PSA stands for prostate specific antigen.
Prostate cells are the only place in the body this is produced.
If you are perfectly healthy your PSA is usually really low, somewhere below 4.0. That is depending on age. If you are under 50, your PSA should be much lower than 4.0. Somewhere around 50 men's prostates start enlarging and producing more PSA.
Having a higher PSA means something unusual is going on in the prostate. The following things can cause the PSA to rise.
Sex
Riding bicycles
Infections
Strenuous exercises
BPH - natural enlargement of the prostate due to aging
Prostate cancer
I listed cancer last because if you are in your 30s, 40s, or even 50s or even older, one of the other reasons may well be why your PSA is high. But if you are older than 60, you likely will get prostate cancer.
Now, if you have had your prostate removed like myself you shouldn't be producing ANY PSA. If you do, then that means the cancer has spread outside of the prostate.
Here is my current PSA curve
My Current PSA Curve
And here is my previous curve.
My previous curve
Wednesday, March 7, 2018
ADT aka lets turn this man into a woman
Well, not exactly.
First, ADT stands for Androgen Deprivation Therapy.
Oh that's real clear, tell us more dummy!
Okay, okay.
Androgens basically are sex hormones that your body produces. Testosterone and androstenedione are the principal ones and are present in greater numbers in men, but women have them also. Women's bodies just turn them into estrogen.
The key word is testosterone. So ADT for men tries to deprive the body of testosterone.
OMGoodness, why in the world would you do that? Simple, PCa thrives in a T rich environment. ADT tells your body to stop producing T, thus slowing the growth of PCa.
I am currently on Eligard, previous other drugs I have been on are: Firmagon, Lupron, and Casodex. All of these work to slow or stop the production of T.
The side effects of any one of these drugs can easily be looked up, or you can go to my first blog post and read about Lupron.
Long term use of these is pretty critical for persons with metastatic PCa. They can work for very long periods of time or just a few short years. I have been on them since late 2013, except for one year that took as an HT vacation. Currently, I am on intermittent ADT. This means I take it every three months and after nine months if my PSA is stable then I can stop for awhile.
But why would you do that?
Two reasons: One, this crap really makes you feel like the south end of a north bound horse(read my first post). And two, eventually ADT stops working, so you do the intermittent to prolong ADTs effectiveness.
First, ADT stands for Androgen Deprivation Therapy.
Oh that's real clear, tell us more dummy!
Okay, okay.
Androgens basically are sex hormones that your body produces. Testosterone and androstenedione are the principal ones and are present in greater numbers in men, but women have them also. Women's bodies just turn them into estrogen.
The key word is testosterone. So ADT for men tries to deprive the body of testosterone.
OMGoodness, why in the world would you do that? Simple, PCa thrives in a T rich environment. ADT tells your body to stop producing T, thus slowing the growth of PCa.
I am currently on Eligard, previous other drugs I have been on are: Firmagon, Lupron, and Casodex. All of these work to slow or stop the production of T.
The side effects of any one of these drugs can easily be looked up, or you can go to my first blog post and read about Lupron.
Long term use of these is pretty critical for persons with metastatic PCa. They can work for very long periods of time or just a few short years. I have been on them since late 2013, except for one year that took as an HT vacation. Currently, I am on intermittent ADT. This means I take it every three months and after nine months if my PSA is stable then I can stop for awhile.
But why would you do that?
Two reasons: One, this crap really makes you feel like the south end of a north bound horse(read my first post). And two, eventually ADT stops working, so you do the intermittent to prolong ADTs effectiveness.
Me and my new friends - Uri an Al,
This is me and my new friends!
Yes, once you have a prostatectomy you will be closer to these fellows than your previous best friends ever were.
Here's the thing. You have to keep your sense of humor. This is imperative, as not having one will drag you down a path that is dark.
Love more, laugh more, give more, forgive more, live more!!
Biopsy Results
I promised biopsy results, and I'll get to that shortly. But I wanted to mention the tool they used on me, I call it the wand of pain.
Please make sure you are either knocked out or that your Uro waits long enough for the numbing agent to take effect. My Uro waited maybe 2 minutes before he started with the biopsy.
I felt every dang needle stick, and it was like being poked with a sewing needle each time. To add to this, the clicking he said I'd hear was more like a loud clacking. I jumped every time that thing went off. This was unarguably the most uncomfortable and painful medical procedure I'd been through ever.
To the results: Gleason score of 8, honestly that's it.
Now what is a Gleason score? A GS is made up by adding two numbers together. The first number is the grade of how abnormal the most prevalent cancer cells are. The second number is the grade of the second most prevalent cancer cells. Mine was a 4+4. The individual numbers can range from 2 to 5. 2s are generally ignored. It's when both numbers are 3 that they say you have cancer.
Now to discuss the aggressiveness of PCa by Gleason score.
Gleason 6 - Low risk, not aggressive, typical treatment is Active Surveillance. You just monitor your PSA results over time. And if it rises too rapidly then you proceed to some sort of treatment. If it's a true G6 it likely will never metastasize.
Gleason 7 - Intermediate Risk (3+4)s are usually treated like G6 but clearly there is greater risk than a G6. (4+3)s are treated like G8 because that 4 in the leading position is not good.
Gleason 8 through 10 -- High risk prostate cancer. This means it has a high risk of becoming advanced prostate cancer. And by advanced, it means it likely will metastasize to your lymph nodes, bones or some organs.
Please make sure you are either knocked out or that your Uro waits long enough for the numbing agent to take effect. My Uro waited maybe 2 minutes before he started with the biopsy.
I felt every dang needle stick, and it was like being poked with a sewing needle each time. To add to this, the clicking he said I'd hear was more like a loud clacking. I jumped every time that thing went off. This was unarguably the most uncomfortable and painful medical procedure I'd been through ever.
To the results: Gleason score of 8, honestly that's it.
Now what is a Gleason score? A GS is made up by adding two numbers together. The first number is the grade of how abnormal the most prevalent cancer cells are. The second number is the grade of the second most prevalent cancer cells. Mine was a 4+4. The individual numbers can range from 2 to 5. 2s are generally ignored. It's when both numbers are 3 that they say you have cancer.
Now to discuss the aggressiveness of PCa by Gleason score.
Gleason 6 - Low risk, not aggressive, typical treatment is Active Surveillance. You just monitor your PSA results over time. And if it rises too rapidly then you proceed to some sort of treatment. If it's a true G6 it likely will never metastasize.
Gleason 7 - Intermediate Risk (3+4)s are usually treated like G6 but clearly there is greater risk than a G6. (4+3)s are treated like G8 because that 4 in the leading position is not good.
Gleason 8 through 10 -- High risk prostate cancer. This means it has a high risk of becoming advanced prostate cancer. And by advanced, it means it likely will metastasize to your lymph nodes, bones or some organs.
So, I guess I should explain PCa
So, I guess I should explain PCa
Simply put, PCa is prostate cancer.
I have PCa, I was diagnosed with it in October of 2013. But that is also another sad story on my part.
<Sad Story>
In 2011 my primary care physician did a PSA test (prostate specific antigen) on me and suggested I go to a Urologist. Well, I blew him off, sigh..........
BTW my PSA was 7.6, once it goes over 4.0 it is suggested to have a Urologist take a look and treat if necessary.
Note: Just before my 50th birthday my PCP performed a PSA test and it was 4.0. It wasn't over 4.0 so he didn't refer me to a Uro.
BTW my PSA was 7.6, once it goes over 4.0 it is suggested to have a Urologist take a look and treat if necessary.
Note: Just before my 50th birthday my PCP performed a PSA test and it was 4.0. It wasn't over 4.0 so he didn't refer me to a Uro.
</Sad Story>
Back to the story, in October 2013 my PCP again took a PSA test and strongly suggested I get a biopsy. Well, this time my PSA was up to 20.6. I agreed to go to a Uro (I'll refer to him as a Uro now because I don't like to type.)
So, I went to the Uro and set me up for a biopsy. Told me all the usual garbage of it doesn't hurt you will just hear some clicking sounds.
BS Barbara Streisand!!!!!!!!!!!!! They stick an electrical pole up your backside then shoot needles into your prostate. Well, that's obviously exaggerated. But mine hurt, I felt all 13 of the needle pricks. One to numb the prostate and the other twelve were samples. I guess he didn't wait long enough for the numbing to take effect. I'll leave out the bloody details of me cleaning up. Results in my next entry.
BS Barbara Streisand!!!!!!!!!!!!! They stick an electrical pole up your backside then shoot needles into your prostate. Well, that's obviously exaggerated. But mine hurt, I felt all 13 of the needle pricks. One to numb the prostate and the other twelve were samples. I guess he didn't wait long enough for the numbing to take effect. I'll leave out the bloody details of me cleaning up. Results in my next entry.
Lupron
This is my first entry, so don't expect much.
Someone asked me about the side effects from taking Lupron, my response below.
The list of possible side effects is long but here are mine.
No sex drive,
My testes are smaller
Depression because of no sex drive and my testes are smaller
Lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller
Weight gain due to not having sex which is due to lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller
Mood swings due to not having sex which is due to weight gain due to not having sex which is due to lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller.
Seriously, no sex drive, depression, lack of motivation, weight gain, mood swings, and my balls are smaller.
But most importantly, I'm alive! This is the most important side effect of taking "hormone" therapy for prostate cancer.
Someone asked me about the side effects from taking Lupron, my response below.
The list of possible side effects is long but here are mine.
No sex drive,
My testes are smaller
Depression because of no sex drive and my testes are smaller
Lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller
Weight gain due to not having sex which is due to lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller
Mood swings due to not having sex which is due to weight gain due to not having sex which is due to lack of motivation due to no sex which is due to depression because of no sex drive and my testes are smaller.
Seriously, no sex drive, depression, lack of motivation, weight gain, mood swings, and my balls are smaller.
But most importantly, I'm alive! This is the most important side effect of taking "hormone" therapy for prostate cancer.
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