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Old 06-17-16, 10:08 AM   #1
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Prostrate Cancer Treatment

Interesting news item today. Fighting prostate cancer: Treatments evolve, from robotic surgery to hormonal therapy | NJ.com
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Old 06-17-16, 11:30 AM   #2
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My father passed away 36 years ago at the age of 53. Those sure were the "dark ages" when it comes to treatment. Early detection gives you many more options than waiting for symptoms. Your specific PSA is not an indicator, but having a history of PSA will show a change. Also don't be a coward, and get a "digital" exam. A few minutes of discomfort can save you from a lot of pain.

Every male in my family has had prostate cancer so i've been getting checked since I was 45. I'm 60 now and still cancer free.

Every day is a day closer to more options. There are treatments today that weren't available yesterday. Who knows what will be discovered tomorrow.
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Old 06-17-16, 11:34 AM   #3
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They have come a long way from when my grandfather had it and there was basically nothing they could do but pain management. I was 15 when he died of the cancer spreading into his lymph nodes.

I'm a prostate cancer survivor who had to do hormone treatments and radiation because of my leukemia. My very aggressive prostate cancer was diagnosed not long after I started my oral chemo medication. Since I couldn't come off the oral chemo I didn't have much choice as to which procedure to go with, although I would have preferred the robotic surgery. I've never understood the reason why that panel of non oncologist and non urologist say PSA testing is not necessary unless there are symptoms. I had no symptoms and it was the PSA velocity, not the PSA number, that prompted me to do a biopsy. I'm glad I did because it was about to spread out of the prostate and into the surrounding tissue had I not done the biopsy. I would have been in the same boat as my grandfather had that happened.
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Old 06-17-16, 11:48 AM   #4
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The surgeon who did my prostatectomy five years ago preferred to do it the 'old fashioned way'. He would do the DaVinci if I had asked, but listed the possible complications. The DaVinci robotic method does not allow for 'feel' - like when the surgeon is stretching a nerve fiber too far. The patient really wants to have as few complications as possible, and a 'loose bladder' - the inability to hold back urine resulting in 'leaking' is NOT a good thing! Either is nicking something that shouldn't be nicked. Or cutting or tearing the nerves that allow for retention of blood in the penis (and erections)...

Oh, and the surgeon who did my prostatectomy is the Head of the Urologic Oncology Center at University Hospitals in Cleveland, the teaching hospital of Case Western Reserve University School of Medicine. I trusted his judgement. I had absolutely no problems or complications with his work.

Like oldnslow2, every male on my mother's side of the family has been afflicted with prostate cancer. Her dad died of it in 1962, long before they had any form of treatment for prostate cancer. The male cousins on that side all have it, but none opted for a total prostatectomy like I had. They had opted for either conventional radiation or the radioactive 'seeds'. I didn't want to have that threat of it progressing later in life. Also, radiation and the seed method make surgical removal of the prostate more difficult if the cancer progresses because the radiation 'cooks' the surrounding tissues, making it like a tough piece of meat.
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Old 06-17-16, 11:49 AM   #5
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it was the PSA velocity, not the PSA number,
This bears repeating. You can still have a "low" number but if its gone higher than you historically have, you need to look into it.

John, glad you're doing well and still riding.
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Old 06-17-16, 11:49 AM   #6
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I'm astounded at how few people get yearly physical exams. So many people I know take care of their cars better than they do their own bodies ... it's bizarre!

I've been getting yearly physicals for the past 20 years, and for as long as I can remember, a PSA and digital exam has been a part of that.

I'm not a fan of the "what you don't know can't hurt you" school of thinking, so even if PSA tests can give false positives, I'd still rather have the information so I can choose to act on it or not.

Anyway ... So far, so good. Early detection IS the best way to beat cancer.
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Old 06-18-16, 07:29 PM   #7
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Originally Posted by John_V
it was the PSA velocity, not the PSA number,
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This bears repeating. You can still have a "low" number but if its gone higher than you historically have, you need to look into it.
Yep, it is the RATE of increase you have to watch. My PSA 'number' was still in the low-normal range, but it had doubled in one year. Doc ordered a retest in six weeks. Higher still. Then ordered the biopsy. Cancer found in one half of the gland. Waited six more weeks for an open surgery date - and the post-op biopsy found that it had spread to the whole gland.

Yes, early detection is the key!!!
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Old 06-18-16, 08:10 PM   #8
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Velocity is the key, I agree . I had my prostate removed this past February, and yes it was the rapid increase in my PSA number that led to a confirming biopsy . 1 in 8 of us will have this problem at some point in our lives . Get checked, and regularly .
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Old 06-19-16, 04:36 PM   #9
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I had a high PSA several years ago, not sure about the velocity, but my GP ordered a biopsy, which was not pleasant by the way . . . . but it came back negative and that was very good news for me.

Could still happen though.

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Old 06-19-16, 07:27 PM   #10
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The standard TRUS 12 core biopsy is not an overwhelmingly accurate means of biopsying the prostate. Much can be missed because the procedure does not get to the far side of the prostate and thus can very easily miss cancer cells that have begun to form a lesion.

Transperineal 3D mapping biopsy of the prostate: an essential tool in selecting patients for focal prostate cancer therapy. - PubMed - NCBI A transperineal 3D prostate mapping biopsy is far more accurate and detailed.
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Old 06-20-16, 05:32 AM   #11
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There has been a lot of discussion about this in the 65-85+ thread.
I had the da Vinci robotic surgery on Dec 21, 2015 and was back riding in less than 2 months.
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Old 06-20-16, 07:24 AM   #12
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What? there is a new cancer treatment you take laying prostrate? Or do you meant "prostate"?
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Old 06-20-16, 09:34 AM   #13
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What? there is a new cancer treatment you take laying prostrate? Or do you meant "prostate"?
No, only the cancer itself is lying prostrate.
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Old 06-20-16, 10:42 AM   #14
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I had a high PSA several years ago, not sure about the velocity, but my GP ordered a biopsy, it came back negative and that was very good news for me.
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Hope you have had follow up PSA's taken after the initial negative biopsy .
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Old 06-20-16, 02:11 PM   #15
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Hope you have had follow up PSA's taken after the initial negative biopsy .
Yes, on a yearly basis. The high PSA was directly after a pretty brutal double-century before I'd discovered prostate friendly saddles. Actually, it was the 2nd consecutive double-century weekend; Knoxville Double followed a week later by Tour of Two Forests. So my prostate was badly hammered, badly swollen and that was no doubt the cause or at least part of it.

Since I got my prostate friendly Selle Anatomica saddle, no problems!

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Old 06-20-16, 02:35 PM   #16
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Since I got my prostate friendly Selle Anatomica saddle, no problems!

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I've been riding on Selle Anatomica X series saddles for ~2 years. They're great.
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Old 06-20-16, 03:21 PM   #17
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Amazing how such a small, nearly useless gland could cause so much trouble.

Dealing with it since '03, here.
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Old 06-20-16, 05:26 PM   #18
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Yes, on a yearly basis. The high PSA was directly after a pretty brutal double-century before I'd discovered prostate friendly saddles. Actually, it was the 2nd consecutive double-century weekend; Knoxville Double followed a week later by Tour of Two Forests. So my prostate was badly hammered, badly swollen and that was no doubt the cause or at least part of it.

Since I got my prostate friendly Selle Anatomica saddle, no problems!

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Rick,

Is there any corelation between high PSA and cycling? I couldn't find much. My PSA keeps increasing but I've had three biopsies over the past few years and they all are negative. I'm wondering if 8-10 hours of weekly riding on a minimalistic saddle might be a factor.
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Old 06-20-16, 05:43 PM   #19
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Rick,
Is there any correlation between high PSA and cycling? I couldn't find much. My PSA keeps increasing but I've had three biopsies over the past few years and they all are negative. I'm wondering if 8-10 hours of weekly riding on a minimalistic saddle might be a factor.
I'm not a doctor but a friend of mine who is, and is also a cyclist, says an intense cycling (or any sports) effort right before a blood test can skew the results and make both PSA and cholesterol read high. So I'm inclined to say yes, but . . . the saddle issue is separate (though possibly related) question.

In my case, I did double-centuries on consecutive weekends on a Sella Turbo saddle causing my prostrate to swell so much I couldn't pee and had to have a catheter put in. Sorry if this is TMI.

After it was taken out I had the blood test and the high PSA and the biopsy. That was back in 2006 if I remember right. I bought one of the original Selle Anatomica saddles and that totally solved the problem . . . for me. YMMV, of course, but there are lots of prostrate friendly saddles out there in addition to Selle Anatomica so I'm not trying to sell anything here.

I would advise to make sure you are fully rested and recovered before you have you next blood test to see if the numbers are dramatically different. And check with your doctor if he/she is a cyclist. Sorry to sound too negative here but in my experience doctors who are not cyclists or are not familiar with the stress our bodies suffer when riding . . . just don't get it.

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Old 06-20-16, 06:16 PM   #20
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Thanks Rick.

My prostate thing has me confused. I didn't ride for three days before the last two PSA tests so skewed results isn't my problem. I'm wondering if somehow the pressure on the prostate from everyday riding for an hour or more can cause PSA levels to rise.
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Old 06-20-16, 07:51 PM   #21
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Thanks Rick.

My prostate thing has me confused. I didn't ride for three days before the last two PSA tests so skewed results isn't my problem. I'm wondering if somehow the pressure on the prostate from everyday riding for an hour or more can cause PSA levels to rise.
I will reiterate, if your biopsy was a TRUS, it DOES NOT reach much of the prostate and can give a false sense of security. As far as resting the prostate before a blood test, no bicycling, hard exercise, sex, horse riding....... for an entire week before the blood test.
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Old 06-20-16, 08:23 PM   #22
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I will reiterate, if your biopsy was a TRUS, it DOES NOT reach much of the prostate and can give a false sense of security. As far as resting the prostate before a blood test, no bicycling, hard exercise, sex, horse riding....... for an entire week before the blood test.
The biopsy was a TRUS but some samples were taken very deep as well. Prior to the last one, I had an MRI that concentrated on the portion where the TRUS doesn't really get. The alternative is a "saturation" biopsy done as a surgercal procedure where over 50 samples are tsken from all over.

I will take you advice and abstain from everything for a full week next time.
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Old 06-20-16, 10:08 PM   #23
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Rick,

Is there any corelation between high PSA and cycling? I couldn't find much. My PSA keeps increasing but I've had three biopsies over the past few years and they all are negative. I'm wondering if 8-10 hours of weekly riding on a minimalistic saddle might be a factor.
On that I'll respond that my urologist says there is none, but I talked to another that said there is , sooo.... and another didn't want his patients to ride 3 days before a PSA test . That last bit leads me to believe there is at least some correlation .
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Old 06-21-16, 01:47 AM   #24
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The biopsy was a TRUS but some samples were taken very deep as well. Prior to the last one, I had an MRI that concentrated on the portion where the TRUS doesn't really get. The alternative is a "saturation" biopsy done as a surgercal procedure where over 50 samples are tsken from all over.

I will take you advice and abstain from everything for a full week next time.
I had the TRUS by urologist resulting in 9 of 12 positive with Gleason range 6 to 9. After the bilateral orchiectomy, my choice since I do not agree that drugs are always the best solution, I continued treatment by Dr. Gary Onik who performed his saturation Transperineal 3D Prostate Mapping Biopsy resulting in Gleason 10. A deep TRUS is not the same as a 3D.

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On that I'll respond that my urologist says there is none, but I talked to another that said there is , sooo.... and another didn't want his patients to ride 3 days before a PSA test . That last bit leads me to believe there is at least some correlation .
The more I read the more I agree of a possible effect occurring.

Best of luck to all.
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Old 06-21-16, 05:41 AM   #25
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Thanks Rick.

My prostate thing has me confused. I didn't ride for three days before the last two PSA tests so skewed results isn't my problem. I'm wondering if somehow the pressure on the prostate from everyday riding for an hour or more can cause PSA levels to rise.
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I will reiterate, if your biopsy was a TRUS, it DOES NOT reach much of the prostate and can give a false sense of security. As far as resting the prostate before a blood test, no bicycling, hard exercise, sex, horse riding....... for an entire week before the blood test.
I went through radiation treatment for my prostate cancer last July - September, and I rode 8-10 hours/week during the treatment. Towards the end of the treatment, I tried a training ride on my TT bike and when I got down on the sticks my prostate told me it was NOT a good idea. I did a century three days after completing the treatment to celebrate. I also take a week off prior to a PSA test and want to add using a riding mower to OTG's list - pressure and vibration are what elevates the PSA count.
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