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Brent Pettigrew lives in Ohio, USA. He was 54 when he was diagnosed in November, 2001. His initial PSA was 9.30 ng/ml, his Gleason Score was 7, and he was staged T1c. His choice of treatment was Surgery (Retropubic Prostatectomy). Here is his story.

In April 1998 my PSA was 1.0 In the Fall I had knee replacement surgery that led to post catheterization prostatitis which was treated with various antibiotics in '98 & '99.

My PSA was 2.5 in August 1999. My PSA was 4 in June 2000. I went to a local Urologist that said my prostate was normal sized and told me to not worry because I was too young for prostate cancer. I insisted on an ultrasound which he later cancelled because it was inconvenient to his schedule.

From September 2001 to November 2001 my PSA went from 8.9 to 9.3. My ultrasound guided biopsy showed cancer in the right lobe but none in the left.

I weighed my options: I was the first in my family with PC, it was a rapid rising PSA, I was young, all factors in my research indicated my best option was RP (Surgery). I wished for nerve sparing surgery since there was no initial signs of cancer in my left lobe. I researched surgeons and elected to have RP at the Cleveland Clinic (Great doctor but bad hospital experience).

Based on initial biopsy the surgeon left the left nerve bundle. The post-operative histopathology report showed more cancer on the left than the right with some cancer cells in the fat around the left seminal vesicle. My side effects were minimal with occasional incontinence but retention of potency.

My PSA remained at 0 until June 2005 when it was 0.20. I elected to have EBRT (External Beam Radiation Treatment) in June 2006 which brought the PSA to 0 again. In June 2007, it recurred at 0.20 Then it became 0.30 in December 2007 and now is 0.60 (April 2008). I am now weighing my options.

UPDATED

September 2009

Mostly I'm just watching and waiting.

My urologist/surgeon/oncologist at Cleveland Clinic wanted to see the doubling time. Well, it's doubled and no one knows yet what to do. I can begin hormonal treatment - ADT (Androgen Deprivation Therapy) but no one recommends chemotherapy. There is the suggestion of radiation again but I don't like the option relative to damage to other adjacent tissues. I think my PSA is about 1.20 now and was last run in April, I think.

I try not to think about it too much as it does no good to dwell on the cancer. There's too many other things to be appreciate than to dwell on the fact I have cancer and can't get much of an erection.

UPDATED

March 2011

I'm continuing with no change to my diet or life style. I am about 70 pounds overweight and still work 45-50 hours a week.

I am very mildly incontinent. I can still experience an orgasm.

In May 2010 my PSA was 5.2 with a doubling expected based on history to occur every 6-7 months. My plan was to begin Androgen deprivation when my PSA got to 10. My next PSA was in November 2010 and the PSA had dropped to 4.1 so I felt a temporary reprieve.

I'll retest in May (it is March now) and it will probably be over 10 and I will begin the hormones. Stay tuned. Maybe the prostate cancer fairy has rescued me :-)

UPDATED

February 2012

My PSA was 6.3 in May, 2011. It went up to 8.5 in August of 2011. It was 8.3 in December 2011. My plan was to do nothing until my PSA reached 10.0

At that time I'll resort to ADT, maybe. My oncologist at the Cleveland Clinic says that the average time for ADT to work is about 7.5 years. [It is important to understand that there is a wide range of periods for which ADT works. The median may well be 7.5 years, but there are examples beyond that.] Then you get hormone resistant adenocarcinoma.

With all the potential side effects of ADT, I may decide to do nothing until it mets. [Again it must be said that there is a wide range of reactions to ADT, some of which are of no concern to the man undergoing the therapy.].

UPDATED

July 2012

My PSA is at 10.6. This represents a doubling of every 10 months. My doctors at Cleveland Clinic say to become worried about a PSADT of

UPDATED

August 2013

I have postponed any further treatments as I am not too excited about ADT and the side effects. I know I risk metastasis but am almost willing to accept my fate rather than feminization and all the secondary risks along the way. I'm due to go to Cleveland Clinic to discuss this further with my Oncologist so there will be an update later.

UPDATED

November 2013

I recently had my PSA checked and the result was getting high enough to get my attention. Cat scan/ body scan showed inguinal lymph node uptake and enlargement. Based on that I decided with my doctor's rec that I begin ADT. Casodex orally, daily, for a month then Lupron injections. I've had little if no side effects from the Casodex but I expect that all to change with the lupron.

UPDATED

March 2014

Currently, I am on casodex daily and goserelin implant every 3 mo. This was started @ January so am due for my next implant soon. My biggest problem has been the inability to sleep more than a few hours at a time. I'm 5 weeks removed from bilat knee replacement so that isn't helping my sleep habits either but thats less of a problem now. My Doc is for no break in the ADT but I'm interested in 3mo on and 3 mo off depending on PSA results.

UPDATED

June 2014

I have locally metastatic advanced prostate cancer. I was on 4 months casodex and had the dolorex implant. I elected to forego the dolorex implant (too many side effects) at my last visit but have maintained the casodex. My doctor doesn't agree with my decision but is very understanding and accommodating as I think I am sometimes his worse nightmare client. I know just enough to be dangerous. At my doctors direction, we are monitoring my PSA. I would be unlikely to have a low testosterone level so I am not monitoring that at this time. Anyway, today's PSA is 0.0. At some point in the future I will get the implant when the PSA rises. My chances of cancer control is not as good with the single medication but my overall disposition is much better which counts for something. I am still working 3 twelve hour days a week. Knees are getting better and am getting stronger and thinner.

UPDATED

June 2014

Oops! My implant is goserelin (Zolodex). Please excuse my previous entry.

UPDATED

March 2015

I've been on casodex only after beginning casodex then an implant of goserelin since 12/13. The implant was not very enjoyable so my doctor allowed me to go off it and continue the casodex 50mg daily only. While monitoring my PSA and the testosterone levels. So far the PSA has been zero even though my testosterone is 337 (241-827) on 2/19/15. On my last bone scan my diagnosis was changed to "locally metastatic" adenocarcinoma. So, things are better than expected since my doc said the casodex alone would not hold the cancer in check. Best wishes to all.

UPDATED

January 2016

Update: I decided to not receive the full compliment of ADT when I found the Goserelin injection to have too many side effects when combined with casodex oral. After I began the casodex then received the goserelin, I was too miserable from the side effects. My oncologist agreed to try the casodex alone and I've been fortunate to continue to have a PSA of zero. My values are checked every 6 months. The last PSA test was 12/2/15. My last testosterone was 337 (N=241-827) on 2/19/15. The reason I chose to receive only one of the two commonly administered ADT drug combos was from my research on YANA and other internet sources. I was also lucky to have an understanding oncologist at Cleveland Clinic that went along with my wishes. I still work part time but am now slowed down by sciatic nerve and back pain as well as the side effects of knee replacement that went bad. Looking forward to getting the knee problem resolved though. I've really not changed anything in my diet or daily routine. I've quit obsessing over my locally metastatic cancer and have pretty much put it in God's hands.

UPDATED

December 2016

My PSA is till nonexistent and my treatment remains 50mg casodex only. Again, this was against my oncologists rec as a monotherapy in his mind would not be adequate to keep my cancer under control. But, the side effects of casodex plus the goserelin implant were so severe and because I read in these patients reports that some had good luck with casodex only, I decided to take a chance and so far it has paid off. I could not have made that decision without access to these patient's histories. So, since my last post, I've had a knee replacement redo in Feb, 2016. But soon after, I developed some odd form of psoriatic arthritis and that is holding me back. But I still work 2-3 days a week. I now take methyltrexate every 7 days and 5 mg prednisone every 2-3 days. I am blessed to have a "quiescent" locally metastatic presence of adenocarcinoma and great doctors at the Cleveland Clinic.

UPDATED

December 2017

Today I've decided to stop my one chemo agent, casodex. I'm 70 and with all my other health issues, I don't believe my cancer will become a huge issue before I die of other things. So, I'm willing to lose the casodex side effects in favor of some improved quality of life. Hopefully, the cancer will be slow growing. Overall, I've had a good run with only casodex.

Brent's e-mail address is: bryanvet1 AT gmail.com (replace "AT" with "@")


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