YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

BRONZE

Anton Schwarz and Karen live in Nottingham, UK. He was 52 when he was diagnosed in February, 2008. His initial PSA was 4.19 ng/ml, his Gleason Score was 7(3+4) and he was staged T1c. He is undecided as to his treatment choice . Here is his story.

Am a fairly fit (swim for 1/2 hour daily). Company Director of an Engineering group (laser cutting and fabrication). Married with 2 children (Boy 16-1991 & Girl 13 -1995)

A routine medical assessment picked up a PSA of 4.19.

I saw my GP who was inclined to leave it. I requested referral to a specialist (luckily I have med insurance).
Urologist advised biopsy. First was inconclusive in one sample of 12. Second was positive in one sample of many.
Gleason 7 (3.4)
Staging T1c
MRI shows T2 at most M0 N0 cancer - contained in gland, peripheral signal (small/low) on RHS and unidentifiable possible signal on LHS.

Urologist very strong advice (almost insistent)for surgery (keyhole) which is his speciality.
Oncologist also advised radical prostatectomy - particularly as my mother had breast cancer and he was concerned with re-emergence in the future.
Brachytherapist states that I am suitable for all main curative options Due to see HIFU expert in July. (Surgeon also does HIFU but I regard him as my surgeon so prefer a second opinion)

My current feeling (end June 08) is towards Brachy. because of reduced side effects (in probability terms). I am aware of possible re-emergence and am researching salvage options . I am also fairly confident that the situation is improving in terms of research and resource.

I hope to decide before a major family holiday in July and aim for treatment end of August (to ensure fitness by the time the ski season returns!!)

I will keep you posted.

thanks
Anton

 

UPDATED

October 2008

 

 

Had an enhanced MRI scan (end August) which shows no evidence of cancer. Am due to have prostate mapping end Oct(co-ordinate biopsy) to determine if there are any other cancerous areas. If not then I may be eligible for focal therapy as part of a trial. The likelihood is that this will be HIFU but a new laser treatment has been floated as a possibility.

Later: Just to clarify as my last update is perhaps unclear.

Focal Therapy is currently being investigated whereby in cases where the cancer is localised it may be possible to just treat the cancerous area rather than the whole gland. This would hopefully result in fewer and less drastic side-effects.

My specialist ( Mark Emberton - UCL London) is using HIFU (and I believe there is a laser treatment - although I'm not sure if I would want to be the first human to try it!!). There are also trials (possibly in the States) using cryotherapy.

My own situation is that the enhanced MRI showed no areas of cancer. All this means is that there are none large enough to register. (over 0.5cc i think) I still have the original biopsy result showing Pca cells. I have now had the prostate mapping biopsy ( template guided co-ordinate biopsy) and await results. This could show one or more small localised areas, and therefore allow consideration of focal therapy.

It could also reveal multiple foci over the gland and therefore push me down the route of whole gland treatment.

Good luck and I'll keep you posted.

 

UPDATED

December 2008

 

 

Hi - I've changed my current treatment to active monitoring as I'm still involved in research and don't feel any urgency to make a specific treatment choice.

The results from my prostate mapping biopsy, unfortunately, revealed that there is cancer on both sides of the gland. This means that I am not eligible for the focal therapy trial. The results confirmed that it is at very low volume and that gleason is 3+4.

Mark Emberton has suggested treating one side (HIFU) and then monitoring for a while (possibly years) before treating the other side. The thinking is that the space between treatments may allow some healing/recovery of the erectile nerves on the first side to give a better chance of erections after treating the second side.

I'm not in any rush and intend to see the Brachytherapist end of Jan for further discussions. My latest PSA is 1.7, down from 4.10. I don't know if this is good or irrelevant and await further advice.

I'll post when I have more info. Good luck to everyone!!

Anton

Anton's e-mail address is: aschwarz@laserexp.co.uk