New Member saying Hello

[TravelerInKY]

I'm Steve and live in Western Kentucky, near Evansville, Indiana. We live in my husband's hometown - moved here two years ago from the Sacramento, California, region. We love it here and our town had its first Pride celebration yesterday that was well attended. I've watched my PSA rise over the past 7 years. I had a TURP in 2018 to help with urine flow, no cancer was found. A biopsy in 2022 also indicated that there was no cancer. My last PSA test was 9.64 in April, so my urologist recommended another biopsy, this time under sedation and (I think) ultrasound-guided. Of the 12 samples, one was (3+3) and two were (3+4). In some ways, it was a relief to finally know that there was cancer to explain the PSA rise. My dad was treated for PCa about 10 years ago when he was 83. We never discussed his treatment, so I am not sure what he did, but it was some kind of radiation. His brother (my uncle) was also treated for PCa using brachytherapy. Although the family never talked about it, my mom believes that my paternal grandfather also had prostate cancer, but he also had many other health issues and died in 1971 at age 65 from a massive heart attack. I have an appointment with a radiation oncologist on July 12 and then a follow-up with my urologist on August 13. I hope to make a decision by then on what course of treatment and plan for the future. I will be 67 in three weeks, and hope to have many, many more years ahead of me! I've been reading and learning as much as I can to make an informed decision. Reading your stories is helping tremendously. Thanks to you all!

[Tall_Allen]

You may want to read this:

prostatecancer.news/2021/12...

Also, your GS3+4 cores do not necessarily mean that Active Surveillance is out of the question. It depends on the volume of pattern 4. You may want to get a second opinion from the pathology lab at Johns Hopkins:

pathology.jhu.edu/patient-c...

[TravelerInKY in reply to Tall_Allen]

Thanks for sending the link to the report. It was interesting reading. However, as someone who doesn't enjoy anal sex (either top or bottom), some of those recommendations aren't relevant to me. And I have to disagree with the comment in the report that an orgasm without ejaculation isn't an orgasm! Since my TURP and ongoing Flomax/tamsulosin medication, my ejaculations are mostly dry anyway, but there is definitely an orgasm!

[Tall_Allen in reply to TravelerInKY]

It actually says, "Getting used to orgasms without ejaculation takes some psychological readjustment, whether gay or straight."

[TravelerInKY in reply to Tall_Allen]

But it also says, "We either ejaculate at orgasm, or we don't have an orgasm."

[Tall_Allen in reply to TravelerInKY]

You are taking that out of context. That's referring to the way we have been trained. What it says, in context is:

"While women can fake orgasms, men can't. We either ejaculate at orgasm, or we don't have an orgasm. Ejaculation is how men communicate that "it was good for me." Men are disappointed when their partners do not "cum." RP removes all ejaculate except for Cowper's gland secretions. RT reduces ejaculation, but in a recent trial of SBRT patients at Georgetown, only 15% were without ejaculate after 2 years. Anejaculation excludes men from relationships with other gay men. It is more bothersome to gay men (Wassersug et al.)

Ejaculation is how we've signaled orgasm to ourselves since puberty. Getting used to orgasms without ejaculation takes some psychological readjustment, whether gay or straight."

[PrettyUnhappyGuy]

Whatever path you choose, commit to it. I find periodically attending a support group to be really helpful because I learn what other guys do and how they cope. Also, you HAVE TO be your own advocate. Doctors and nurses will, to a large extent, try to push various treatments on you. Make sure you know the whys and the specifics. I feel good about my decision to go with SBRT radiation, but feel I made a mistake agreeing to ADT since the side effects have been really bad for me and, from what I've read, it offers, at best, an extra 5% chance of remission, in my case 90% instead of 85%.

Advertisements for cancer centers and even doctors themselves will greatly downplay side effects and generally don't care at all about anything to do with emotion or sexuality, but if YOU care about those things you need to do your homework.

I *do* see that Kentucky has an NCI-designated cancer center. If you can go to an NCI center they're generally much better equipped to treat you than a community hospital.

Keep us posted on your progress/decision.

[TravelerInKY in reply to PrettyUnhappyGuy]

Lexington, KY, and Indianapolis are each about 3 hours away and both have NCI centers. It's nice to have options. Our local hospital is part of the Deaconess organization, and they follow MD Anderson protocols. I know that I have to be my own advocate, but I'm grateful for you and the others here for support!