Plumbing: Charlie’s Story Part I

Detail from Adam by Albrecht Dürer (1507)

Inside Adam and every male lies the walnut sized prostate gland. Woe be it, when that gland swells and disrupts the normal flow of things.

Unfortunately, the prostate often becomes a cancer site in men over 50. When that happens, the healthy alternative to radiation treatments may be surgery to remove the prostate. The prognosis for the re-plumbed system is good.

You may remember the prostate gland from your junior high school Family Life or Sex Education course. Actually, I went to school in Montana in the 50s when sex education was unheard of, so the text in my library, Human Growth- New School Edition (1969), must be that of one of my children.

The definition of the prostate deemed suitable for 8th graders was:

“Prostate gland – an organ surrounding the upper end of the urethra in the male: it produces some of the fluid that mixes with the sperm to form semen.”
—Human Growth

That’s OK, but for us older guys, the important part is the role the prostate plays in the urinary system.

For those who don’t remember, the Internet is the place to go for a refresher. WebMD has an excellent illustration of the whole system including the healthy prostate. If you look at their illustration you will see the urethra connecting directly to the prostate.

When cancer attacks the prostate there is swelling that constricts the urethra and urination can become a big painful problem. A guest blogger, Charlie, who recently had a prostate operation, has this to say:

Plumbing Issues—

“If you are a male and:

• You dribble when you pee
• You get up 2 to 4 times a night to go
• You sit down to go

then you (and the person who lives with you) might find this story interesting to read.”
—Charlie

Screening for prostate cancer is the attempt by doctors to identify a cancerous growth and determine whether treatment is required. There are currently two methods used:

“One is the digital rectal examination (DRE), in which the examiner inserts a gloved, lubricated finger into the rectum to examine the adjoining prostate. The other is the prostate-specific antigen (PSA) blood test, which measures the concentration of this molecule in the blood.”
—wiki

Most of us older males have had experience with the never enjoyable DRE. The PSA, on the other hand requires only a blood test, which may appeal to some. If DRE detects swelling or if the PSA is elevated a surgical screening may be recommended. Neither test is definitive; so the doctor may recommend a screening method that involves surgery.

Surgical screening for prostate cancer is done through a prostate biopsy in which small samples are removed from the prostate gland. The samples are sent to a lab to be tested for cancer. The procedure does not require hospitalization, but may involve some discomfort on the patient’s behalf.

Let’s pick up our guest’s narrative and see how screening worked for him:

“I have been a very healthy person (knock on wood) – no broken bones, no operations, etc. I have always been able to do and eat whatever I wanted with seemingly little consequences. Then I turned 60.

After my regular physical check-up my doctor said I had an elevated PSA and I should get it checked out and have a biopsy done. I really did not know what an ‘elevated PSA’ meant nor did I fully understand what the biopsy process was.

Well I was about to find out.

I spent a lot of time trying to find a doctor to do this procedure (we lived in a small southern Vermont community – i.e. hospitals and doctors are not known for being really good in anything).

Luckily, a very good friend of ours worked at Fletcher Allen Hospital in Burlington, VT, and she recommended Dr. S, an excellent urologist (that’s a person who specializes in my kind of plumbing issues).

I called and scheduled an appointment to meet with him. I liked Dr. S immediately and quickly felt very comfortable with him.

Then came the day of the biopsy: first, I was prepped— do you know that they go through your ‘back hole’ to get to a problem with your ‘front hole’? (Hopefully you understand these very technical medical terms.)

Dr. S said he’d be taking 12 samples. I said OK and started counting. Almost immediately, I lost count.

Here I am 60 years old and can’t count to 12 yet my granddaughter could count way past 12 when she was 3!

I’m not sure if I was green when I wobbled out of Dr. S’s examining room, but that’s what Robin (my wife) said I was.

OK – I admit that I liked Dr. S a little less now.

The results came back positive.

Now I was worried. No, I was really scared.

Dr S was wonderful. He explained to my wife and me the treatment options and encouraged us to seek out other doctors, and he arranged for us to talk with specialists about treatments other than surgery.
Dr S is a surgeon (i.e. cut it out and get rid of it).

After a lot of help, and talking with family, friends, and people I did not know at all that had been through this very problem, and reading everything I could find, we went back to Dr S to discuss options again.
Given my circumstances, one of the options was ‘watchful waiting’ and that was the course that we all agreed was appropriate. BUT this would mean more biopsies.”
—Charlie

Wow, let’s take a break here. The next post will follow the “watchful waiting” process.

Postscript
According to the National Cancer Institute:

“Prostate cancer is the most common non-skin malignancy in men and is responsible for more deaths than any other cancer, except for lung cancer.
The American Cancer Society (ACS) estimated that about 218,890 new cases of prostate cancer were diagnosed in the United States during 2007.
About 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 34 will die of it.

A little over 1.8 million men in the United States are survivors of prostate cancer.”
—Nat’l Cancer Institute

So we guys should be informed, be aware, but we don’t need to panic.

Carto
Day 76: Human Growth- New School Edition, Lester F. Beck (1969).
###

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About carto

Retired software engineer who grew up in Montana, went to Montana State College in Bozeman, and moved to California to work at Stanford Research Institute (SRI). Carto's Library is about books I've read and liked; Carto's Logbook is about photography, travel and adventure. Mt. Maurice Times is tall tales mostly biographical.
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