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PROSTATE CANCER SUPPORT SITE

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Ron and Yvonne Carter live in Virginia, USA. He was 62 when he was diagnosed on 22 January 2004. His PSA was 4.6 ng/ml, his Gleason 3+3=6 and his staging T1c.

Here is his story:

Like just about everyone diagnosed with prostate cancer, I was shocked to be told that I had it, having assumed that my elevated PSA was simply a natural function of age. Besides, like many other victims of this disease I have since encountered, I had worked hard to keep myself fit (running, bicycling) and had pretty much stuck to a low fat diet. So not only was I shocked, I was a little angry, thinking about all the good things I might have eaten had I known I was going to get this disease anyway.

Since my diagnosis, I have wavered back and forth between radiation and surgery, buffeted by the conflicting opinions and horror stories that can easily be found on the Internet. I have also gradually come to realize that I am fortunate to have a very low-grade, non-agressive form of cancer (2 cores less than 5%, one core 10%), Gleason (3+3), PSA 4.6.

At this point, it appears that I stand a very good chance of being "cured" no matter which of those two treatment options I ch oose. So I am leaning toward permanent seed implant, that being the less invasive, less traumatic option. BUT there are those side effects. Perhaps a 5% risk of serious urinary problems. Okay, good odds--unless you happen to fall into that 5%. On the other hand, with radical prostatectomy, you run approximately the same chance of serious incontinence. (The odds of impotence seem about equal.) That's what I am now trying to determine.

When I make the final decision, I will update.

UPDATED

24 March 2004

 

After much deliberation, depression, agonizing, and frequent flip-flops, I have decided on brachytherapy (SI). Even though my cancer is apparently borderline-significant (Gleason 3+3, two cores less than 5%, one core 10%), I decided against Watchful Waiting, mainly because of my temperament. I would be wanting to check my PSA daily, and if it went up one decimal place, I would succumb to panic. Also, two readings of the slides indicate that there IS cancer. Not much, but it's there. While I might be able to keep it from growing through careful management, I doubt that I can make it disappear.

So early on, I knew it would have to be surgery or radiation. I was under a great deal of pressure to choose surgery from, quite naturally, surgeons but also other prostate cancer patients. Nevertheless, the more I researched, the more I became convinced that brachytherapy is just as reliable as surgery with less risk of debilitating side effects.

I still have some trepidation, perhaps naturally. I have seen some studies suggesting that foregoing external beam radiation is a bad idea, but my radiation oncologist has convinced me that, in my case, any benefit would be outweighed by the additional risk of side effects. I also worry about radiation-induced secondary cancer showing up one day down the road, but the data is inconclusive on that score.

So off I go in a couple of weeks to have the little devils blasted into my prostate. I will post periodic progress reports (hopefully, positive).

UPDATED

10 May 2004

 

On Friday, May 7, 2004, Dr. Michael Hagan at the Massey Cancer Center in Richmond, Virginia, implanted 83 palladium seeds into my prostate. The procedure itself was absolutely painless. Almost pleasant, in fact, like having a really great nap. The volume study that preceded it by a couple of weeks was, however, a different story, mainly because of the need to insert a Foley catheter. (A catheter is also inserted during the procedure itself, of course, but at that point, you have been anaesthetized.)

The procedure took just over an hour. Dr. Hagan likes to keep his patients overnight to be sure that everything is looking good, so I spent the rest of Friday and all of Friday night in a very hot, uncomfortable room attached to the catheter, which was pulled at 7:30 a.m. Saturday, much to my relief. I needed no pain medication whatsoever and walked to the parking deck with my wife for the trip home, stopping once for lunch (two hot dogs to compensate me for all the months I've been eating tofu, tomatoes, soy milk, and cereals).

So far, I have had no major side effects. Urinary flow has been slowing a bit with maybe just a bit more frequency than before the procedure, and I am getting pretty sore but ice packs are helping. All in all, having known many men who opted for radical prostatectomy, it doesn't seem right that I am getting off so easy. (I keep thinking about the old exercise mantra: No pain, no gain.) If this indeed is all it takes to defeat the cancer, then I am a very, very fortunate man.

 

UPDATED

May 2009

 

 

I reached the 5-year mark this month with a PSA of 0.04 and am thankful for that. I do have some sexual dysfunction, but I was having problems before treatment. Viagra helps to some degree, but I hate taking the stuff. I also have some bowel problems, but these are minor. No urinary problems. All in all, I am more than satisfied with my choice of treatment and with the physician who performed the procedure--a real artist, Dr. Michael Hagan, of the Massey Cancer Center in Richmond, Virginia..

Ron's e-mail is roncperu@yahoo.com