Thistlecap, I'm very sorry for your diagnosis and pray that can can successfully navigate the complicated treatment options and live a long life.
I'm going to share a lot of detail about male and female issues because my head was in the sand for decades. I rarely went to doctors or took any preventive tests or shots.
All men should be aware that there is a raging debate in the medical community about the need for and efficacy of PSA tests. There are dozens of articles that discuss the various arguments and points of view, but
HERE'S a fairly recent article that leans to the anti-PSA test side, but does link to medical authorities. In a nutshell, the US Preventive Services Task Force and the American Academy of Family Physicians essentially recommend against the PSA test. The American Urological Association (which is the most self-interested) disagrees, but has modified it's recommended PSA testing schedule.
I personally recommend discussing (indeed, cross-examining) your urologist about these competing research studies and points of view. Unfortunately, you may find him not particularly knowledgeable. Many doctors are more akin to plumbers than scientists. Ultimately, I make my own decisions based on my own medical research. I currently opt to have annual PSA tests at age 70, which I had ignored from about age 55-65. I decided to do so because of increasingly intolerable BPH.
BPH, which at least 50% of men will get, significantly interfered with my canoe and camping life. I'd have to stop at every rest area on a highway and often be very creative. I'd have to get up four or five times a night, which isn't conducive to a good night's sleep in a tent. I had to carry relief bottles in my vehicles and with my camping kit.
I took every herbal concoction I could research beginning at about age 50, but they ultimately didn't stop the progression of the BPH. I still take them, but I finally agreed to take medication after I began to see a urologist. I first took tamsulosin (Flomax), which provided immediate and dramatic improvement, but then seemed to slowly lose effectiveness after a few years. We then added finasteride (Proscar) to the tamsulosin. That combination has been quite effective for several years now and has reduced the daytime and nocturnal frequency problems significantly. Often I can sleep through an entire night.
Both medications have similar side effects: retrograde ejaculation and a loss of libido. Those side effects are a long way from impotence, however, and there is no incontinence whatsoever. (Both impotence and incontinence are big risks of prostate cancer surgery.) However, the cause of the loss of libido is very confused with simple old age, which does the same thing independent of the BPH. A much younger man would likely be bothered by these BPH medication side effects much more than an older and less sexually active man.
Yellowcanoe's sharing of her cancer contributed significantly to motivating me to research gynecological cancer risks, because my wife's mother had died of ovarian cancer. That research helped convince my wife to have pelvic sonograms and MRI's along with tumor marker blood tests, some of which were difficult to finagle through Medicare. The imaging showed a mass on the ovaries and a thickening of the uterus. Through my own research -- not our internist's mechanistic referral -- we then located a doctor who we thought was the best credentialed gynecological oncologist in Connecticut, trained in laparoscopic and robotic surgery at Harvard, Yale and the Mayo Clinic.
Dr. Zhou recommended removal of the ovaries and fallopian tubes and a hysteroscopy ("DNC"). My wife had that laparoscopic surgery last week. No cancer was found in the ovaries, just a benign tumor, and we are awaiting final pathology results of a uterine polyp that was found. Her surgical recovery has been uncomplicated, and she hasn't needed to take even a even one ibuprofen for residual pain. We've also scheduled counseling for genetic testing for the BRCA gene mutation (the Angelina Jolie problem), though it's unlikely my wife has that issue. The test is important for our daughter because the gene mutation can be inherited.
Both men and women should get their heads out of the sand regarding the reproductive organ diseases of advancing age. There are similar debates now raging about the proper use and scheduling of breast exams and pap tests. Get advice from doctors -- more than one if you are confused -- and also do your own research if you feel comfortable doing that. Personally, I don't buy most of the arguments against preventive testing. This issue relates more to
what to do if you get a positive result from one of those tests. At worst, you could end up having unnecessary cancer surgery with bad side effects, which does happen in the case of prostate cancer. At best, you will save your life from a horrible death. Medicine is as much an art as a science, in my opinion, and it all involves a balancing of risks in a wilderness of uncertainty.
