Survived A Heart Attack..Now Prostate Cancer

[Bolt-O]

Celebrating my 6th anniversary of surviving the "Widow-maker" heart attack (100% occlusion of the Proximal Left Descending Anterior Coronary Artery resulting in a STEMI) . So very fortunate that I got to the ER on time, and avoided substantial heart damage. I'm still on meds to help prevent a recurrence, keeping my BP lower, LDL cholesterol below 50, and diabetes meds to keep with insulin resistance.

[Bolt-O]

Short update, PSA in early June was 3.14, which is again not much different than previous, so my Urologist doesn't believe that the prostate cancer is not aggressive, but still has to be watched, and another test in 3 months, or September. Other than the decipher test, which could help predict if what ever cancer is there would be a problem, there isn't much to do. As far as other issues, my primary care docs suggested adding Jardiance, due to an appearance of proteins in my urine, indicating possible kidney problems, and Zetia, to drop my LDL cholesterol below 50. I'm pretty fortunate to have pretty good care as a military retiree.

[Bolt-O]

Just saw that President Joe Biden was diagnosed with metastatic Prostate Cancer, Gleason 9, which is not good. All I will is that its surprising news, with how slowly prostate cancer progresses. Wishing him the best in his treatment, as I do for anyone with this diagnosis. 21 years ago, my dad was fighting metastatic PCa that also was in his bones, but lost the battle. Apparently the former president's cancer is hormone sensitive, and will have a better chance than my dad with advances in treatment.

[Bolt-O]

Just a short update on my Prostate Cancer Active Surveillance. In December, I had a PSA that was not much different than the previous one done, but with that one done, my urologist changed his recommendation to treatment, pending results from a MRI and a PSA retest in February. This time, I did the MRI at UCSD at the Komen Family Outpatient Pavillion. The machine there appeared to be newer than the one at the VA, so I thought it might be able to locate any problem areas better. However the results were pretty much negative for visible tumors (if one was found, it would have gotten a grade (PI-RADS) from 1 to 5, the worst would have been a 5. Based on that and the PSA, the urologist said it probably was safe to watch a little longer, but he will get my last biopsy graded with a decipher test, which will help determine if it's still safe to not treat as the cancer is still only inside the prostate capsule, and not metastatic. Probably will update this in June.

[Boltjolt]

Not so sure about zinc. I took it for about 6 months, then the PSA popped to 8, which I had to retest to get back to 4.16 It might have been the particular lab, or some other factor. I'm also on Finasteride, which reduces the prostate size, which is supposed to lower the PSA number What is more important is the if the number is ramping higher, and so far its been flat to slightly higher for the last year. I think I would have asked for a retest if the number actually fell a lot. I'll ask the doctor about zinc though. I heard aspirin may also help as it reduces inflammation but I'm already on it.

Well, I'm no Dr but I somehow got an inflamed prostate when I was 15 which was I bit of a shock to the Dr.

I knew nothing about it or what it even was, I just knew I felt like I had to pee all the time. Long story short, I was given zinc for it, don't recall if I took anything else but It went back to normal.

Started taking it again in my twenties just because I was told to take it for that and it was good for other things and been taking one every morning since then.

To renew an insurance policy a few years ago I had blood work and on the results it tested for many things and saw my PSA was pretty low to the range it gave.

[Bolt-O]

Not so sure about zinc. I took it for about 6 months, then the PSA popped to 8, which I had to retest to get back to 4.16 It might have been the particular lab, or some other factor. I'm also on Finasteride, which reduces the prostate size, which is supposed to lower the PSA number What is more important is the if the number is ramping higher, and so far its been flat to slightly higher for the last year. I think I would have asked for a retest if the number actually fell a lot. I'll ask the doctor about zinc though. I heard aspirin may also help as it reduces inflammation but I'm already on it.

[Boltjolt]

Oh, how time flies. I forgot to update my midyear talk with my urologist, the PSA retest came back at 4.16, which was good to to him to continue Active Surveillance. Just had the PSA tested for my scheduled followup next week , 4 this time. What I think that means nothing changes. My guess though is that at least an MRI will be needed, which is fine, but annoying as hell. I want to talk to him about genetic testing as well, to see if the very small cancer is likely to spread.

PSA is more of like a 'check engine' light to me, an MRI can find obvious tumors, but my previous MRIs showed only suspicious areas. There is something the radiologist will estimate for visible masses, called a PIRADs score, but they didn't assign one for the last two. If I get an MRI this time it will be at a UCSD Health facility vs. the VAMC, but we'll see.... probably no difference as the VA has a 3T MRI.

Take Zinc if you dont already. Been taking it for years and my last PSA was very low.

[Bolt-O]

Oh, how time flies. I forgot to update my midyear talk with my urologist, the PSA retest came back at 4.16, which was good to to him to continue Active Surveillance. Just had the PSA tested for my scheduled followup next week , 4 this time. What I think that means nothing changes. My guess though is that at least an MRI will be needed, which is fine, but annoying as hell. I want to talk to him about genetic testing as well, to see if the very small cancer is likely to spread.

PSA is more of like a 'check engine' light to me, an MRI can find obvious tumors, but my previous MRIs showed only suspicious areas. There is something the radiologist will estimate for visible masses, called a PIRADs score, but they didn't assign one for the last two. If I get an MRI this time it will be at a UCSD Health facility vs. the VAMC, but we'll see.... probably no difference as the VA has a 3T MRI.

[Whydachargers?]

5th year anniversary of the heart attack...last EKG was clear, no beat skipping, BP is fine, lipids are ok, and so is A1C, but will be on maintenance drugs forever, can't let the stent to be closed. Great to be alive.

WOW!!!

[Bolt-O]

5th year anniversary of the heart attack...last EKG was clear, no beat skipping, BP is fine, lipids are ok, and so is A1C, but will be on maintenance drugs forever, can't let the stent to be closed. Great to be alive.

[Bolt-O]

Status update, on the Active Surveillance. PSA late January was 4, but PSA taken last month jumped to 8.4. Urologist (and I) were concerned as that would indicate a need for treatment. The weird thing about PSA is that it isn't accurate, and can jump around with the lower values, it could just mean more issues with BPH or prostititus, not necessarily due to Cancer getting more aggressive. He ordered another PSA done, last week, and came back to 3.4. That made me and the Urologist happy, but we will do another PSA early July. I was getting ready to review options with radiation with other docs, but glad to wait now.

No real idea on why the jump, but it could have been the lab (done at Balboa Naval MC), or the zinc I was taking. Stopped the zinc, it wasn't really helping anyway. So if the follow up is around 4, no action until December.

On the heart side, converting from full dose Lipitor to full dose Crestor. Primary Care doc wants to see lower LDL, and Crestor has been seen to do that with lower side effects (didn't have them anyway.)

[Bolt-O]

6 Month update... PSA results were good, came down from 5.5 to 2.9. Finally after being on Finasteride for 2 yrs, its now being effective in reducing the size of my prostate. It also shows that the small amount of prostate cancer is not yet a concern. Next check will be a PSA in 6 months. Heart is ok too, my latest EKG was normal.

I will be transitioning my care to UCSD Health from the VA Health for urology, but that shouldn't be a big issue ... Most of the specialists care is done by UCSD or Scripps at the VA. My case, as it is pretty straightforward, has been handled by UCSD/VA residents, but today I met with a staff doctor from UCSD, that is a urology oncologist. Nothing wrong with the VA, as all the work done by residents are monitored by UCSD attending. Being dual eligible for VA and Tricare makes this possible... one of the benefits of being a military retiree.