YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

BRONZE

Scot Kinnaman and Judy live in Missouri, USA. He was 50 when he was diagnosed on May 22, 2009. His initial PSA was 4.8 ng/ml, his Gleason Score was 3+3=6 and he was staged T1c . He is undecided as to his choice of treatment. Here is his story.

I am a 50-year old Lutheran pastor living and working in St. Louis, MO. My wife of 32 years and I have 2 children and 4 grandchildren. At age 40 my general practice doctor added a DRE (Digital Rectal Examination) and PSA to my annual physical exam. For several not very good reasons, I had neglected having my annual since age 47. My father was diagnosed with metastasized prostate cancer at age 61 and died in 1994 after 3 terrible years of chasing the cancer from outbreak to outbreak. So, at age 50 I decided that I needed to get serious about getting my PSA. After all, it was not a question of if, but of when.

On April 28, instead of going to my GP for the exam and PSA testing, I went directly to Metropolitan Urological Specialist in St. Louis. I mention them by name because my research and experience show them to be one of the best physicians groups in this specialty in the area. My exam showed only a slightly enlarged prostate. My PSA was 4.8 - the target for me with family history was <2.5 . Dr. de la Paz scheduled me for an ultrasound-guide transrectal biopsy. That biopsy was performed on May 14. I talk about this experience more fully on my journal.

Just before the Memorial Day weekend, on May 22, I received the news that the biopsy was positive for cancer. Three of the 12 samples indicated less than 30% cancer, the Gleason sum was 6 (3+3), classified as low risk, and graded as T1c. Subsequent bone scan and CT scan showed what the doctor already had projected, that there is no indication of any metastasis.

At this point I have upcoming appointments with Metro's director of radiation therapy to discuss the radiation options of IGRT (Image Guided Radiation Therapy) and brachytherapy and another associate who specializes in Da Vinci robotic assisted surgery. If I don't qualify for Da Vinci, my doctor would perform the traditional transpubic open surgery, should we choose a surgical solution.

I'll update when we make a decision as to what treatment we will pursue. Again, more words about all on my journal.

Later: Several YANA members have contacted me after my initial post. Thank you for your notes and support.

I wrote: "If I don't qualify for da Vinci, my doctor would perform ...open surgery." There have been a couple who questioned what I meant by this. I have had a umbilical hernia repair using the reinforcing mesh. There is a risk that engaging that mesh with a port during laparoscopic surgery may result in an increased chance of infection. My primary urologist did not have the experience to have strategies to work with this. I was referred for consultation to a radiologist and to a surgeon who has just completed his 504th da Vinci procedure.

For us, once "cancer" was mentioned, active surveillance/watchful waiting was not a choice we could personally consider. We took HIFU, freezing, and heating off the table. There was not enough track record for me to yet be comfortable with choosing these therapies, no matter how interesting and promising they sound. We were left with radiation and radical prostatectomy as the best curative therapies to find out more about. The radiologist offered a "cure" rate equal to RP, but I eventually decided against radiation. My father's family has a multiple instances of cancer. Should I choose to use radiation now, if cancer should again raise its ugly head in the lower pelvic area, surgery could not be an option in the future. Age and family history leads us to believe that RP is the best answer for us at this time.

Our surgical consult was with Dr. Luis Anglo out of St. John in Creve Coeur, MO. He performed 300 open procedures before switching over to da Vinci. As I said, he has completed over 500 robotic assisted surgeries. His open and informed consultation was positive and comforting. He pulled no punches, openly talked about the risks and side effects. Everything I have read indicates the best hope for successful surgery and minimizing IC and ED after surgery is dependent on age/healing capacity and the experience & expertise of the surgeon. I am convinced we have our man.

CT scan indicated a possible thickening of the rectal wall, and my urologist wants me to have a colonoscopy to be sure no other problems are present. I'll get this done and then get surgery scheduled--hopefully July or August

 

UPDATED

July 2009

 

 

MY FRIEND PETER:

I made a new friend last week. You don't always get to pick your friends ahead of time, and such is the case with Peter. He showed up during the course of my prostate surgery. I was totally unaware of his arrival, but he was greeted by everybody in attendance as one uniquely qualified for his task. By the time I regained my senses after the surgery, Peter had obviously become a fast friend. He cared for me deeply and touched me in ways I had never experienced before. And I found I couldn't leave him behind. Upon my release from the hospital, my wife and I made a place for this new friend in my life.

Peter has been faithful; despite my outbursts and even wishing him harm, he as stuck by me without question or recrimination. Peter is giving; he retains nothing for himself but passes on all that he has every minute of every day.

These hot, fast friendships have their challenges. We found that Peter was a bit demanding and a bit clingy. And while his friendship tapped an inner well I rarely thought about, having him around each minute of each day is wearisome. Peter is an "up front" sort of friend, but admittedly very private. So, getting ready to leave the house with Peter is stressful and frankly exhausting.

My friendship with Peter is as close a relationship as I have ever experienced. It is also an ill-fated relationship, for today Peter and I must be parted. The reality is that I must move on in my recovery, and I have to go, alone. Peter cannot go for me. The absence of his indwelling presence will be a void in my life. Farewell, my friend, Peter.

[During a radical prostatectomy, a Foley catheter is inserted into the urethra. The catheter assists the surgeon during the transection and resection of the urethra and then supports the urethra as it heals. The patient keeps the Foley catheter in place from 7 days to 3 weeks depending on the procedure and the surgeon involved. I named my catheter "Peter."]

Scot's e-mail address is: prkinnaman@gmail.com.