Not Everything That Happens is Cancer - 9 June 2012

I have to thank a couple of blog-readers for some inspiration for new posts.  First goes  to Ben, the Mobile Biohazard Man in Louisiana, who shared a recent diagnostic ordeal that reminds me of Sebastian's false alarm reported a couple of posts ago, way back in March of this year!  Another goes to new reader and "fraternity member" Steven, who correctly spells his first name the same way I do.  His prompting will lead to another new post in a week or two.

Back to Ben in Louisiana.  As part of his attention to general health, he went to his primary doctor (not the urologist) for a routine check up at the end of April.  Blood work was taken in advance to find that his PSA level had continued to elevate from 1.2 to 3.5 and now up to 5.4.  While this is not unusual for BCG patients, the doctor was thorough and performed a routine and quite unpleasant procedure used for men called DRE.  (As a side note, my PSA has remained low at 0.6 recently, and my DREs had all been negative except to note normal growth in the prostate.) 

Unfortunately for Ben, and the doctor detected a "small lump" on the prostate.  At this point the natural reaction is panic - there may be prostate cancer in addition to the bladder cancer.  Both Ben and his wife were very concerned.  In early May, Ben visited his urologist for a follow-up, and the second doctor confirmed the presence of the lump - estimated at 8mm in size (same as Sebastian's bladder polyp).  The specialist felt that his preliminary opinion was a clogged duct, small cyst, or perhaps a granuloma (which is quite unusual and not as serious as it sounds). 

The only way to be sure was to conduct a prostate biopsy, another quite unpleasant procedure - mostly due to the sounds one hears.  Ben's took place in late May, using the common "rear entry" method.  Here is how Ben described it in his own words:

Now for all those that have not had prostate biopsy, just let me say that is an eye opening and memorable experience. He punched 14 holes thru wall of colon and into prostate under local. Don’t let me exaggerate, really not much pain, but quite unnerving, the needle gun makes a loud click with ever shot.

Three days (and sleepless nights) later, the pathology results came in - NO MALIGNANCY, but inflammation, fibrosis, and granuloma, which in this case was a cluster of cells (probably BCG) that had settled in the prostate and became encapsulated by the body for protection - thus forming the small lump the doctors felt.  There is no treatment necessary as the body will slowly absorb and deconstruct the granuloma over time in its natural healing process.  So all is well that ends well!

Subsequent to the original posting, I learned that both Ben in Alabama and new reader Steven have had similar experiences, so this may not be so uncommon after all...

Ben's advice is, "Don't Panic!"  Lots of things cause PSA to rise, including BCG, and not all prostate lumps are cancerous.