Urologist Visit

Today I had an appointment with a PA urologist, Susan Palmer, to followup on my recent high PSA reading of 10.5.  She was very competent, knowledgeable and informative.  I have to admit that having my deepest internal anatomy probed by a beautiful 30-something woman was, well...different.  I don't know what else to say about that.

Anyway, there is no surface indication of a tumor, although one lobe is larger than the other, which is not unusual.  The interesting thing about prostate cancer is that there are no reliable non-invasive tests.  The PSA test is only an indicator of possible problems, as is the physical examination.  The only way to know is to do a biopsy, which is an uncomfortable procedure and is not without the risk of infection (3%).

As is my wont, I had done a some research in recent years about the efficacy of doing the PSA test.  Many physicians and organizations advise against it for a variety of reasons, including false positives and negatives, the slow growth rate of prostate cancer, and the potential debilitating side effects of treatment.  Since I have no family history of prostate cancer, I suspended taking the PSA test after 2009, when my number was about 2.0.  As I mentioned in a previous post, I only opted to revisit this test because of the potential risk of secondary cancers associated with my MM chemo treatments.

I had a very good discussion with Susan about my options, one of which would be "See ya later".  I don't have any unusual symptoms and have no trouble urinating.  Also, I have not noticed any recent changes that might be cause for suspicion.  Therefore, I opted to have another PSA test done in a couple of months.  At that time, we can see if my elevated test result was an anomaly, whether it is stable, or is increasing.  If it goes any higher, I think I would opt to have a biopsy done.  Otherwise, I would probably just continue to monitor it.  If I do end up having a biopsy and the results were to be positive, that would bring up a whole new set of decision options to consider. 

Susan made an interesting point.  If one's life expectancy is less than 10 years, they generally do not recommend drastic treatment options for newly-diagnosed prostate cancer, because it is slow-growing and usually takes ten years or more to metastasize into a life-threatening situation.  Now I am a real optimist.  I personally expect to be here to continue to amaze, amuse, and confound everyone around me ten years from now.  But statistically, that would make me an outlier. 

So!  Here's the bottom line.  I'm not going to do anything drastic.  I will await my next test results in February and take it from there.  In the meantime, I don't plan to worry my pretty little head about it.  There is life to be lived, and that's what I'm going to do.