Tony
& Susie Fraser live in Blackwood South Australia. Tony was 53 when diagnosed
in July 1998 and his initial PSA was 5.8 ng/ml with a Gleason grading of 4+4.
His initial staging was T2a and he elected to have a nerve sparing radical prostatectomy.
The post operative biopsy confirmed the Gleason 4+4=8 but upgraded the staging
to T3b.Tony's
story:
After my annual check up in May 1998 my vigilant doctor called me to advise me
that my PSA had risen in the past year and even though he when examined me he
could feel no abnormalities to my prostate, he recommended that he refer me to
a urologist as soon as possible.
I
duly visited the urologist in late June and was subjected to a further digital
examination during the urologist was able to feel an abnormality on the prostate.
The next step was to have a biopsy done and wait a nervous few days for the result.
The diagnosis was T2a and Gleason 4+4, with the recommendation to have radical
surgery rather than any other form of treatment as the prostate capsule was thought
not to have been penetrated. Further, I was referred to a urologist who specialized
in nerve sparing proceedures.
We
were also given all the alternative options available at the time to consider.
I decided to go for the nerve sparing radical prostatectomy. I harvested 4 units
of blood and had the operation 1 October 1998.
The
results of the biopsy done at that time were PSA 5.8 ng/ml, a staging of T3b &
Gleason 4+4. The surgery removed the seminal vesicles as well as the prostate
gland and lymph nodes. It took a full 6 weeks to recover from the surgery, but
it was a relief to
have the catherter removed after 10 days.
Nerve
sparing was not possible on one side and on the other the nerve was shaved, consequently
impotence has been a problem but Viagra does help. I have regular PSA tests which
have remained under 0.1 until October 2001, then went to 0.2 in September 2002.
I'm
still watching and waiting until PSA reaches 0.3 when all options will be considered.
My
PSA was 0.2 in Dec.2002 and after a catscan and MRI were all clear I had Radio
Therapy in Jan/Feb 2003 a total of 64 Grays.
The
next PSA test in Nov 2003 was 0.3 and the latest PSA in April 2004 is 0.4.
I
am now watching and waiting to see if there is any escalation in the doubling
time of the PSA rises.
Tony's
current PSA is 1.80 ng/ml and here is his update.
As
a result of the radiotherapy I have had a deteriorating bladder control to the
extent that my incontinence is a major factor in my QOL. (5 to 8 pads per day)
I had an artificial urinary sphincter inserted in Feb 2005 and have recently had
it commissioned with a resounding success, absolute minimal leakage now!
I
had a set of scans October 2004 which were clear. I will continue to watch my
PSA progression until it reaches around 5 before considering any further treatment.
My
update is as follows:
Latest
PSA August 06 was 8.8 ng/ml. I am having a full set of scans tomorrow and hope
that all is OK.
I
have not yet begun hormone therapy and have set the next review next February,
subject to tomorrow’s results and the next PSA test in November The PSA is currently
increasing at about 45% per test and I am reluctant to start hormone therapy until
it reaches 20 plus. I hope to get a bigger bang for my buck doing it this way.
My
PSA in June was 20.3 ng/ml and after an official diagnosis of Bony Metastasis
we decided [my wife and urologist] that is now time to stop playing chicken and
get on with hormone treatment.
I
started on Zoladex in July and aiming to do three lots of implants. I expected
my PSA to below 1.0 ng/ml in August but after 3 months of hormone therapy my PSA
was 6.8 ng/ml, not as low as I wanted. I am currently on my second 3 month implant
and will probably do a third.
I
am well but I get very tired in the afternoon and start to have trouble with incontinence
even though I have a an artificial sphincter
Tony's
e-mail address is: tony_fraser@bigpond.com.au
