My doctor has started me on annual PSAs in 1990. In May, '94, my PSA had shot up from 5.8 to 11.6. The biopsy came back as a Gleason 7, and a DRE staged me with a T2b tumor.
My first Urologist told me to "bank your blood," and " I have scheduled you for surgery in June." Period! I went to Johns Hopkins for a second opinion where Dr Epstein upgraded my Gleason to an 8. Since I had just turned 71 that day, Dr. Pat Walsh refused surgery, and brusquely told me "Get Radiation."
My wife was a scientific librarian, with contacts at the NCI and NLM, so we haunted the stacks for around a month, reading almost everything available on both curative and palliative therapies available at that time. In that search, we found the Partin Tables that had been published in Urology in July, 1993. Interesting, as that article had x/y graphs rather that the boundaries used today. I found that I was on the ragged edge of lymph nold and vesicle involvement.
I went for another "second opinion" with Dr Jane Grayson, (Harvard, Stanford, NIH) a radiation oncologist who ran the Alexandria Hospital Cancer Center. She was well aware of the new method of seeding the prostate (interstitial brachytherapy) and had sent a physician team to Seattle to train under Drs. Ragde, Blasko and Grimm. She made an appointment for me with Dr. Grimm, and Pat and I went to Seattle in July of '94, where I was worked up by the team at the Swedish Hospital. After reviewing the results,Dr Radge told us that I was on the borderline of their protocol, but, IF I wanted to go for the seeds, then he believed the Alexandria team that had just completed training could do the procedure.
On return to Alexandria, Drs Dan Clarke (Rad Onc) and Roger Wiederhorn (Uro) took over. I received a five week series of modified dose radiation to the pelvic area from Dr. Clarke. Then, as new equipment had been installed in one of the operating rooms, it had to be calibrated. So, I found myself on the table and in the stirrups as the "calibratee" for a solid three hours. (Nope! No sedative, and that probe was a killer!)
Two days later, on 14 October '94, I reported to Same Day Surgery at 6:00 am. By 7:00 am I had received an epidural and was on the table for real. Dr. Peter Grimm had flown in from Seattle to "Replicate The Program." (In Air Force parlance, that's Quality Control). He scrubbed for the procedure.
As an inquisitive engineer, I chose to remain conscious throughout the procedure, and I was able to track everything that went on via a huge monitor positioned for the patient. Fascinating!
As my prostate was around 28 grams, there were no problems inserting the needles, as I was implanted with 77 Pd103 seeds. As I was the first patient in the Washington DC Metropolitan area to receive the seeds, there was a bevy of physicians observing the procedure, and, at one time, I counted seventeen extra heads in the room. (My wife later remarked that those doctors could recognize me only if they were able to see the area between my sphincter and scrotum)
Three hours later, I was seated in our living room, with a wee dram of Talisker in my hand.
Early side effects: The radiation made be very tired, and I didn't dare drive a car after around 3:00 pm. Also, for several months following the procedure, I had to know the location of every bathroom in every home or facility I was in.
Long term side effects: With radiation and seeds, there are two significant side effects, viz., Impotence and Incontinence. I am not incontinent, but impotence gradually arrived over a two year period. My age,72, didn't help, either, and I got to the point where Viagra and Cialis were ineffective.
My wife truly was my partner throughout. I can't stress loudly enough and long enough for a newly-diagnosed man to include his wife, significant other or partner at the outset, and to accompany him to every consultation. After all, the decision that they make for his curative or palliative therapy will have lifelong consequences. The choice should be a team decision.
Following seeding, my PSA dropped drastically -- and stayed down. I didn't experience the "hump." So, my latest PSA (last week) was 0.109. After 19 1/2 years, I'm still in remission. Sopme people might say that I'm "cured"; however, I don't profess to believe in any certain cure. As long as I can keep that dragon at bay, I'm happy.
Now in my 21st year of remission. At age 91, I am "deteriorating on schedule:" however, none of my physical issues, other than impotence, are related to my prostate cancer therapy.
At age 93, and in the 22nd year of remission, I still sweat out every six-month PSA test. I've been able to use the same laboratory in the community hospital for every PSA check since undergoing therapy in 1994. Some physicians might say I'm "cured"; however, I'd rather be objective and think I'm in a very long-term remission.
George's e-mail address is: gberger AT his.com (replace "AT" with "@")