YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

BRONZE

Bob Dr lives Pennsylvania, USA. He was 55 when he was diagnosed on December 22, 2006. His initial PSA was 5.8 ng/ml, his Gleason Score was 3+3=6 and he was staged T1c. He is undecided as to his course of treatment. Here is his story.

Insurance application for "best" rates denied due to PSA of 4.1 ng/ml. Insurance approved at a 10% premium increase.

May 2004 PSA 4.1 fPSA 21%
Jul 2004 PSA 3.3 fPSA 9%
Feb 2005 PSA 4.2 fPSA 10%
Jul 2005 PSA 4.2 fPSA 10%
Feb 2006 PSA 4.9 fPSA 8%
Jun 2006 PSA 5.3 fPSA 8%
Sep 2006 PSA 5.8 fPSA 9%
Dec 2006 Biopsy
24 cc gland
7/13 cores positive for PCa
Gleason 3+3=6
Feb 2007 PSA 4.8
Aug 2007 PSA 6.3 fPSA 6%

Never any symptoms.
Never any DRE indication.
No family history.

Considering lower morbidity treatments if next PSA Dec 2007 is 6.5 or higher. Probably Brachytherapy with Caesium.

Did PSA testing help discover this cancer 5 - 15 years before it would have started causing problems?

 

UPDATED

July 2008

 

 

Additional PSAs

Nov 2007 PSA 6.0 fPSA 7%

Mar 2008 PSA 6.6 fPSA 8%

Jul 2008 PSA 8.2 fPSA 6%

Looks like things are degrading. Started to investigate treatment options. At this point RCOG (Radiotherapy Clinics of Georgia) is publishing some good looking statistics in terms of reducing PSA for 10 years or more and in reduced risk of morbidities.

 

UPDATED

January 2009

 

 

Hi - I haven't updated things for a while. I decided that I would undergo a second biopsy if my PSA went over 7.5. (First biopsy in December of 2006 was positive in 7 of 13 cores, GS 3+3, but other details were lacking and my urologist at that time wasn't very communicative. Since my PSA stayed around 5 I decided to defer treatment for a while.) When my PSA went to 8.2 in August 2008 I had a second biopsy (in September). The last needle of 12 cores was the only one positive and only 5%.

I believe that I would have more treatment options with a PSA under 10 so I started interviewing practitioners in earnest. I found an excellent doctor who does over 300 RRPs a year and statistically I would probably less than 5% chance of permanent incontinence, about 30% - 50% chance of permanent impotence plus chances for other "inconveniences" (climacturia? Are you kidding?).

I also interviewed a radiologist about Interstitial brachytherapy and IMRT. I then interview a radiolgist at MPRI (Midwest Proton Radiation Institute) about proton therapy and decided this was less likely to cause problems in the 0-3 year post treatment time frame. Morbidity and mortality for different treatements beyond this time period is speculation.

January 5 I'll be half way through 44 treatments with only minor issues (infrequent urgency, balloon discomfort, inconvenience (temporary relocation), additional expense). Thankfully I'm able to work remotely and have not missed a single day of work. Round trip from my apartment for treatment is about 1 hour. (Thank you UI.)

Question for surgeons - Has there been a randomized clinical trial demonstrating the nerve sparing surgery is as safe and effective as non-nerve sparing surgery? [No there has not - nor have there been any randomised clinical trials in the US comparing surgery to any other treatment]

 

UPDATED

May 2009

 

 

I completed proton therapy at MPRI on February 4 2009.

My pre-treatment PSAs were 8.2 on July 14 2008 and 7.2 on October 21 2008. I started proton beam therapy at MPRI on December 2 2008 and finished on February 4 2009. My first post-treatment PSA taken May 8 2009 was 2.6.

Since ending treatment I had some minor urinary and bowel urgency and now wake up to use the bathroom about once a night when previously this would be a rare event. As a testament to the mild effects of PBT I placed 48th out of 112 finishers in my age group in a recent half-marathon.

“Humorous” side note. A nurse called me with this initial post-treatment PSA result along with some other standard blood tests. She said everything was normal and my PSA was 8! I asked her to send me a copy of all the test results. This caused a few worrisome days until I got the written report. Turns out my % free PSA was 8 and total PSA was 2.6 – about right where I expected 3 months after treatment.

 

UPDATED

November 2009

 

 

I am 9 months out of PBT (proton beam therapy) at MPRI. I've been experiencing a small increase in bowel and urinary urgency but so far that (and a falling PSA - 1.7 in September 2009) are the only effects of treatment. PBT is the only treatment I've had. If you have low risk disease and are "younger" then you should give PBT a close consideration.

At the rate things are going, I can see my self losing interest in PSA testing and this group within another couple of years.

Drop me a note if you have any questons.

 

UPDATED

June 2010

 

 

In March 2010 PSA down to 1.2.

Only small problem is an increased bowel urgency. Noticable but not significant, just something different and unless I find out otherwise, will attribute to the proton therapy treatment's effect on colon.

Bob's e-mail address is: rd@tech-center.com