Questions about prostate cancer

[GiveTheManABreak]

I just want to get this all off my chest, I know the answer is really "Wait and find out" but I would like to talk to people about it if that's ok.

The person in question is a 60+ gentleman, I'll just be calling him Bob Fakename for his privacy.

Bob had a medical emergency 2 years ago and is on life long medication for it, but this is something unrelated to anything else mentioned here.

So Bob has been having issues with his lungs. A few months ago a CT scan found nodules on his lungs and he was then sent for a camera down there to see if they were cancerous. After that we were told there was no cancer in the lungs, but the doctors wanted to do a CT scan of the full body to see if there was cancer somewhere else and the nodules were a sign of it spreading to the lungs. That CT scan also came back clear. The lung doctors then sent Bob for a PSA test. This came back at 11, so he was referred to urology.

The urologists was quite baffled by this, they said they'd never had anyone referred to them by respiratory before, but they would take a look. They told us Bob would need a MRI and if that showed anything of significance then he would need a biopsy.

Now he has had a call for a biopsy next week.

Bob also has a fungal infection on his toes. He visited the doctor today who told him that he would need medication to clear it up, but looking at Bob's notes it would be best to wait until the results for the biopsy because "things aren't looking great."

...? We are both full of questions.
Does being sent for a biopsy mean it's pretty likely he has prostate cancer?
Do the nodules on the lungs mean it's likely it's spread to his lungs?
What in earth does the doctor mean about not treating the fungal infection? Is it because it would interact with cancer medication? Or because they're expecting him to pop his clogs before his toes clear up??

I would greatly appreciate any thoughts on this, or even just a pat on the shoulder and a good thought for Bob.

I would assume that the doctor didn't want to further complicated any treatment required for the prostrate by being on medication for the toes, but poor choice of phrasing

Is the fungal infection on his toes or toe nails. Nail fungal infections are hard to eradicate and they be concerned about an interaction between the anti fungal medication and any treatment for prostate cancer if that is confirmed by the biopsy. If he had metastatic prostate cancer in his lungs that it very serious, probably worse than if it has spread to bones and or lymph nodes.
Does he have a date yet for the biopsy?

The only way they can be certain is if they do a biopsy and even then there can be false positives or negatives. Happened to my husband unfortunately.

The fungal infection is in the nails, not the toes.
Yes he has a date for the biopsy early next week.
The concern about it having spread to the lungs is very worrying.

You can only tell if he has prostate cancer by doing a biopsy. A PSA of 11 needs a biopsy.

That's pretty much all you can say at the moment.

It is unlikely with a PSA of 11, it has spread to the lungs, you would normally see a PSA in the 100s or 1000s for that. Although it is not impossible.

It's also possible that he has more than one cancer. Is there any plan to biopsy the lung nodules? He may have a prostate cancer that is of minimal significance but something else in his lungs.

I'd suggest the doctor did not want to treat the fungal toenails as the medication has to be taken for many months and carries a risk of liver damage. If Bob is still having cancer investigations, now is not the right time to start a potentially risky medication just for the sake of some toenails.

Hi, did they biopsy the lung nodules when they looked at them? It sounds like they were confident the lung modules were not malignant from your op.
Without the prostate biopsy they do not know if he has prostate cancer. Psa can be raised for other reasons, a urinary infection, recent digital examination of the prostate, recent ejaculation (maybe not up 11) and benign prostatic hyperplasia (unlikely in 60 Yr old but not unheard of)
A psa of 11 suggests IF it is prostate cancer it is localised disease, curable and not spread outside the prostate to the lungs.
Occasionally we see a minority of prostate cancer patients who secrete very low psa levels with advanced disease, but they are the exception, not the rule.
Has he had the mri of the prostate yet?

Sorry, just seen he had the mri, so they are proceeding to biopsy as it's likely they've seen a suspicious area in the prostate, if it is cancer with a psa of 11 it highly likely to be contained, curable and not metastatic. You say Cancer was not found in the lungs when they investigated the lung nodules, that's really reassuring.... Not sure why they proceeded to do the ct once they'd established that.

You say 60+, how old is he? Nearer 70? Early 60s is young for prostate cancer in the absence of a family history

Not sure if I’m allowed to post here but these people are great prostatecanceruk.org/get-support/our-specialist-nurses

Thank you for all the responses. They never did a biopsy of the lungs, as far as I understand the camera into the lungs showed no sign of cancer, but if that is the case I'm not sure why they started looking for cancer in other places (although obviously glad they did if it turns out to be prostate cancer)

Early 60's not late, no family history.
Reassuring to hear it is likely contained and curable, that was my original thoughts but then my mind started running away with me.

Please try and stay as calm as poss and read to much into things. As a previous poster has said I would advise contacting Prostrate UK by telephone day time hours they are an absolutely fantastic source of information, advice and support for you and your husband, DF, brother or friend etc.

My husband 59 years old with pc and was told it’s very common, I thought that so young but according to his consultant it’s not. As he said men can get pc a lot younger

Any more info OP?

DFil is in the same boat and isn't sharing info. We know it's stage 4 prostate cancer and in the bones and lymph but not a prognosis.

DH is beside himself but discovering this could me a 10 year plus battle I don't really know what to think. My own DDad went from pancreatic cancer and that was super quick.

Struggling to be a support for DH and DMil when none of us know any more. He is refusing the doctors to tell him anything.

Is DFiL refusing treatment? Stage 4 is bad and I would guess treatment would be hormone treatment and Chemo. Can DH contact the Doctor directly? I don't know if they are allowed to talk to relatives these days, but maybe worth a try if FiL's elderly and perhaps a bit overwhelmed with the diagnosis.

How did the biopsy go?

Like anything else the treatment for stage 4 Prostrate cancer varies depending on each individual case and a few other factors (whether it has left the prostrate and is in the bones and depending on PSA results, Gleeson scores, any other health conditions etc etc) and what the MDT decide for the individual etc. It could be various tablets, injections, more tablets, radiotherapy and thats it or it may or may not also involve chemo.

The GP and hospital would be unlikely to speak to a relative without the patients permission due to data protection. Unless maybe the relative attended the hospital or GP appointment alongside the patient or unless the patient didn’t have full capacity and the relative had a health power of attorney.

@RitaSueandBobtwo · Today 20:47
Like anything else the treatment for stage 4 Prostrate cancer varies depending on each individual case and a few other factors (whether it has left the prostrate

It's PROSTATE, no prostrate.
Stage 4 means the cancer HAS spread beyond the prostate gland. No "if" or "whether".

https://www.nhs.uk/common-health-questions/operations-tests-and-procedures/what-do-cancer-stages-and-grades-mean/

"stage 4 – the cancer has spread from where it started to at least 1 other body organ, also known as "secondary" or "metastatic" cancer"

@2bazookas predictive text I sadly know only too F* well my DH has a diagnosis of it too so absolutely no need whatsoever to be pedantic or PEDANTIC!!!