Calvin W. lives in Buckinghamshire, England. He was 57 when he was diagnosed in December '06. His initial PSA was 13.0 ng/ml, his Gleason Score was 3 +4 = 7 and although he says he was staged T2, that is the pathological staging. His clinical staging would have been T1c. His choice of treatment was Radical Prostatectomy. Here is his story:
In November 2006 I had a full medical check-up as I have done every few years past. Expecting the usual comments about needing to lose some pounds and get more exercise I was staggered to be told by my regular Doctor that the report he'd received showed an elevated PSA count of 13.0 ng/ml. The most recent check of this was in 2002 when it was 3.0 ng/ml. The Doctor said that the level can rise through infection so gave me a course of antibiotics and then another blood check in four weeks. The second blood check still showed 13.0 ng/ml so I was directed to a Urologist who arranged a biopsy.
I was quite concerned about the biopsy as it sounded painful but in the event it was not too bad, just uncomfortable and undignified! The result came back negative which was a relief for me but my Urologist said that the check provided around 80% confidence that there was no problem. To raise that confidence to 99%+ I should have another biopsy where instead of the eight samples taken they'd take fourteen, that is seven in each side of the prostate.
The second biopsy results showed cancer at the rear of the gland mainly on the left side although there was also some in the right hemisphere.
To get to this point had taken some four months and my mind had looked at some very gloomy scenarios, my brother-in-law had died the previous year of liver/pancreatic cancer which took him away in four months after diagnosis. PCa is not the same but a mind works wonders on creating fearsome outcomes if you allow it!
I then had an MRI scan to see if the cancer had migrated out of the gland capsule and a bone scan to find if it had also found its way into my bones. Both results were negative which was a huge relief.
My wife and I then had a long talk with the Urologist about what action to take. I favoured Brachytherapy (seeds) but was told the chances of getting all the cancer nodules I seemed to have was low to medium. High dose radiation was an option but it produces adhesions to the rectum wall. This means that if it does not work, surgery to remove the prostate afterwards is very difficult without cutting into the rectum itself with attendant problems of subsequent healing and infection.
I chose a radical prostatectomy and six days later it was carried out. I was told by the Urologist to expect 5 days in hospital and 3 or 4 weeks recovery. Other medical staff told me 6 to 7 days in and 6 to 7 weeks recovery at home. Following the operation I awoke with an epidural in my back so felt nothing below my waist. I was asked many times if I was in any discomfort but I was in none at all, just dozy for a day.
The most annoying thing about it all was the catheter and bag which was attached for two weeks. That was a big inconvenience and an embarrassment to me which I know is a stupid reaction.
It's now four weeks after the operation and I am walking a couple of miles a day, the incontinence is getting better each day and I should be completely 'dry' in a couple of weeks. My Urologist showed me the pathology report on what was removed and there are 4 pictures of slices showing random dark areas all within the prostate capsule and no break-out. I was told that I should have a PSA check in a couple of months and that, "it WILL be clear".
I am just so glad I went for that check-up and found this early. I felt 100% fit and had no other symptoms of prostate problems. The first biopsy showed it was a normal size at 23mm yet the PSA level of 13.o ng/ml was a red flag that could not be ignored. Family history also is that both my paternal uncles had it with one dying of it and the other having an RP. It is believed my father and grandfather also died of bone or lymph cancer as a result of PCa.
I am thankful beyond belief right now and will nag every 50 year old man I meet about knowing his PSA level!
UPDATED June 2008
I had my surgery one year ago so this is my anniversary update.
I've had four PSA checks over the year at three month intervals and all have been at or below 0.01 ng/ml. I now plan to have two this coming year and go to once a year thereafter. I still have the erectile dysfunction that surgery nearly always produces and my Urologist is working with me to see what can be done. Mail me if you'd like details.
All found going for the surgery was the best idea for me but each case is different as we know.
UPDATED October 2009
My last PSA check was in January this year and it was 'less than 0.1' which I am very thankful for. It's been almost 2 1/2 years since my radical prostatectomy and the PSA level has never risen above 0.1. I will have another check in December this year and then two more in future which will take me to five years. At that point I'll cut it to a check every two or three years I suppose, having regard to my Doctors' advice of course.
Physically I am in great shape apart from a so called 'mini-stroke' this year. The consultant says that's a misnomer as it was a TIA, a Transient Ischaemic Attack. Result being that I'm now taking a few 'blood drugs'.
The lasting impact from the prostatectomy has been that I cannot get an erection now and maybe being aged 59 is a contributory factor. I've tried Cialis and that just gives me a stuffy nose all day but injecting 'Caverject' does work. I think that stuff could cause a piece of wet string to become rigid! My sexual desires are dropping also and I think that my mind is aware that no erections happen now and so it maybe thinks that means I don't have the desire so in turn 'turns down' my arousal. It's a flimsy piece of reasoning I know but it's the way it feels to me. Having had that desire for most of my life is a strange feeling to lose it more and more.
UPDATED February 2011
Another year passed and that makes it almost four years since I had my prostate removed.
I'm glad to say that I have had no increase in my PSA since then and it's been below 0.1 or 'not measurable by our equipment'. Last measured April 2010, due again in a month's time.
I still struggle with Erectile Dysfunction but I'm coming to terms with it. Being 60 now I suspect it would have been an increasing problem even without the RP operation. I use Caverject for that and it works as I said in a previous update.
UPDATED December 2012
I had a check up in May this year and have just got around to this update thanks to a prompt from Pierrot. Thankfully there's nothing to report as my PSA remains at below 0.1 or unmeasurable. That is now 5 1/2 years since my operation.
I still nag every 50 year old man I meet to be sure he's had a PSA check and mostly they do accept my advice after saying it was something they intended to do but hadn't yet arranged. Here's looking for another update next year.
UPDATE October 2019
It's been a while since I updated my story so I'll do that now. The good thing is that there is nothing significant to add! My PSA was last measured a year ago and was practically unmeasurable and my doctor has not thought it worth measuring again this year. I will ask for it again next year as a routine precaution.
The only downside is teh Erectile disfunction and that can be offset by using the injectable 'Caverject'. As I am almost 70 my hormones are reducing so that the sexual urge is not so pressing anyway.
So, 12 1/2 years after my Prostatectomy and looking forward to another 12 or more I hope.