YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

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David Price and Clare live in Leeds, United Kingdom. He was 56 when he was diagnosed on 30 June, 2009. His initial PSA was 4.1 ng/ml, his Gleason Score was 3+4 = 7 and he was staged T2c. He is undecided as to his choice of treatment. Here is his story.

I've had a PSA of around 3.7. for the past 3 years, rising over the past 12 months to 4.1. After a routine DRE (Digital Rectal Examination) a nodule was felt (later deemed benign). Biopsy showed 8 out of 12 samples with cancer (average of 13% volume).
Cancer found in both lobes, but, because of Gleason, it's been deemed low-to-moderately aggressive.

Only one tumour was visible on the MRI and no spread to nodes or seminal vesicles, so completely contained (as far as MRIs can be trusted!). Cancer couldn't be felt, but biopsy shows it in both lobes, so I guess that explains the T2c staging.

I'm now going to weigh up the pros and cons of the treatment options available to me, do more research, and take my time coming to a decision.

I feel as though the worst part (at least of this phase of the journey) is now over. Not knowing is definitely the worst, and we can get on with our lives again!

 

UPDATED

September 2009

 

 

In response to a reminder to let us know what he was doing, David replied:

I'll be talking to Leeds about Brachytherapy this week, and having HIFU snazzy MRI next week - so there'll be more to tell. But there's loads more on the blog!

 

UPDATED

October 2009

 

 

Had MRI scan at UCLH in London. Report shows 'large volume' of tumour on left gland, with some cancer on right side too.Possible microscopic escape on left, so I now have a 'possible' staging of T3a (I don't know how reliable a 'possible' staging is....) Still no seminal vesicle involvement, but with possible escape they say I should have bone scan.

I was told today that I'm still a candidate for HIFU, but for whole gland treatment. This is a bit of a blow, as the impotence rates - which are very good for hemi-ablation or index lesion, aren't quite so good for full gland. It also may mean that I may not qualify for the clinical trial.

I have meetings next week and a template mapping procedure due at the end of November.

 

UPDATED

January 2010

 

 

Well, my decision (6 months after initial diagnosis) has been made. My first choice (HIFU) was discarded after a frank and productive consultation with Mark Emberton at UCLH in London. I'm glad I initially pursued UCLH for treatment, not least because their high-def MRI showed a much sharper picture than my initial scan. (Why we continue to scan after a biopsy is beyond me, but there is now government support to trial pre-biopsy MRIs.)

It was clear that the location of the largest tumour (close to the sphincter) makes the risk of side effects with full-gland HIFU, no better than radiation.

My hometown oncology centre, (in Leeds) is about to follow the Canadian model of single-dose HDR (High Dosage Radiation Therapy), followed by IMRT (Intensity Modulated Radiation Therapy) 'lite'. My oncologist (Dr Bottomley) recommended this to 'mop up' any possible extra-capsular spread (MRI showed possibility of microscopic escape). This consists of 15 low dose beams about 2-3 weeks after the initial HDR treatment. I'm currently on low-dose Casodex, prescribed as both a holding-mechanism (my tumour is close to the capsule edge) and to shrink the tumour pre-treatment. I'm not experiencing any side-effects other than sore and lumpy nipples (I'm told both are not uncommon).

I feel happy with my choice. I realise that there have been risks with waiting 8 months between diagnosis and treatment, but there are (in my opinion) bigger risks in rushing into an inappropriate treatment choice.

I will update after treatment. In the meantime, I keep a PCa blog, if anyone is interested in my story.

David's e-mail address is: pricedav@gmail.com