I went to my Family Practice MD for a routine medication check. As a routine screening, we checked my PSA and he did a DRE (digital rectal exam), and found a nodule on the right side. My PSA was 2.6, with previous tests of 2.5 in 2006 and 2.7 in 2007. I have been taking Avodart 0.5 mg every other day to prevent male pattern hair loss. (This probably reduced the size of my prostate and lowered my PSA vs. those not on Avodart). My FP referred me to a urologist to further evaluate the prostate nodule. I am a health care professional (clinical pharmacist), and already knew some things about prostate cancer, but I began reading in earnest. The urologist confirmed the presence of a nodule and recommended a biopsy. I read that a nodule doesn't necessarily mean Prostate Ca, but the urologist stated that it was likely.
The biopsy was not painful, but the hematuria was a bit disconcerting. Waiting for the results call was a bit nerve wracking. I was told that the results were positive for prostate cancer - Gleason Score of 4 +3 = 7. There were 12 zones tested (4 positive - one 3+3, two 3+4, one 4+3). Needless to say, but I was somewhat shocked and concerned. I definitely went through all the stages of grieving (denial, anger, bargaining, depression, and acceptance). But I soon got to a place where a positive approach was going to be the best for me. The urologist discussed radiation, cryotherapy, but based on my age and the biopsy results recommended surgery and that I was a candidate for Robot Assisted Laparoscopic Surgery (RALP, Da Vinci). I continued to read, found the YANA website, and talked with several others that had prostate Ca. The side effects of incontinence and impotence can occur with radiation or cryotherapy, and I didn't want to leave the gland and the possibility of missing cancer cells. In addition, I was told you can use radiation after surgery, but surgery is not as good an option after radiation. I decided that the surgery was the best option for me. The surgeon had done over 250 robotic procedures and had a very good reputation, so I scheduled it as soon as I could (they suggest waiting 6- 8 weeks after biopsy) so I could get back to golf, softball and boating as soon as I could.
My surgery was done on May 13th and it went very well. I went home the next day. The pain was tolerable, less than I had expected. The catheter took some getting used to, but was less of a problem than I had expected. I was able to go places with the leg bag. Getting the catheter out was great. I wore a security pad for a few days, but was really continent within a week. I do need to go more often and think ahead so that I don't have urge incontinence (leaks), but overall it has been very good. Fortunately, my pathology report came back as no extra-capsular extension, surgical margins, seminal vesicles and lymph nodes were negative. In addition, my tumor was down graded to 3+4=7 (from 4+3) based on the clinical pathology. Therefore, no additional treatment was recommended at this time.
My post-operative recovery has been very good. I will now just wait and monitor my PSA every 3 months. I have enjoyed reading about the experiences and choices of others, and am willing to help others in any way I can.
My three month post RALP PSA was less than 0.10. I am very happy the PSA test was undetectable, but I am looking into the benefit of the ultra-sensitive PSA test for future monitoring.
I am very pleased with my post-op recovery. I am having no problems with incontinence, and sexual function is pretty good.
Just had my one year post surgery exam and PSA test. All is good. PSA is less than 0.1 and exam was fine. No problems with incontinence.
I am enjoying life and working on accomplishing items on my "Bucket List". I traveled to California to drive on Highway 1 and see the Big Sur, the Monterey Peninsula and Pebble Beach.
My best to all!
I have now passed my 2 year anniversary since my RALP procedure. I have had my PSA checked every 3 months, and it continues to be undetectable (less than 0.1). I have no symptoms of disease by physical exam or lab tests (PSA). I have no incontinence (none since the first few days post-op). I now go to every 6 month PSA checks.
I am happy with my status, and glad I had the surgery. Despite what the new USPSTF guidelines suggest, I am glad I had my PSA and DRE done and that my prostate cancer was diagnosed early so that I could make an informed choice about my treatment options. My brothers were then tested - one had prostate cancer (Gleason score 7) and had RALP surgery, and the other brother did not have disease. I continue to read about prostate cancer diagnosis and treatment and to talk with other men about the disease. I am happy to be cancer free, able to work and pursue my hobbies and interests (travel, golf, biking, boating). Please feel free to contact me. My best to all. David
I have passed the 3 year anniversary of my Robot Assisted Laparoscopic Prostatecomy (RALP). My PSA continues to be undetectable. I am very happy about this and my confidence increases with each passing year that I am disease free. I have virtually no incontinence problems unless I wait too long, then there can be some real urgency and leakage. As long as I go regularly, I have no problems. Sexual function is different than before (no ejaculation, some decreased length), but I am able to have sexual intercourse. I have no regrets about my treatment decision. Looking forward to a continued disease free future. Please feel free to contact me if questions. David
I am now 4 1/2 years status post RALP surgery. I have no major symptoms or side effects. It is rare for me to think of myself as having had cancer. I do think about prostate cancer awareness and make a point to tell other men about the disease, screening, diagnosis, and treatment options. I am now getting my PSA; checked every 6-12 months as it continues to be less than 0.1 ng/ml. I continue to look forward to a disease free future.
After almost 5 years, my PSA, which had consistently been less than 0.1, increased to 0.11. This raises the possibility that I am having a biochemical recurrence of my prostate cancer. I have increased the frequency of my PSA measurements and consulted Dr Eugene Kwon at Mayo Clinic. Dr Kwon ordered an abdominal MRI scan to look for any signs of recurrent cancer. We will continue to monitor my PSA and when it reaches approximately 2.0, then we will do a Choline C-11 PET scan and consider possible further treatment (either focused radiation, or chemotherapy). I have graphed my PSA values and using an algorithm am monitoring my PSA doubling time, which appears to be approximately 15 months.
After approximately 5 years post robotic surgery, my PSA became detectable (had been less than 0.1). My PSA is now 0.26 and has a doubling time of about 14 months. I have consulted Dr Eugene Kwon, MD at Mayo Clinic in Rochester, MN. He specializes in recurrent Prostate CA. We are monitoring my PSA every 3 months, and when. It gets to be between 1 and 2, will do the choline PET scan to determine where the PSA producing cells are, and what treatment if any to undertake at that time. The possible treatments include focused radiation, chemo, anti-testosterone, other, or a combination of these. Hoping for the best looking forward.
David's e-mail address is: david-fuhs AT msn.com (replace "AT" with "@")