Do you know your risk factors?

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/1/2010 2:47 PM (GMT -6)   
There are a couple risk factors in the world of prostate cancer that I'd like to ask.

1> Do you know your risk factors before screening for prostate cancer?

2> Do you know your risk factors after diagnosis?

I did not know that I was a high risk man when I was screened. The primary reason is that no one had the disease in my family. I have a brother and a father still alive and there was no history. My father was the only male in his family and his father died at 60 from complications due to diabetes. This is a very real question when deciding whether to be screened. We have adopted sons and we have, as in my case, patients that are the first in the family to be detected. My brother and my father know they are at higher risk because of me. But I had no clue. Now my dad's issue is real and didn't rear it's head until after I was treated for advanced disease. I would ask the question "if you don't know what your risk factors are, should you error on the side of caution and be screened at a younger age?"

On the second question, Patients with a Gleason 6 low PSA, say 3.5, only one core of 16 positive 5% may appear to be an indolent case. But if their brothers had aggressive disease and they lost a father and uncle to the disease they are not a low risk patient and should consider intervention. This one did not apply to me, but if my brother, who is 51 get's those results, I would probably encourage intervention.

Your thoughts?

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 6/1/2010 2:41:49 PM (GMT-6)


daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 6/1/2010 3:39 PM (GMT -6)   
Tony,
I'm adopted and never had any desire to find my birth family, my wife did push for it for medical history reasons. Needless to say I now think it's a good idea.

I opted for PSA testing just because I knew that the DRE only finds fairly advanced cases, not because I knew of any familial risk factors.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04
05-03-10 1 week without pads


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/1/2010 3:46 PM (GMT -6)   
Great post Dave.
That was exactly what I was looking for. Many screening guidelines state "high risk" guys should screen sooner than the norm. I am wondering if it is worth while to pressure them to say "high risk or men who don't know their risk factors"...

I hope you noticed we share a lot in our experience with prostate cancer. I'm a 3b guy with bilateral SVI. You can do well just stay positive a try to take each step at a time. I am in remission after three years...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 6/2/2010 12:42 PM (GMT -6)   
I knew I was higher risk because my father was diagnosed with PCa when he was 52. I called my dad when I was diagnosed and his first response was "call your brothers." One doc said their chances are seven times higher than with no family history. My youngest brother, in his early 40's got looks of disbelief when he asked to be checked until he recounts family history. Now, he says, even his dentist starts reaching for a rubber glove.
Diagnosed at 54
PSA 8.7 Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7 Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09 Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5 T3b
Catheter out at 2 weeks no nighttime incontinence Pad free week 5
PSA 6/6/09 <0.1; 9/10/09 <0.1; 3/11/10 <0.1

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