Post-ops and Prostate Cancer

[thegame925]

Can Post-ops get Prostate Cancer?

I have a friend in the UK, (black, originally from Zimbabwe), whom I met initially as a P4P customer.

She then became a friend in so far as I became her mentor (in terms of advice).

Before Christmas 2009 she visited Thailand and had SRS surgery which has been 100% successful.

Last night she asked me a question that I can€™t answer and have been unable to find anything by searching the internet.

She wants to know if there is any possibility that, in the future, she can get prostate cancer.

Logic tells me that the answer must be €œYes€, she can get prostate cancer but I would welcome the thoughts of any BMs with medical or practical knowledge.

And if the answer is "Yes" do are LBs generally wear of this future risk?
Do the SRS Clinics warn of this possibility?

[mardhi]

Why would she care? I remember asking my doctor in Thailand about having a prostate check when turning 40 and she said, "yes, should do it" but then went onto say, "having said that, even if its diagnosed the chances of survival at any stage of identification are tiny" (and my doctor is a teaching professor at Chulalongkorn medical school !!!!!!) - interesting to say the least and said very matter of factly.

Directly though to your quesion sorry have not got a clue.

Cheers
Mardhi

[kahuna]

Much different in the States... My PSA blood levels are routinely checked...If they are elevated it's off for a visit with the urologists for a more thorough exam which may include a biopsy...In my case, it has...

In the USA about 1 man in 6 will be diagnosed with prostate cancer during his lifetime. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today...

I understand that there may be a genetic link but why would screening be any different in Thailand or Europe...Moreover, why would any Thai surgeon be responsible for counseling an SRS patient...I would think that if you have a prostate gland you can get prostate cancer...

The larger question for Thailand might be, would any ladyboy live long enough to have to worry about prostate cancer...

For your friend, she needs to go see a real doctor for answers...

[mardhi]

I think the point my doctor was trying to make was that early diagnosis does not add to the statistical survival rate (unlike a lot of other cancers, where the earlier diagnosis the better the chances of survival or however they measure these things). As I say it was very matter of fact and they did the blood test and all was fine, but interesting thing to say none the less.

Cheers
Mardhi

[donnykey]

(mardhi @ May 14 2010,15:42) "yes, should do it" but then went onto say, "having said that, even if its diagnosed the chances of survival at any stage of identification are tiny" (and my doctor is a teaching professor at Chulalongkorn medical school !!!!!!)

Mardhi that statement from your doctor is the most ridiculous and uninformed comment I have ever heard.

Are you sure the doc is not a teaching Professor at Chulalongkorn Auto Repairs.

Mate I have got prostate cancer in it's early stage and i plan to live a long life. I regularly keep it monitored with blood tests and biopsies and at the moment my PSA levels and cancer are static. If at any time in the future it worsens it can be treated/removed because I have discovered it in it's early stage.

So the above statement by the doc is so far off line it's not funny.

I'd be changing doctors my friend.

Cheers DK

[guydesavoy]

I'd change Docs too. It is well known that in the case of prostate cancer,  early detection significantly improves survival/treatment/recovery prognoses. Hence the campaigns encouraging regular checks for males 50 and over.

All the best to you DK  

TG I'm not sure whether SRS would increase that risk. Perhaps that is the issue ?

[mardhi]

(guydesavoy @ May 14 2010,16:04) I'd change Docs too. It is well known that in the case of prostate cancer,  early detection significantly improves survival/treatment/recovery prognoses. Hence the campaigns encouraging regular checks for males 50 and over.

All the best to you DK  

TG I'm not sure whether SRS would increase that risk. Perhaps that is the issue ?

Well known? Not according to this paper from the US National Cancer Institute:-

"Does prostate cancer screening save lives?
The benefits of screening and local therapy (surgery or radiation therapy) for early prostate cancer remain unclear, and it is not known for certain whether prostate cancer screening saves lives. Because of this uncertainty, NCI, which is part of the National Institutes of Health, is supporting research to learn more about screening for prostate cancer. Currently, researchers are conducting a large randomized clinical trial, called the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, to determine whether screening with PSA tests and DREs reduces the death rate from this disease. The researchers are also assessing the risks of screening. Specifically, men who have an elevated PSA level or a suspicious DRE are more likely to have a biopsy, which is an invasive procedure, and, if the biopsy is positive, the risks of surgery, radiation therapy, and even active surveillance (also called watchful waiting) must be taken into account.


I think and i am no expert as I say, this was just a comment from my doctor but the comment they made was consistent with this above view - i.e there is no statistical evidence that early detection of prostrate cancers has increased survival rates. The following comment from a paper published in the New England medical journal seems to support this view:-

PSA screening is controversial primarily because of the absence of randomized trials documenting that early detection and aggressive treatment of prostate cancer can reduce mortality. Although widespread screening in the United States has led to a shift toward the identification of earlier-stage disease and better short-term outcomes after diagnosis, only randomized trials can prove that these apparent benefits are not simply attributable to lead-time bias and length bias. Lead-time bias refers to the bias that arises by adding the time gained as a result of earlier diagnosis to the survival time, and length bias refers to the bias that arises because of the preferential diagnosis of more indolent cases of cancer through the use of screening.

In the absence of randomized trials, the unusual epidemiology and natural history of prostate cancer further fuel the controversy. With the advent of PSA screening, the lifetime risk of a diagnosis of prostate cancer is now about 16 percent, whereas the lifetime risk of death from prostate cancer is about 3.4 percent.1 Obviously, most prostate cancers that are diagnosed in the United States are not destined to be fatal. This relatively high ratio of the cumulative incidence to the cumulative mortality was evident even before PSA testing became widespread, at a time when treatment was less aggressive. It is attributable to the relatively slow doubling time of early prostate cancer, commonly three years or more,3 and to the fact that this diagnosis is frequently made in older men, who are likely to die of other causes.

Nevertheless, an estimated 31,900 men died of prostate cancer in the United States last year.4 The rationale for early detection is not only to reduce mortality, but also to prevent morbidity from local symptoms such as bleeding and urinary tract obstruction and the development of painful metastases. For men concerned about prostate cancer, the finding that they have normal results on PSA testing may provide reassurance, although the possibility of a false negative result must be recognized. These potential benefits must be weighed against the potential drawbacks of PSA testing, primarily the side effects of aggressive treatment in the event of an abnormal test result and a subsequent diagnosis of cancer, the anxiety associated with a false positive result, and the burden of dealing with cancers that otherwise might never have become evident.

So to keep this in perspective, maybe the comment should have been "there is no evidence that early detection has improved survivability rates" - what is interesting from reading this is the comment I have highlighted that in bold above about the fact that most prostate cancers are not fatal (i.e the person diagnosed with the prostate cancer, goes onto die of something else - similar thing happened with my grandfather - I recall being told after his death at the age of some 92, that he had prostate cancer however it was not that had caused his death.

Cheers
Mardhi

[Socrates999]

(mardhi @ May 14 2010,15:42)  ...about having a prostate check when turning 40 and she said, "yes, should do it" but then went onto say, "having said that, even if its diagnosed the chances of survival at any stage of identification are tiny" (and my doctor is a teaching professor at Chulalongkorn medical school !!!!!!) - interesting to say the least and said very matter of factly. ...

She's probably correct- in Thailand.

In a real country, I believe you'll find that the results are different!

I was involved with research & treatment of prostate cancer for about 3 years at a medical uni in the states. The post-op question is interesting, as early stages are usually androgen-dependent. A typical sequence might run chem/irradiation treatment, surgical removal of prostate, removal of testicles. At that point, prostate cancer cells will generally go into remission for a time, but then the androgen-independent growth kicks in. Cells frequently metastasize to the spinal cord and joints at that point.

I could see where one could go right to the androgen independent stage (or at least, that would be one's first awareness), so the lack of high levels of testosterone production might not preclude prostate cancer.

[mardhi]

(donnykey @ May 14 2010,15:34)

(mardhi @ May 14 2010,15:42) "yes, should do it" but then went onto say, "having said that, even if its diagnosed the chances of survival at any stage of identification are tiny" (and my doctor is a teaching professor at Chulalongkorn medical school !!!!!!)

Mardhi that statement from your doctor  is the most ridiculous and uninformed comment I have ever heard.

Are you sure the doc is not a teaching Professor at Chulalongkorn Auto Repairs.

Mate I have got prostate cancer in it's early stage and i plan to live a long life. I regularly keep it monitored with blood tests and biopsies and at the moment my PSA levels and cancer are static. If at any time in the future it worsens it can be treated/removed because I have discovered it in it's early stage.

So the above statement by the doc is so far off line it's not funny.

I'd be changing doctors my friend.

Cheers DK

Donny my test was done two years ago so forgive me if my recolection of wording is not exactly correct and its probably true to say that the actual comment would have been something like:-

"having said that, even if its diagnosed the chances of increased survival at any stage of identification are (tiny) unconfirmed" - i.e as I said in the comment above - it has not been proven that earlier detection of prostate cancer has had a improvement rate on survivability rates (and also take into account the comment that the while its picked up in 16% of Americans, it actually is the cause of death in only some 3% of cases - thus meaning 13% of the people (or roughly 75% identified with the cancer) actually died of something else.

Please keep this in context - its not meant as a flippant comment - just relaying what my doctor mentioned to me in passing and it would well appear to be correct based on the little reading I have just done in the last hour. Considering I have had the same doctor for some 5 years, this comment would also need to be taken in line with the fact that I am a smoker - and she always says snide comments about it will be smoking that will likely kill me and if your worried about prostate cancer - focus first on stopping smoking (i.e in my case and in her view I have a much greater chance of dying from a smoking based disease than prostate cancer). Hopefully this makes sense and keeps it in perspective (especially as far as the original comment was made to me).

All the best to you

Cheers
Mardhi

[guydesavoy]

Thanks for the clarification Mardhi.

[pacman]

Here's my 2 bahts worth -

PSA testing has been widely discredited & with the everpresent risk of a false negative result, it can cause unnecessary angst among guys who get a high reading.

All males will eventually develop prostate cancer if they live long enough but they are far more likely to die with it than from it.

I have two friends receiving treatment for prostate cancer at the moment with varying results.

One guy has had his prostate removed & is in good health (relatively) but hasn't had an erection in years.

The other guy took an alternative medical treatment that worked for some guy who wrote a book on his success.

It seems the writer was lucky but my friend wasn't & has been told his cancer has broken out of his prostate & he now has secondary cancers & a poor prognosis.

As to Mardhi's doctor's comment, I am glad he clarified the conversation because Donnykey was right, it was an uninformed comment by someone who shouldn't be kept on as a doctor.

And my deepest sympathy goes to Donnykey, he dropped his bombshell with little comment. I can understand his lifestyle choice to take all the trips to LOS he can. It is only when we are faced with such news that our priorities become clear.

As to TheGame's original question, I have read that prostate cancer is fed by testosterone, of which 95% is produced in the testicles. The androgen that Socrates refers to is the precursor to the production of testosterone but I don't know which of these is the more relevant hormone as far as prostate cancer is concerned.

Once the testes are removed in SRS, despite the comment made by Socrates, IMO I would think that the girls chances of developing prostate cancer have been reduced by a very large margin.

And I doubt that a medical professional would offer much more certainty than that. After all, if the prostate is still there, then it could become cancerous.

[guydesavoy]

I think the original quote from Mardhi's doc (or at least the recollection thereof) created some confusion. It seemed to suggest that an early detection of cancer had no bearing on the outcome. Coupled with that, the 'controversy' about the efficacy of screenings specific to prostate cancer (PSA), which in the grander scheme is perhaps a red herring and more of an internal debate...

The Mayo Clinic :

Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is detected early €” when it's still confined to the prostate gland €” has a better chance of successful treatment.

Prostate cancer can spread to nearby organs or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to other areas of the body is more difficult to treat than cancer that is confined to the prostate.

PSA testing combined with DRE helps identify prostate cancers at their earliest stages, but studies haven't proven that these tests save lives. For that reason, there is much debate surrounding prostate cancer screening.

(I have include that last bold print as it does highlight the apparent ambiguity).

So whilst the actual practice of PSA tests, in itself, may be questioned, I don't think that anyone would argue that if there is a cancer there, you had better know about it and monitor it so it doesn't become 'aggressive' and spread. That is just common sense. In many cases if the prostate cancer remains under control, then no further action may be required. But I would rather know sooner than later and then decide accordingly.

[Bumpa STIKKA]

Hands up if you didn't understand Socrates999 post!

[Jake_Sully]

I would think no but cancer is kinda too horrible a thing to just dismiss without any real info.

However I would say the most important thing here would be her knowing it would be partly genetic as in have any other males in her family had prostate cancer (which is how people know they're at risk for a cancer.)

And I happened to check since you provided the details.. so..

[guydesavoy]

Once you get on top of the androgen bit, the rest is a piece of cake