My name is Douglas Adam. Born 1943. Height 6'3". Weight 16.5 stones. Married with an adult son Russell aged 30 and daughter Lucy 27. Living and working in Stirling, Scotland.
After a spell of poor erections and a growing awareness of a slow urinary flow after a few pints of 70 shilling ale in the rugby clubs of Scotland, which did not alert me to anything particularly serious being wrong, I decided I should have a check up.
In June 1991 I visited my Doc thinking I might have diabetes. A digital rectal examination as part of the check up showed I had an abnormal prostate gland necessitating further testing. That included urinary flow tests - poor flow, a 12 core biopsy - very positive for PCa and a negative bone scan which was about the only good part of the exercise.
Most of July I spent on holiday in Greece, walking and travelling round Athens, Delphi, Larissa, Meteora and Crete. Pure dead brilliant!! I was feeling invincible on my return, tanned, fit and happy at 14 stone [that's about 195 lbs or 89 kilos for non Scots] after all the heat and travel, and then I got my test results from Stirling Royal Infirmary. I had advanced prostate cancer. It was like having a bucket of iced water poured over me. "But wait a minute, not me, I'm fit, not in pain, my PSA is 4.8, etc. Yet the Urologist said not just prostate cancer, but advanced prostate cancer!" And so started the rest of this journey of my life which I enjoy despite everything!
My Prostate Cancer Summaries
August 1991 - I was diagnosed with PCa at age 48: PSA 4.8: Gleason 5+5 WHO Grade D, poorly differentiated; Clinical staging based on DRE: T 3; Path stage based on Biopsy: C1; TRUS volume 30 cu.cm; Bone scan clear. In September 1991 I had an RRP in Kings Park Hospital Stirling. Surgery and pathology revealed capsular penetration, but no seminal vesicle and no nodal involvement, no positive margins.
In December 1991 I had a course of radiotherapy carried out at the Beatson Oncology Institute Glasgow where I attended 5 days a week for six weeks to receive 65gy radiation to prostate area. Generally, my very high level of physical fitness from seven years of sprint training, gym work, circuit training and swimming greatly helped my recovery from both procedures and as the months passed I started back into exercising again. 1992 to early 1996 were good years. I started a new business, had plenty of energy and enjoyed life. Following RRP/RT I was clinically impotent with not much success from Caverject or VEDs but I was continent except after an excess of wine, single malt whisky or beer when great care was needed!
Quarterly PSA tests and meetings with Urologist from 1991 to 1995 showed PSA holding at <0.5 undetectable in accordance with assays used by Stirling Royal Infirmary path labs. However, in March 1996 my PSA was seen to have increased to 2.4 (a December PSA test showing a recurrence of my PCa with a PSA of 1.3 from my December PSA test overlooked in error!) Continuing with quarterly PSA testing, by December 1996 my PSA was PSA 5.7 showing a rapid PSA doubling time in keeping with my initial diagnosis of aggressive PCa back in 1991.
With Christmas and New Year 1996 passed, in February 1997 I started Hormone therapy, 1 month on Casodex and then Zoladex 84 day Depot injections quarterly thereafter. By May 1997 my PSA was <0.5 showing a great response to Zoladex and it has remained there. During this period of hormone therapy, I experienced the hot flushes, (bearable but irksome particularly in business meetings or over a romantic dinner!), total loss of libido, depletion of physical fitness and stamina, impotence - a nightmare, general fat redistribution and muscle tone degeneration, joints aches and pains, short term memory problems, slight periodic swelling of right lower leg and foot. Otherwise no problems! It all sounds worse than the reality of living with PCa and getting on with the day to day business of life!
In August 1998, PSA still <0.5 feeling fat and sluggish, weight gain 3.5 stones [that's almost 50 lbs or 22 kilos for the non-Scottish] in past 18 months on HT, lethargic, fuzzy mentally and needing some of me back, some QOL (Quality of Life!), I decided to stop Zoladex and monitor PSA and other markers monthly while off medication. Last PSA still <0.5 at 15th September 1999 after fourteen months off HT. I bought the Vitamin E, Genestein, Calcium Citrate + Vitamin D and Selenium and attempted to change to a low fat diet (which I do believe is very important for PCa survivors). So far though, I have not taken the caps off the bottles and I still enjoy cheese, beer, red wine along with the dark green veg and fruit! QOL! Say it again, QOL! I have no self control, but … I stopped smoking in 1985 from 70 a day to zilch. Was that self control or what?
So what do I believe in now?
I am not "cured" but in "remission" for as long as I can keep my cancer cells responsive to hormone or other treatment. How long is that? They say 24 months on average. So then what? And the answer to that is, I really don't know except that I believe firmly that a strong immune system makes the little buggers have to fight that much harder to get on top of the body's natural response system. While that particular battle rages, I pray that one of the boffins comes up with a treatment, if not a cure then a palliative treatment, that will let me see out my life naturally.
If it is not to be, it will have been because of my ignorance of the symptoms of Prostate Cancer that I now know I had for years before I was diagnosed. Now ask me why I am involved with PCa Support Groups in Scotland. I have a twenty-nine year old son. I may have been developing PCa since I was in my mid to late thirties and had no reason to have a DRE or a PSA test. But my son will hopefully be aware of the difficulties that this disease presents in diagnosis. I look in the mirror when shaving. I have no pain, the occasional bit of discomfort, yes, but no real pain. Do I look ill? Not really, unless I have had a particularly late night, worrying about financial stuff, or a working week-end or a bad night's sleep when the face tells a tale of neglect. But that's life, not death, life.
Am I angry? No not really. Am I sad? Yes, very sad for the life I may miss. Am I positive about the outcome, the future? Yes, I am. Don't know why really. The stats are not good for late diagnosed Prostate Cancer but right now, with no pain etc. prostate cancer is not preventing me from doing most of what I need to do. It sure makes it more difficult, but on the other hand, it opens my mind up to the things all round us which are so precious. Drive up the Perth road and see how green are the fields and Lowland hills with the sun on them. Go to the lochs of the Trossachs or drive to Skye.
I used to look and not see. Now I see beauty everywhere. I drive to places I have never seen before. I look at the stars and moon on clear nights. I bought a self-made tape of opera in a charity shop in Perth six months ago for 50 pence which keeps me going on my drives South to London or brings tears to my eyes in "hormonal" moments. Such magnificent beauty and! depth of feeling all around me heightens my sadness, but anger? No. I seek answers, try alternative treatments, healing, visualisation. It helps and works for me, but I am lucky to have a Partner (Maree) who specialises in alternative therapies. I am 56 now, have had treatment for over 8 years for aggressive cancer and never felt ill or sore from anything other than the after effects of treatments. So three score years and ten will do me, please God.
Age now: 57 Current PSA: <0.5. Current Treatment: Intermittent hormone therapy. When I last reported on my Prostate Cancer journey in September 1999 I was 14 months into my first "off" cycle of intermittent hormone therapy after Surgery and then Radiation Therapy in 1991 then 18 months of Zoladex monotherapy starting in February 1996. I am waiting for the result of a PSA test taken on Monday but I am very happy to let you know that after twenty-two months without any further hormone therapy, my PSA is still <0.5! All I need now is some sunshine this Summer here in Scotland
Life is just brilliant, since it is now well over three years since I stopped using Zoladex and my PSA is still <0.5! Not bad for the first go at Intermittent Hormone Therapy. So life is good even if business is still a struggle!
Now in his 60's Doug is still enjoying life to the full. Here is his update:
Nothing much to report really which is obviously great news for me. I've been "off" all HT since August 1998 and am still at <0.1 PSA. How cool is that! Maree keeps telling me I am cured but I don't quite have her faith after one recurrence.
My immediate concern is to stay well and build my business in order to sell up and live a simple life in some warm, Med style climate with Maree! We also have an embryonic project to run holidays offering holistic courses in Crete during the Summer months and in Thailand during the winter months. Maree is a clinical hypnotherapist, Healer, International Life Coach and God knows what all. Her spiritualism and mind development is way beyond my basic lower order capacities!
All the best of all good things to you all, Doug, frae Stirling, Scotland's Braveheart Country.
After stopping all treatment in 19th August 1998, my PSA is still less than 0.1 ng/ml and I am in good nick apart from increasingly creaky bones! I was diagnosed in 1991 so after 15 years, that is a great result and I pray it continues!
Just a quick update to say that my PSA has remained at <0.1 since I had 18 months of intermittent hormone therapy with Zoladex in 1996/7 for a recurrence after RP and RT in 1991 and I'm loving every minute of that!
I'm very happy to say I am still in remission with a PSA of <0.1 and no recognisable symptoms of PCa. After 16 years and 9 months since diagnosis and primary treatment in 1991, I've been blessed.
So it happens...long may it continue for me and for every man on this journey.
Since my last update, I have nothing really to add except my ongoing joy to be in remission after my relapse in 1996 and then finally, my 18 months of hormone therapy ending in August 1998 which was my last treatment.
Long may it continue and my best wishes to all who are involved with YANA as visitors and members.
Doug Adam, 11th August 2009
[I dropped Doug a line to congratulate him on his rugby team beating the South African Springboks and asked how he was. This is what he said:]
I am still well and in blessed remission or cure. The only health worry I have is increasing aches from arthritis and I am nowhere near able to retire in fact I'm even busier than ever!
For the record my PSA is still less than 0.1 and so I am still in biochemical remission, and after diagnosis in 1991. I hope that is a comfort to your newer readers in particular!
Thanks for the good work you are doing and best regards to all.
Now 70 y/o and after surgery and radiotherapy in 1991, then hormone therapy with Zoladex for a recurrence in 1996, I'm still symptoms free and PSA undetectable. I guess PCa treatments and diagnosis have improved radically since 1991, but I was still fortunate to have a great Urologist and have healing from my Partner, Maree. So life is good and I hope that will be so for anyone reading my story. Best wishes Doug
Now 71 y/o and my health and absence of symptoms are both unchanged since my last update.
Best wishes to all
72 years old now and still free of symptoms. So leading a very busy normal life since the intensive treatments period from 1991 to 1998.
Best wishes to all who read this. There is always hope!
It's sometimes hard for me to believe that I was diagnosed over 25 years ago and I'm still in self employed work at 73 y/o with no sign of any further recurrence.
All best wishes to fellow survivors and their families.
on a cold but sunny day in Scotland.
Doug's e-mail address is: firstname.lastname@example.org