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Gene Koshiol lives in California, USA. He was 50 when he was diagnosed in March, 2009. His initial PSA was 6.50 ng/ml, his Gleason Score was 6, and he was staged T2a. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

I went in for an annual physical which included lab work with blood being drawn and PSA test. The results showed an elevated PSA at 6.5 and the Dr. ordered another to confirm with the results pretty much the same. Let me point out that prior to the PSA test I was never told to refrain from sex, alcohol, caffeine, bike riding, or anything that may effect the PSA results.

I was referred to a Urologist for a DRE (Digital Rectal Examination). He had researched my medical record and saw that my previous PSA test results from 2 years ago was a 3.65. During the DRE the Dr. stated that he felt the right side of the prostate felt a little hard and ordered a biopsy. Sixteen cores were taken with four showing positive, 1 at 1%, 1 at 10%, 1 at 20% and 1 at 100%.

So the next step was to discuss further options of treatment. The urologist recommended the surgery due to my age and early detection and the cancer should be contained within the prostate and I should have a full recovery based on my health and all things considered.

I did a lot of research and spoke with the radiologist who also recommended the surgery due to scarring from radiation treatments that can cause more problems if surgery is required later.

So that's what I did on May 21st 2009, almost two months from my diagnosis. Surgery went fine, after I awoke they gave me pain medication via IV and I mostly slept, I went home the next day about 4 pm. The catheter wasn't really as bad as I expected but still was glad to be rid of it after 11 days. Having it pulled out takes your breath away for a second but it's over quick, compared to the other pains following surgery (gas, bladder spasms, etc..)it was nothing really.

I was hoping to have the pathologist report at the same time but for whatever reason it was not available, however, 2 days later I got the call from my urologist and the bad news that they had found signs of cancer from a tissue sample taken around the prostate during surgery. It was a devastating blow considering everything that I had been told regarding my chances of the cancer having spread outside the walls of the prostate, they were all wrong.

I am currently scheduled to see a radiologist to discuss the path report and see where we go from here. I will keep you informed and will appreciate any guidance or information you can offer at this point.


August 2009

My PSA one month after surgery was 0.07 and at this time was referred to Radio Oncology who wanted to process me for seven weeks of radiation therapy. In his words anything over zero was a positive and needs to be treated.

I decided to wait at least until the 3 month period and see what my PSA is at that time (up, down or the same) before making any decision. My urologist said he has had other patients that didn't have signs of cancer at the margin with PSAs higher than that and concurred with my decision for now to wait. Well, tomorrow is three months and I've had the PSA test so we will find out the results.

I have learned and read so much since this all began and nothing seems for sure. I look forward to listening to similar stories from others and will follow-up soon.

Later: Good news today, 3 months after surgery my PSA was a 0.01 down from 0.07 one month after surgery, knock on wood, let's hope it stays there. If I would have listened to my radiologist I would had 7 weeks of radiation by now. I think these guys tend to error on the side of caution too much but that's the way it's become due to so many law suits. On the other hand I may need radiation in the future should my PSA start to rise again but we'll deal with that then. My best to all.


February 2011

It has been almost two years and my PSA to date has been zero and my health is good.

As for my erections which I think everyone is most concerned with, they have returned for the most part to about 80-90% some days even better. It took almost a year but there has been steady improvement and maybe with time it will be even better. I would encourage anyone to use a pump as soon as possible to help prevent any shrinkage and continue using it as it helps with stimulation and blood flow. I didn't use it as regular as I probably should have and lost about a half inch in length. I have also been on Levitra which helps but I believe it is the 24 hour type and would like to try something different more of the use as necessary prior to sex and see if that helps with better erections.

Good luck to all and feel free to contact me with any questions.



April 2012

Update. Soon to be 3 years and everything is fine. Most important as men want to know, erections have returned including night time and morning. Not like they use to be but 90 -95% and occasionally 100% so I'm still hoping, although I'm not getting any younger either so who knows. It works and the wife is happy too. Too late to second guess and if I live a long life with no recurrence I guess it was worth it. Even then I'll wonder if it was really necessary. I'm here to answer any questions you have. Good luck.


April 2013

Four years now and everything is normal. Still doing good, lets hope it stays that way permanently.


May 2014

5 years PSA; still zero, no change and nothing new to add. Good luck to all.


July 2015

Over 5 years, knock on wood. Interesting clinics don't check PSA anymore when doing blood work, you have to specifically request it if going in for lab work. During my physical I asked how's my PSA and they said we don't check it anymore, too many false positives etc..if you are having problems or request it they will check it. Both VA and my local military out patient clinic. I never had any problems or history. Makes you wonder.


September 2016

All is well 7 years plus. Knock knock keeping the faith.


December 2017

Almost 8 years, all is well.

Gene's e-mail address is: kosh4 AT cox.net (replace "AT" with "@")