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PROSTATE CANCER SUPPORT SITE

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Paul F and Janet live in Maine, USA. He was 44 when he was diagnosed on January 25, 2009. His initial PSA was 3.4 ng/ml, his Gleason Score was 6 and he was staged T1c. His choice of treatment was . Here is his story. He is undecided as to his choice of treatment. Here is his story.

My doctor began my PSA screenings when I turned 40 due to the fact that my father had developed prostate cancer in his early 60's. Initially my levels ran in the neighbourhood of 2.6. In May of 2009, my levels had climbed to 3.35. Although a DRE (Digital Rectal Examination) revealed nothing my doctor, concerned by my age and family history, ordered up a second screening to include free/total ratio. This test returned a PSA of 3.4 and a free/total of 20%. Not below 10 but certainly not above 30 either. We decided to run another screen in about 6 months.

In November 2009 I had another screening done, this time PSA 3.5 and free/total of 17%. Again, nothing in the "red flag" zone, but because of my age and family history, my doctor ask that I follow up with a urologist. At the initial meeting, the Nurse Practitioner gave me a most thorough DRE, and while everything seemed normal, a biopsy was recommended. At this point I'm thinking fine, why not, let's settle this once and for all. My biopsy was scheduled for January 15, 2010, with my follow-up set for January 25, 2010.

The day before my follow-up I decided I should educate myself a little just in case my biopsy came back positive. I went in the next day armed with at least a conversational knowledge of Gleason Scores and staging.

I was informed that the biopsy results did show cancer in 4 out of 7 samples taken from my left side, Gleason 6 (3+3), and 3 of those indicated cancerous cells in 25% of the core. The right side was less, in 2 out of 7, Gleason 4 (2+2), and in < 5% of the core. Although I was stunned by the diagnosis, my quick education in Gleason Scores told me the 6 was lower grade and saved me from a panic attack. My urologist began explaining the surgical options he could provide, but at that point I was still a little stunned and decided to take some time and regroup and educate myself some more.

With the help of this site and others, I revisited him last week armed with a boatload of knowledge and questions. His recommendation was surgery, and while he had trained on the robots, he prefers doing open surgery. I've scheduled consultations with radiation oncologists as well as other surgeons in around the Boston area, but at this point I'm pretty sure I'll be opting for surgery.

Which type of surgery is still to be determined, as everything I've read suggests that both provide similar results. With my age and health, either would be a good choice, so I'm more concerned about the skill of the surgeon and less concerned about which tools he/she utilizes.

 

UPDATED

April 2010

 

 

I was already leaning towards surgery, but still wanted to explore all of my options. I met with a top radiation oncologist in the region, and given my circumstances, he also felt surgery was best.

I received an email from a member who recommended that I read the Marckini book. I found it to be extremely enlightening. I think if I'm ever in a position of needing to kill a cancer, I will definitely explore the proton beam option. But given my circumstances, I still felt that a prostatectomy was best for me.

Since my urologist preferred open surgery, I needed to hear from the other side. I met with a very skilled RALP surgeon at the Lahey Clinic in Burlington, MA. This man was everything they tell you to look for in a robotic surgeon; skilled, experienced, well trained, and extremely confidant. I probably would have let him do the procedure right there on the spot had he asked. When we left there, my wife and I agreed that if we did not return there for the procedure, it would not be because of the surgeon. I had hoped that after this visit, my decision would be clear. No such luck, I was still undecided.

So after several weeks of reading and researching and meeting with doctors in every specialty, I realized I had a bunch of new questions for my urologist. We scheduled yet another follow-up with him.

My urologist, and our hospital, is only a mile from my house. Two days before meeting with the urologist, the hospital held an open house to unveil their recently remodeled surgery wing to the public. We felt we should check it out, perhaps it would aid in our decision. As expected, the hospital staff was full of familiar faces. More importantly, we saw and felt a renewed sense of pride and optimism in the level of service they could provide our community. It was a nice visit, but I couldn't make a decision based on sentiment. Still unable to make a decision.

Monday came and we prepared to meet with the urologist. As I reflected on my weeks of cancer research, cancer treatment center visits, and appointments with cancer specialists, something occurred to me.

I don't have cancer, my prostate does. I'm trying to get rid of the prostate before the cancer spreads to me. My immediate focus had to be on a successful prostatectomy and any conceivable situation that may occur as a result of the procedure, provided the cancer was in fact contained to the prostate as anticipated. I rewrote my questions for the urologist and then we headed out.

We were about half way through our questions when the answer became clear to my wife and I. My urologist, and our hospital, is more than capable of providing the services we need. We have a good plan of action in place for the prostatectomy and any needed treatment thereafter, and we have a course of action elsewhere if the cancer was not contained.

At the onset, I had hoped that my decision would have come sooner and easier. However, in the three weeks since my decision, I have not had a moment of doubt. My surgery is schedule in two weeks, on April 22.

In the meantime, I'm washing windows, readying the pool, and preparing for another season coaching Little League. Staying involved with the kids should motivate to get back on my feet and get back out there as soon as possible.

I hate that this is interfering with baseball, but life gets in the way of things sometimes. For the time being though, this is still a speedbump.

Paul's e-mail address is: pafs2010@aol.com