My PSA has always been below 3.0 and I haven't had a digital exam in about 7 years....BIG MISTAKE. I was always under the impression that a PSA below 4.0 was ok. I've had a physical exam every year with blood work through the VA and the doctor did not do a DRE (Digital Rectal Examination) - I guess because my PSA was low.
My new VA doctor didn't like the PSA going from 2.9 in 2008 to 3.92 in 2009 so the exam was done and she said one lobe had a problem. A few days later I was in a Urologist's office and he felt the left lobe harder than the right. He ordered a 12 point biopsy. The results showed:
1) Core in the left lobe with a small focus of atypical glands suspicious for carcinoma.
2) Prostatic intraepithelial neoplasia (PIN) high grade. There was also a core in the right lobe with the same diagnosis.
3) Also one core in the left lobe showed Adenocarcinoma of the prostate. Gleason score 6 (3+3), involving less than 5% of the total biopsy length of the core. Also one core in the right lobe showed the same thing and same Gleason score involving 20% of the core.
That was last Thursday. Today, December 21, 2009, I have had a CT Scan of the pelvic area and today in a couple hours scheduled for a complete body bone scan. Next week one more test, a cysto to check the bladder. Hopefully only the prostate is affected and I will sit down with the Urologist to plan the attack.
I am 70, but a young 70 if that is possible. Still very active, work in a pro shop part time and play golf a couple times a week. My wife and I also put lots of miles on the car since the kids are spread out all over the USA.
For peace of mind, I don't think I will be a good candidate for WAIT AND WATCH. But I will wait until my long talk with the Urologist after all these tests are over.
This website has provided a large amount of information. I'm so glad I found it. More to come.
Well my wife and I sat down with the Urologist yesterday, Jan 13, 2010 to discuss the results of all the tests and what treatment was available for me. Good news....the CT scan, bone scan and cystoscopy had all shown that the cancer was contained in the prostate. My PSA of 3.92 was my pre diagnosed level and has not been checked again.
My doctor laid out all the options from removal to wait and watch. First a little background on my Urologist. He started his practice in Ocala, FL in the 80's and became the first surgeon in the USA to do prostate robotic surgery as day surgery and the catheter came out in 4 to 5 days....I was impressed. He has since stopped doing surgery and has dedicated his practice to research from which I hear he has several patents. I was lucky to get him as he really is not seeing patients anymore but my timing was good because one of his doctors had recently left the practice which made him short handed.
I told him that I was leaning toward Da Vinci surgery especially after hearing of his results. I told him that I would like to have him do it. He said he was sorry but the hospital had given up the Robot Machine and it was located in Georgia and he was not doing it anymore.
He then started to tell me about treating this with radiation. I was thinking that most doctors that specialize in one technique would push patients in that direction and now he wants to talk about radiation? So I listened very intently. He told me "based on what I know, if I were in your shoes, I would choose the CyberKnife®" Wow, I have heard of it but had not read much about this procedure. [Seems Frank may not have followed all the links on the Yana site!] The doctor described how it was a highly intensive radiation dose that was done for only about 5 days and with a great amount of accuracy and no pain or side effects. The only invasion was to put several markers in the prostate prior to treatment. He assured me that this procedure was well beyond the experimental stage and recommended two doctors in the Tampa, FL area that were very good. As it stands right now I am waiting for my appointment to take the 88 mile ride to Tampa.
More to come.
Well it is Feb. 4, 2010 and I am in a motel 4 miles from the CyberKnife® Center in Brandon, FL. I have decided on CyberKnife® for my treatment. I can tell you I am not looking forward to 8AM tomorrow when they will place the gold markers in my prostate. My oncologists says it will be painless...hopefully he was levelling with me.
The drive here is 90 miles from my house so I did not want to get up before the crack of dawn, take a fleet, then drive a couple hours especially with the traffic going into Tampa. The Homestead Suite is pretty nice...like a small apartment with a kitchen. I think when I finally get the 5 days of CyberKnife® I will stay here that whole week to eliminate the driving. Next week, after the markers and prostate has settled down, I will come back here for the MRI and CT scan for the computerized planning for the robot arm. I'm hoping to get CyberKnifed later this month.
More to come.
Later: I got to Tampa Bay Radiation Oncology at 7:45 for an 8 AM appointment. They took me in at 8:10. I expected the worse and it never came. [Frank demonstrates a basic 'Law' - things are never as bad as we imagined they will be.]
A nurse first brought me in to an examining room and said drop your drawers and stand there with your elbows on the examining bed. She has a needle in her hand and I panicked a bit. I know I was getting a numbing shot but this big needle...oh my god!!! Then she said this is just an antibiotic shot just in case of infection. I wiped the perspiration off my brow as she stuck me in me butt. With procedures like this it's the unknowns that get you.
So I sat for 5 minutes. Then they took me to the room where the gold markers would be inserted. The technician assured me it was not a big deal. I laid on my side and he lathered up the wand and inserted it ....a little discomfort but not bad. Then he administered the needle for numbing and I can honestly say it was not even close to the pain when you get novocaine in your mouth for dental work. He then put another shot in the other side of my prostate but I did not even feel this one because the area was already numb from the first shot. Then he waited 5 minutes.
My Oncologist came in and they inserted the gold markers...5 of them. I felt a tiny bit of pressure but that was it. Pulled the wand out and they started talking about me living 90 miles away so why not do the ultra sound now instead of me making an extra trip. So another wand went in....no pain...and they did the ultra sound which is going to be used in conjunction with my MRI and CT scan next Friday to set up the software to control the robotic arm that will radiate the prostate.
The radiation will begin February 22 for 5 consecutive days and that should be the end of it.
Later: Feb. 27, 2010 - Yesterday (Friday) I completed my first CyberKnife® treatment.
My wife and I drove to Brandon (Tampa) the day before and checked into the Homestead Suites which is only 3.5 miles from the CyberKnife Center. The Doctor took me into the control room and showed me the screen that he will be monitoring while the radiation is going on. The five gold markers were very clear on the screen.
He took me into the radiation room and I lay down on a platform bed that was comfortable. Put a couple of pillows under my head and one under my knees for comfort. Getting situated on the bed in the correct position took about 15 minutes. The audio system allows us to talk to each other while he is in the control room. He made me hold my hands over my chest then wrapped a Velcro, approximately 8 inch wide, strap around my arms and over my hands to make it real easy to relax with my upper body secured. My legs were not secured. I knew I had to lay motionless while the radiation was being performed.
He started the robot and I never felt anything. The robot arm would take a position for about 4 seconds then change to another position. In 35 minutes it was over. At one point I kind of nodded off and was awakened when the robot made a "clunking" noise. After treatment we went to lunch and then drove back home (90 miles). I have the weekend off and will return to the motel on Sunday to have my next 4 treatments in succession.
So far so good. Off to work this morning at the Pro Shop like nothing happened.
It is March 9, 2010 and I am five days post CyberKnife®.
The five treatments went well. I had some bladder "twinging" and BM's for a couple of hours after each treatment but other than that no traumatic effects. I got up each morning and went for my walk. I do get a little tired doing any strenuous activity now but that is getting better every day. I played golf yesterday. I started taking Flomax 3 days into the radiation and now I have stopped taking it. Everything seems to be working at least as good as pre-treatment. If this works, CyberKnife®'s the way to go.
I will continue to post PSAs as I get them. I do have a follow up visit with Dr. Steel in Brandon, FL next Tuesday. I'm sure he will put me on periodic blood testing for PSA.
More to come.
Later: It is now 19 days post CyberKnife®. About a week after my last CyberKnife® treatment I started bleeding from my rectum during BM's [This is technically proctitis]. It was an ugly gooey mucus type material. I contacted my oncologist and he said it was not abnormal to have the rectum get a small portion of radiation which could cause these side effects. 19 days later the bleeding has just about ended and I am feeling very good. Back to work...back to playing golf. For about 2 weeks there was this constant feeling that I needed a BM....now that has gone away.
My next post will be when I get my first post CyberKnife® PSA result or if something unexpected happens.
It has been three and a half months since my last CyberKnife treatment.
I got the PSA results today and it has gone from 3.92 down to 1.3....hurrah!! I know that it will take a year or two to really bottom out. I am real pleased with 1.3.
As far as after effects from Cyberknife.....NONE!! I feel great...all the parts are working. Time will tell but right now I am very satisfied with the whole Cyberknife process and outcome.
I will post after the next PSA.
Sept 2010 and I had a 6 month post CyberKnife PSA test. It went from 1.3 to 1.8. I have not seen my doctor yet but from what I read this is called "bounce" and can be expected for a couple years. I will see him in November when I get back to Florida.
So far no post CyberKnife problems.
I had a PSA done in November as part of my VA physical. PSA came back as 1.99.
Talked to the doctors and they are still not concerned.
About three weeks ago the radiation proctitis kicked in with rectal bleeding. I started taking a stool softener and stopped taking my daily dose of aspirin and the bleeding is under control.
I have more blood work scheduled in March so will get an updated PSA.
My PSA, 2 years post cyberknife, is 0.361. I had a DRE May of 2012 and there were no symptoms of any tumor. I feel great and would recommend cyberknife as a non invasive treatment that works. I have no side effects. I will get another PSA in a year.
Life has been good 6 years after Cyberknife radiation. I would recommend it to anyone.
Frank's e-mail address is: firstname.lastname@example.org