Terry
Fee and Barb live in Winnipeg, Manitoba, Canada. He was 66 when he was diagnosed
on November 4, 2009. His initial PSA was 5.58 ng/ml, his Gleason Score was 7 (4+3)
and he was staged T2b. His choice of treatment was . Here is his story.
I've
had yearly PSA tests with semi-annual DRE (Digital Rectal Examination) since I
was 50. At 55 this was changed to yearly PSA and DRE.
About 2004 I began
to experience the urinary symptoms of BPH (Benign Prostate Hyperplasia) or prostate
cancer. DRE by GP showed slight enlargement of prostate with normal range PSA
in low 3's thus probably BPH.
In 2008 urinary issues deteriorated to the
point of urination every 1/2 hr during day,
2-3 at night, occasional pain
and never feeling my bladder was fully empty. My annual PSA and DRE were done
in March 2008 with PSA 3.8: normal DRE.
After having 2009 PSA test in February
prior to DRE in March, my GP called indicating an alarming increase in PSA and
to go to lab today for repeat PSA before physical. PSA level on repeat is 4.4
DRE was performed and GP response was - bad news : abnormal - good news : prostate
size unchanged and smooth as billiard ball. Appointment arranged with urologist
for consult.
Received confirmation for consult with Dr. John Milner the
pre-eminent urologist in our city who performs around 150 prostate surgeries a
year for June 4 2009. During consult Dr. Milner indicated that with my PSA level
20% chance of cancer. After DRE and confirmation of GP finding indicated odds
increased substantially so 12 needle biopsy for September 4 2009. I was given
a 20 day supply of Flomax to urinary issues to try with prescription if it appeared
to be effective. This did nothing and I did not fill prescription.
Biopsy
for September 4 rescheduled for October 4 2009. This one of the drawbacks of dealing
with a very busy urologist. Biopsy on October 4 2009 was performed by a resident
who was doing all biopsies for the three urologist at this clinic. I was given
a sample of Xatral to try for 20 days with prescription to deal with urinary issues.
This medication worked immediately. An appointment scheduled for follow-up November
4 2009. Much research on prostate cancer done on internet prior to follow-up to
biopsy.
Arrived for biopsy follow-up November 4 2009 and was given a copy
of the lab report which showed cancer positive 5 of 12 cores all confined to left
lobe. Dr. Milner explained the biopsy report and showed me on a model where the
tumor was and probable size.
The following is a summary of lab report:
right
lobe benign prostatic tissue
left lobe invasive prostatic adenocarcinoma Gleason
4+3 1.5 mm 15% of core: GS 4+3 0.5 mm 3% of core: GS 3+4 1.2 mm 10% of core: GS
4+3 13 mm 90% of core: GS 3+4 6.0 75% of core: GS 7
staging T2b prostate size
40cc PSA 5.85
After the biopsy I had done considerable research on prostate
cancer and had been given pamphlets on BPH to study. So on the biopsy review I
was not completely ignorant and therefore was not surprised that biopsy results
were positive for PCa Dr. Milner explained in detail the treatment options available
for me how they are performed and probable side effects.
Dr. Milner had
stated that with no treatment at all prostate cancer will take about 10 years
from onset to cause illness. Since my symptoms started about 5 years ago I probably
had 5 years before illness set in so my wife and I both agreed that treatment
was necessary and that surgery was the only option for the following reasons.
1)
This could be a one time treatment no more PCa.
2) Overall 90% success rate
with a very experienced surgeon.
3) Ultimate biopsy, no doubts about staging,
grading and capsular escape.
Since we have no Da Vinci robots here Dr.
Milner indicated he could refer me to Edmonton to have robotic surgery or to and
Oncologist for radiation. We did not wish to travel to Edmonton so RRP (Retropubic
Radical Prostatectomy) is our choice.
I had a consult with another urologist
at The Manitoba Cancer Clinic and he agreed with our decision and that Dr. Milner
is the best there is at RRP. All three urologist and my GP agree there is no real
evidence of capsular escape and surgery should have a good outcome.
RRP
surgery scheduled for Mar 12 2010.
Terry's e-mail address is: tsfee@shaw.ca
