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Old 05-15-2013, 07:38 PM   #1
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Prostate cancer and Sportsmobiles

Ok, this has nothing to do with Sportsmobiles. If you are not concerned about prostate
cancer just close this thread and go to another topic. This is not intended to scare or
upset anyone, but with over 30,000 men dying every year from this disease this is an
important subject and much of the information I share here was not available anywhere else.

1 man in 6 will suffer from prostate cancer. 1 in 6!! I am one of the unlucky ones. My
diagnosis started with a routine PSA test that was slightly high (4.6 vs. 4.0 max limit),
followed by a biopsy and some worrisome days. There are many on this forum that are or will
be in the same boat. If you or someone you know is suffering with this disease I will offer
some observations that may help you through the first couple of months. My dad went through
this 20+ years ago, we never talked about any of it until I was going through it - then he
said my experiences mirrored his.

I spent hours talking to doctors and learned about treatments and complications - but
nothing about how it can affect your day to day life. There is a book, Prostate Cancer for
Dummies. Get a copy and read it. It is a very good reference on the subject


There are 4 main options for prostate cancer:

- Surgery to remove the prostate

- External beam radiation to kill the cancer (and adjacent tissue)

- Implanted seed radiation to kill the cancer (and adjacent tissue)

- Watchful waiting. Keep an eye on the cancer, but do not treat.

Watchful waiting is primarily for patients who's tumor is not expected to be a problem
before the end of life. Very slow growing tumors and older patients.

Generally younger, healthier patients choose surgery. The prostate is removed and biopsied.
If you choose this option you will have a answer as to the whether all the cancer was
removed or not.

Generally older or less healthy patients opt for one of the radiation treatments because it
is easier on the body and doesn't have the physical recovery issues.

There is no Chemotherapy for prostate cancer. Generally, Chemo kills fast growing cells
(most cancer, hair) and prostate cancer is slow growing. Prostate cancer that has spread
beyond the prostate is not always treatable. If you are in this condition, you and your
doctor have difficult decisions to make. You have my sympathy.

If you choose treatment, start the Kegel exercises as soon as possible. These exercises
strengthen a muscle that is needed to close off the urine flow, a task the prostate handles
until it is removed or damaged by treatment. The muscle is the same muscle that women use to
control urinary flow. It takes about 3-6 months to get reasonable bladder control after the
exercises start. After the 3-6 months you probably will no longer need to wear diapers, but
you may still need some form of incontinence control (underwear pads). The sooner you start
the Kegels the sooner you will have urinary control.

For multiple reasons I chose to have surgery instead of radiation. This is a choice you need
to make with help of your doctor. Your preference may be different than mine. The success
rates for the 3 forms of treatment are nearly identical, your decision will be based on
factors other than the prospects for a positive outcome.

Since I had surgery, I can not comment on recovery from radiation. Perhaps there is someone
else on the forum that can discuss external and implanted radiation.

Here are some thoughts about pre and post surgery.

If possible, schedule surgery late in the year. Diapers will be needed until you regain
control of your bladder. Diapers are basically plastic and waterproof. In moderate weather I
found myself sweating in the diaper. I cannot imagine wearing a diaper in hot weather. Since
prostate cancer is slow growing it is usually acceptable to postpone treatment for a few
months. I had planned on hiking to the bottom of the Grand Canyon and back up in one day, so
I put off treatment for 3 months, until after the hike. I'm glad I did because I lost enough
muscle during recovery that I don't think I could do the hike now. And I suspect at my age
(66) it will take a year or two to rebuild the muscle and stamina to do that strenuous hike.

Even with minimally invasive Robot Assisted Laproscopic surgery (even more so with
conventional surgery) you will have very sensitive abs. By doctor's orders I could not lift
5 lbs. for 3 months. I was unable to get into or out of bed by myself. And laying flat
(stretching my abs) hurt so bad I refused to go back to bed. In order to be able to get up
and down by myself and sleep sort of comfortably I rented a reclining chair. Using my arms I
was able sit down on the recliner, lean back and sleep in reasonable comfort. And I could
use my arms and legs to get the recliner upright and then up and out of the chair. After 1
month I had recovered enough to get back into my bed. My strongest advice is: If you opt for
prostate surgery, have a recliner ready before surgery. I cannot even imagine post surgery
recovery without having the recliner.

You will leave the hospital with a catheter for a couple of weeks. Sitting (essentially on
the catheter) is painful. I had to sit on open centered pad to take the pressure off. After
the catheter was removed I was still quite sensitive for a couple of months. Sitting on two
pillows, one under each cheek will make it more comfortable. You will need adult diapers
when the catheter is removed, and until you gain bladder control. Start those Kegels early
for a faster recovery.

During the first 3 months after surgery you may be physically restricted. Watch your diet!
With the reduced activity, I gained 20 lbs. in 3 months!! Nothing to do but sit around and
eat. Getting the weight off is very difficult for me.

After you have enough control to stop wearing diapers you can resume most normal activities.
I was told NO bicycle riding for 6 months. I'm not sure if a special, two pad, prostate safe
seat would reduce the downtime or not. For sure a normal bike seat is quite painful after 5
months.

Good luck with whatever treatment you choose.

If you have any other questions or concerns, feel free to PM or email me using the buttons

below.

Mike

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Old 05-15-2013, 08:12 PM   #2
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Re: Prostate cancer and Sportsmobiles

I heard or read somewhere that "most men don't die OF prostate cancer, but most men die WITH prostate cancer". Keep up the fight
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Old 05-15-2013, 08:19 PM   #3
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Re: Prostate cancer and Sportsmobiles

Great information Mike,
It is good to have people that have or had cancer offering to help others. I have been helping two friends of mine that were diagnosed with cancer and they say it has helped a lot, we talk or email often.

Thanks Mike,
Woody
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Old 05-15-2013, 09:08 PM   #4
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Re: Prostate cancer and Sportsmobiles

Quote:
Originally Posted by twogone
I heard or read somewhere that "most men don't die OF prostate cancer, but most men die WITH prostate cancer". Keep up the fight
That's what my doctor told me when I mentioned that my dad had undergone prostrate cancer treatment.


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Old 05-16-2013, 06:31 AM   #5
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Re: Prostate cancer and Sportsmobiles

Had prostate cancer 3 years ago.

The book my urologist gave me to read about options was: "100 Questions & Answers About Prostate Cancer", second edition.

One of the guiding factors treatment is ones age and health. Prostate cancer is in general a slow growing cancer and many men will die of old age rather then cancer.

I also was lucky. My PSA had been less then 1 for several years. Then in one year it jumped to 3.8. My GP was concerned about the one year sudden increase. So to the urologist I went and had a biopsy taken. 6 out of 12 samples (samples taken from all over and in the prostate) had cancer. Because of my age and very good health history it was judged that there was a very good chance I could die from the cancer before old age. Therefore "watch and see" was not a good option

The course of treatment I choose was BRACHYTHERAPY. Rather then implanting radioactive seeds and leaving them, radiation is applied from within the prostate in high dose for a short time (minutes) and removed. Two outpatient treatments two weeks apart and that was it. Brachytherapy is a cool treatment. Had no side effects from the procedure other than what is normal (ie: tired for a period of months after radiation treatments while body adjusts).

I have gone for exams (blood work) every 3 months for the last two years. PSA value is now in the area 0.9 or less (and I still have my prostate). Am now switching to a 6 month exam cycle and in a couple of years should be going to a once a year cycle.

I have a friend who choose removal. He felt that was his best option and least worry. Several treatment options available for each of our own personal requirements and wants.
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Old 05-16-2013, 10:38 AM   #6
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Re: Prostate cancer and Sportsmobiles

Herb, I should have mentioned that family history is a big factor:

- Parent or sibling had prostate cancer (my case - yes)

- Parent or sibling with Ovarian cancer (my case - yes)

Those results factored into my decision.

It seems riding a bicycle can influence a PSA reading. My friend had a PSA of 7.8. His physician told him to stay off his bike for two weeks and upon retest his PSA was under 1. For my PSA test and retest I road my bike 4-5 miles to the hospital. At that time I had no idea a bike ride could change a PSA result. Would the cancer have had another year to grow if I had driven across town?? Does it matter? I made my choice based on what I knew and I'm not going to 2nd guess after the fact.

Mike
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Old 05-16-2013, 10:46 AM   #7
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Re: Prostate cancer and Sportsmobiles

Mike,

I didn't intend to down-play your decision. Even though my doctor said what he said to me, I take my test results seriously. Heck, I hit 50 back in the Fall, and I subjected myself to the 'special' colon procedure that goes with that territory. Some poeple however, will hear the same thing and decide that means they can ignore tests, test results, family history....

I plan on being around a long time, so I'll do what it takes to increase my odds.

BTW, interest tidbit about the bike riding. Hadn't heard that before.


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Old 05-16-2013, 01:34 PM   #8
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Re: Prostate cancer and Sportsmobiles

My best wishes to you, Mike, and kudos to you for your bravery and for creating this post.

At 62 now, Ive been tested regularly and will decrease the interval now. I do a lot of cycling, seriously road riding, 3500 miles last year. Never heard about the cycling/psa level association before. Fortunately no family history of it, but blood tests are cheap. My wife's a cancer survivor. We need to maintain maximum awareness. Thanks for your tips.
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Old 05-17-2013, 09:16 AM   #9
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Re: Prostate cancer and Sportsmobiles

In an effort to enable doctors to practise what is known as "evidence based medicine" there has been a push in recent years to look more carefully at the way medicine is commonly practiced. As a result, there have been a couple of new guidelines issued for cancer screening in the last year or so. One is for breast cancer and the other for prostate cancer.

Both aroused a lot of ire and have been quite controversial. It was astonishing how much emotion and anger came out in response to an attempt to accurately quantify the risk/benefit ratio of testing and treatment. So it is worth remembering that these are large scale population studies intended to guide doctors and patients in making decisions based on their individual circumstances, given the most current, best evidence we have. These are not 'death panels' or an attempt to take away or otherwise limit the individuals right to choose treatment. It's nothing more than an admission that medicine has not always been providing the most appropriate treatment and is an attempt to address that. "First do no harm", remember?

The essence of of the research is that testing is perfectly appropriate for certain high risk groups but not as a routine procedure for everybody. The potential harm from false positives or unnecessarily aggressive treatment has a high social and financial cost. Treatment for cancer is not benign and if you don't really need it then it can cause serious and unnecessary damage

The shorter version of the guidelines from the American Urological Society can be found here:

<http://www.auanet.org/education/guidelines/prostate-cancer-detection.cfm>

The longer version here:

<http://www.auanet.org/common/pdf/education/clinical-guidance/Prostate-Cancer-Detection.pdf>


Since most of us are likely at the age where the annual digital exam and PSA test is but a boring routine I hope this helps clarify things.
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Old 05-17-2013, 09:37 AM   #10
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Re: Prostate cancer and Sportsmobiles

Quote:
Originally Posted by witoke
Since most of us are likely at the age where the annual digital exam and PSA test is but a boring routine I hope this helps clarify things.
I never found the digital exam boring, quite the opposite!

And an experience I never have to repeat.

Mike
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