I am 55. In October 2007 had a DRE and a blood test. After the blood test which showed a PSA of 27.5 I was sent to department of urology at my local Hospital to see a consultant urologist who carried out a biopsy.
The biopsy showed a Gleason 4+3=7 adenocarcinoma. This is a bilateral involving 50% on the right and 70% on the left along with perineural invasion. With Gleason Score of 7 and the high volume of tumour, I was told that surgery or radiotherapy would be appropriate depending on the results of CT and bone scans, but that radiotherapy was the most likely option for me in view of the high volume disease together with perineural infiltration.
The letter sent to my doctor after my CT and bone scans on December 11, 2007:
His bone scan I am pleased to report was reassuringly normal his CT scan was interesting. It is essentially normal with the exception of some lymphadenopathy, the lymphadenopathy was in a slightly abnormal position.
We are going to recommend treatment with hormonal manipulation
I am confused as to the treatment as I thought it would be radiotherapy just looking for any kind of guidelines or anyone who can offer some input who might have been in my position .
Just an update: I have been to Hospital today (February 12, 2008). My PSA is down to 2.7 - it was 27.5 3 months ago. I am now being put on 3 monthly ADT (Androgen Deprivation Therapy) implants to be done at my own GPs, with a visit to the hospital every 3 months. The specialist was quite reassuring at the hospital and he was quite pleased with my new PSA. Must say he was a lot more positive than the last guy I saw (Dr Gloom)
I have asked my GP to get me a second opinion just to put our minds at rest. I feel I should be on RT at some stage or at least have another scan to check my nodes. The doctor at the hospital feels as the PSA has gone down, my nodes should have as well. Surely a scan would confirm this?
As PSA is down to 1.4 I am staying on implants until PSA rises.
Side effects so far loss of libido, tiredness, a little weight gain. Working normal just getting on with life as I feel fine.
Good luck to everyone else.
There seems to be a problem with my nodes. Over the last four weeks I have been in pain which resulted in a stent being fitted. Ever since this I have been in pain - lower back, left leg and stomach. I'm now on pain killers (Oxycodone hydrochloride 20mg twice a day). I can only walk about 100 yards and my left leg swells up and I'm out of breath and sweating Below is the report I got today on the last scan I had on July 12, 2009.
CT abdomen/pelvis with contrast : comparison is made with the previous CT scan of November 2007.
There has been marked progression of the disease since that time. There is now a large nodal mass on the left pelvic side wall measuring 6x5 cm in diameter. This is compressing the left ureter and causing a early left hydronephrosis (THIS IS WHY THE STENT WAS FITTED) and delaying excretion by the left kidney.
There is also enlarged nodes seen in the left obturator chain, left common iliac chain, and left para-aortic areas. No bony metastases in the areas imaged. Normal liver, biliary tree, gallbladder, pancreas and kidneys. No bowel abnormality.
Conclusion: marked progression of nodal disease since 2007 I went off to see the oncologist on August 5, 2009.
They have taken new blood test today and are checking everything including testosterone test. I am starting EBRT (External Beam Radiation Treatment) to enlarged nodes next week then a course of chemotherapy after that. I have been given Dexamethasone (steroid) to start with and also be given Oramorph for the pain relief.