YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

BRONZE

Paul M. lives in California, USA . He was 58 when he was diagnosed in November, 2009. His initial PSA was 0.73 ng/ml, his Gleason Score was 6 and he was staged T2a. His choice of treatment was Active Surveillance. Here is his story.

My Nurse Practitioner referred me to a urologist after feeling what seemed to her a nodule during the annual DRE (Digital Rectal Examination). He confirmed it, biopsied my prostate in November and found 1 of the 12 cores to have a well-differentiated cancer that was 10% of the core. My previous PSAs were 0.50 in 2005, 0.50 in 2008, and now 0.73, so a possible doubling time of two years. He recommended either surgery or brachytherapy, saying that active surveillance was not appropriate given my relative youth.

Initially, I focused my attention on choosing between the two treatments offered, and found myself leaning towards brachytherapy. The urologist, whom I have found excellent in terms of his ability to communicate and his command of the research to date, had strongly suggested that my wife and I visit him for a consult, and we discussed with him the comparable survival rates and side-effects, postponing a decision for a few months. Further web searching revealed to me an increasing use of active surveillance for younger men meeting certain criteria. I took this research to my urologist and an oncologist, both of whom supported me in monitoring the cancer. I will have a repeat PSA in April and a biopsy mid-2010. The main concern that I brought to them was that active surveillance would not endanger me by allowing the cancer to extend beyond the prostate between tests; I was assured this is almost completely unlikely and that monitoring the situation is both safe and reasonable, given my particular case.

Meanwhile, I have visited two complementary medical practitioners. One, a highly respected acupuncturist, was for me the opposite of what I wanted: she promised miracles, with no evidence and she denigrated conventional treatments. The second, a "naturopathic doctor," is someone I will work with on diet, supplements, and tests. While my diet and lifestyle have little room for improvement, as I have long adhered to virtually all of the usual dietary and lifestyle advice, he has ordered a number of blood tests and has already started me on a few minor changes to my diet and supplements. My attitude is that each year without treatment will be a year without the possible side-effects of treatment; also, with each year, increased knowledge and improvements in treatment will be available to me; lastly, I may have a cancer that is so indolent that I never need treatment.

Emotionally, the first month was quite intense for my wife and me, as we got a crash course in what cancer is, how it is treated, etc. While my urologist did not say an immediate treatment decision was necessary, he also had originally expressed his opinion that I should pursue treatment within 4-5 months, so this added some urgency to our consideration of the topic. The overall effect has been to increase the closeness of an already close marriage. I chose certain people to talk to during that month, and intentionally have not shared it with others, and these friends and family members have been very supportive.

Some books and web information has been tremendously helpful, others I consider pretty poor or even harmful. I have kept a list of these things for anyone interested.

 

UPDATED

July 2010

 

 

At four months my PSA declined from 0.73 to 0.5, at eight months it went down to 0.48. If those levels seem ridiculously low for a diagnosis of prostate cancer, remember that it is not the absolute value but the trend up (or now down) that matters. My biopsy was based not on PSA but a DRE that revealed a nodule. My urologist considers the decline in PSA significant (regardless of all the questions about the PSA test) and will have me return in 4 months.

I am very fortunate to have found an excellent Naturopathic Doctor. He is trained in medicine, can analyze all of my blood tests, but is also able to spend ample time with me on diet and lifestyle. I am not going to spell out my entire treatment plan simply because it is specific to me and my entire health situation (not just prostate cancer but asthma, and various numbers on other tests that my N.D. felt were either too low or too high). For the prostate cancer, he confirmed my existing diet of low saturated fat, high vegetable intake, no dairy, no red meat, and lots of nuts (including specifically brazil nuts for selenium), and had me increase intake of lycopene (cooked tomato products) and pomegranete juice. Detoxing was, and continues to be, a big part of his program, through diet, a supplement, and sweating (sauna or exercise). Relaxation and spiritual practice also. Also an awareness of exposure to carcinogins in plastics and other toxics. Over the past eight months he has requested various blood tests, common enough ones that my medical doctor has routinely OK'd them. I am also pleased that he has recommended very few supplements, and those he has are almost all the simple vitamins and not expensive.

Paul's e-mail address is: mmwatching@gmail.com