Good News and Bad News

[Ken Shelmerdine]

Well I'm really pissed off. I've been having various tests on the transplant build up programme and after a blood test to check any prostate gland problems they did a biopsy (not pleasant). The upshot of it is that the biopsy showed that I have the early stages of prostate cancer.

 I found this out  only yesterday so as you can imagine I'm pretty down in the dumps about it. The good news is that the prognosis is very good. The consultant said that it is the least aggressive form and would not get to an advanced stage for 12 to 15 years. I should be cheered by that I know but it's just that C word, and knowing I have it has really knocked me for six.

He says there are three options. 1. to undertake 'watchful waiting' where I will have check-ups every three months until the PSA levels indicate some form of treatment is essential which could be years: 2. Surgery to completely remove the prostate: and 3. Radiotherapy.

I think my choice is going to be radiotherapy but I'm worried sick at the thought that the radiotherapy could also damage my peritoneal lining and therefor stop PD from working efficiently so that I would have to do Haemo. The urology consultant couldn't give me an answer to that as he has no experience of dialysis related matters. I will be attending the renal clinic this Monday 17th Dec so I'll ask the question.

If anybody knows the answer right now please post, I'm going to be so stressed out about it over the week-end.

[Joe Paul]

That sucks Ken, I have no answers for you, but will keep you in thought and prayer

[2_DallasCowboys]

So sorry toread this!!!
Will be praying for ya.

Anne

[KR Cincy]

You're right Ken...hearing the C word just takes your breath away. It triggers every frightening thought you've ever had to come to the surface...but as I've learned, you can fight it. You're doing the right thing by gathering as much information as you can before making a decision on your course of treatment. It's scary, complicated, and depressing...but keep the faith and know we're all here if you need us.

[bolta72]

so sorry to hear about this, has the cancer spread outside the prostate ? If not taking it out may be a good option. My father had his out at 87 with no problems.

[bolta72]

I meant to say having it taken out.

[paris]

Oh Ken, I am so sorry. It doesn't seem fair that you have to deal with this also. This just seems like a cruel joke.  Do whatever  is the most effective method to get rid of this. I am glad it is the least agressive type, but I want this "C" thing gone from your body.  You know you are special to me and I don't want you to have to go through this.  Sending lots of good wishes and positive thoughts your way!!

[stauffenberg]

Since on the one hand prostate cancer can often remained self-contained and never cause you any problems for decades, perhaps not even before the end of your natural lifespan, while on the other hand any treatment of prostate cancer can have all sorts of negative side-effects from urinary incontinence to sexual impotence, for most patients with minimal, early-stage prostate cancer it is better just to monitor the condition to make sure it doesn't get worse, but otherwise to leave it alone.

In your case, however, since you are contemplating a kidney transplant with its intensive suppression of the immune system, would might regard taking a passive approach to the prostate cancer as too risky.  For patients with developed prostate cancer, the waiting time after the cancer is cured before a transplant can be performed is 2 years.  For patients with purely localized disease, there is no waiting time for a transplant.  So it is all a judgment call. 

There are also things you can take to influence the course of prostate disease positively, such as saw palmetto and pumpkin seeds (but in moderation on dialysis, because of their potassium content).  Whether there is any contraindication to taking saw palmetto because of its potential interference with immunosuppressive medication, I don't know.  However, as a transplant recipient, I eat fresh pumpkin seeds every day as an insurance against developing prostate disease and there is no interference with my medications from that.

[xtrememoosetrax]

Hi Ken,

So sorry to hear this.  As if you needed something else to deal with on top of PD . . . .

I work at a university-affiliated cancer treatment center, but I am NOT a doctor or nurse.  I do medical transcription, which means that the little I know about this stuff has been picked up -- NOT from doing it or going to school for it -- but from typing about it!  Okay, with that disclaimer out of the way, here is what I think:  My recommendation would be that you talk to a radiation oncologist, a doctor who actually specializes in radiation therapy. You MAY have more than one option for radiation therapy.  Here, one option for prostate cancer patients is a treatment called radioactive seed implantation, which involves, I think, quite low levels of radiation and very localized treatment.  I also know that with conventional external beam radiation they certainly TRY to very closely target the tumor itself without damaging surrounding structures.  How well this works in practice I cannot say.  There is also a newer twist on this called intensity-modulated radiation therapy which is supposed to be even better at delivering the "right" amount of radiation to the "right" place.  Of course, I don't know if these treatments are available to you or if they would be appropriate for you.  What I CAN say is that, judging from the doctors I work with, I think that they would take very seriously your concern about the risk of damage to your peritoneum and would be more than willing to help you weigh the potential risks and benefits.  (Unfortunately, of course, they probably don't know sh*t about PD  . . .  sigh . . . the joys of the highly specialized medical world . . . .  .  Still, though, worth a try, I think.)

One more thing: It is my impression that any kind of radiation therapy generally involves fewer risks of urinary incontinence, impotence, etc., than does surgery.  Again, though, talk to your doctors or other professionals about this.

Best of luck with sorting all this out, and please keep us posted.  We'll be thinking about you.

[livecam]

I have a friend, actually a coworker who is retired now who was diagnosed some years ago and decided on the surgical option.  The surgery was successful, his recovery uneventful, and he went on to return to work until retirement.  He leads an active life and has had absolutely no further problems with this issue.

[Deanne]

I'm sorry Ken! My dad and brother were both diagnosed with prostate cancer. My dad's was detected early and he chose to be "seeded." I think it was a relatively simple process, affected no other organs, and he continued his normal life. Just hearing the "C" word is enough to scare the bejesus out of me!

[okarol]

  I hope you find the best solution for you Ken.

[thegrammalady]

the pollyana in me (my mother's fault) says prostate cancer caught early is curable. that said and out of the way, i'm sitting here crying because i feel so bad for you. anytime the doctor says cancer or precancerous, it hits hard. been there done that, never want to go there again. hoping the best for you, whatever you decide to do.

[Ken Shelmerdine]

Just want to say thank you for all your kind thoughts, encouragement and some very useful information.I think I'm getting into a more positive frame of mind. They said it can be completely romoved by radiotherapy and if the answer to my question this coming Monday is no it won't damage the peritonium and yes you will still be able to do PD then I'll be a lot happier. Whatever happens I'm going to fight this!  

Thanks again you are all such wonderful caring people.

[Romona]

Ken, I don't know what to say. 

[angela515]

Well, obviously I have never had prostate cancer as i'm a girl... but I have had a form of cancer, so I have had the "C" word come up... just this year in fact, after my transplant. Mine was in my thyroid... and they removed the thyroid with it on it while they were doing my parathyroidectomy. I then had a biospy on my other thyroid and was told that spot is also cancer, but so small, they would 1) never even found out about it in my lifetime if they weren't already in there digging around for my para's to take out and 2) it is so small it will probably never ever be brought up again during my life. I still will have a check-up in a year (which is coming up the begining of next year) to do blood work, to just ease my mind that all is still nothing to worry about.

Like you, first hearing the "C'" word is devistating. Actually my mom took it harder than me and soon as she heard it she started crying right there. My first thought was oh great, I got this transplant for nothing.

I hope you take a deep breath, and talk with the doctors for the best plan for you. 

[Sluff]

You can beat this Ken. I know you can. I mistakenly was diagnosed with adrenal gland cancer. Who heard of such a thing but after extreme testing they gave me a clean bill of health. I know what it's like to recieve that kind of news. My support and prayers are with you all the way.

[kitkatz]

Hey Ken. I know nothing about this kind of thing, but I send my support and prayers your way.

[Wattle]

Sending support and a BIG {{{HUG}}} for you.   

[KICKSTART]

Oh Ken , what bad news. I hope it all goes ok for you and you get all the info you need to decide what to do 

[Black]

Well, crap!    What else could they throw at you!?!  At least it is a type that gives you some time to learn and weigh all of the alternatives, and it was caught very early.    Besides, better to catch it now than after you have transplant and are on drugs which could make it grow faster.  Hope all goes well. 

[paddbear0000]

Ken, I'm so sorry about this! You are in my thoughts and prayers. I'm glad you have such a positive outlook though. You are one of the people I look to when I am feeling unsure about things. You always seem like a rock! 

[rose1999]

Hi Ken, so sorry to hear this.  My husband had (very advanced) prostate cancer and I'd say if you are offered an op then seriously consider having it.  His was found too late as it had already spread to the bone (yet he was only 46 and symptomless at the time) and (after hormone treatment) he had radiotherapy,but they can only give you so much before it affects the bowel.  It also leaves the skin tender (as if you've had sunburn) and he had to be very careful what he did, e.g. could not have the shower too hot or it hurt, had to use Simple soap etc.  So, in my view (and that's all it is) then getting rid of it, if it has not spread outside the prostate has to be a good thing.  Barry did have hormone treatment initially and that worked well for 2 or 3 years, has your consultant discussed that?  I'd also suggest you look up the Prostate Cancer Charity web site www.prostate-cancer.org.uk. as they have a lot of useful information and their nurses are very supportive.

Good luck Ken, I'll have you in my thoughts. 
Rose xx

[goofynina]

  How dareth they tell sir Kenneth Shelmerdinizzle such news,  OFF WITH THEIR HEADS!!!      You know your in my prayers and in all of my goodest thoughts my friend, think positive and remember, we love ya and we care 

[Bajanne]

My caring thoughts and prayers are with you all the way.  Today is 14 years since I had a mastectomy due to breast cancer. We are survivors, aren't we!