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.