My name is Joel and I was diagnosed with Gleason 8 prostate cancer on March 10, 2015. As I'm sure is typical, I was grateful that my wife was in attendance as we got the news - I was numb. I've been seeing my urologist (who will also be my surgeon) since 2011 when my G.P. noted an increase in my PSA at my annual check-up. My biopsy then was clear and I've been tracked ever since on a regular basis.
My urologist has suggested two options - surgery, for sure, and a clinical trial that is referred to as PUNCH (I don't know what the acronym means) and PRC.3 - the trial is randomized and selection is done by computer. If I elect the trial, my name is submitted and I am place in one of two groups - group A has surgery immediately and group B has six treatments of chemo (Doxacetel) and two hormone treatments over and 18-week period. This is followed by surgery, usually about a month after the series of treatments has ended.
I am hoping that someone reading this may either be in the trail and willing to comment, or may be someone who was offered the opportunity and decided against it. Frankly, any informed commentary is very welcome.
The aim of the study is to reduce the rate of recurrence in the Gleason 8-10 range - I should have mentioned that this study is only for men in that range - and I'm to understand that recurrence is currently 60% within the first five years following surgery.
My doctor is, and has been, enormously supportive, direct and in no way selling me one way or the other. He does feel that I should consider doing this - how much easier, of course, if there was a single choice and no further decisions to make.
I'll happily respond to any questions that may arise from this - and I hope that someone out there has something to offer a guy just starting to find his balance.
After a week to consider whether or not to submit my name into the clinical trial for men with 8-10 Gleason, I met with my urologist/surgeon and, with the trial manager, completed and submitted.
Within two days, I was informed that I have been randomized for surgery rather than chemo (six treatments with three-week intervals) and Hormone (two treatments, three months apart) prior to surgery. It's very hard to know how I feel, frankly - without any information yet available to determine whether the pre-surgery protocol will reduce the rate of recurrence, I am doing my best to deal with what is real, what I can dedicate myself to rather than making myself crazy wondering which "side" is the better place to be. In discussion with my surgeon before I was assigned to surgery (without the pre-surgery protocol) he said he considers this a no-brainer - he is confident that both groups will be well managed and especially well taken care of.
My surgery was the end of May 2015. I am monitored every three months for PSA and, to date, PSA is undetectable. I am in a study that mandates follow-up every 3 months for 3/4 years, then every 6 months for the same length of time, followed by annual monitoring. This can continue for a maximum of 15 years - and the protocol may change if there is any recurrence where treatment contradicts the requirements of the study. Naturally, if the study itself is ended, so is my affiliation with it. The fact that I am being monitored so closely, and by my urologist/surgeon, is very reassuring - the continuity of care and healthcare providers reduces the anxiety of 'starting over'.
At the second anniversary of surgery - PSA is undetectable. In a study (PUNCH) that requires monitoring every 3 months (first 3 years). Otherwise, life is what it was like prior to diagnosis.
Joel's e-mail address is: joelgreenberg AT rogers.com (replace "AT" with "@")