Health

What Do You Do…

When you are told you must be tested for prostate cancer, then what?

I am not writing this for any other reason than my need for someone to “talk to”. Sympathy is not what I seek. I don’t have all the answers I need yet to even know for sure. But I have run into a quagmire of medical information, much of it contradictory.

My doctor called yesterday, after my 3rd blood test to check my PSA levels again. He told me he wants me to see an urologist ASAP. In 10 weeks, my PSA levels have gone from 6.4 to 6.6 to 6.8. He said at my age I should be lower than 6.5. I looked this up and other medical information states that number should be no higher than 5.5.

Here are the facts as I know them about prostate cancer, which can affect anyone, mostly men over the age of 65:

• Good doctors in this field are hard to find if reviewing comments from patients. These comments are often contradictory.
• Some say the PSA test for a 70+ year old man is 5.5. Other information says 6.5.
• Men are over tested for prostate cancer, and after 70 should NOT be tested. PSA tests are increasingly inaccurate the older the man gets.
• PSA tests are a measurement, not an indication of cancer. A normal reading can happen even if someone has cancer. I high reading, especially in older men, can happen and mean nothing.
• A digital exam is more accurate and is what I had. A lump was felt.

According to Texas Urology Specialists, a normal PSA level for men is:

• 0–2.5 ng/mL for men aged 40–50
• 2.5–3.5 ng/mL for men aged 50–60
• 3.5–4.5 ng/mL for men aged 60–70
• 4.5–5.5 ng/mL for men aged 70–80

The Harvard Medical Task Force recommends that men ages 55 to 69 make a shared decision with their doctors regarding routine prostate cancer screening, which usually means periodic blood tests for prostate-specific antigen (PSA). The task force advises men to stop screening once they reach age 70.

More often than not, a mildly elevated PSA happens in men with an enlarged prostate or another reason besides cancer. And even if cancer occurs, many older men are likely to have a low-grade version that does not alter their quality of life or longevity.

The US Preventive Services Task Force advises against PSA screening in men older than 69 years due to the risk of false-positive results and overdiagnosis of indolent disease. The American Urological Association (AUA) recommends against routine PSA screening of men older than 70 years. However, the AUA acknowledges that some men age 70 years or older in “excellent” health may have more than a 10–15 year life expectancy and might benefit from screening.

According to an AUA panel: “Men age 70 years and older who wish to be screened should do so after an understanding that the ratio of benefit to harm declines with age, although there is evidence that men with high-risk disease in this age range may benefit from early diagnosis and treatment over a decade or less.”

So what we have here is a conundrum. What to believe and what to do are the questions. I don’t know. But I have an interview with an urologist on Feb. 1st.

I have read there is a new laser technology to kill prostate cancer cells in early to medium circumstances. I have read a prostate MRI is recommended. If this shows positive for anything, then a MRI guided biopsy is suggested. But the laser technique is more friendly. Of course the questions then arise, what is covered by insurance and how much are the costs? No answers without multiple phone calls and appointments.

Questions, questions, questions …

It is also said that stress causes high blood pressure. Mine has been spiking for three days to over 180. Three different medications daily and they too do not work. This I have told to three doctors. “Oh, just keep taking them and come back in ___ months. Is this stress of possible prostate cancer a cause? Who knows?

Three months and multiple tests at the heart institute in which I tested normal, yet I still am over 180/85. Did you know when this happens you are dizzy, lightheaded, can’t think straight, and feel nauseous? These symptoms kick in at readings of 150 and up. I’ve been as high as 210.

Why, after one year and four doctors, can I not get help? I keep telling them the drugs they are giving me don’t work. I am taking three different medications for blood pressure, one at night and two in the day. And remain in the 180s. I was at the doc’s office last week and tested at 160/80. Take them for three more months and come see me in February.

Nope. I called his office and said enough of this. The medicines do not work. Find me something that does. I will see him again next Tuesday, not in three months. At least they answer the phone. Have called the heart institute three times … no answer. Leave a message and the call will be returned within 48 hours. Nice.

Note that any doctor you call on the phone has a legal out. They tell you to dial 9–1–1. Just in case you can’t wait for a call back in a couple of days in order to get an appointment in 2–4 months from the time they respond.

Questions, questions, questions …

Here’s a question: When will our elected representatives stop acting like clowns and do something about the lack of a national health system? Healthcare in this country gets worse every year.

Hoping the information I provide here may help someone with similar issues.

Thanks for listening/reading.