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extropic
I am happy for your out come. Keep an eye on it.
For you and others I will describe some things I learned about Prostate Cancer. (At least this is my understanding, but I am not an MD.) You may not want to read this, but if you are a man you should! Ignorance can kill you.
For all of you other guys who maybe living in the dark: I did considerable reading on this subject when I had to. It turns out that the statistics are not great for any of us males. The probability that a man has PC is roughly equal to his age! That is, highly probable as you age. Say you are 60, then the probability that you already have PC is 60%. More years yields poorer odds!!!! However, PC is very slowly growing and there is a good chance that if you are 90 and you have just developed PC, odds are that you will die of something else before the PC gets you! Comforting thought! (In the definition medical diagnostics terms is that this means that the cancer maybe "benign." Benign does not mean that you do not have the cancer! It simply means "good".)
It turns out that while a PSA (prostate specific antigen--google it for the meaning. You can also google to determine what the levels should be by age.) test is not definitive it is a good indicator of PC. What is really important is the change in the PSA. You should have it tested every year. (It is a simple blood test.) Then you should track the number over time. In general it will increase with age, but if it goes up rapidly then make sure you see a doctor and they should recommend that you have more tests. There is an out patient test where they sample the prostate and biopsy the samples to see if they can find cancer. Since the samples are very small they may miss a cancer, but for sure it is not large yet. (They have devise a draconian gun like instrument with a trigger for quickly grabbing these samples. My analogy of this thing is a miniature "alien movie critter that takes a sudden bite".) The doctor will probably wait a while and then do another test and maybe keep sample testing every year or so.... along with more PSA tests. Keep tracking them. Remember PC usually grows slowly. What you absolutely do not want to do is to wait until the cancer has spread to the lymph node system. At that point you can have PC cells all over the body and treatment other than chemical is virtually impossible and the other cancers that may form can get you before the prostate is the problem.
By the way, getting a false high PSA test can happen. For example, a lurking infection some other cause.... This clearly causes anxiety for some folks. Also, because the PSA test is not totally free of cost the insurance companies do not want to pay for it if they do not have too. So now, unlike in the past, the recommendation is that when you get old you not have the PSA test any more! Dumb! That is just be ignorant about your status. I personally would rather know if I have a problem than not know! At least I can plan accordingly.
Once PC is discovered there are basically three paths for dealing with it. As expected none are great, but...
1) "Wait-ful watching" is the phrase that the medical folks use. Dumb! It means keep having tests and if they get really bad then make a different decision to either just let it runs its course..... or choose one of the remaining options. (The idea is that if it is progressing really slowly, then maybe it is effectively "benign".) The down side is either you do not know what is going on, but know that you have a problem. This would be more of an anxiety trip for me than getting a false PSA test!) But each to his own. The other downside is the continual tests which will be the sampling test with biopsies. While the sample biopsy tests are not terible there is some discomfort, some would say pain, and there is a possibily of infection given that they go up the anus to grab the samples.
2) Radiation. That is, radiate the hell out of the prostate and kill ALL the living cells. Along with this hopefully the cancer cells are also destroyed. While radiation can prove to be effective it is very hard not to damage surrounding tissue. The upside is that there is no cutting (surgery). However, this area is full of nerve cells. In fact, there are nerves that lie right on the prostrate. Also the urethra runs from the blatter right through the center of the prostate. There are two muscles that control urine flow and they have nerves that control them. I think they are called the urethral sphincter muscles. Basically that means that they squeeze the uretha. One is at the bottom of the blatter (top of the prostate) and one is at the bottom of the prostrate as the uretha is headed towards the exit! Their functions are different but both important. The one at the top is voluntary (you do not think about it) and hold the uretha shut to keep the blatter from leaking. The one at the bottom is involuntarily (you have to think about it to make it work) and it is the one that you use to stop the flow while it is already occurring. In addition, there is a nerve that enables one to have an erection. Who knows what other nerves maybe near by..... So what is the down side of radiation treatment: a) Possible loss of the abitity to have an erection. b) Possibly incontenance of either type, or both. Possibly lasting forever. c) Damage to surrounding tissue. For example, if the large intestine nerves are damaged and causing the intestine to fail to work properly can leading to blockeages which is very serious. I am sure that there are probably other issues, not the least of which is that high dosage radiation can cause other forms of cancer. However, I don't think the doctors will tell you all of the possibilites as they do not want to scare you off for any treatment. Too much raditaion or radiation to the wrong spot and you have problems. Too little radiation and at least some of thethe prostate cells, and the cancer cells, remain alive! Nevertheless, it is an option that some folks take as they do not like the 3rd approach.
3) Surgery. Removal of the entire prostate by surgery. Cut it out! The upside is you know the prostate and the cancer cells inside of it are gone! The downside: a) Surgery. A good surgen will NOT do this by laparoscopy (small incision in which instruments are inserted to do the internal cutting and extraction via pieces), which is in vogue, but is not as complete as a good old fashioned slit where the doctor can actually see what he is doing and removal of one or multiple large pieces. b) if the PC cells had already left entered the lymph node system then they are still in the body. (Of course that is also trued of radiation). A good surgen will take several of the near by lymph nodes and run a biopsy on each be sure. c) A very good surgen can try to carefully move the nerves that lie on the prostate surface and possibly leave them undamage, but probably traumatized (maybe will heal). This may minimize the probabily of the loss of being able to have an errection. They call this a nerve sparing proceedure. Likewise, for the nerve at the bottom of the prostate. However, the current techniques do not allow for saving the voluntary nerve at the top of the prostate. Hence, this sphincter muscle will no longer function. Hence, it would seem that incontenance is a sure thing. The Upside: a) The involunetary sphincter muscle at the bottom of the prostrate will most likely be spared and still function. Hence, by "thinking" stop the flow incontenance will be controlled. With the proper excercises it is possible to convert the muscle to being voluntary and so one no longer has to think about it...much. b) The large intestine nerves are unlikely to be damaged as they are surrounding tissue that is untouched. No incontenance on this end. If all has gone well the PC is gone and will no longer be an issue. If you are not trying to have childern one does not miss it! (Want to know its function: search on "what is the function of the prostate gland"). c) once the prostate is gone the PSA blood test should read 0.0! So monitoring this will tell you if any of the cancer cells escaped into the node system. If so the PSA reading will not remain at 0.0. You have a sure way to tell.
That is pretty much it. For most cases the PC moves very slowly. So if you have it take your time and find a really good doctor. One who deals with the prostate radiation or removal on a daily basis if at all possible. They are out there as this is a common decease. There are a lot of urologist doctors who do a prostate surgery once in a while. Not a good choice as they may not have the best skills and this definitely requires skills....
Some machinist can make a very nice clean cut surface while others leave a lot of burrs. Do you suppose this has a lot to do with experience and knowledge of the materials, tool, speed, and feed rates?
Dave
