Prostate Cancer - Ignoring It Won't Beat It

In January this year, at the age of 53 the last thing I expected was to be diagnosed with prostate cancer - I’d thought it was reserved for ‘old-gits’…although I guess that puts me firmly in that category! :grinning:

Thank goodness for my excellent GP here in France who decided to add a PSA (Prostate Specific Antigen) test to my annual full bloods when I turned 50. Had he not done that one simple thing (or had I still been in the UK?), I doubt I would even know today that I had prostate cancer.

Apparently prostate cancer is affecting more and more guys in their 40’s and 50’s so I’ve made it a bit of a mission to shout about it which, to my surprise, has often resulted in ‘tumbleweed’ moments. Generally folks are not comfortable talking about prostate cancer - certainly not to the same extent they are talking about say, breast cancer.

In France, prostate cancer is the most prevalent of all male cancers. Last year 53,465 new cases of prostate cancer were recorded and 48,763 new cases of breast cancer. I’d had no idea it was such a huge deal. Source: Institut National de Cancer

I never had any symptoms, never had any issues and never felt unwell. My PSA readings started to rise, little by little, around 2 years ago (i.e. higher than the accepted maximum level of 3.1 in France). Then biopsies in January confirmed I had cancer. Since then, the treatment and support I have received has been frankly amazing. I’m also so lucky to live near Toulouse where the cancer treatment facilities are top class - amazing facilities that I never even knew existed. A whole new world and I can’t pretend I havent been scared to bits at times.

I’m doing just great now and have just had my 3 month review which shows my prostate cancer as undetectable. As with most cancers, I won’t get the all clear for 5 years buy hey, onward and upwards - life is for living!!

So the upshot of my post is really to raise awareness about prostate cancer, encourage you boys (and the girls and boys who love you) to get a PSA test and, at the very least provoke conversation.

Prostate Cancer UK

ANAMACaP - France

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Excellent news @anon88888878 glad to hear you’re well :slight_smile: Thanks for the post, I’ll be sharing it. I have a full blood test coming up but I don’t imagine that (PSA) is included or do you think it is requested due to age?

@james Hi James my PSA test was added by my GP (MT) when I turned 50 so I guess that makes it an age related test. However…guys in tbeir 40’s get prostate cancer and generally know about it due to symptoms. A couple of my mates in their 40’s have recently been tested - it’s sooooo easy here so what the heck - just do it for peace of mind.

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Hi again Simon,

Good to hear of your successful operation. I’ve had PSA tests for about ten years incorporated in the normal blood test pocedure. Just looking at the last two years results my PSAs are 0.54 (2015) and 0.66 (2016) so no worries there for the moment at least.
A close mate in England was diagnosed about 7 years ago. It wasn’t possible to operate so the doctors have used drugs to keep him stable. His readings started at about 60 would you believe and even peaked to over 200 ! The main treatment prescribed was hormonal with some chemo thrown in. I believe the main hormone used is progesterone. Apparently injecting doses of the female hormone acts against the prostate cancer. His PSA is now well below the 3.1 limit at 1.6 so he and the doctors are very happy with that.

Peter Hi and thanks for your input! Good news about your PSA levels - you must be doing something right!! Also good news about your mate - sometimes surgery is just not possible and sometimes, as in my case, surgery was the only viable option. It’s a very individual thing and some guys simply walk out of the consultant’s surgery, sell up, buy a yacht and travel the world - according to my lead consultant!! I just decided I was too young and had loads of things to do…

It’s a funny thing though - over 400 views of this topic in less than 2 days and yet very little input. Maybe that’s just indicative of the perceived stigma around prostate cancer - I’m sure a similar discussion on breast cancer would have stimulated far more open discussion…funny old world.

PSA testing is so very easy here in France and as Peter says, can simply be added to your annual ‘bilan’ - it’s free and it could save your life.

I think there is a ‘it can’t happen to me’ attitude among many blokes and of course many others don’t want to think about it…
Women are more realistic about such problems I feel though in some cases as with my late missus for example they can be shy of 'not wanting to ‘bother the doctor’. She had had problems with going to the toilet for a few months and only went to her GP after she was just about unable to pass solids ! She ignored the blood probably hoping it would go away and it was no surprise when a colonoscopy a week later reveales a giant tumour in her colon which meant about 22cms of colon having to be removed. Unfortunately the cancer had time to spread to the liver and that was curtains…she was only 56 !

I think you’re bang on Peter - sadly! Your own experience must have been crushingly painful and I guess one of the lessons (for want of a better word) is about how our own decisions (or lack of them) affect those closest to us. I don’t mean that to sound critical in any way - it’s just really brought home to me the effect my cancer has had on those around me. Above anything I’m trying to do my best for them.

Those of us who have moved here recently may know that there is no compulsory PSA testing for over 50s or even 60s in the UK. Anyone who read this NHS info on the subject would find it very difficult to make an informed choice I feel.
http://www.nhs.uk/Livewell/Prostatehealth/Pages/psa-test.aspx

It’s definitely a subject that many of us know little about, or would rather not, but your experience should be a wake up call for those of us that didn’t know testing is available here. I will certainly be requesting one.

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Great Chris - one down and a ‘few’ thousand to go!! :slight_smile:

Not only is PSA testing readily and freely available in France - it’s a 10 second job, a simple blood test that can be undertaken at any of the myriad of ‘high street’ labs - with or without a prescription from your GP / MT. Obviously without a prescription it will mean paying a small fee.

My local lab (Biodoc Foix) normally puts the results up on my online account the same day if I have the test before midday. Bloody brilliant.

Hi all, I am so glad, Simon, that you are over the worst and wish you all the very best with the rest of your recovery. A close relative of mine was diagnosed last year (in his early 50s) and told me his brother had it too. The figures you quote on diagnosis levels in France as against breast cancer are frankly alarming! You are right to flag it up - there is so much information and awareness around breast cancer (though, sadly, not so much around male breast cancer) and yet prostate cancer is viewed as something only old men get. I shall be frog marching my beloved off to the MT tout de suite! Take care.

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Thanks for your input and kind words Wendy and I hope your ‘beloveds’ PSA test goes well - remember the vast majority of them do! More than anything it will be peace of mind.

Our local Ariege Cancer League recently announced an active campaign throughout the month of October specifically to promote Breast Cancer screening. They will have stands manned by lots of volunteers in hospitals, health centres and some of the larger pharmacies. Via their Facebook page I applauded them and asked them when they would include Prostate Cancer in such campaigns? Their response was very ‘odd’ - implying they have other priorities: ''il existe déjà mars bleu pour le cancer du colon ensuit va commencer un programme sur le cancer du col de l’utérus puis seulement ensuite pour la prostate.’’

I’m not trying to take anything away from the fight against other devastating cancers - but the fight against Prostate Cancer is most definitely an uphill struggle. Incomprehensible when it is by far the most prevalent male cancer in France - well ahead of colon and lung cancers.

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in spite of the fact that the S of PSA means specific, this old test is not specific at all, and many things can change it, like riding a bike or after a TR (toucher rectal: digital rectal exam) and even some medicines. The false increase of prostate cancers in France is due to the fact that now we search for them and when you search, you often find and when you find, you want to treat!
Even doctors are not clear and not all of them get sufficient knowledge to take a correct decision. So don’t worry about your prostate! Ask several doctors and correct ones.

My brother was diagnosed in the UK a couple of years ago after the doctor decided that he had not been for a routine check up for too long (he wanted a repeat prescription for gout). He opted for surgery and was also very keen to raise awareness amongst the people he works with - an auctioneer so has plenty male acquaintances in the farming community amongst others. He was surprised how many others either had had a scare or decided to get checked out after he talked to them. Definately something worth talking about.

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The PSA test is the easy bit! It may only take 10 seconds but the implications and the decisions need a lot longer. When I was practising as a GP in UK I would usually spend about 20-30 minutes discussing the pros and cons of PSA testing and its significance. It isn’t an easy decision and it is very hard to advise about how to proceed. It is very individual and depends on much more that the PSA result but even then there are many difficult questions. Very good summaries are available on the UK Prostate Help Association (www.prostatehelp.me.uk) and I would always give patients there printed handouts and send them away to read it and think about before coming back to talk to me again before making a decision (theirs of course not mine).

I hope all of you who have had either investigations or treatment have had good outcomes.

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I changed Dr’s 30 months ago, my new Dr suggested I go for blood tests, old Dr didn’t bother. These included PSA. By the way, I had no symptoms at all.
MY result was 34, i ended up having, Echography. Scintigraphy, Scanner, Biopsy, cancer discovered, MRI etc etc culminating in a Prostactectomy Totale, in July 2014. My PSA initially went down but started rising again after 6 months, so had a course of RT and hormone injections - 1 hr 45 mins each way in a taxi, not fun. But I now have a PSA of 0.07. And stable at that. Very pleased. Still have Hormone injections every three months, had one this morning actually.
I knew nothing about this subject before, now i am very knowledgeable
Get you PSA checked I say.

Couldn’t agree more Richard. The PSA test is simply a precursor to actual diagnosis. No reason whatsoever to put off having one. Sadly the world is full of ‘ahhh buts’ and reasons not to do something - however, where cancer is concerned , the risk is simply too great. Prostate cancer is easy to diagnose accurately - no if’s, no but’s.

France has a real issue in openly talking about prostate cancer - just take a look at Facebook and the number of followers on ProstateCancer.co.uk compared to the French equivalent ANAMACaP.

So guys, man up and get tested - please. It takes courage to have the test but it’s so much better than waiting for symptoms.

History first, then lessons learned: I was diagnosed almost four years ago, through my MT prescribing a full blood test for entirely other reasons. My PSA was 39 and I had almost no symptoms - just the less easy (but not difficult) passing water that most older men get. The surgeon I was referred to took a reading of 39 as indicating agressive prostate cancer and prescribed a bone scan and biopsy. The bone scan was clear and first biopsy was inconclusive - it showed only a very small amount of cancer - at odds with the PSA number, so he had another one done - fortunately both with general anasthetics, which I’d recommend. Anyway the second showed a Gleason 7 (3+4). I had started reading up and decided I didn’t want the removal op regardless, but accepted initial hormone therapy followed about a year after my diagnosis with intense targeted radiotherapy, daily for two months. The hormone therapy is designed to shrink the prostate and bring down the PSA, not to cure the cancer. It brought the PSA down to 1.24 just before the radiotherapy, and makes it easier for the radiotherapy to target and kill the cancer accurately. The surgeon wanted to continue the hormone treatment for another year after the radiotherapy was complete and I had one more implant, but refused further hormone treatment because of the side effects. I also began taking curcumin regularly. After the radiotherapy my PSA eventually bottomed out at 0.04, which my MT said was unusually low; my waterworks started to work a bit better, but I did have some undesirable side effects from the both radiotherapy and the hormone shots. Since then it has been increasing - quickly at first but now plateaued at < 0.5. The surgeon says I shouldn’t worry unless it gets up to 10 !
However, the biggest problem for me was that it appeared that I must have sudden aggressive cancer at age 65, shown by the high PSA - around 40 for three more tests until the hormone pulled it down. However, I had never had a previous PSA test and I now know that PSA does not measure cancer, it just measures PSA, which can be elevated for all sorts of other reasons. So I did not have aggressive cancer, just an ordinary one that happened to give high PSA readings. As the PSA test is not a direct measure of cancer amount or aggressiveness, it tends to give false- positive readings resulting in many cases of unnecessary treatment, often with unpleasant side-effects. This does NOT mean you shouldn’t have your PSA tested. What it means is that you should start having it measured well before the common age for prostate cancer to take hold. If I had had previous readings I would have known if it was increasing quickly or slowly - apparently most prostate cancer typically takes 10 to 20 years to take hold, and a slowly increasing PSA over that time would have indicated a less dangerous cancer, that might not have needed any treatment at all, whereas a very low score over many years followed by a sudden increase might indicate aggressive cancer, which is often fatal, but can be treated if caught quickly. I am convinced that my very low post-RT PSA score, my continuing improvement in functions and the gradual disappearance of side effects was also helped by my taking curcumin, and I continue to do so. The other big lesson I learned from my MT was that most Brits coming to France have unhealthily low Vitamin D3, due to too little sun exposure in the UK and inadequate testing for it there, though some attention to D3 has recently started to be given. Shortage of Vitamin D3 is one of the crucial causes of all sorts of health issues including enabling cancers to take hold. So get that tested as well and get the MT to give you booster shots. Mine gave me a big dose of 180,000 IU straight after my first blood test and I continue to monitor it. I’m generally fine in summer (especially this summer!) but take boosters every winter.
So my lessons:
1 Start getting your PSA tested early before you have any waterworks symptoms - say age 40 - 45 for most people - and repeat once a year, more often if it starts to rise to 3 or 4 or more.
2 Make sure your Vitamin D3 is at the level it should be and top it up properly when necessary. Over the counter vitamin tablets are insuficient to make a difference - you need proper prescribed strength doses, normally a liquid to be swallowed, in the order of thousands of IUs, so the blood test is usually necessary to accurately assess how much you need;
3 Be aware that PSA tests only measure PSA, not cancer, so high PSA scores do not mean a death sentence except VERY rarely, and even then, even more rarely quickly.
4 Educate yourself about treatment options in advance. If you live to be older than 85 virtually all men have prostate cancer by that age, but DON’T die of it, as it normally takes so long to develop to a dangerous level that something else will get you first.
Finally, “watchful waiting” is a viable approach for most post 65 men who get PSA scores above 3 or 4, so normal life can continue safely until something does really have to be done, which may never happen.
I rate the internet and telephone service run by Prostate Cancer UK very highly. See http://prostatecanceruk.org/ They do lots of information leaflets you can download and very good telephone helpline manned by helpful and sympathetic people.

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Rhys - great synopsis and input. Age is a massive issue when making decisions related to prostate cancer. I was 53 when definitively diagnosed with prostate cancer after 2 years of ‘watchful waiting’.

As I mentioned earlier - according to my surgeon, some guys decide to do nothing, sell up, buy a yacht and sail the globe. They tend to be a lot older than 53.

Thankfully my French MT (GP) is very proactive in encouraging his male patients over 50 to add a PSA Test to their annual ‘full bloods’. It’s not always the case in the UK as demonstrated by the article below from the Prostate Cancer UK website. Here’s a copy of their Facebook posting today…

We’re very saddened to learn of the loss of Kevin Vardy to prostate cancer last Sunday. It’s a huge loss for his family and leaves all of us who campaigned with him bereft. He will be deeply missed by all whose lives he touched and by those who worked with him at Prostate Cancer UK.
Kevin was an inspiration. A man who in spite of his diagnosis – and because of it – led a passionate crusade to improve use of the PSA test and to find a better way to make sure more men have the chance for an early diagnosis. His passion and drive impressed us all and motivated Prostate Cancer UK to develop a survey to help target our resources toward areas where men are not having a good PSA test experience or are being denied a test.
Kevin, who was repeatedly denied a PSA test, allowed us to make his story the first response in our survey that – thanks in large part to his efforts – now records the PSA testing experiences of hundreds of men across the UK. We will carry on this important work and aim to fulfill Kevin’s ambition for better, earlier diagnosis of prostate cancer.
You can read more about Kevin and his work here:

My GP Wouldn’t Give Me a PSA Test

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