I'm Sharon the wife writing about our experience with prostate cancer. I say "our" as, when you are married, it is an experience you both go through. Alfred was 66 in March 2014 and is still working. Back in 2009 Alfred had a bypass. As a result he had 6 monthly cardio check ups after that and still does through our local GP. One of the blood tests they did was a PSA test. Never an internal exam. He was averaging around 3 for his PSA for several years. He had an enlarged prostate for at least the past 10 years and was up numerous times during the night to go to the loo for years as well. The PSA then jumped but all we were told was "we'll keep an eye on it as it's a bit high". We didn't think to ask what the reading was. You know what it can be like - you just assume the Doctor knows if there might be a concern. Of course you look back and think "why didn't we ask what it was". It was 5.9!! It had almost doubled in 6 months. That was in the first half of last year, 2013. If we knew then what we know now we would have insisted that we be sent to see a Urologist. Then he had his cardio check up in about October and the usual blood work but they forgot to do a PSA this time. Then in about late November Alfred was seeing the Doctor about something and having a couple of blood tests done. I mentioned that a PSA hadn't been done this time so he added that to the blood test. It came back at 9.1. The Doctor gave us a referral to see the Urologist.
Bad timing. It was the week of Christmas and everyone had now closed for the holidays. To back track a little. Alfred had a colonoscopy in December for something totally unrelated and in the results it said "a large irregular malignant feeling prostate palpable on PR examination" so we already knew what to expect when we finally saw the Urologist in January. He had a biopsy in February and while waiting for the results to come back the Urologist wanted him to have CT scans and the full body scan done so he could see all the results to look at when we went next. All the scans were clear and the cancer had only just escaped the prostate. Gleason 4+5=9. We don't know what his official stage rating is. The cancer and the tumour were only on the left side. The right was clear. He recommended radiation and hormone therapy. He started off with a hormone pill, which name escapes me, for one month. 2 weeks into the medication he was to have his first injection of Zoladex 10.8 into the abdomen. The Urologist said he will have those for 3 years. Why radiation and hormone therapy rather than surgery? The Urologist felt that there was no point in having surgery as most likely he will then need radiation later and he felt it was the best choice of action for him. And because of the position of the tumour there was also concern about the bladder and outcomes if surgery was what we wanted to do.
We saw the Oncologist next at the Cancer Centre at the nearest hospital to where we live. A 2 hour drive there and a 2 hour drive back. We had a long appointment about treatment. Alfred had gold seed implanted on the 3rd of June, and the pre-radiation appointment on June 24th. On June 19th we saw our Urologist for a follow up appointment as to how Alfred was doing, and a scheduled PSA test result. His PSA had gone down to .013. At the pre-radiation treatment we saw the Doctor, a Nurse, and a Prostate Nurse who only deals with prostate cancer patients. He also had 3 tattooed dots put on his body and a ct scan and other things as pre-preparation for the radiation treatments. We left very well informed about what was going to happen and the side effects and other bits of information such as using unscented soap, taking cranberry tablets at night, staying hydrated etc, eat healthy, exercise etc. We went home with booklets, and leaflets and folders of information. And a cute yellow water bottle that was his to keep and to bring with him every treatment!!
Radiation starts in exactly 8 days - July 15th 2014. He will be having 39 treatments x 5 days a week. At the end of each week we will receive a sheet of paper to tell us at what time his appointments are for the following week. Once a week he will see the Doctor. Once a week he will see the Nurse. And the Prostate Nurse told us that even though she doesn't have scheduled appointments she tries to see everyone who is having treatment every week. We have been very well looked after already and Alfred hasn't even started the radiation sessions. Everything has been clearly explained.
Because of the distance we are to cover to drive there and home we will be staying in the City Monday to Friday and travelling home on weekends to check mail, mow and just sleep in our own bed!
And so our journey begins.
As of Friday the 5th September Alfred has finished 39 treatments of radiation. He is doing well. The course of action now is to continue with the Zoledex for another 2 and 1/2 years. He will be having 6 monthly PSA testing and a link up between the Oncology Department of the Cancer Centre where he was treated and us at our GP's conference room where we live. Otherwise we'd have to travel nearly 2 hours every 6 months for a check up. It went well with few dramas. The staff, doctors, nurses and others involved made the whole process easy to go through.
Hello. I'd like to update Alfred's progress. We went to our Medical Centre today for a link up with the Oncologist at the Hospital where he had his radiation. He had a PSA test a couple of weeks ago so we were going to get the results of that and just to chat about how he's been doing. He last PSA which was done 3 months after he started hormone therapy was .013. This was before the radiation. So he finished the radiation a couple of months ago and has been doing well. It's summer here so he feels the hot flushes more than in winter. He does get tired at work but he just stops and has a bit of a rest. No other symptoms to speak of and he's doing well. His current PSA test is .009. The Oncologist said that they have gotten better technology and can now read the PSA to a 3 number reading. Hence the reading. Alfred had a cry afterward when we saw the GP as it's been a bit of an emotional week as it's been leading up to finding out the PSA results. (as well as one on the way to the Doctor's office). The Oncologist doesn't want to see him for a year and doesn't want to do a PSA until a year has passed as well. Smooth sailing so far for us.
It's been 1 year since Alfred had his last PSA test. It was due anytime now as he will have a phone link up with the Oncologist on December 2nd. He had his test a few days ago and we found out yesterday while at the Doctor to get his referral updated, that the PSA is .008. Last year it was .009. We expect the Oncologist to just ask him how he's feeling, any problems, and we'll do another PSA this time next year.
Alfred continues to live and work and get on with his life. You do get used to it being in the background of your life, but you don't think all too much about it - until the regular appointment, and the regular PSA. Then it all comes to the surface and stares you in the face. Alfred is planning to work on his diet (make it more healthy!) and as we are now going into summer he will no doubt feel those hot flushes a lot more than in winter time.
Another year has passed. This morning Alfred had a phone call appointment with the Oncologist who is the Head of the Cancer Unit at the Hospital when Alfred had his radiation treatment. It was a short 3-4 minutes conversation. The Doctor was pleased with things. He is now going to have Alfred have 6-monthly instead of yearly PSA tests and also will be checking his testosterone levels at the same time. There was a discussion as to what happens if things change and what would then be the next step.
The current PSA result was .008 like last year. In a couple of days Alfred has his last 3-monthy Zoladex needle. The Doctor did say it might be a year before the effects of the hormones wear off and he might in fact have more hot flushes instead of less for a while while his body starts adjusting hormonally again.
What has the last 12 months been like? Hot flushes and some tiredness. Alfred is 68 now and still working full time. We did wonder what it was going to be like after his radiation treatments and still being on the hormone injections - how was it going to affect his ability to work as he has a manual style job. He has been doing very well. He will be 69 in March and has decided to retire in June.
Alfred is looking forward to when the hot flushes stop and he can feel more energetic (mostly likely to walk up the beach to go fishing when he retires says the wife!!)
We are thankful for how things have been going and will now have to deal with the emotional 6 monthly blood tests. But at least there is ongoing commitment from the Oncologist and our local GP.
Alfred's e-mail address is: email@example.com