Following initial diagnosis, MRI scan showed enlarged lymph node/s with PCa contained within capsule but hard up against lymph nodes and seminal vesicles.
Therefore initial treatment was restricted to 6 months ADT to see what happened to enlarged nodes. Logic being that if they shrank while on ADT then PCa had spread to nodes.
By March 2008 it was clear that nodes were not shrinking, which suggested PCa was contained within capsule and made me eligible for ADT. However to be double sure Oncologist wanted me to have PLND (Pelvic Lymph Node Disection). An operation which was sucessful 12 lymph nodes 'harvested' all found to be clear of PCa. However I spent summer of 2008 in and out of hospital with post-op urine infections and lymphoceles (Great pools of lymph fluid leaking from lymph system as side effect of PLND).
Attempts to drain lymphoceles were only partially successful, so in January 2009 we decided to go ahead with EBR (even if this meant 'frying' the lymphoceles).
EBR successful, PSA down to 0.1 by April 2009, and remained so throughout 2010, while I remained on adjuvant ADT. Last Zoladex implant January 2011.
PSA rose only gradually during 2011 and 2012 taking 2 years to rise to 2.0, but in 2013 it started to rise ever faster doubling to 4 by September and 6 by November.
So currently (June 2014) back on ADT with PSA nicely controlled at 0.2, with ongoing tests to assess suitibility for HDR Brachytherapy as a post EBR salavage.
I would love to hear from anyone who has had HDR after EBR, I do not know how the risks of side effects double up, I am told impotence is virtually guaranteed, I am keeping my fingers crossed on the continence front!
The tests in 2014 showed that the cancer was still contained within the capsule which made me eligible for HDR Brachytherapy.
I had a template biopsy in November 2014, and the actual HDR Brachytherapy in February 2015.
The procedure for both is broadly the same, 3 days 2 nights in hospital. On day 1 I had a stong enema, day 2 under general anaethsetic they drill the matrix into the prostate and you awake with a large bore catheter in place and a large bottle which looks like it comes froma water cooler flushing out the bladder. Day 3 they remove the catheter, and providing you are continent, which I was, you are free to go home.
Hopefully the HDR Brachytherapy has done its job, however because I am currently on ADT (Prostrap) as a belt and braces approach, we won't know untill next year. Subject to confirmation I will cease ADT this winter and so it will be interesting to see what happens to the PSA next year.
I would describe the side effects of HDR Brachytherapy as two fold. Immediately after continence was a struggle, I suspect that the large bore catheter used to flush and cool the bladder stretched the sphincter. However within a couple of weeks I was over this, managing to go down to the pub and wear light coloured trousers! Now 6 months on, I still have a little discomfort when I first sit down on a hard seat, I guess my prostate is still tender?
Following on from the HDR Brachytherapy in February 2015, I had my last Prostrap injection in November 2015, so by February 2016 the Hormone Therapy was over.
In March 2016 PSA was 0.1, by June it was only 0.2, so my Oncologist decided I was doing so well that we could cease 3 monthly PSA checks, and revert to a 6 monthly PSA monitoring.
I am feeling well, starting to get my body back to what it was, I have hairy legs again and even start to wake up with an erection.
One tip I read somewhere that there is some biochemical that prevents muscle wastage as we grow older, and it's found in apple peel, so don't peel your apples, eat them whole.
So all in all, life is good right at the moment, I am now a retired grandfather enjoying life.
To update, here I am 10 years after diagnosis, 'effectively cured'. I know some say we shouldn't use the c-u-r-e word, as its bad karma. So I say 'effectively cured' because here I am, ten years after a Gleason 9 diagnosis, getting on with life, playing games with my grandchildren, having totally forgotten that I have cancer.
It is now almost 3 years since I had salvage brachytherapy, it's 2 years since I ceased hormone therapy, and my PSA bobs along 0.4 last year, 0.2 last May, 0.5 last September. As my consultant points out with an accuracy of +/-0.1 such figures are nothing to worry about.
I do not know whether or not I still have some cancerous cells, but I no longer worry, because at this rate of progress I will not die young. Most refreshing is that we have cleared our home of all the books and paraphernalia to do with cancer.
So for those of you confronting a recent diagnosis like T3 Gleason 9, there is light at the end of the tunnel.
Dave's e-mail address is: dsdavekirkham AT yahoo.com (replace "AT" with "@")