My name is Mike, and my wife Maria and I live in South Carolina. This is a second marriage for both of us (my prior wife passed in 2006 at the age of 48, leaving me to raise our 14 and 12 year old children.) The five children we collectively have are all grown, and so far have given us six grandchildren. Since we have successfully completed raising our own children, we now raise other people's children (we are foster parents, and so far have had 47 teenagers come through our home.)
I received my diagnosis in August, 2016 (on my birthday of all days). PSA = 12, Gleason = 6 in 1 of 12 biopsy samples, 35% cancerous, stage T2a. Based on the MRI, the urologist said that there is an 8mm tumor completely contained within the prostate. He recommended a choice among three alternative treatments:
1. Robot Assisted Laparoscopic Prostatectomy (total removal of the prostate). He said his partner does these, and has a lot of experience.
2. External Radiation - Nine weeks, five days per week of targeted radiation treatments.
3. Brachytherapy (internal radiation -"seeds").
I'm 54 years old and otherwise in good health.
On a personal note - my wife lost her father to lung cancer in 2007 - on my birthday. To spare her more grief, I might need to get a new birthday.
After consulting with a radiation oncologist, we ruled out the external radiation option, due to the potential for more general side effects, and the inconvenience of 45 visits to the hospital.
With a tumor that appears to be wholly contained in the prostate, and a Gleason 6, it is highly likely that no cancer cells have made their way out of the prostate yet. In addition to this, there are a number of other things factoring into our decision between Brachytherapy and Robot Assisted Laparoscopic Prostatectomy:
1. We have ruled out AS due to my age, relatively good health, and the doubling rate of my PSA. It was 6 last year and two years before, then 10 at my annual physical in June of this year, and then 12 in July. (The urologist placed me on antibiotics both times after the 6 readings.)
2. The argument is still out as to which treatment has better long term non-recurrence results. Based on what I have found, this ranges from a draw to a slight advantage for the Brachytherapy.
3. Immediate side effects are probably worse for the RALP, but long term are worse for the Brachytherapy.
3a. I recently spoke to a friend who is still recovering from open prostatectomy. He is very pleased with the result.
4. Should we opt for RALP, the urologist who will perform the procedure has done it many hundreds, if not thousands of times, thus improving the chances of a positive outcome with regard to side effects.
5. Emotional concerns - definitely a large factor in our decision, because I will be living as a cancer survivor, and I want as few unknowns as possible into the future, and I would like to live those years with my wife at my side, not suffering from her own fears. With the RALP, the side effects will be immediately apparent, but also very likely treatable, and the only real unknown going forward is the chance of my PSA going up again later on. Given my numbers, this probability is quite low, but should this happen, there will be treatment options. With the brachytherapy, however, there could be side effects that might not show up for a number of years. Because of this, both of us are leaning toward RALP.
We are awaiting one final piece of advice before making our decision. Through the health plan provided by my employer, we have a service called Expert Medical Opinion. With this program, three separate doctors look at my records and give a report. Once we have their opinions, we will proceed with our chosen treatment.
UPDATE: Two weeks have passed since I typed the above, and we have come to a decision regarding treatment. After many long talks with my wife, with doctors, with friends, and with friends who are doctors, we have elected to pursue the Robot Assisted Laparoscopic Prostatectomy. I have a consultation appointment next week with Dr. T. Brian Willard at Carolina Urology Partners, West Columbia SC. He will be the surgeon performing my RALP. He has done this procedure hundreds of times, which makes me feel a lot more comfortable in my choice, since based on what I have read, the experience of the surgeon is a large factor with regards to the potential appearance of side effects after the surgery. Also, I want to have the pathologist's report after the surgery, to confirm the initial diagnosis, and to be more certain that the cancer had not left the prostate. At this consultation we intend to ask him about a PET scan, to give us even more confirmation that the cancer has not metastasized.
This is but the latest trial that God is allowing me to go through. There have been many prior, including the sudden loss of a wife and the mother of my children. I have found that these trials without exception have caused my faith to become stronger - certainly not immediately, but eventually - and have placed me in a better position to help others cope with similar situations. I expect no different this time, and I hope that this site and other online forums will be places where I will be able to provide that help and support to someone who needs it. The journey will not be fun, but the outcome, whatever it may be, will be for the better. God has also given me the best wife I could have ever dreamed of. Maria has stood by my side and given me endless love and support. As conveyed in the lyrics of a recent Lauren Daigle song, I will trust in Him.
This is where I stand as I type these words. I will provide updates as my story progresses. I welcome emails from fellow fighters and survivors.
One year after RALP my PSA remains 0.00. I still suffer from ED in spite of being prescribed Cialis, and I still have to wear a "panty liner" for minor incontinence.
P.S. We now have had 54 teens come through our home. We currentry have four living with us.
Mike's e-mail address is: kegler AT gmail.com (replace "AT" with "@")