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Dick Fay lives in Los Angeles, California in the USA . He was 63 when he was diagnosed on September 10, 2007. His initial PSA was 7.51 ng/ml, his Gleason Score was 3+3=6 and he was staged T1c. His choice of treatment was Laparoscopic Robotic Prostatectomy . Here is his story.

I am a 63 year old divorced male living in Southern California. I have a great fiancée, two wonderful adult children, and two super grandkids.

I went in for my "annual" physical on September 10, 2007. I must confess that I had missed a year or two. I expected to be told that I was somewhat overweight and was worried about cholesterol, etc. Blood pressure was a little high but the big problem was that my PSA was 7.54. My family doctor put me on a regimen of an anti-biotic for 10 days and scheduled a follow up PSA test.

I was worried sick about the cancer and postponed plans to sell my house and move. I had a foreign vacation planned for last Oct - mid November. The family doctor said to go. I got the second PSA results on Oct. 3rd - 5.51. So a nice reduction but still above 4.0. I scheduled an appointment with a local urologist that would lead to a biopsy and also began serious research into options. I became concerned that things were moving too slowly and looked for another urologist for the biopsy, found one, but then was advised by a physician friend not to use him and to stick with my original plan. Which I did.

Had the appointment with the urologist on Oct 15. PSA is 5.68, about the same as the 5.51. The DRE done by my family doctor and by the urologist found nothing unusual. Biopsy is scheduled for Nov 20th, and follow up for results on November 27th.

My research in Gleason scores, etc. continues on the Internet and in books. I have been having some problem with urination. Need to go and can not kind of thing. Urologist told me it was not from the cancer but I am worried. I did decided that if cancer was present to have laparoscopic surgery by Dr. Thomas Ahlering at the UC Irvine Medical Center.

The TRUS and biopsy were not pleasant but not much worse than a colonoscopy. On the 27th I got the results, Cancer in 7 out of 12 samples, Gleason of 3-3. Bone scans scheduled for the 21st. I called Dr. Ahlering's office and got an appointment for December 7th, pre-op for December 21st, and the operation for Jan. 2nd 2008.

The scans found no metastasis. I was really worried and very happy with those results. Dr. Ahlering seems both caring and confident. He does not take insurance so he will be out of network. He found nothing doing a DRE and seems confident that I will be ok. I am starting to feel good about it and confident that I will get rid of the cancer.

The pre-op was no big deal. I am participating in various studies and needed another DRE. Nothing amiss.

I checked into the hospital at 11 am on Wednesday, watched some TV in the waiting room, then was called for the surgery. The anaesthetic worked like a charm and the next thing I knew it was over. The next morning I was given a menu with no restrictions. Dr. Ahlering came over, said everything was fine. He also found and removed a non-cancerous growth the size of pea near by bladder that was probably causing the urination problems. My fiancée came for me we went back to her house. Catheter is the only issue.

I was nauseous on Friday, but then every day after that was better. After a week went back and got the catheter removed. Dr. Ahlering called and said that the biopsy after the surgery showed that the cancer was contained in the prostate and that the margins were clear.

I used pads all of time for about two months and after three months only rarely. Dr. Ahlering prescribes a ¼ dose of Viagra each day, which is covered by my plan. Have not tried that function as yet.

My first follow up with Dr. Ahlering is scheduled for April 17th. I had a PSA test and got the results - 0.04. I will wait and see what Dr. Ahlering says but that looks pretty good to me.

 

UPDATED

October 2008

 

 

Everything is fine. PSA remains undetectable.

 

UPDATED

March 2009

 

 

Everything is going great. Just got remarried at age 64.

The only change is that I am now having my follow up checkups done by my local doctor rather than Dr. Ahlering at UCI Medical Center. Dr. Ahlering is GREAT but my insurance carrier no longer covers UCI. So a visit to Dr. Ahlering is an hour drive each way and $70 which was fine. But now I get billed something like $250 for the time I am in UCI's room which is crazy. My local doc is $20 and 10 minutes away.

Understanding and keeping up with insurance coverage is a must and a pain.

My PSA was undetectable which at the local lab means less than 0.04.

 

UPDATED

September 2009

 

 

Went in for my 3 month check up, about 20 months after surgery. My PSA came back at 0.06. I have a follow up and it was 0.06. Went to another lab and will get results next week.

I am not sure what this means or what my next steps will be. My family doctor seems concerned and he was doing the monitoring. My surgeon seems much less concerned as the 0.06 is still very low. My problem is that it was below 0.04 every test I had after the surgery.

I will schedule a visit with the surgeon in the near future.

 

UPDATED

December 2009

 

 

My doctor's lab now only reports PSA as low as 0.10 ng/ml. Mine is less than that.

Life is very good.

 

UPDATED

February 2010

 

 

Couple of points.

I forgot to write that the pathology after the surgery raised my Gleason score to 3 + 4 rather than 3+3, so I am not sure if I am on the right page for Gleason score.[Dick is referring to the Gleason Score Index which shows the clinical staging, so he is in the right place]

While life continues to be good I am concerned about my PSA and would love to hear from anyone with relevant experience. I had the surgery on Jan 2nd, 2008. All PSA tests up to September 2009 were less than 0.04 which is the minimum for the lab. In September I had two PSA tests of 0.06. The surgeon said my numbers were very good and he did not concerned until the PSA his 0.1 or 0.2. My family doctor told me that his opinion was that anything below 0.1 was probably "noise" and that the lab was only going to report 0.1 or greater. My December 2009 PSA at 23 months was less than 0.1. Should I be worried about the 0.06? Is is really "noise."? [The aspect of 'noise' in very low PSA readings is covered in Ultra Sensitive PSA]

Later: Just had a follow up PSA. Less than 0.10. I am going to assume that the 0.06 of last September was noise.

Dick's e-mail address is: wrichardfay@gmail.com