A low or normal PSA and still have prostate cancer? You bet!

Oh that quirky PSA!

Prostate Diaries

 The article below is one of the few times I have actually seen written the concept of a low PSA and prostate cancer. Why is it important?

Because often times men will have a physical exam by their family doctor and everything is checked but the prostate by rectal exam. (Remember the article that stated that 70% of men have never had a rectal exam.)

How does this happen and why? Well men don’t like a rectal exam. The family doctor gets a PSA with his normal blood work along with the chemistries, CBC, etc and it comes back normal. The patient is told that the PSA is normal and it ends there. Everybody is happy, the doctor did not have to do the rectal exam (doctors don’t especially like doing the exam either…that’s why there is a specialty called Urology) the patient did not have to have the exam…

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Famous men with prostate cancer…and listmania

Who did John Lennon write “Come Together” for?

Prostate Diaries


My Listmania page on Amazon…Famous and interesting men with prostate cancer. 

I love history and particularly biographies that not only tell you about the  person but the times in which they lived. 

For instance: Timothy Leary’s life was crazy. Lennon wrote “Come Together” for his gubernatorial race in California against Ronald Regan. He did not complete the race because he was arrested for possession of marijuana. Amazing, and that’s just the tip of the Leary iceberg. 

Unfortunately, while researching this list, I came upon the following this am. 

David Hinckley

From ‘Rebel Without a Case’ to ‘Easy Rider’, Dennis Hopper brought an edge to every role

David Hinckley 

Sunday, May 30th 2010, 4:00 AM 

Dennis Hopper died Saturday at the age of 74. He is best known for playing characters who didn't trust the rules.

Dennis Hopper died Saturday at the age of 74. He is best known for playing characters who didn’t trust the rules.

Hopper wrote and produced the movie 'Easy Rider' in 1969.
Columbia Pictures

Hopper wrote and produced the movie ‘Easy Rider’ in 1969.

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“Mr. Smith I spared your nerves during your prostatectomy for prostate cancer.” As my mother would say,”Oh spare me!”

A robot potency does not assure!

Prostate Diaries

If you see the nerves better with the robot and “you spared them” why is it then that people still have erection issues? Why is that to date there is no better success rate shown by the robot vs traditional open prostatectomy? The following is quite good.

Look at the next video…does it appear that they actually see “the nerves” or they where they would be? Can you see a “nerve.” If they think they see the nerves, then do they see the “subvisual” branches that then go to the prostate? I think not. And that is why there is so much variance in how people do after a “nerve sparing ” prostatectomy. There is still a lot we don’t understand and I am bit disappointed in surgeons that announce to their patients,” I spared your nerves.” I think it would be fairer to say, ” I feel very good…

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common search on google that gets to prostate diaries…”sex drive after prostatectomy.”

If I am going to be impotent I want to look impotent!

Prostate Diaries

orators become dumb… when beauty speaketh-shakesphere

Okay…one more time. 

  • sex drive is called libido and is dependent on testosterone
  • testosterone is not affected by removing the prostate
  • testosterone is produced by the testicles and gets into the body through the blood stream independent of the prostate
  • potency is the ability to get an erection
  • an erection after prostatectomy is a function of sparing the nerves
  • a prostatectomy does not affect the testicles or the level of the males hormones or testosterone
  • it is possible to have a very high libido and not have the ability of having an erection (which can happen after any treatment of prostate cancer)
  • fertility is the ability to have children which is unrelated to potency or libido…but will go away with a prostatectomy but may not with radiation of the prostate

So…In answer to the search question…Sex drive or libido which is hormonally driven… will…

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Bill Aucoin, Kiss, Billy Idol, Cutthroat Trout, and Post Modern Music, Fly fishing, and of course that ole chestnut…Prostate cancer.

Prostate Diaries

Each fall  for about 15 years some friends and I went hiking and fishing out west to some of the nicest trout waters and areas in the world. Above is one of my favorite pictures. On this particular occasion we were in Idaho on the Selway river in the Bitteroot Wilderness very near where Lewis and Clark traversed in the early 1800”s.  Several things about this picture. One to get to this spot we flew in by bush plane and then hiked three or so days with backpacks to get to about three miles from this spot. Me and one of my of fellow fisherman hiked the additional  several miles from our base camp with just our fly rods to get to there. The fisherman there is me…the rod is a Orvis 5 wt. fly rod with a Battenkill real and 3 lb. tippet. I was using “terrestrials” or “hoppers” that I had tied before the trip. What you see…

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What’s it going to take to prevent patients presenting with prostate cancer too late to cure?

Increased awareness and early detection is the name of the game for any cancer.

Prostate Diaries

The above picture was taken last year almost to the day in Orange Beach, Alabama. I remember the day vividly. My wife and I went to the beach and for almost every minute of the day construction vehicles were working and making noise just outside our condominium. It was comical how loud and persistent the noise and activity was. BP was paying money for the clean up and Orange Beach was using every penny of it looking for tar balls. We would see workers shift sand all day and from what we could tell from our balcony and on our walks very little was being found. It looked very “governmental to me.”

Anyway, just before I had left Gainesville a patient who had been diagnosed with prostate cancer with a high Gleason score had had a bone scan. I was concerned about it. The patient and his wife became “office…

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the prostate and prostate cancer….the rodney dangerfield of cancers and organs

I was so ugly when I was born the doctor slapped my mother! RD

Prostate Diaries

Five reasons the prostate is the “Rodney Dangerfield” of organs…it gets no respect.

“I’m not a sexy guy. I went to a hooker. I dropped my pants. She dropped her price.”- R.D.

The reason why the prostate doesn’t get any respect has a little to do with the very nature of the organ and its disease and a little to do with the mindset of the male.  The perfect storm which is a gland that the male can’t see or feel and a cancer that doesn’t cause symptoms until it is too late is the reason for the tragedy of over 25,000 deaths a year in the United States a year. Look at the following reasons and see if  you see  yourself or that of a loved one who isn’t guilty as well.

  • Unlike a women’s breast that gets all the attention an organ could ever want, the prostate lives…

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Question: Would the Interstim device from Medtronics help post prostatectomy incontinence like it does for female urinary incontinence? Northeast Georgia Urology

The InterStim and PTNS device both stimulate the nerve at the S3 foramen to “quite” the badder and improve urinary frequency.

Prostate Diaries

Usually not. But there  is a situation where it could be of value. But first an overview of incontinence as it pertains to the male, the sphincter, the bladder, and the body with and without a prostate. The following is an excerpt from my book and explains the caveat about an overactive bladder in the face of a recent prostatectomy. The Medtronic Interstim device can be placed in a test fashion as an  out patient. I have inserted dozens over the years, not in a post prostatectomy patient, and when it works- it works very well and negates the need for medications that are either partially effective or have pesky side effects (dry mouth and constipation).  This Medtronic video on Facebook is actually quite informative and explains the physiology of this situation.

  • the most common type of incontinence after prostatectomy is stress incontinence-you leak with activity
  • there is also total…

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