YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

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Mike McLafferty and Karen live in Florida, USA. He was 63 when he was diagnosed on April 1, 2008. His initial PSA was 4.7 ng/ml, his Gleason Score was 3+3=6 and although he says he was staged T2a, it seems that this might have been his pathological staging and that his clinical staging was T1c. His choice of treatment was Brachytherapy with neo-adjuvant EBRT (External Beam Radiation Therapy). Here is his story.

In December of 2007 I informed my Primary Care physician that I was beginning to have issues in maintaining an erection. My wife had mentioned that my erections were not as "hard" as they were in the past so I figured it was time to look for some help.

The doctor ordered a PSA test to see if there might be some correlation between my ED and prostate function. The PSA came back at 4.7, so I was referred to a Urologist for further testing. The Urologist convinced me that because of my age (63) the 4.7 reading was a bit high and that we should do a biopsy. He performed the biopsy a couple of weeks later and cancer was confirmed in 8 of the 12 core samples. The lab diagnosed the adenocarcinoma at a Gleason Grade 3+3=6. At this level, my Urologist indicated to me that I had the luxury of choosing between several treatment plans: surgery, radiation, cryo, etc. His suggestion was external beam radiation.

From that point on I realized that no one had the perfect solution for my particular cancer and that I would have to do my own due diligence to determine what was best for me. Unfortunately, the decision on how to successfully treat/cure cancer was going to be made by a person totally unqualified to make those decisions - ME!

My first visit was to a radiation oncologist recommended by my Urologist. While he was pretty sure of himself, he spent most of the appointment telling me the dangers of having surgery. I wasn't convinced.

My next appointment was with a surgeon at the renowned Cleveland Clinic. He on the other hand was just a convinced that surgery was the proper answer. I did like him and the hospital and decided that I would go that route. We scheduled surgery for early September. About a month later the Cleveland Clinic called to ask if we could move up the surgery as the surgeon was leaving the hospital and moving out of state. They said that I would be his last patient. WHOA NOW! While I wanted him to operate (he had performed over 500 nerve sparing, radical prostatectomies using the Da Vinci robotic system), his presence or lack thereof after the operation might be critical. I began looking for other options.

About this time an old Air Force buddy of mine mentioned that PCa was considered service connected for service men with "boots-on-the-ground" in Vietnam. We had flown together in and out of Vietnam on many occasions. I decided to contact the VA and see what they recommended.

The Urologist there told me that for men of my age surgery was the gold standard. And if I opted for a prostatectomy it would be performed by a resident under the watchful eye of a more experienced surgeon. Not wanting to offend I asked what other options were available. I was referred to a local civilian hospital to discuss seed implant radiation. The doc was great and convinced me that their combo of external beam (23 doses) and temporary seeding of high-dose-rate Iridium-192 was the best.

Not only was I now convinced that this option offered the best chance of avoiding the dreaded double I - incontinence and impotence - but the VA would pay for it!

Within a week I began the external low-dose treatments. At their conclusion I was set up for the first of two implant procedures. The second was performed two weeks after the first. The hospital staff were wonderful and from what I could tell did a great job. The proof is however in the pudding.

Three months after the last implant procedure I had a follow-up PSA exam. It came back at 2.4. Going down. From what I have read, the radiation treatment does not drop the PSA reading to near 0 for quite a while.

My life is back to more-or-less normal 6 months from the last treatment. I did suffer a bit of fatigue right after the treatment and I cannot work the same number of hours as before. The doctors say that this may not be related to the PCa but just aging. I doubt that my strength levels would deteriorate that much naturally. My ED has worsened and even with pills an erection is not always guaranteed. So far no incontinence but there are no guarantees that it won't start.

Overall I feel like I made the right decision and would recommend it.

 

UPDATED

May 2009

 

 

At the end of March, I had another PSA done and the number has fallen to 1.0. The urologist was pleased.

At about the same time, and almost spontaneously, I started having to void every hour during the day (and sometimes more often) and waking up every hour or two during the night. The pain was similar to the pain I felt the first week after the brachytherapy treatments. The urologist tested for stricture and bladder neck contracture but says that since I am able to completely empty the bladder that those two possible complications are not the issue. He tells me that it is the bladder itself that is still recovering from the radiation and that this could go on for a year or so. Not great news but at least I have always been able to reach the toilet before letting go. I do not want to wear pads if I can help it.

Mike's e-mail address is: mhmclafferty@gmail.com