My name is Jim; I’m 53 with a family history of PC, father and two uncles on father’s side; father died 10 years ago at the age of 78 from PC. I have had been diagnosed with BHP for the last 10 years. I haven’t been diagnosed with PC yet, will be getting biopsy on 21 Sep. at the VA Hospital in Boston.
The Urologist that I was using only did a DRE every other year and my PCP never did one, both are with my military HMO not the VA. I was on Cardura for the BHP but started to have high eye pressure and vision black outs. I was placed in the VA hospital for an evaluation for stoke, which was negative and was ask to stop the Cardura to see if things might get better, which it has. I did a follow up with the Urologist I had and he disagreed about stopping the medication but my urination problem get better also. He was also seeing me about a kidney cyst which he said was nothing to worry about. Well, at this time I thought that it might be a good idea to get a second opinion by the VA to see if my problem (blood in urine) was my kidney or my prostate. The VA Doc went over my info reading the ultrasound reports on my kidney and my PSA results then the DRE was done, she is going to redo all my blood work to get the results up to date in the VA system. She said that my prostate was enlarged on the left side and there was also a lump and with my last PSA of 1.4 and a family history she wishes to do a biopsy.
I have books on order to do my research, research!!
Jim, 54, 5 level Cervical Laminectory-2003, sclerotic lesions in hip found Nov 2006, GERD, 30% Carotid artery blockage, Kidney Cyst, Asthma, Eye problems, Prostate BPH, Tripling of PSA.
Meds, Tramadol HCl, Flexeril, Omeprazole, Nitrostat, Plavix, Albuterol, Saw Palmetto, Multi Vitamin Mens
You mentioned that the doc wants to do a biopsy. I highly encourage you to make sure she does. I had a routine physical (I'm 41) and the doc decided to do a DRE since I had only had one done 5 years earlier. I have no history of prostate cancer in my family but my dad does have kidney cancer (renal cell carcinoma). My doc felt a lump and ordered a PSA which came back at 1.4 (like yours). I was referred to a urologist who said he always performs a biopsy when a nodule or bump is felt during a DRE, regardless of the PSA results. Lucky or unlucky, depending on your view, 2 of the 13 core samples were positive for cancer. Luck in the sense it was caught early, unlucky I have prostate cancer.
Be sure to have the biopsy to rule out cancer, especially with your family history. If it comes back positive, you will have options for treatment and your journey begins like many of us on this forum. I have gotten a lot of good information and support from this forum. Good luck to you.
Thanks for the reply; I’m getting the biopsy there is no question about that. I just need an OK to stop my plavix, it only used for prevention since I can’t take aspirin, I don’t have heart problems. I’m trying to find out what type of surgery the VA offers? I think I know what type I would pick; the DaVinci with sparing is my first choice. A wait and see at my age is out of the question. I’m seeing this Urologist on the 9th and will ask a lot of questions on what type of surgeries are offered at that time. I just wish I didn’t have to wait unto the 21 Sept for the biopsy.
Jim
Post Edited (Jim-N1BRP) : 7/30/2006 8:05:45 PM (GMT-6)
I would attempt to get the biopsy done much earlier. If the VA can't fit you in, how about a urologist in the community
Reply:
I’m going to call them tomorrow and ask if there is an earlier date and to be placed on a standby list, so that if anyone cancels I will be called in sooner. I’m also going to tell them that I don't mine a weekend or night appointment. As for a community Urologist, can't do that with the HMO that I’m in. It’s my retired military HMO I have to use there doctors.
Hi Jim, Your journey begins... if we can help in anyway... just ask. There are a lot of postings that you can gain a lot of information from. We are all in this together... Helping each other on good and bad days. Please keep us up to date as to what transpires. Yes... the waiting is the worst part!! We blinked and it's been 7 months since we first began our journey. Take Care, Lee & Buddymama bluebird
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Buddy 53 RRP April 3, 2006 PSA 4.6 Gleason 3+3=6 T2a Confined to Prostate
I need to go over the journals and some more of the posts to get a good feel of what others have used for treatment and why. I will be seeing the Urologist on Tuesday the 9th and should have some news about my latest PSA and if a Free PSA was done. I’m trying to move up the biopsy date, the wait is indeed the worst part so far. The only questions I have for now is does anyone know or have heard about the PVP laser procedure? Plus is the main draw back of seeds, Brachytherapy, is you can’t have surgery after if needed?
Most surgeons will suggest that one draw back of opting for seeding first is it may eliminate surgery as a back-up option later. Secondly surgeons stress the point that if the cancer is contained within the prostate surgery will remove it immediately. These are compelling reasons, but you still need to explore the other options very carefully. Once the procedure is done is not the time to change your mind.
As you research you will find that all the procedures yeild excellent results. So unique to your own set of circumstances one of these techniques will be best. The one thing which is not reflected in the data is the emotional issue, and that is what we're here for; how do I feel about my choice and why?
Please keep us up-dated on your search, and ask lots of questions.
Seen the VA Urologist (NP) on 8 Aug my PSA jumped to 3.6 from a 1.4 on 11 May 06. I’m still scheduled for the biopsy on the 21st Sept but also on the cancellation waiting list to go sooner. The VA won’t do a FreePSA if the total PSA is below 4.0, being it would not be actuate. I was told that I would not get biopsy results until two weeks after the biopsy, that’s when they schedule the biopsy follow up visits. At that visit the doctor will also go over the treatment options, the Urologist (NP) I just seen said I might even be send to a near by hospital if need be. I hope with that statement that an option for robotic with nerve sparing will be offered. I have been reading the forum and “The Complete Prostate Book”; I also have two others to read. BlueBird, Lee & Buddy, I have a copy of your journal save.
A question I have is should I request a local with the Biopsy or just go with the numbing jell?
I had just the numbing jell for the 14 cores taken, and if I had it to do over again I might opt for the local. It was'nt unberable, but the 15 minutes that the procedure took seemed much longer. Now that I look back on it the less discomfort you have to deal with the better.
I must have the wrong urologist. I have had 30 cores taken (two biopsies) and neither time was a numbing agent used. I am jealous. Just my luck. Whoa is me.
If medicare pays 80% for the Robotic Laproscopic prostate removal, you would think that the VA would be on board with this procedure. It will be the standard of care before long. If your numbers are low, you might want to take the watchful waiting approach for a year or two. Changes in the bureaucratic/technical procedures may be worth waiting for. I did that for 4 years and it was worth it.
Swimom, I just read a good chapter in the book about what you just said, jell and local is the best way to have a biopsy done as you stated.
Steve, the funding for VA health care is so far different from Medicare. The VA picks the surgery team, with a resident, and the type of surgeries offered is by a case be case basis. I read that there is some research on the West coast that the VA is going in Seattle and San Francisco using the De Vinci. I’m not sure if VA Boston is doing any De Vinci research with Boston University Medical Center although Boston Medical Center does have the De Vinci they have only done about 70 surgeries to date. As for waiting until the VA will be doing the De Vinci if not offered is out of the question, with a PSA that tripled in just 3 months.
My husband went with the Brachytherapy treatment - if you have any questions, please don't hesitate to ask. We're 2/3 of the way through treatment - he's finished in October, 2006 and his latest results are very good.
First, I think I need to apologize to Steve for being a bit snappy; it was a bad health day for both me and my wife.
I just got off the phone a short time ago talking to the VA. Would you believe that they let the junior residents do surgery? I also asked if I wish to use a non VA doctor, if I could get the biopsy simples for a second view by a pathologist, they said no just a copy of pathology report. With this information I have been looking around and think I found a good doctor in my area that does Laparoscopy surgery.
Julie thanks for the offer but with my age of 53 yr, I think De Vinci or Laparoscopy might be my best pick. Although I might need you & Lee to post some information to help keep my wife’s mind at ease?
Jim - Definitely a local - BUT - make sure the urologist waits for it to take effect before (s)he starts snipping. My quack started immediately after he injected me, and the first 6 cores were unbelievably painful. After that I barely felt anything.
I seen my new primary last Thursday (7 Sept), I had to change my primary to get the Urologist I wanted. My PSA on this visit was still high 3.21, so the referral was given to see the Urologist, DR James Ellis. On Monday, I meet was DR Ellis, what a nice and caring doctor. We discussed the need for a biopsy and the different types of treatments, best for my age. He scheduled the biopsy for this upcoming Monday, 18 Sept, and I’ll get the results back by Friday. I have canceled the biopsy that was to be on the 21st with the VA since DR Ellis is the doctor I wish to do the surgery, if needed.
Jim. I'm glad you've finally found the right urologist for you and you really like that makes a big difference. Curtis and I met his DiVinci urologist Monday and we both liked him immediately. No surgery date as of yet since the doctor is on vacation for 2 weeks. If your wife would like to talk I know that I and the other wives would be happy to chat with her.Ellen
