Danny
Staggs and Dianna live in Texas, USA. He was 56 when he was diagnosed on December,
15, 2005. His PSA was 3.7 ng/ml, his Gleason Score was 3+3= 6 and he was staged
T2a. His choice of treatment was Surgery - DaVinci Robotic Laparoscopic Prostatectomy.
Here is his story:
In
early December, 2005, my PSA had climbed from 1.9 ng/ml to 3.7 ng/ml in 14 months
- my GP suggested I see a Urologist - the PSA Velocity was alarming. I made an
apointment with the Urologist my GP recommened and underwent a biopsy on December
8, 2005.
One week later, the Urologist called to tell me that I had PCa -
he asked me to bring my Wife with me the following morning to discuss 'options'.
The
following morning he explained the Gleason Grading System and that my PCa scored
3+3 for a Gleason 6. He also explained 'staging' and told me that my PCa staged
at T2a.He then explained that my tumor was 'too close to the apex' to be operable
without 'positive margins' and bladder incontinence - e.g. he didn't feel that
he would be able to remove all the Cancer without leaving me incontinent. He injected
me with my first 4-month shot of Lupron Depot to begin killing my testerone (to
shrink my prostate and my tumor), he recommended Brachytherapy (Radioactive Seed
Implants) and referred me to a Radiation Onocologist.
The Radiation Onocologist
was very good - he very was personable, extremely informative and very relaxed
- we never felt rushed with him. He also felt 'the margins were too positive'
for surgery and that Brachytherapy was my best option.
I spent the next
two months researching everything I could find on the subject and decided that
since two Doctors (one Urologist and one Onocologist) felt Brachytherapy was my
best option, I already had a 'second opinion'.
I scheduled the Brachytherapy
for April 5, 2006 and went in on March 8, 2006 for an Ultrasound 'volume study'
and a CT Scan - both as preparation for the Brachytherapy procedure. These procedures
confirmed me as a viable candidate for Brachytherapy, so I went home to await
the April 5th procedure.
The next day, March 9th, 2006, I went to a local
Prostate Cancer Support Group - my first appearance at this group. The Support
Group had a guest lecturer that day, Dr Randy Fagin (a young (35 yrs old) Urologist),
who is one of the premier experts in the USA in a procedure called DaVinci Robotic
Laparoscopic Prostatectomy.
Dr Fagin presented this procedure in a very
clear and concise fashion and made it very plain that he had never seen in (he's
performed over 500 DaVinci procedures) a case of 'localized Prostate Cancer' that
presented 'margins too positive' to be considered candidates for the DaVinci procedure.
I also met a couple of guys who Dr Fagin had operated on and they were ecstatic
about him!
I went home and discussed this with my Wife and we both felt
it would be best to make an appointment with Dr Fagin and discuss this further.
I
called Dr Fagin ( he accepts patients from
all over the world) the next day (March 10th) and he met with us on March 15th
- he reviewed all the medical records I had faxed from 3 doctors, performed a
TransRectal UltraSound and assured us that he could remove my Prostate and was
almost certain that he would see 'negative margins'. He also presented the statistics
that he accumulates (they're available on his web page)from his DaVinci procedures
and explained that his patients average 2 pads per day, 6 weeks after surgery
and it improves from there - he has extremely low occurence of Bladder Incontinence
and very good statistics in all other areas.
We elected to forego the Brachytherapy
and opted to have the DaVinci procedure instead. Dr Fagin explained that he only
'spared nerves' when he was sure he could do so and still remove all the Cancer
- we concurred with that - life is much more important than erectile function!
The
procedure was scheduled for March 22nd, so I immediatly drove to St David's hospital
(Austin, TX) for 3 hours of pre-op paperwork and tests). On March 22nd, we drove
to the Surgery Wing of St David's and I was immediately taken to a room where
I changed into a gown, layed on a bed and had an IV administered. A few minutes
later a Dr (Anesthesiaologist) visited and explained her part in the procedure
and what I could expect. A couple of minutes later one of her nurses came in and
started the IV drip - with antibiotics and a sedative - they then wheeled me to
the Operating Room. I vaguely remember them asking me to help them move me from
the bed to the surgical table - but, that's all I recall until I woke up in recovery
- I remember I was very happy in recovery and telling all sorts of bad jokes.
I was moved to a room, where I rejoined my Wife and Daughter - they told me the
DaVinci procedure took 2 hours and the recovery took an additional hour.
I
remained in the hospital over night and went home the following day - less than
24 hours in the hospital! I wore a Foley Catheter for 6 days and, while it was
not the most comfortable experience of my life, it was tolerable. On the day the
catheter came out, Dr Fagin gave me the wonderful news that 'all margins were
negative'!!! He also presented me with a copy of the pathologist's report - it
turned out that my pre-op Gleason 6 (3+3) was really a Gleason 7 (4+3). Had I
continued as planned with the Brachytherapy, my PCa would have been significanly
undertreated!!!
The biggest problem I had was post-surgery bladder spasms
- they felt as though someone was trying to electrocute me thru the tip of my
penis - this, even though I was taking bladder spasm medication as part of my
post-surgery drug regimen. I had to call the Dr at 10pm on a Sunday night and
he called in Xanax (a sedative) to my Pharmacy. With the catheter, I had no need
to get up at night and, with the Xanax, I slept for 7.5 hours that night!
Dr
Fagin's 'full package' includes a Physical Therapist that specializes in relearning
bladder control - it's been 3 weeks since my surgery and I'm wearing 4 pads per
day now - I could probably do with 2, but the Lupron Depot hasn't yet worn off
- I still have hot flashes and sweat a lot, so for comfort, I'm changing pads
more than would normally be necessary.
I'm doing extremely well - back
to walking 3 miles each morning - life is good!!!
I return to Dr Fagin
on May 23, 2006 for my first post-surgery PSA - given the fact that my PCa was
originally staged too low, I'm somewhat nervous about the PSA, but Dr Fagin assures
me that my PSA will be nil...
In closing, I would like to make a few points:
1)
The ONLY way you can ever be sure that your PCa is staged correctly is to have
your prostate removed - once it's removed it can be analyzed completely by a Pathologist
- then you know whether the biopsy was correct and the treatment appropriate.
2)
ALWAYS get a second opinion from another surgeon - preferably from a surgeon who
does a different procedure (e.g. one 'open prostatectomy' and one 'laproscopic'
(preferable Da Vinci)).
3)
If you have Brachytherapy and it doesn't erradicate the PCa, you CAN'T have additional
Radiation - e.g. you've eliminated radiation as a backup plan.
4)
If you have radiation (including Brachytherapy) and it doesn't erradicate the
PCa, it's highly unlikely that you will be able to have 'salvage surgery' - it's
(I've been told) 'just too messy' because of the scarring caused by the radiation.
5)
Lupron Depot made our life miserable - extreme mood swings, extreme hot flashes
and chills, extreme fatigue (probably from laying awake most of the night crying),
shortness of breath, and on and on... I wouldn't wish this on anyone - BUT, I
would take it again if it were my only option.
I hope my story helps someone
else in their quest for the best way in dealing with their PCa.
Thank
you,
Danny
I
returned to my Urologist on May 26th for my 8-week PSA results and learned that
my PSA was "undectable" (< 0.1). Needless to say, we were ecstatic!
My
current status is: I feel great!!! Much better than I have for over two years!!!
With
the help of an excellent Physical Therapist (Kimberlee Sullivan, DPT), I have
conquered my incontinence - I quit wearing pads 6-7 weeks after the catheter came
out.
I
finally feel like the single 4-month Lupron Depot shot is almost out of my system
- the Lupron side-effects are almost completely gone - no hot flashes, no chills,
no energy loss and especially no more cobwebs in my head - I can actually remember
things again!!!
And
with the help of the Erectaid Vacuum Pump System, things are starting to get back
to normal again.
Life
is great - I even have a fly fishing trip coming up next month - something that
I wasn't sure I would ever have the energy for again. I hope everyone has a chance
to experience this level of normalcy again!
Well,
it's been 8 months since my surgery and 6 months since my last PSA check - I'm
excited to say that my PSA came in at 0.000!
My
recovery is complete: No incontinence and erections have returned! All this in
spite of the side effects of the GERD and Blood Pressure drugs that I take.
I
still have some residual emotional issues (mood swings, periodic depression, etc.)
from the Lupron Depot therapy I had, prior to surgery. But, some of this could
also be side-effects of the above drugs. I'm working on resolving these issues.
I
can't say enough good things about Dr Fagin and Kimberlee Sullivan, DPT - the
best surgeon/Urologist and Physical Therapist that anyone could possibly ask for!
I've
mentored a number of people in the past 6 months and like to think that my experiences/insight
have proven helpful!!
Alle
de beste!
I
FINALLY feel normal again! Even though I had my last PSA a couple of months ago
and it came back 0.00 and the cancer was gone, I couldn't figure out why I felt
such gloom and doom. No matter that I felt physically whole again, I could never
seem to put the cancer behind me - I always felt as though my life had fallen
completely apart.
I
was seriously considering mental health counseling when my Wife suggested my testosterone
might be low - my Urologist confirmed it - the low threshold is 200 and mine was
240. If you've read my story, you know that I was orignally given a 4-month shot
of Lupron Depot to kill my testosterone in preparation for the Brachytherapy that
I never had. Apparently I have never recovered from the Lupron Depot shot!
My
urologist started me on AndroGel (testosterone replacement gel) and told me that
it may take a while to see an improvement - within one week I felt very much like
my old self - I'm no longer depressed and no longer feel like I can't cope. I
hope sharing this helps someone else down the line.
I
also wanted to mention that Mike Stucky of msnbc.com has a very good on-going
series of articles about his own trip thru the PCa maze. You can read and/or listen
to/download PodCasts of him reading from this
link- he writes a new article every other Wednesday.
All
the best to everyone!
Danny
My
6-month PSA check was excellent - it was < .001
Danny's
e-mail address is: djstaggs@suddenlink.net
