lawyer, who happens to be a very close family friend was stopping in a lot to all the legal paperwork. We all new it was coming soon, but my FIL just wanted to hold out till Feb 15th, his 35th wedding anniversary. On the night of the 15th he was doing very bad, so bad that we called the priest to do a reading of the last rites. He hadn't spoken much that morning and was in a coma-like state that night. After the last rites (at 10pm) his breathing and heartrate seemed to get back to normal. The next day it was like the night before was a dream. My FIL was back to chitchatting & had an appetite again. He survived the day & night of his 35th anniversary! He even held my son and they did a little dance together :) We all got some time with him to talk, and the day went so well. The next morning things were pretty quiet. It was just my MIL, SIL, BIL, my husband, DS & me. BIL & DH were downstairs playing some video game, me & SIL were upstairs watching, so embarassing, but Blue Crush, and MIL was changing DS's diaper when my DH went to check up on his dad. At around 1:30p my FIL passed away, peacefully in his sleep. It was just 6 weeks at the most from when they found out that the cancer had spread to his bones. Because of the family business, friends & large family there there were 4 calling hours to visit. 2 on one day and 2 on the next. I've never seen so many people and flowers at any other wake. We were all READY for it to happen, even though it was only 6 weeks that he was home and critical it seemed like such a long time. The wake, funeral and after were all done in fine Irish charm. LOTS OF WHISKEY!! There was even a little porn...gasp, but that's another story :)

DH and BIL now get checked every year, even though you shouldn't have to get yearly checks till after 40, because of their father they now get it every year. It does make me nervous because it may be hereditary AND I have 2 sons also.

I'm sure that when diagnosed early it is totally manageable. I'm in ultrasound and while doing my externship we did lots of prostate ultrasounds on many men that were diagnosed and managed for 10+ years. I'm not really sure why in such a short amount of time (diagnosed in 11/02, passed a little over a year later in 2/04) this happened to my FIL, if it was due to the onset of his diabetes, or the fact that he kept on working till he found out that it had spread to his bones, or I don't even know what.

There are many sad things about this happening to my FIL but I think that the worst of them all is that he was only 54. My DS was the only grandchild (named after him) and he's missed our wedding, the birth of our 2nd son, my BIL wedding which was this past Oct, and they just found out that she is expecting this month!


Like I said, I hate being the bearer of a bad story, but I just wanted to share my experience. I'm sure that all will go well with your family, and will pray for the best.

[chiqanita]

Sorry to hear about your FIL. Hope all goes well for him.

FIL had prostate cancer in 1994. He had the radical surgery immediately. It was tough. DH stayed at his side for several weeks.

It's been over 10 years now and thank GOD FIL is fine. FIL healthier than ever and very happy. Doctors say it is hereditary and suggest all male offspring watch diets (eat lots of fruits and veggies), exercise and get check ups regularly to minimize risks.

[kensjen]

I'm sorry to hear about your FIL. But I agree with PPs, it is a very survivable disease.

My FIL and his twin brother were both diagnosed a few years ago. They both had surgery and are doing well. Your DH may want to be sure to have his well exams every year and have them check him, that was one thing my FIL passed along to my DH...as it can be hereditary.

Peggy covered all of the technical stuff and was a lot of help with her post. I just wanted to send some hugs and support. Try not to worry too much, he will likely be just fine.

[bcky2]

i totally dont want to hijack this thread but thank you for your information! it helped give me some insight to what is going on with my dad. thanks!

[713abc]

My mother's boyfriend (mid-sixties) just went through this. He considered all of the options, consulted the top doctors in NYC, and then decided his best option for living a long live was to have the radical surgery to remove his prostate, which took place a few weeks ago. He was a nervous wreck and very depressed leading up to the surgery, but once it was done he found recovery to be easier than anticipated, and was greatly relieved that they were able to determine it had not spread and no further treatments were necessary. Now he is on top of the world, so happy to have it behind him.

I was very relieved that was the treatment method he chose, because it seems to give the best chances of a permanent cure.

[phirey]

Sorry last night's post might have been a little discombobulated, it was DD's witching hour and I typed most of it one-handed! ;-0

Anyway, I realized from others' posts that I didn't address the familial factor. First let me say that the prevailiang theory is that ALL men, if they live long enough, will develop prostate cancer. A very interesting study was published where they did autopsies on every male accident victim in Detorit for a period of time. They found prostate cancer in men in their 30s (younger than most screenings occur) with a linear increase as men age. So now one argument is that a biopsy is just uncovering something that we statistically already knew -- that 40% of men over the age of 50 have prostate cancer cells. Most cases of prostate cancer represent one of the slowest growing cancers known. We usually tell patients that from time of diagnosis (by PSA, rectal exam, and biopsy) to the time it first starts causing symptoms is probably 15-20 years. That's why age is such an issue with treatment.

For example, a man in his 80s probably has other "comorbidities" as we call them, such as heart disease, hypertension, diabetes, or emphysema that will cause his death sooner than a newly discovered cancer will. So we frequently don't treat -- we do what's called watchful waiting. But a guy in his 40s with a diagnosis -- quite frankly we freak out. Usually a younger guy -- also African Americans for some reason -- will have a more aggressive/hereditary form. That's the kind that we worry about in families.

So if a man's father is diagnosed in his 70s or 80s, I wouldn't necessarily worry about him or his sons. Sure, he needs his annual screening, but so do all men. But if his Dad was diagnosed in his 50s or even 60s, and/or died quickly as the PP's FIL did, then those annual screenings are even more important.

Also, for the comfort of all the women here, there are new screening tests on the horizon, better than the PSA. The PSA really *sucks* as a screening tool but it's the best we've had. Think of it like breast self-exam versus mammography. Before the PSA, the only screening was rectal exams (and we know how much the guys love these!). At that time prostate cancer mortality was high because by the time a cancer was felt, it had a better chance of having spread. PSA screening has allowed for earlier diagnosis and earlier treatment, therefore incredible survival rates. So with the onset of newer testing, our DHs and sons will be even more likely to be caught early and treated quickly, so even familial cancers shouldn't freak us out.

I hope I'm helping and not just throwing confusing facts. Please email if you need clarification.

[BeachBaby]

First, Julie, I am sorry to hear about your FIL. I hope that he will have a quick and full recovery. It is a scary time, to be sure. My own FIL was diagnosed with prostate cancer probably 5 years ago, he had his prostate removed (he was in his mid-50s at the time) and he has fully recovered.

Peggy, if I may, can I ask a question about when men should start being screened? As I mentioned, my FIL was diagnosed in his mid-50s. They are, however, African American so I understand that increases my husband's own risk. He is currently 36. Will they do both a rectal and PSA, or just one or the other? Thanks for your help, the information you provided was clear and helpful.

[kss611]

Thank you for that information. My uncle who lives in Atlanta was just diagnosed with prostate cancer and I just forwarded your response and link to the article to him.

[phirey]

The American Urological Association says healthy men with no additional risk factors should begin screening at age 50. Screening should include BOTH the PSA adn the DRE (digital rectal exam). If there are additional risks such as family history or African-American, they should start screenings at age 40. So he get four more years before you get to start nagging! ;)

HTH

[nicoleandjackson]

JulieAnn--

The PPs have posted some great information above. I have five prostate cancer survivors in my family: my paternal grandfather, my step-grandfather, DH's paternal grandfather, maternal uncle, and my FIL (who also has survived testicular cancer). Three of the five were diagnosed in their sixties, and the other two in their seventies. All five have had the removal surgery and fully recovered. All of them have maintained excellent quality of life post-surgery.

Since my DH has cancer all over the place in his family history, he has well-visit exams every year (and has since his early twenties).

Sending good thoughts to you and your family, and here's hoping for a full and fast recovery for your FIL.

Nicole
Mommy of Jackson 4/30/02


Who's the Biggest Boy? It's Jackson!
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