Keith
Novak and Darla live in Texas, USA. He was 48 when he was diagnosed on November
14, 2008. His initial PSA was 4.5 ng/ml, his Gleason Score 4+3=7 was and although
he says he was staged T2c, this is his pathological stage: his clinical stage
would have been T1c. His choice of treatment was da Vinci Prostatectomy. Here
is his story.
THERE
WAS NO RESPONSE TO AN UPDATE
REMINDER
IN 2010
SO THERE IS NO UPDATE.
Due to rising cholesterol levels, and starting my "50" physicals at 45,
I have been checking my PSA for the past 3 years. This past September I had the
fortunate news that my cholesterol had dropped from 250 to 150. But then came
the equalizer, my PSA had risen from 3 to 4.5 in a year. I was referred to a urologist,
Dr. David Cuellar at Urology Austin, a very good choice for me as he is very easy
to talk to and explains things in layman's terms.
After the initial DRE
(Digital Rectal Examination), it was determined that a biopsy be performed on
November 5th. We met again on November 14 to go over the results. Quite shocking
I might say as I had no symptoms of any prostate issues going into this. 6 of
the 12 samples showed 4% to 25% of the areas were affected. We (Dr. Cuellar, my
wife and I) reviewed my options for treatment and the possible side effects of
each. Darla and I then took a week to absorb all of this information and begin
our internet education in hopes to "do the right thing". After a heavy dose of
information overload and narrowing down my choices to the da Vinci assisted prostatectomy
and the HIFU, unproven, non FDA approved but seemingly very promising remedy,
I felt that the best piece of mind for me was to remove this from my body and
hopefully, that would be the end of it.
We scheduled the surgery as soon
as possible after the biopsy (right after the 6 week wait required post biopsy)
Monday, January 5th 2009. Surgery I was told went very well and for the most part,
my recovery time in the hospital went ok. There was some gas pain that took an
extra day to get moving and one stressful episode of IV reinsertion, but all in
all easy recovery and I was released on Wednesday evening.
My follow up
was scheduled for the following week where after the imaging was done, the catheter
was removed and the results from my Post Op pathology were discussed. This is
where I started to get a little antsy. The surgical margins came back positive,
with capsule invasion but not through, and some tertiary Gleason 5 patterns. Both
lateral and posterior margins were positive. Fortunately, no seminal vesicle invasion
was found.
My biggest fear about this has been the possibility of leakage
or spread of the cancer outside of my prostate. I do NOT want to be chasing this
for the rest of my life. So I contacted an oncologist on my own to see what the
"cancer" people had to say about the results. I was quite surprised and concerned
that they wanted to start a radiation treatment series right away. I was less
than 30 days removed from the surgery! Was it THAT bad?
I have since slowed
the Oncologist down and am going to see Dr. Ian Thompson on their recommendation.
Dr. Thompson it appears is one of the premier urology/oncologists in the country.
Hopefully he can shed some light on what the best course of action would be given
all of the information.
I have had, until today, what I would consider
an above average recovery. My catheter was removed Wednesday the 14th and I have
been out of the diaper since, with only very minor drips associated with laughing,
coughing, etc. I went back to work right away and even played several rounds of
golf over the past couple of weeks with no pain or problems. ED has been a non
issue for the most part as things are working just fine. I would say that Dr.
Cuellar and his skills with the da Vinci process did an outstanding job sparing
any nerve damage, which was my number two concern behind cancer removal.
My
stress now lays with the results of the surgical margins, the aggressiveness of
the oncologist and the now concerning PSA result that I just received today, February
4th of 0.20. I am going to get another PSA in two weeks and see if hopefully it
is still trending down. Or if it is on the way up already. Wish me luck!
