My GP sent me to a Urologist in February 2009 as a result of my PSA being elevated at 5.9. A rectal exam by my GP and the Urologist felt normal to them with the prostate being normal size and consistency. Not feeling comfortable with the PSA, the Urologist ordered an ultrasound and the result revealed what he called a soft tissue mass on the left side of the prostate. As I was feeling some discomfort in the scrotum area, he put me on an antibiotic sulfa drug and then did the PSA test again. It had fallen to 5.6.
At this point he ordered a biopsy. On February 25th 2009 he took eight core samples of the prostate tissue and at a visit to his office on March 6th, I was diagnosed with Prostate Cancer. The report detailed, "TRUS biopsies of prostate left adenocarcinoma of prostate involving part of 1/4 biopsy fragments, less than 10% of the surface area involved, Gleason score 3+3 = 6/10. TRUS biopsies of prostate right, negative for malignancy."
I was told it was low grade, slow growing and treatable. He further ordered a CT scan for March 17th to ascertain if the cancer has moved outside of the prostate, although, he rather doubted that. He explained that the treatment options available to me included surgery, radiation and HIFU. He further explained Radical Prostatectomy, both retropubic and perineal, Laparoscopic Radical Prostatectomy, and Robotic Assisted Laparoscopic Prostatectomy. He discussed Eternal Beam Radiation therapy and Brachytherapy. He also explained the experimental HIFU treatment currently underway.
I have spent the past week getting educated on the internet and have been thoroughly reviewing all the options he presented. This included watching a complete Robotic Assisted Prostatectomy procedure on a webcast along with joining this group and compiling dozens of links to information centres, Additionally, I joined a local Prostate Cancer Support Group and was fortunate to hear a Urologist speak on HIFU who potentially could be involved in my treatment.
After the results are in from the CT scan I will make a decision on my treatment. In the meantime, my wife Diane has been right there by my side as have other friends and family and I have already heard from one member of this forum who kindly offered to connect with him at any time.
While waiting for my CT Scan results, I have begun fighting back against the cancer in my prostate. Some years ago I used visualization techniques, with success, to help me with another medical problem as a supplement to primary treatment.
This time, I have named my treatment HIFLA, High Intensity Focused Laser Ablation, and I have an imaginary laser gun to administer it. Before going to sleep each night, I focus the gun on the cancer cells, which appear in my mind as bright flashes, and I ablate them into oblivion. As well, I visualize my PSA starting a slow decline from the current level of 5.6, and plot the lowering reading on a imaginary chart.
This, in no way, will replace my primary treatment option when I decide it, but rather act as a further aid in the fight. I firmly believe that my mind can play an important part in my health and once having made the decision to fight, it can be a powerful aid in the battle.
Today I am visiting my GP for a discussion of my options.
Later: Today I received the results of my CT Scan which thankfully read "No pelvic adenopathy".
With a huge sigh of relief, I forged ahead with my Urologist and asked for a referral to the surgeon in London Ontario who performs the Robotic Assisted Surgery with the da Vinci robot. I await an appointment to meet with him and discuss this option. Additionally, I clarified the staging with my Urologist to be "T1c".
If I am at all uncomfortable with the RALP option, my backup plan and second choice would be Laparoscopic Radical Prostatectomy with an experienced surgeon in Hamilton Ontario.
Failing that, my third choice would be Radical Retropubic Prostatectomy.
This is a very personal choice and has a lot to do with the comfort level of potentially removing the cancer from my body. Both Diane and I are in total agreement on this route and it now remains to finalize the details as to which surgery and when it can take place.
With a surgical consult now in place for April 20th, I am eagerly awaiting the date for a frank discussion with the surgeon. In the meantime I just finished reading Dr. Stephen Walsh's "Guide to Surviving Prostate Cancer" which I found most helpful. It certainly provided the information I was looking for and more.
Why don't Urologists and doctors suggest these resources to us when we are diagnosed? It seems that there is a distinct lack of patient education, at least, from my urologist. There are so many good resources out there but it seems you are left on your own to discover them.
Later: The surgical consult was completed today and I have decided on robotic assisted laparoscopic surgery which is now booked for September with a possibility of obtaining an earlier date should a cancellation occur. I am comfortable in this decision that it is consistent with all my thoughts and beliefs and will give me the platform to continue to be well into the future.
I continue to fight the cancer with my visualization techniques and am researching the dietary and lifestyle trends that have some interesting possibilities in providing more mechanisms to fight future recurrences after treatment.
On September 2nd, I will travel to London Ontario for my pre-op checkup. This is a reminder that the surgery is imminent. My robotic surgery is scheduled for September 29th.
In the time since my diagnosis, I have been doing a lot of research into lifestyle changes. As a result of reading books like The China Study, The Food revolution, Healthy at 100, Reversing Heart Disease, Eat to Live, and Becoming Vegetarian, we have completely revised our diet. After eight weeks of becoming vegetarian, my blood pressure has dropped from 130/98 to 110/70 with no changes in medications. Additionally, I have returned to me age 35 body weight. My body mass index has also come down to the favourable 22.6 value. I feel much better and have more energy. In my mind, I am beating this cancer.
My hope is that the new diet has had a positive effect on my PSA and that the cancer has been kept under control since my diagnosis. In my mind I have done everything in my power to fight this disease and am hoping after the prostate is removed that good news follows.
My Da Vinci Robotic surgery was completed on September 29th, 2009, in London Ontario. The six hour surgery went without any unexpected issues and according to the surgeon, it was a clean procedure. While he was in the abdomen, he looked around at the other organs and reported that everything looked very healthy including the bladder neck. This was especially good to hear as it may help with continence issues.
I was in hospital for 3-1/2 days, a day longer than expected, as I was unable to pass gas by Wednesday which is a prerequisite for discharge. With the aid of some suppositories, things got moving on Thursday and I was released at noon on Friday October 2nd. The 2-1/2 hour drive home went well with one stop to empty the leg bag.
There was no noticible pain from the procedure other than gas cramps. I took 2 Tylenol 3 on Tuesday evening after the surgery, at the nurses insistence, even though I felt I could get through the night without them. Regular strength Tylenol followed for two days to relieve scrotum tenderness and then I was off pain killers completely.
One by one the restrictive hardware was removed during my stay, including the IV and pelvic drain. By Friday I was down to the catheter and TEDS stockings for the trip home. I soon became familiar with the catheter care and favoured the use of the leg bag during my waking hours and the night bag for sleeping.
The day after I arrived home I started walking around my neighbourhood, increasing distance each day as I felt stronger. This resulted in some mild bleeding in the urine, which always cleared itself up within a few hours of returning home and has decreased daily as I am healing.
I am pretty much back to my regular activities, excluding lifting or stretching, and am feeling quite well in advance of my post-op visit to London on October 14th. At that meeting I hope to hear the pathology results and will of course, rid myself of the cathater. The visit includes a session with a Physiotherapist for Pelvic Floor Training which I hope will aid my return to continence.
Later: October 14th was catheter removal day and I received my pathology report on my prostate. Gleason Score remained at 3+3 = 6 as it was when originally diagnosed. There were no positive margins. Tumors were found in both lobes and involved 3-5% of the prostate. There was no Seminal Vesicle, Perineural, Lymphovascular or Lymph node involvement, and the bladder neck was also cancer free. That was the best news I could have hoped for.
After the catheter was removed, I was told by the nurse to take my time getting up from the examination table and to get dressed with a pad and leave. I carefully sat up and immediately urinated on the floor. It was not unexpected but still came as a surprise and left me embarrassed. Later that day I attended a physiotherapy session on pelvic floor training and went home to Niagara-on-the-Lake.
The day progressed using 4 pads with plenty of urinary leakage. The first night proved to be somewhat of a success as I was able to get to the bathroom twice, holding my urine in, without leaking. The next morning I was able to shave prior to showering and held urine in control until just before the shower when I voided in the toilet. It was a pleasant surprise that I could do that on day two. Walking is proving to be a challenge with leakage, but hopefully over time, and practicing the exercises, continence will improve.
My last checkup was in November of 2010 and my PSA was undetectable. I am now on a yearly checkup for PSA and am otherwise in good health.
I am very lucky to be in this position and am grateful for that every day.
I am now in year three of zero PSA;. Two annual followups after my DaVinci surgery have produced PSA; at undetectable levels. I continue to follow a healthy diet and positive position in my mind and hope for future followup visits to be the same.
As of the Spring of 2013, and after my annual checkup, my PSA is undetectable. My Oncologist who did the Robotic surgery says that there is a 98% probability that my cancer will not return in my lifetime given my post operative pathology. That is about as good as it gets in my mind and I am truly lucky to be in this position.
As of the Spring of 2014, and after my annual checkup, my PSA is undetectable. My Oncologist who did the Robotic surgery says that there is a 98% probability that my cancer will not return in my lifetime given my post operative pathology. That is about as good as it gets in my mind and I am truly lucky to be in this position.
As of this Spring 2015, my PSA is still undetectable. That is five years and a bit after Robotic Surgery in London Ontario in September of 2009 to remove my prostate. I am feeling very fortunate to have survived this for this long with a 0 PSA. My Oncologist stated that I had a 98% chance of the cancer never recurring which is very good odds in my books.
Regards to all,
I returned from London yesterday after my annual checkup with my oncologist. I am now coming up on seven years after my surgery and my PSA was 0.015 ng/ml. After an update to the testing procedure three years ago, my PSA has shown a value where prior to that it was zero. This new test is more accurate and as the oncologist says shows results that can be concerning when there is no need for it. He said that there are tiny glands around where the urethra was reattached to the bladder that can produce minute amounts of PSA and that is likely what is showing in my result as I have shown similar readings on the last three tests which show a flatline profile on a graph. As long as this remains constant near the same value, he is not concerned and booked me for another blood test and visit one year from now. I remain very optimistic that I will stay stable and continue to be positive.
Well, it is now July of 2017 and I have just returned from London Ontario after meeting with my oncologist. I changed my yearly appointment from January to July in order to avoid a 3 hour winter drive to London. The drive was so much better.
My current PSA was 0.012 ng/ml which is basically undetectable. He told me that after almost 8 years post surgery, this was a very good outcome and bodes well for the future. The lab facility changed the test for PSA several years ago to make it more accurate and therefore the readings go to 3 decimal places. The theory is that if changes in PSA start to happen, they will be seen sooner with the more accurate tests and treatment options can begin earlier. My oncologist is skeptical that this is true as he believes some residual PSA emanates from glands in the area where the urethra is reconnected to the bladder after surgery and this reading can fluctuate from year to year showing dips and dives. This has been the case with me as I have had readings as high as 0.017 ng/ml down to 0.012 ng/ml in the past 8 years.
I am truly blessed to have come through this illness with few repercussions and value every day that I have to spend with my family and hobbies.
Bill's e-mail address is: notl06 AT gmail.com (replace "AT" with "@")