Hi David Roy, - Since you apparently still have a Prostate, the rise in your PSA reading could come from any number of causes and could be temporary or more prolonged, depending on its actual origin.
Surgical procedures can vary widely in both scope and severity, depending upon the location and the extent of the specific case being treated, so it is impossible to know why you do no longer experience ejaculation upon orgasm.
To my knowledge, the colectomy and/or proctectomy, by themselves, would not normally affect the production and/or delivery of ejaculate, which are not part of the same excretory system, however it MAY well be that the extent of disease present may have prompted the excision or damaging of the vas-deferens or even the Prostate itself, but these factors are unknown from your Post.
In any event it is unlikely, in my layman's OPINION (I am not a Doctor) that ejaculation, or lack of it, is unlikely the cause of your PSA elevation, but the cause could still be benign (non-cancerous) rather than Cancerous, with Prostatitis (inflammation) being a real possibility.
Of course, it COULD also be Cancer and further investigation by your professional advisors is necessary to determine its actual source.
As Replicant suggested, you may wish to pose the question to Dr. Judd Moul (MD) on this site. who is much better prepared to answer your question with authority, than am I. Good luck! - John@newPCa.org (aka) az4peaks View Thread
Hi Anon, - It is difficult to address your question before you have the results of your Biopsy. In general, however, if you have Prostate Cancer (PCa), it is quite likely that it won't threaten your mortality for several years. In fact, depending on its Stage, it may even be cureable with appropriate treatment.
Of course, at this point, it is pure speculation as to whether you actually have PCa, in spite of your highly elevated PSA reading, but this should be more clearly defined after you have obtained the results of your Biopsy.
PSA blood tests are NOT Cancer specific and therefore, a Biopsy is necessary to determine the cause of the PSA elevation. Much more should be known soon and until then, just realize that PCa is often a slow growing disease and is usually very treatable, with high and prolonged survival rates.
Once more information is available, your specific situation can be better and more accurately addressed. Good luck! - John@newPCa.org (aka) az4peaksView Thread
Hi Mik, - Before deciding on treatment, I would suggest that you have the slides from your Biopsy sent, for a second opinion, to a recognized specialist in examining Prostate tissue. Johns Hopkins and Bostwick Laboratories are 2 that come to mind, but there are others, generally found at institutions with high enough volumes to justify such pathologic sub-specialization.
Once the subjective Gleason Scores are confirmed, you can more confidently move ahead in your INFORMED decision making. You have choices and you have time to make them but first you need to be comfortable that the status of the disease you have now is accurate. A map to a desired destination is not nearly as helpful, if you don't know where you are now located on it.
There is time to learn but anecdotal tales of what happened to other INDIVIDUAL patients, is not nearly as reliable or helpful, as is the cumulative evidence derived from published, peer-reviewed medical studies reporting results from groups of men, with similar disease characteristics.
We are all individually different which is why we can each be separately identified by DNA. In addition Prostate Cancers can vary as well, but you can learn about PCa and you have a reasonable time frame to do so. ALL treatments have POTENTIAL side effects (morbidity) but most are age sensitive and your younger age may well prove to be your greatest ally.
At 58 y/o you have an actuarial life expectancy of 22 years and that is the time period that needs to be considered, not the shorter term 5 to 10 years usually cited in medical studies. I will be happy to answer any specific questions you may have, if you desire. Good luck! - John@newPCa.org (aka) az4peaksView Thread
Hi CCA9674, - After 2 Cryotherapy treatments and a rising PSA of over 7, I would GUESS that what is meant by "flat", is that the Prostate cells have been architecturally altered by the treatments, so that the Prostate has essentially been destroyed.
There is probably no target left for further localized treatment efforts, which means that the rising PSA is most likely coming from disease that is "systemic", which means it it likely to be circulating in his blood/lymph systems rather than from a localized tumor. IF TRUE, this means that his Prostate Cancer (PCa) can spread to other parts of the body (metastasize), with bones being a favorite target, although it can spread to any other vital organ.
Systemic disease is thought to be incurable so, if applicable, the goal changes from one of attempts to "cure" the PCa, to one of attempting to "control" what has now become a "chronic" disease. Some form of Hormone Therapy (HT) is the usual initial treatment, designed to block the production and reception of testosterone in the body, which is thought to fuel PCa growth.
HT is, usually, quite effective for widely varying time periods, in any individual patient, that are normally measured in years rather than months, so he has a good chance of living out his natural life expectancy, even if my ASSUMPTIONS are correct. There is morbidity (side effects) connected with such treatment, such as possible hot flashes, weight gain and suppressed libido.
Of course, all this is conjecture at this point, with the brief information you have furnished. But it may be worth discussing with the attending Physician who would have the full medical record available and could further clarify his situation. I hope this has helped! - John@newPCa.org (aka) az4peaksView Thread
Hi happyna2five, - If he is not being managed by a Medical Oncologist, I suggest he see one, as soon as possible, preferably one experienced in treating Prostate Cancer, (PCa) That is the specialty that is best equipped to deal with advanced PCa. Good luck. - John@newPCa.org (aka) az4peaksView Thread
Hi Wes, - That is great to hear! It looks more and more like the recurrence WAS localized. Each "undetectable" PSA (0.1 ng/ml) year improves the odds of REMAINING PCa free. Best personal regards and good wishes, my friend! - John@newPCa.orgView Thread
Hi Dr Moul, Dr. Marks and all, - We are very fortunate to have both these distinguished Urologists make comments on this Board.
Although I have never personally met either of them, I have followed Dr. Moul's career and research since he was the head of the Department of Defense's, Prostate Cancer (PCa), widely respected, research program and I am familiar with Dr. Marks and his best selling book on the subject.
Doctors, we sincerely appreciate your efforts on the behalf of those of us with PCa (whether active or not) and thank you both for your efforts to expand the educational resources for patients and your contributions to the field of knowledge about the disease. - John@newPCa.org (aka) az4peaksView Thread
Hi bobcare, - What were you told? If the Prostate Cancer (PCa) has already metastecized to the bone, it is highly unlikely that radiation is going to cure his PCa. This is because his disease is probably systemic, rather than localized, and Radiation is a Local treatment.
Radiation can sometimes reduce (debulk) the primary tumor and in some cases even "spot treat" a specific metastatic lesion, but more often is used for "palliative" treatment (to relieve pain or other symptoms. Hormone Therapy (HT) is often instituted to try to "control" the Cancer's spread and reduce the rate of growth.
HT is usually highly effective for WIDELY varying time periods but, EVENTUALLY, it tends to become "hormone refractory", and no longer effective. The effective time-frame is usually measured in years rather than months and some men have PROLONGED periods of effectiveness and even temporary periods of remission.
You may wish to investigate the possibility of a consultation and second opinion, with a Medical Oncologist, who specializes in such treatment, preferably one that has PCa experience.
Please note that, although I consider myself a well informed layman, I am NOT a physician and the above should be discussed with your professional advisors. Good luck! - John@newPCa.org (aka) az4peaksView Thread
I have a Wall Street Journal article about Nono Knife that you may find interesting. I will E-Mail a copy of the entire article, for personal use, to anyone requesting it by E-mail, to:
"John@newPCa.org" (aka) az4peaks "022 "022 OCTOBER 5, 2010 Some Doctors Question New Cancer Treatment NanoKnife Used in Select Hospitals Shows Promising Results, but Hasn't Received 'Gold Standard' Test, Maker Says
By THOMAS M. BURTON Some doctors are raising concerns about a new cancer-treatment device that uses electrical jolts to zap tumors but that hasn't been through a large clinical trial to prove it's safe and effective in people.
The device, called NanoKnife, is currently being used in about 13 U.S. hospitals including Baptist Health Medical Center in Little Rock, Ark., University of Louisville, and Shands Hospital/University of Florida in Gainesville, Fla. Each machine costs as much as $300,000. Some of the hospitals are aggressively promoting the device in ads and media presentations. One radio ad by the University of Miami's Sylvester Comprehensive Cancer Center says NanoKnife offers "real hope" to patients with liver, lung or kidney cancer with "almost no side effects." The NanoKnife has been tested on animals and a small number of human patients, says its manufacturer, AngioDynamics Inc. of Queensbury, N.Y. "We have not done randomized, controlled clinical trials, the so-called gold-standard studies," says company chief executive Jan Keltjens. "We think this is a very promising technology for treating cancer that is otherwise untreatable." Regarding the hospitals' ads, Mr. Keltjens says, "We are not part of the whole PR machine. It's not something we are happy about." He declined to elaborate. The NanoKnife, which is also available in five hospitals outside the U.S., has so far been used to treat about 300 cancer patients world-wide. Doctors who have used the device say it has saved lives, including among prostate-cancer patients. While complications from the treatment have been reported in a few patients, some doctors say they are mainly concerned about what isn't known about the device because of a lack of evidence.
"There is growing concern in the interventional oncology community [that the NanoKnife> is being widely adopted prior to having gone through the necessary rigors of controlled investigations and clinical trials," says Riad Salem, chief of interventional oncology at Chicago's Northwestern Memorial Hospital. Northwestern doesn't have a NanoKnife, he says. The NanoKnife's journey from testing in animals to being promoted as a cancer fighter highlights a shortcut the Food and Drug Administration allows for granting regulatory approval to certain medical devices. When a device is deemed similar enough to another already on the market, it can get approved with little or no clinical evidence." - - - the article continues but is too long to complete here because of Posting limitations by WebMD.View Thread