Prostate cancer

[likaleather]

This seems to be one place to get firsthand information.  Not looking for medical advice just experiences from others.  I have a referral to see a urologist due to results from a blood test.  PSA level was 5.7 (but dropped a month later to 4.7) and the free PSA was 14%.  Those results put in at a 24% chance of having prostate cancer.  I've been doing research and it looks like this diagnosis has more of an impact on gay men than straight.  I'm hopefully jumping the gun and have nothing to worry about.  I'm hearing lots of doctors (and people in general) want to jump and remove the cancer (aka prostate in this case) and there could be other options.  Anyone have any experience or thoughts?

[phillygwm]

I was diagnosed when I was 45; my doc had been monitoring me because of a family history of early onset prostate cancer.  Thankfully, mine was caught very early.

I opted for radiation rather than a radical prostatectomy because I was (or wanted to be, at least!) sexually active.  So against the advice of friends, I got brachytherapy.  This was 15+ years ago and that's no longer the standard of care but I'd definitely recommend radiation:  Easier procedure (same day surgery), I was jerking off a few days after, back to work in 5 days, etc.  Downside was that it hurt like hell to piss for a while after.  And years later, I had urethral strictures.  But minor compared to what might have been and I'm just as cured as someone without a prostate.

Feel free to hit me up privately, if you prefer.

[phillygwm]

Sorry, I should have added this to my prior email but it's been a while and some things didn't occur to me immediately.  I know this is long, especially considering the last post, but you'll want all the info you can consume if you wind up having PC.  Hopefully, that won't be the case!

I was on an online group for gay men with PC.  They were very helpful.  Google "Gay men prostate cancer".  I should have stayed to pay it forward a bit but I wanted to get my mind off things.  But the more people you speak with, both docs and patients, the better informed you'll be, medically and emotionally.  I chose the 4th doc I spoke with.  But you're correct: gay men have different issues than straight.  For instance, you're probably familiar with the questionnaire you fill out at the docs every time.  One of the questions is whether you can confidently get hard enough to penetrate.  Well, that standard is different between an ass and a vagina and, in any case, someone may be a total bottom!

I'd also recommend an NCI designated cancer center.  Even if your case is routine, stuff happens.  If it does, they've seen everything.  That might not be the case in a community hospital.  I was lucky to have 3 such hospitals in my area.  I chose the smallest one.  I didn't have a guy who specialized in gay men but if you find that, all the better.

I mentioned radiation, which was an unusual decision that I'd absolutely do again.  Not so much the permanent seeds, since that's no longer the standard of care.  But maybe cyberknife, proton therapy, etc.  I haven't stayed up on all the options but they're better than they were in 2011. 

Your doc will 100% recommend surgery because he can do that.  You'd need a radiation oncologist for other options.  Of course, the vast majority of folks opt for surgery because it's assumed that if you have it out and the biopsy shows clean borders, you're cured.  I was speaking with a guy who was also 45 at the time of dx, with a young family.  He was talked into surgery for this reason:  He wanted certainty more than quality of life.  I think there have been advances on the surgery side as well but I don't keep up on it.  But ultimately, some people will require radiation anyway and he did (as did my father, which influenced my decision) so what did surgery buy him?

My father was dead (not PC related) by the time I was dx'd so I couldn't ask him questions and he never went into a lot of detail at the time.  In fact, I only learned from my aunt that my grandfather died of PC when I was an infant.  He was 57 so he probably had it in his 40s as well.

Edited 12 hours ago by phillygwm