Cancer – reasons for hope in the near future

Swerd

Swerd

Audioholic Spartan
What is the first reaction people get they learn they are diagnosed with cancer?

Run for your lives! It’s the end of the world as we know it.
Or
It’s something we might be able to live with for some time, if it's detected early and managed right.

I’ve gotten first-hand experience with these feelings twice during this year. First, in the early spring, my wife of 40 years got diagnosed with breast cancer. She was lucky, as it was diagnosed as a slow growing type. It was also detected very early, in a routine annual mammogram. Subsequent MRI scanning and biopsy showed the location, extent, and nature of the tumor. It did require surgery, mastectomy, but the results were extremely good. After surgery, pathology analyses of the tumor margins and lymph nodes were all negative. The pathology also showed the initial diagnosis based on the MRI and biopsy was correct – no further tumor types or sites were found. The best news was that no radiation or chemotherapy was needed. The future would bring twice yearly mammograms, but that’s a much easier price to pay than suffering through radiation and chemotherapy treatments.

The lessons we learned were:
  • 3D mammograms work well. Would a standard 2D mammogram have detected her tumor as early?
  • MRI and ultrasound guided biopsy also work well. They gave the surgeons a clear idea of what they faced. There were two surgeons, a breast cancer surgeon to do the mastectomy, and a plastic surgeon to begin the reconstruction and manage my wife's post-surgery healing.
  • Breast cancer surgeons, at least those where I live, seem to know their business quite well. Same goes for the plastic/reconstructive surgeon.
Later this summer, it became my turn. Again, it started with an annual physical exam. My PSA level rose, nearly doubling from about 5½ to 9. This is not necessarily alarming, but I have a family history of prostate cancer. My father died from advanced metastatic prostate cancer in 1989, and his brother (9 years younger) also developed it. Both were diagnosed at age 68, although in hind sight, my father’s disease had clearly began much earlier. By the time he was diagnosed, it had already spread from the primary tumor site. My uncle had radical surgery (with permanent nerve damage) that removed his prostate, and allowed him to live cancer-free until he was 80. I have a vivid memory of a conversation I had with him where he said “you know what you have to do”.

And so, despite initial fears of impending doom, I went to see a urologist. Because I live nearby several medical schools, I went to a urologist at Georgetown University Hospital. My brother Dan (who occasionally posts here) is a radiologist there, and he recommended the urologist to me. That certainly helped a lot. Thanks Dan!!!

In rapid order, I had an MRI scan, which identified two possible tumor sites. This was soon followed by an ultrasound-guided biopsy. Computer technology now allows the digital image from the MRI scan to be placed over the real-time digital image from the ultrasound as the biopsy was done. It allowed directly sampling the two possible tumor sites. The biopsy's pathology report confirmed what the MRI radiologist had suggested, that I had two small malignant tumors in my prostate. My urologist called me with those results, and said I should schedule a visit with him to discuss my options. I asked directly, how soon should this visit be, IS THIS URGENT? He said sometime within August will be fine, suggesting that it was not urgent.

So I made an appointment for the next available time, near the end of August. That seemed quite distant to me. I wondered why. In another two days, I heard from another friend who is an experienced pathologist. Based on the MRI and pathology reports, which I sent him, he thought my tumors posed little danger. He went so far as to say he thought one of my options would be do no therapy now, but keep watching it. He said:

This is nothing to worry about!!​
Your lesions by ALL likelihood are confined to prostate and I’ll be very surprised, if it turned out to be different. You wouldn’t need prostatectomy at this time. Active Surveillance is the way to go with annual or every 6 months evaluation of PSA and examination and every 3- 5 years biopsy, perhaps. Having said this, given your family history, it is likely that it won’t go away and there is a chance of becoming more aggressive albeit gradually with adequate time to catch it if it did so.​
This disease will not do you serious harm, no worries, don’t lose sleep over this!​
So I’m in pretty good spirits… make that elated. I thought you’d like to know :).

Please understand that his comments are those of a distant family member who is an experienced pathologist – he is not one of my physicians. I don’t doubt what he says, but I’ll know more details about treatment only after I see my urologist later in August. This may very well explain why he didn’t think I needed to see him sooner.

In the meantime, I’m feeling PDG.

More lessons learned:
  • It ain’t over till the fat lady sings. This includes cancer diagnoses.
  • Get your prostate examined every year, unless you don’t have one.
  • Don’t waste time worrying, unless it helps. (Hint: It doesn’t.)
  • It does help to have some MDs in the family. Thanks to both my radiologist brother and the distantly related pathologist!!
  • Maybe I should buy that lottery ticket.
So this long story brings me to my real point.
  • In cancer, some things have changed for the better in the last decade or two.
  • Cancer diagnosis isn’t always a death sentence. It must be diagnosed early, before it becomes metastatic. With early diagnosis, depending on the type of cancer, there are curative options. My wife is an example. And, now I seem to be an example of the type of cancer that can now be detected early and simply watched in the future without taking drastic action.
My own thoughts go back and forth. Sometimes I think I’ll follow the standard conservative advice and go with continued surveillance. At other times, I want curative therapy right now. In fact, I want multiple types of curative therapy, freezing (cryo-ablation),ultrasound ablation, and radioactive seed implants – all at once. Maybe it’s good that I have to wait until late August before anything gets decided. I’ll be glad to be a bit more sober-minded about this.

Thanks for reading. [/END RANT]
 
Pogre

Pogre

Audioholic Warlord
I believe we're gonna figure out how to eradicate it eventually. The have been some very positive results using modified viruses to specifically target only cancer cells.

They work by infecting the cancer cells causing them to multiply until the cell bursts, releasing antigens that alert your immune system to the threat. That is my uneducated understanding of it. There could come a time soon when all you might need for treatment could be a shot or even a pill.

@Swerd I'm so happy to hear that things are gonna be okay for you! I'd miss you 'round these here parts. :(
 
Verdinut

Verdinut

Audioholic Samurai
In 2010, I had a trans-urethral prostatectomy. It wasn't because of cancer but due to hypertrophy which was decreasing the urine flow to a great extent at times, thus causing the bladder not to fully get emptied. Before the surgery, the urologist had prescribed a medication which worsened the problem to the extent that I had to go back to see him and had a urinary catheter with a bag installed while waiting for surgery. I don't wish that bag thing to anyone. Since that time, everything is going fine.

But just after surgery, I couldn't urinate. So a young nurse, had the function to install me a catheter again. She most likely didn't have much experience with penises, and it probably was the first time that she was attempting it. She hurt me while trying to insert it. That's one of the reasons why I don't like bladder bags.

As for prostatic cancer, several years ago on TV, on a British program featuring general practitioners, one of them said that one of the best ways to prevent cancer was to be sexually active, and if someone has no partner, then he should know what to do with himself.
 
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Alex2507

Alex2507

Audioholic Slumlord
I thought it was spam on my phone because of the Nazim name attached to yours, so I reported you to the spam police. Whoops ... finally read it. Withdrew the spam report. I wondered how they (you) knew about the gmail acct. :rolleyes:

Real glad you're good. Real glad Bonnie's good. Real glad you got some doc's in the extended family too. All of 'em in one room makes it so you don't know whose brain to pick first. I paid a price for not taking the advice (of Fari's wife I believe) to remain in the hospital for as long as possible. Next time I'll know.
 
Swerd

Swerd

Audioholic Spartan
As for prostatic cancer, several years ago on TV, on a British program featuring general practitioners, one of them said that one of the best ways to prevent cancer was to be sexually active, and if someone has no partner, then he should know what to do with himself.
Years ago, in the early 80s, when my father was first diagnosed with prostate cancer, I was a young scientist at my first real job at the US National Cancer Institute. My boss at the time, told me prostate cancer was caused by too many ejaculations, as if we all have a finite amount we are allotted :oops:. I never did know if he was kidding me or not.

Now you tell me about that British MD who claims the opposite :eek:. One of those two was either just kidding, or was the unfortunate product of a Catholic education.
 
Verdinut

Verdinut

Audioholic Samurai
Now you tell me about that British MD who claims the opposite :eek:. One of those two was either just kidding, or was the unfortunate product of a Catholic education.
Yeah, the Catholic religion had no business in our sex life and I missed a lot of pleasure before getting married because I didn't know any better. I finally woke up but in the late. My father used to say that the church had no business with regard to what happened in a bedroom and he was darn right!.
 
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GO-NAD!

GO-NAD!

Audioholic Ninja
Regarding prostate cancer, my doctor says far more men die with it, than because of it. Of course, individual circumstances vary, but his take is that if you exhibit no symptoms and there isn't a family history, there is little justification for screening. I'm OK with that.:)
There is a provincial colon cancer screening program here though. Bi-annually, from the age of 50 onwards, every Nova Scotian receives a screening kit. All you have to do is $hit on a stick and mail it in. :oops: The logic is that early detection saves lives and also saves money for the health care system.
 
Swerd

Swerd

Audioholic Spartan
Regarding prostate cancer, my doctor says far more men die with it, than because of it. Of course, individual circumstances vary, but his take is that if you exhibit no symptoms and there isn't a family history, there is little justification for screening. I'm OK with that.:)
Doing yearly PSA blood tests in all men above age 50 to screen for prostate cancer is controversial. Some don't require it, but how much the screening should be reduced is not clear. Clearly, with PSA screening, the death rates among US men due to prostate cancer has dropped starting in the early 1990s. See below.

From: Cancer Facts & Figures 2018; American Cancer Society, Atlanta, GA.
"The overall age-adjusted cancer death rate rose during most of the 20th century mainly because of the tobacco epidemic, peaking in 1991 at 215 cancer deaths per 100,000 people. As of 2015, the rate had dropped to 159 per 100,000 (a decline of 26%) because of reductions in smoking, as well as improvements in early detection and treatment. This decline translates into more than 2.3 million fewer cancer deaths from 1991 to 2015, progress that has been driven by rapid declines in death rates for the four most common cancer types – lung, colorectal, breast, and prostate."

Cancer Death Rates among men in the USA, 1930-2015
1565012711960.png

Cancer Death Rates among women in the USA, 1930-2015
1565012728186.png
 
Pogre

Pogre

Audioholic Warlord
Here's some food for thought (literally, pun totally intended).


There's plenty of evidence in support of claims that eating a lot of heavily processed foods (smoked, cured, etc.) can lead to colorectal cancer. I cut way back on my bacon or any other foods high in nitrites and nitrates after watching this video.
 
Verdinut

Verdinut

Audioholic Samurai
Here's some food for thought (literally, pun totally intended).


There's plenty of evidence in support of claims that eating a lot of heavily processed foods (smoked, cured, etc.) can lead to colorectal cancer. I cut way back on my bacon or any other foods high in nitrites and nitrates after watching this video.
You've just mentioned it: Eating a lot! If you eat bacon and ham once or twice a week, I don't think it's a lot and abusive.

In Canada, Canada Packers, one of the largest meat processors, have removed the nitrites from their bacon and ham. Fortunately, bacon and ham containing nitrites are still available and that is what I eat.

One of nitrites properties is to increase nitric oxide in blood which has the effect of dilating blood vessels. That nitric oxide increase helps men maintaining erections so they might not have to get medicine to obtain similar results.
 
Verdinut

Verdinut

Audioholic Samurai
You've just mentioned it: Eating a lot! If you eat bacon and ham once or twice a week, I don't think it's a lot and abusive.

In Canada, Canada Packers, one of the largest meat processors, have removed the nitrites from their bacon and ham. Fortunately, bacon and ham containing nitrites are still available and that is what I eat.

One of nitrites properties is to increase nitric oxide in blood which has the effect of dilating blood vessels. That nitric oxide increase helps men maintaining erections so they might not have to get medicine to obtain similar results.
And I recently saw a TV commercial in which a company is promoting nitrate or nitrite as a food supplement. :eek:
 
Verdinut

Verdinut

Audioholic Samurai
You've just mentioned it: Eating a lot! If you eat bacon and ham once or twice a week, I don't think it's a lot and abusive.

In Canada, Canada Packers, one of the largest meat processors, have removed the nitrites from their bacon and ham. Fortunately, bacon and ham containing nitrites are still available and that is what I eat.

One of nitrites properties is to increase nitric oxide in blood which has the effect of dilating blood vessels. That nitric oxide increase helps men maintaining erections so they might not have to get medicine to obtain similar results.
Preparing bacon in a microwave oven instead of a skillet can avoid producing cancer-causing substances called nitrosamines:

https://www.sun-sentinel.com/news/fl-xpm-1988-01-13-8801030553-story.html
 
Swerd

Swerd

Audioholic Spartan
Nitrites are essential in processed meats to prevent bacterial growth. Far more people would suffer if the nitrites were left out.

It's very difficult to be rigorously scientific when it comes to food and food additives. What is safe to eat? What is said to be unsafe? And what is actually shown to be unsafe? These questions are hard enough to answer when it comes to new drugs. With foods we eat, there is a lot of hearsay and poorly done science that can lead to wrong conclusions. I'm not knocking the food scientists, they try hard. But their studies are usually too broad, and often get misinterpreted by the popular press.
 
panteragstk

panteragstk

Audioholic Ninja
Nitrites are essential in processed meats to prevent bacterial growth. Far more people would suffer if the nitrites were left out.

It's very difficult to be rigorously scientific when it comes to food and food additives. What is safe to eat? What is said to be unsafe? And what is actually shown to be unsafe? These questions are hard enough to answer when it comes to new drugs. With foods we eat, there is a lot of hearsay and poorly done science that can lead to wrong conclusions. I'm not knocking the food scientists, they try hard. But their studies are usually too broad, and often get misinterpreted by the popular press.
The other issue is that the FDA in general doesn't really have enough budget/resources to investigate everything they need to. Just look at the Oxy epidemic. The whole thing was how quickly the drug passed through the FDA. They even bragged about it. People were told it was safe, FDA had passed it so they believed it. They were wrong.

I'm sure the above doesn't (hopefully) apply to food, but I think they've got their work cut out for them with how much there is out there for them to test. So many manufacturers and so many methods to how they produce things I feel it would be almost impossible.

Then there's the "supplements" that aren't approved by the FDA at all. Who knows what's in that stuff?

I simply try to do what's healthy and hope the ingredients list is truthful and won't hurt me. I try not to take any type of drug (alcohol excluded...) unless I really need it. No pain killers, allergy meds or anything like that just because I build a tolerance to things so quickly. I want the meds to actually work when I need them to.

Really hope everything continues to go well for you.
 

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