Rick
Durbin and Emily live in Massachusetts, USA. Rick was 54 when he was diagnosed
in November 2001. His initial PSA was 20.4 ng/ml and his Gleason Score was 4+4=8.
He was staged T3b and his choice of treatment was Surgery. Here is his story:
During a routine physical exam November 2001, my new primary care physician notified
me that I had a PSA of 20.4 ng/ml. He immediately referred me to a urologist for
evaluation and biopsy. I was 54 and had been in very good health, until then.
The biopsy came back with a 4+4 (8) Gleason score. Two-thirds of the sticks were
over 85% cancerous.
I was sent for a bone scan which came back negative
and then met with the radiation oncologist. His visit was extremely detailed and
helpful to identify what choices I had and how they would impact me. He also got
me involved with the local USToo group at the Cancer clinic. Again, the best move
for me. All involved believed the cancer was contained. I started Zoladex to slow
the growth until treatment.
Through the meetings, I was able to learn
about the results and side effects that the members experienced with their PCa
treatment. It helped me ask better questions and eventually make the right choice,
surgery.
In June of 2002, I had the usual pre-MRI to ready for surgery.
The surgeon I had chosen was the best choice I have made to date. The relationship
was upfront and honest, no beating around the bush. The surgery took 5 1/2 hours
as he found that the cancer had indeed spread into my seminal vesicles and migrated
up into the bladder neck. The lymph nodes were negative on initial pathology at
the beginning of surgery, or he would have stopped there. The Doctor removed the
prostate, SVs, lymph nodes and extra margin from the bladder. It was negative,
which should give me a all-clear from a PCa perspective.
Post visits
with the surgical urologist identified that I was doing well, enough for me to
ask if it was all over? He did tell me that for now yes and I should enjoy every
day, because systemically, this disease returns in cases at this level (20.4/8/T3b).
He said we can make the decisions needed when the situation warrants. He believes
in reducing the trama and morbidity to the person as much as possible. I agree
with that too, but wonder about having to go through the next level of treatments.
My side effects were usual but improved over the 6-12 months. No incontinence
from 2 months post RP, minor abdominal muscular pain while healing, and impotence
improved to the point of minimal use of Rx to return to sexual activity. I mention
that I could not have nerve sparing surgery.
My PSA from July 2002 until
Oct 2004 was undetectable for 7 straight readings. Last fall I had my first 0.1
which was retested 2 times since. Again 0.1 and followed by a 0.2 this spring
2005. My Doc is suggesting that I may consider hormone therapy this fall if the
PSA continues to climb.
During the past 2 years, I had been diagnosed
with Diabetes, high blood pressure and cardio arrhythmia. All of which I have
been able to get well into control and normal, with meds and a lot of exercise.
In the spring of 2004, my primary MD said I had a degenerative lumbar
#1 after my complaining of low back pains. Prescription - keep up the exercise
and careful on the back strain. My concern is now around the recurrence of my
PSA and the far possibility that something else may be going on.
I have
been very active in sustaining my health, weight, physical and mental well-being,
and keeping a real positive attitude. I hope to keep ahead of this disease and
stay on track to fighting it. I'm glad that I had recently found this group to
help me with insight and hope.
Thanks to all and continued progress!
Rick
Currently,
I am 59 yrs old and my PSA this month, August, was 1.0 ng/ml. I am testing every
3 months and watching the doubling time (PSADT) to determine when treatment will
become appropriate. My last readings have gone up every 3 months, from 0.30 ng/ml
Oct 2005, to 0.50 ng/ml , 0.70 ng/ml, to 1.0 ng/ml. I have gone into recurrence
and now seeking the best treatment I can. With the original diagnosis as T3C -
T4 from the pathology report, I was classified as metastatic. Surgery was successful,
but we knew it would return. Now the problem is where is it ?
Researching
the many reports and trials be conducted for PCa, I have learned that Stage 3b/c
in recurrence is considered Stage 4 and shows a 5-7 year probability for survival.
Typically, this stage fails hormone treatments in 1-2 years. The biggest problem
I have is that I feel really great, no pains and I'm staying in good physical
shape. My goal is to get into a clinical trial or advanced treatment so that I
may be able to 'get ahead' of this disease and maybe try to beat the odds.
I
am currently a patient at the Dana Farber Cancer Institute in Boston, Mass. and
have met with Dr, William Oh and next with Dr. Anthony D'Amico to explore what
we can do next. It is not urgent right now, but they want to wait until I reach
4-5.0 so the tumor will be large enough to scan for the with an MRI & bone scan
and see where it is. We are looking at some possible treatments with Docetaxel
(Taxotere) and/or Thalidomide. I'm a bit nervous about the treatment, but more
afraid of the consequences with the normal course, and missing the opportunity
for aggressive treatment while I'm healthy.
For
now, I get my PSA tested, do the things I enjoy and try not to dwell on the PCa
too much, until my November '06 test.
In
September '06, my PSA was 1.45 ng/ml, up from the Aug '06 1.0 ng/ml. The PSADT
is approx 3.4 months, up from the 5.6 months earlier. Although this is early in
the medical view, the doubling shows it is moving more quickly than we would like.
I met with Dr. Warren Suh, radiology oncologist at DFCI, whom assesed that with
the current status, it would be better to go into treatment now than wait until
later. His view was this would be the chance of trying to control the tumor before
it becomes more difficult to manage. He suggested radiation & hormones. Post bone
scan, the team revised their recommendation to only hormones.
My
bone scan showed micro tumors in the left hip socket and right abdominal lymph
node. Not the places to radiate. I'm on Casodex & Zoladex for a year now, with
6 month bone scans and 3 month PSAs to see if it controlled. I'll be starting
Zometa in February to help with any bone loss from the hormones. Overall, my health
stays relatively good and with some of the side effects from the hormones, quite
manageable.
For
now, this is a conservative approach and offers time to monitor my PCa, giving
me time to continue staying healthy and hoping the research advances with some
of the treatments that are on the horizon.
Thanks
and best to all!
It's
the New Year and I am still doing ok. I have been on 3-month Zoladex treatments
since Oct '06 and went through an 8 month series of Zometa to reinforce my bone
integrity from last Feb-Aug '07. Now I get both treatments every 3 months. My
oncologist & I discussed a 6 month 'off' cycle (holiday!) from the Zoladex on
an annual basis, but since it takes 9-12 months to wear off, you never get the
holiday! I asked to stay on the 3 mo. treament plan, which he agreed was probably
better. The side effects post-treatment hit me fairly hard for 7-10 days, but
once I am passed that, I get on with life. My
PSA has been <0.01 for the past 15 months and I currently try not to think about
my cancer or it's attempt to return.
By
keeping my focus on what I can do each day to enjoy life and not regret missing
out, I tend to have more energy and satisfaction. The Zoladex takes it's toll
as we know, but my wonderful wife & I accept that being together is more important.
She retired 3 months ago and we are having some great times just enjoy things
we had dreamed of doing. For now, we fight this together and appreciate the help
from each other and all the wonderful people in our support group.
Rick's
e-mail address is: rdurbin@comcast.net
