Rich
Shelton and Wilma live in Virginia USA. He was 45 when he was diagnosed on March
8, 2006. His initial PSA was 4.8 ng/ml, his Gleason Score was 4+4=8, he was staged
T2 and has not yet decided on his treatment. Here is his story to date:
Well
it's the middle of April and I'm in the middle of my treatment decision. It all
started back in October I was doing a routine over 40 physical, military guy so
the DRE is required. Well the blood came back with a PSA of 4.3 ng/ml, high enough
to warrant a DRE, which found an enlarged prostate. So I was scheduled for a biopsy,
which came back negative. The docs put me on an antiboitic thinking I had prostatitis,
but after a month my PSA did not drop significantly.
I
guess I got lucky because at this point my doc recommended me for a study at the
National Institute of Health (NIH) that uses MRI to locate and treat prostate
cancer. So I went through one very uncomfortable imaging procedure, followed by
an MRI biopsy. The results of the MRI biospy showed cancer in one of 7 cores,
with a Gleason Score of 4+4=8. I guess that was both good news and bad news; good
news, I don't have a lot of cancer, bad news, I've got cancer and it's aggressive.
I've also got a family history, my maternal grandfather died of prostate cancer
in his early 60's. But luckily my father and brother both have normal PSAs, so
I'm the big winner in the family!
I've talked to an Oncologist and two
urologists, here are the treatment options I'm looking at;
1. A combination
of External Beam Radiation (IMRT) combined with Hormone treatment. (this is another
study at NIH). The External Beam Radiation is for two months as an outpatient
while the Hormone Treatment is for over 2 years. My initial analysis is that I
can take the radiation therapy but the Hormone treatment scares the hell out me.
2.
Surgery, Laparoscopic nerve sparing surgery. Not sure aobut this one, I understand
that this is the "gold standard," but the recovery is very lengthly and doesn't
seem to come with any more guarantee than radiation.
So that's where I
am right now. The wife wants surgery, she wants the cancer out of my body and
we can worry about all the function issues later. She may well be right.
Well
I'll make my decision soon so stay tuned!!
OK,
We've made our decision, surgery is how we're going to treat this disease. Why,
because it seems to be the best choice for someone my age with a Gleason score
of eight. My youngest is only 7 and I want to do the most I can to ensure I can
be around when he's 27.
I'm
still not comfortable with the long recovery period, but it seems better than
2 or 3 years of hormone treatment.
So
now the big question is; "Who do I get to do the surgery?" Does it make a difference?
Well
the decision has been made. I will have surgery done at Walter Reed by Dr. McLeod.
I guess I'm lucky, Dr. McLeod has a great reputation so I'm comfortable with him
cutting me up.
I'm
still not comfortable with the recovery or with the possibility that I could need
more treatment than just surgery. But I guess that old saying is true, "The longest
journey begins with the first step" so for me it's time to get stepping!!?
Written
14 July 2006:
Well
it has been one week exactly since my surgery and I am now dealing with the entire
recovery process. My understanding is that the Sugery went well, meaning there
was no cancer outside the capsule and that the nerves were spared.
This
first week hasn't been too bad nor has it been too easy. The two big pains I'm
experiencing are from the surgery and dealing with the catheter. The pain from
the wound is kind of dull aching pain that goes away with medication. The pain
from catheter is a combination of discomfort at having this thing in my body,
and the shock that can occur when the tubing running to the urine bag is moved
quickly!!! One piece of advice, get the tubing that runs down you leg to the pee
bag cut to the right length, not too short and not too long. Anyway the whole
thing comes out on the 24th "God Willing" Then I get to deal with all the other
post surgery issues.
So
what I'm saying here is that recovery is a long long long road. I'm glad so far
for progress I'm making, and I'm trying not to push it too hard. The next big
hurdle will be my first post-operative PSA.
Best
wishes to all.
Rich
Ok,
I got the good news, my current PSA is 0.091 ng/ml, since I had positive surgical
margins I guess I'm not completely in the clear but I feel as though I've turned
the corner on the cancer.
As
for the recovery, I joined a clinical study where I'm given a pill every night
(could be Viagra, could be a placebo)I don't know. I do know that my erections
are returning, they are strong enough for penetration but don't last very long.
I'm
still wearing pads, going through about 4 a day since I've gone back to work.
I'm also a little worried about the flow of urine. I almost always have to sit
down now because I dribble so much we I urinate. Gone are the days when I could
write my name in a urinal!!
Other
than those two problems things are going well. I feel like I can finally start
working out again!! It's great to be surviving!
Rich
says in an e-mail that he is travelling at present but will update when he gets
home. for the moment this is the gist of where he is at:
I
have survived both surgery and radiation therapy. My PSA finally started going
down this July (from 0.11 to 0.07) I will be tested again at the end of November.
Still
a little problem with incontinence, but sexual function has returned (assisted
by drugs). Other than that I'm very thankful for everyday I get and especially
thankful to you for maintain an excellent resource for all of us Pca guys
Well
it has been almost 18 months since my surgery, and 10 months since the end of
my radiation therapy. Today I had a Cystocopy to open my uretha so that I can
pee like a normal man. Thankfuly this procedure is quick and while not too painful.
A Cystocopy is a procedure where a doctor inserts a cystoscope (telescope like
instrument) that allows the doctor to see inside the urethra and bladder. My doctor
was able to quickly (thank God) open my uretha allowing me to urinate more freely.
I opted for this procedure after 6 months of Flowmax and Urolax which did not
improve my urine flow. I should know in a couple of days if this procedure is
successful. With a little luck this will be the last major event in my battle
against Prostate Cancer. Just monitor and watch my PSA drop.
Currently
my PSA is down to 0.08 My PSA has droped from a high of 5.3 before surgery to
0.08 after surgery and raditation. I consider myself extremely lucky, not only
to have survived this long (original Gleason score of 8) but more so to have a
decent return to quality of life. By quality of life I mean that I am now able
to have intercourse (drug assisted), without drugs I am able to have other types
of sexual activity. The one thing I miss is the ability to ejaculate. To me ejaculation
provides some of the pleasure from an orgasm, now that is gone. But on the bright
side my spouse doesn't seem to mind! So for me it's on with life, liberty and
the pursuit of happiness.
Rich's
e-mail address is: richard.shelton@us.army.mil
