Insight into the phases of the Internet forum life cycle: a perspective

On Sep 18, 10:37*pm, "Edward Dolan" wrote:
"JimmyMac" wrote in message

...
On Sep 15, 6:00 pm, "Edward Dolan" wrote:
[...]

I remember after my first PSA test, which was high, I was later examined
by
an old school doctor at the VA who relied strictly on the digital exam. He
assured me I did not have prostate cancer, but still I worried about that
high PSA. So I repeated it until there was no mistake. My PSA was rising
steadily and fast. A biopsy confirmed that I had prostate cancer.

The PSA test is not definitive. But a biopsy is.
PSA is a biomarker that is flawed, but it is the best that we have

until promising horizon methods become available. *In the interim,
free PSA, PSA velocity, and PSA density tests are helpful. *Just the
same, PSA screening remains controversial because it is has not been
definitively established if the PSA test actually saves lives.
Moreover, it is not clear that the benefits of PSA screening outweigh
the risks of follow-up diagnostic tests and cancer treatments. For
instance, the PSA test may detect small cancers that would never
become life threatening.

Almost everyone I know my age has a slightly elevated PSA, but they are all
on the watchful waiting regime. On the other hand, if the PSA is fairly high
to begin with and is rising rapidly, your only recourse is a biopsy, a not
particularly dangerous procedure.

I recently read that 20% of 20 year old already have some prostate
cancer cells. I was shocked and dismayed. As concern a DRE, one can
have prostate cancer without palpable tumors, so just like the PSA , a
DRE is not entirely a sole reliable indicator.

I have just spent the past day at the ER for a stomach ailment. They put
me
through every standard routine test to make sure I did not have something
that was going to kill me. In the end, "you probably got a bug that will
pass." Was that information worth over $1000? Until today, I thought I
might
have stomach cancer.
Often the price of reassurance is steep, but whether worth it or not

is a judgment call that only the individual with the malady and
pocketbook can make.

The trouble is that you never know for sure one way or another. Your
symptoms will normally either get better to get worse. But if you wait on
that outcome, you can easily expire from whatever is ailing you - most
especially if you are old like I am.

Yep, its a crap shoot and a crap shoot is a gamble and what's at stake
is near an dear to you on a very personal level.

Emergency Rooms are truly remarkable places. If you fear for your life, that
is where you want to be.

A trauma center is better yet since trauma centers generally have a
greater depth of experience adn are often associated with teaching
institutions that are on top of the cutting edged of medical
technology and treatment.

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

"JimmyMac" wrote in message
...
On Sep 18, 10:37 pm, "Edward Dolan" wrote:
[...]
Emergency Rooms are truly remarkable places. If you fear for your life,
that
is where you want to be.

A trauma center is better yet since trauma centers generally have a
greater depth of experience adn are often associated with teaching
institutions that are on top of the cutting edged of medical
technology and treatment.

Smaller towns will not have trauma centers. It is either the ER or nothing.
I am struck by the excellence of the doctors manning the ERs. That seems to
be their specialty as they remain on that particular job for years and keep
very odd hours besides.

--
Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

On Sep 21, 10:29*pm, "Edward Dolan" wrote:
"JimmyMac" wrote in message

...
On Sep 18, 10:37 pm, "Edward Dolan" wrote:
[...]

Emergency Rooms are truly remarkable places. If you fear for your life,
that
is where you want to be.
A trauma center is better yet since trauma centers generally have a

greater depth of experience adn are often associated with teaching
institutions that are on top of the cutting edged of medical
technology and treatment.

Smaller towns will not have trauma centers. It is either the ER or nothing.
I am struck by the excellence of the doctors manning the ERs. That seems to
be their specialty as they remain on that particular job for years and keep
very odd hours besides.

Understood. That is merely a choice limiting decision based primarily
upon one's geophysical place of residence/. On another note,
revisiting a previous topic of conversation, regarding detection of
prostate cancer via DRE and/or PSA, one study found that in men 40-50
years of age, tumors detected at time of autopsy were 40% whereas
tumors detected clinically (read DRE/PSA) in the same age group of the
living was mere 1"% ... not very encouraging now is it?

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

"JimmyMac" wrote in message
...
On Sep 21, 10:29 pm, "Edward Dolan" wrote:
[...]
Smaller towns will not have trauma centers. It is either the ER or
nothing.
I am struck by the excellence of the doctors manning the ERs. That seems
to
be their specialty as they remain on that particular job for years and
keep
very odd hours besides.

Understood. That is merely a choice limiting decision based primarily
upon one's geophysical place of residence/. On another note,
revisiting a previous topic of conversation, regarding detection of
prostate cancer via DRE and/or PSA, one study found that in men 40-50
years of age, tumors detected at time of autopsy were 40% whereas
tumors detected clinically (read DRE/PSA) in the same age group of the
living was mere 1"% ... not very encouraging now is it?

The doctors at the VA insisted on a biopsy because of my high PSA test. It
was an in-office procedure and is definitive. But alas, most men never get
to the biopsy point until too late because the PSA test is usually all over
the map. The DRE is pretty worthless. You have to catch prostate cancer
before the physical tumor stage, i.e., before it has spread.

I read every day about men, many not so old, who are still dying of prostate
cancer. The trick is to catch it early before it has spread. Every man over
the age of 50 should be getting the PSA test every year even though it isn't
totally reliable.

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

On Sep 23, 8:35*pm, "Edward Dolan" wrote:
"JimmyMac" wrote in message

...
On Sep 21, 10:29 pm, "Edward Dolan" wrote:
[...]

Smaller towns will not have trauma centers. It is either the ER or
nothing.
I am struck by the excellence of the doctors manning the ERs. That seems
to
be their specialty as they remain on that particular job for years and
keep
very odd hours besides.
Understood. *That is merely a choice limiting decision based primarily

upon one's geophysical place of residence. On another note,
revisiting a previous topic of conversation, regarding detection of
prostate cancer via DRE and/or PSA, one study found that in men 40-50
years of age, tumors detected at time of autopsy were 40% whereas
tumors detected clinically (read DRE/PSA) in the same age group of the
living was mere 1"% ... not very encouraging now is it?

The doctors at the VA insisted on a biopsy because of my high PSA test. It
was an in-office procedure and is definitive.

A prostate biopsy is definitive, but the experience of the doctor on
the other end of the telescope is crucial. Like any profession, there
are some that are better than others at their craft. The one
disturbing risk of a prostate biopsy is needle track seeding which can
spreed the disease.

But alas, most men never get
to the biopsy point until too late because the PSA test is usually all over
the map. The DRE is pretty worthless. You have to catch prostate cancer
before the physical tumor stage, i.e., before it has spread.

Not quite true, Yes the DRE is not definitive nor is a PSA test, but
until better tools become available (some are almost there).that is
what is commonly employed. ON the other hadn you don't have to catch
prostate cancer before the tumor stage and often enough won't. As
long as the tumor is discovered when still organ confined, a
prostatectomy or radiation can, in most instances, be a life saver.
Once the disease has spread to seminal vesicles, lymph nudes or has
metastasized to bone, prognosis is far less promising.

I read every day about men, many not so old, who are still dying of prostate
cancer. The trick is to catch it early before it has spread. Every man over
the age of 50 should be getting the PSA test every year even though it isn't
totally reliable.

Since prostate cancer is now more commonly being discovered in younger
men, the current wisdom is to get a PSA every year beginning at age
40.

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

"JimmyMac" wrote in message
...
On Sep 23, 8:35 pm, "Edward Dolan" wrote:
[...]
But alas, most men never get
to the biopsy point until too late because the PSA test is usually all
over
the map. The DRE is pretty worthless. You have to catch prostate cancer
before the physical tumor stage, i.e., before it has spread.

Not quite true, Yes the DRE is not definitive nor is a PSA test, but
until better tools become available (some are almost there).that is
what is commonly employed. ON the other hadn you don't have to catch
prostate cancer before the tumor stage and often enough won't. As
long as the tumor is discovered when still organ confined, a
prostatectomy or radiation can, in most instances, be a life saver.
Once the disease has spread to seminal vesicles, lymph nudes or has
metastasized to bone, prognosis is far less promising.

There has been a recent large study about which treatment is the least
disruptive to a normal life. Prostatectomy is the worst, followed by
radiation, followed by seeding, the least disruptive.

How is your anti-hormonal treatment going? I just had 1 shot in the belly
prior to radiation and seeding and had a non-ending series of hot flashes
for 4 months as a result. I don't know if I could live with those shots.

I read every day about men, many not so old, who are still dying of
prostate
cancer. The trick is to catch it early before it has spread. Every man
over
the age of 50 should be getting the PSA test every year even though it
isn't
totally reliable.

Since prostate cancer is now more commonly being discovered in younger
men, the current wisdom is to get a PSA every year beginning at age
40.

Yes, better safe than sorry!

--
Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

On Sep 27, 11:48*am, "Edward Dolan" wrote:
"JimmyMac" wrote in message

...
On Sep 23, 8:35 pm, "Edward Dolan" wrote:
[...]

But alas, most men never get
to the biopsy point until too late because the PSA test is usually all
over
the map. The DRE is pretty worthless. You have to catch prostate cancer
before the physical tumor stage, i.e., before it has spread.
Not quite true, *Yes the DRE is not definitive nor is a PSA test, but

until better tools become available (some are almost there).that is
what is commonly employed. *ON the other hadn you don't have to catch
prostate cancer before the tumor stage and often enough won't. *As
long as the tumor is discovered when still organ confined, a
prostatectomy or radiation can, in most instances, be a life saver.
Once the disease has spread to seminal vesicles, lymph nudes or has
metastasized to bone, prognosis is far less promising.

There has been a recent large study about which treatment is the least
disruptive to a normal life. Prostatectomy is the worst, followed by
radiation, followed by seeding, the least disruptive.

How is your anti-hormonal treatment going? I just had 1 shot in the belly
prior to radiation and seeding and had a non-ending series of hot flashes
for 4 months as a result. I don't know if I could live with those shots.

Hot flashes are the least of my worries and I don't suffer too badly
from them. I am more concerned about the long term effects of hormonal
therapy. There is a downside to androgen deprivation therapy (ADT).
Adverse acute menopausal side effects include hot flashes, abdominal
fat deposit, breast pain and/or enlargement, reduction in the size of
testes and penis, loss of lean muscle mass, emotional changes,
anxiety, depression, weight gain, fatigue, impotence, and loss of
libido. More serious side effects include anemia, loss of bone mass
(osteopenia/osteoporosis), Type-II diabetes, cardiovascular disease,
elevated cholesterol and triglycerides, memory impairment, cognitive
decline, adverse effects on the liver, increased risk of skeletal
related event (pathological fracture), colorectal cancer, and excess
serum cortisol. Some anti-aging experts refer to cortisol as the
"death hormone" because of the multiple degenerative effects that it
produces including immune dysfunction, brain cell injury, and arterial
wall damage. Regardless, I had only two alternatives. I could allow
the disease to rapidly progress unabated, or I could opt for ADT to
survive longer. I chose the latter.

I read every day about men, many not so old, who are still dying of
prostate
cancer. The trick is to catch it early before it has spread. Every man
over
the age of 50 should be getting the PSA test every year even though it
isn't
totally reliable.
Since prostate cancer is now more commonly being discovered in younger

men, the current wisdom is to get a PSA every year beginning at age
40.

Yes, better safe than sorry!

--
Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota

"JimmyMac" wrote in message
...
On Sep 27, 11:48 am, "Edward Dolan" wrote:
[...]
There has been a recent large study about which treatment is the least
disruptive to a normal life. Prostatectomy is the worst, followed by
radiation, followed by seeding, the least disruptive.

How is your anti-hormonal treatment going? I just had 1 shot in the belly
prior to radiation and seeding and had a non-ending series of hot flashes
for 4 months as a result. I don't know if I could live with those shots.

Hot flashes are the least of my worries and I don't suffer too badly
from them. I am more concerned about the long term effects of hormonal
therapy. There is a downside to androgen deprivation therapy (ADT).
Adverse acute menopausal side effects include hot flashes, abdominal
fat deposit, breast pain and/or enlargement, reduction in the size of
testes and penis, loss of lean muscle mass, emotional changes,
anxiety, depression, weight gain, fatigue, impotence, and loss of
libido.

The loss of libido I also consider a serious matter in addition to the hot
flashes. It why I will never neuter any of my cats. It is best to function
as a normal creature for as long as possible. Mankind is not smart enough to
mess with mother nature.

What is remarkable to me in light of all the adverse side effects that you
list is that many guys who were being treated and supposedly cured of their
prostate cancer at the VA in Seattle were going to continue the anti-hormone
treatments anyway. That is how much they feared prostate cancer. I thought
that was crazy and never even considered such a course.

More serious side effects include anemia, loss of bone mass
(osteopenia/osteoporosis), Type-II diabetes, cardiovascular disease,
elevated cholesterol and triglycerides, memory impairment, cognitive
decline, adverse effects on the liver, increased risk of skeletal
related event (pathological fracture), colorectal cancer, and excess
serum cortisol. Some anti-aging experts refer to cortisol as the
"death hormone" because of the multiple degenerative effects that it
produces including immune dysfunction, brain cell injury, and arterial
wall damage. Regardless, I had only two alternatives. I could allow
the disease to rapidly progress unabated, or I could opt for ADT to
survive longer. I chose the latter.

You chose the only treatment you could have chosen. I would not worry too
much about those "serious side effects". I had a friend here in Worthington
who had the same diagnosis as you and the same treatment and he lived for
well over 10 years and never had any side effects except the ones I have
already mentioned (he died of kidney failure at age 83). Just be thankful
that the hot flashes do not bother you much and that you do not mind the
loss of libido.

--
Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota