My story is in it's infancy, having just learned of my problem. I have had PSA tests with some regularity for the past several years. Results: have been '96---3.0; '98---4.5; '00---6.5; '02---8.0. Digital exams have not been performed during this period but, in any event, reveal little, if any, abnormality now. Only symptom experienced was having to get up a couple of times during the night which I attrituted to advancing age.
Because of my elevated PSA, my Family Doctor arranged an appointment with a Urologist who, following ultrasound & 6 sample biopsy, advises there is a low grade T1 cancer present. Surgery is not an option because of my previous major medical procedures(Aorta/Bifemoral bipass as well as left femoral popiteal bipass).
I am now awaiting an appointment at the Cancer Clinic for further assessment & advice on future treatment.
I am very greatful for the availability of the information on this web site.
John now has a PSA of 9.9 ng/ml. He was undecided initially but has elected to begin Brachytherapy
His updated story:
Today's trip to the Cancer Clinic and a PSA of 9.9 ng/ml (up from 8.0 ng/ml in August)helped to make the decision to receive treatment now. As mentioned earlier, previous major operations precluded surgery and, for much the same reason, external radiation was not considered appropriate by the Radiation Oncologist. With the PSA rising rapidly,Watchful Waiting was considered somewhat risky since the protocol here eliminates the Brachytherpy option when the PSA exceeds 15 ng/ml.
Hormonal therapy was started today and will continue for 90 days during which time it is expected the prostate will return to near normal size and can then be permanently implanted with radioactive Iodine sources.
While the results remain to be experienced, it's as well to have the decision behind me.
John's PSA is now 0.24 ng/ml. He originally chose Brachytherapy but continues with hormone therapy.
In February 2003 I attended Cancer Clinic & Radiation Oncologist. They did an Ultra-Sound examination to learn the prostate, despite expected high probabilities, had not shrunk to an acceptable size to allow radioactive implantation. The Clinic's protocol is a maximum volume of 50cc in order to qualify for Brachytherapy. My measurement was 70cc. Ordinarily they would look to alternative treatment such as external radiation, however, having regard for extensive vascular bi-passes in the groin area already in place, radiation or surgery are not considered as options.
In the circumstances, hormone therapy will be continued for another 3 months in the hope of better results. Unfortunately experience with this approach has only a 25% probability. The good news is that my PSA has come down from 9.9 ng/ml to 0.24 ng/ml.
John is now 71 and his PSA is 0.13 ng/ml.
Here is his update:
Great news ....attended Cancer Clinic May 14th and learned prostate volume had been reduced to 55ccs and that it was now possible to do the Brachytherapy procedure.
This was performed without difficulty on June 26th under local anaesthetic. Took about 90 minutes followed by 3 hours in recovery after which I was allowed to go home.
Next day I was able to resume all normal activities and experienced no discomfort or pain at all. In the following 2 weeks I had some difficulty with urination at night. This was alleviated by increasing the Hytrin medication from 5 to 10mgs. CT Scan will be done July 25th followed by lab work, X-rays and discussion with the Oncologst on August 7th.
I need not say the results so far have been beyond every hope and expectation.
I attended the Cancer Clinic on August 7 2003 and received a generally excellent report.
PSA was at <0.02 which, in the Clinic's terms, is "imperceptible". Doctor suggested I experiment with adjusted doses of Flomax varing the amount between .4 & .8 mgs per day and also the time from morning to evening in an effort to improve urination flow.
Over the ensuing months all symptoms have gradually improved to a point, where, I now only experence occasional hot flushes/sweats, usually in the evening while nocturnal urination is has improved to about every 2 hours. Have no related problems during the day. Discontinued Flomax January 25 2003 without adverse affect.
It is now 8 months post Brachytherapy--attended the Cancer Clinic February 20 2004 and Oncologist advises recovery is as anticipated--results thus far are good. PSA is <0.02 & DRE indicates satisfactory progress. Minor symptoms of occasional hot flushes/sweats as well as nocturnal urination frequency should improve as testosterone production increases in the weeks ahead. Will have next PSA test in 6 months.
What was a worrisome health problem seems to have been left behind for which I'm most grateful.
It is now 14 months since 147 radioactive seeds were implanted and treatment has met every hope and expectation.
PSA continues to be imperceptable at less than <0.02 ng/ml and, all in in all, there is little in the way of complaint. Testosterone level remains low so continue to have ocasional sweats mostly in the evening. Additionally, urination frequency at night is about every 2 hours and flow tends to be slow. All are considered minor inconveniences. I'm advised this should improve with time but, even if it doesn't, I'm very grateful at this stage of my recovery.
Some 20 months after having had seed implants, my DRE is 'normal' and the PSA continues to be low and stable. Testosterone levels are once again satisfactory and, apart from a somewhat restricted urine flow, all is well. I still have reduced capacity and find it necessary to use the facilities fairly often particularly at night---as often as every 2-3 hours. While a bit of a nusiance it's something I'm glad to be able to report!
The Doctor feels reasonably certain I'm now cancer free but will continue to monitor me every 6 months.
SADLY JOHN PASSED AWAY IN APRIL 2005 AFTER BEING DIAGNOSED WITH PANCREATIC CANCER IN MARCH 2005. THE SPECIALISTS ASSURED HIM THAT THE TWO DISEASES WERE NOT CONNECTED IN ANY WAY.