My family doctor scheduled me for a Summer 2004 physical. It was my first in ten years...almost as long since I had seen him.
My PSA came in a bit high so it was repeated, and increased slightly from 3.2 to 3.4. I was prompted to see a urologist, who examined me (no lumps). My PSA test through him was up to 3.8. I had no symptoms whatsoever.
Three months later, PSA was at 7.7. I scheduled a biopsy, with cancer found in one quadrant. I chose to have an open prostatectomy.
I am a professor, but out of ignorance put off the operation till Thanksgiving break (six weeks later). At the time of the operation my PSA had reached 17. I had cancer in two quadrants, cancer at the margins, but not escaping the capsule. [It is unfortunate that Robert does not give any details of his Gleason Grades here, or in his diagnostic description. That is the most important item in trying to establish the aggressiveness of the disease. PSA levels are less accurate on their own because they can be affected by many other causes - see PSA 101.]
Post-op, I had testicles the size of grapefruit! That took a few days to resolve itself. On my day of release, I was encouraged to walk a bit, before my Foley bag was removed. Exhausted, I cut my walk short and made it back to the room. Luckily, a nurse came in for a regular vitals check: Heart Rate 170, BP 65/50. No pain, but both lungs blocked, one almost totally, due to a "cascade" of pulmonary embolisms. I survived, with a healthy heart of a bike riding addict. But, an extra 3 weeks in the hospital as the steadied the anti-clotting medication.
Standard course for a while. PSA down to immeasurable. After three months, I was off the anti-clotting medication as well.
Then 18 months later, my PSA started to rise at the same 3 month doubling rate. When it hit 0.42, I scheduled myself for SRT (Salvage Radiation Therapy) [my urologist opposed it]. Standard 39 treatments, with no side effects (rode my bike the 6.7 miles for the treatments). Standard post-SRT success: gradual decline of PSA to 0.01 or immeasurable.
In late 2008, my PSA went to 0.02, then three months later to 0.04, then 0.07. I was scared. And HT (Hormone Therapy) - ADT (Androgen Deprivation Therapy) seemed on the horizon. Then it dropped to 0.04. then hovered between 0.02 and 0.01. [This series of results seem to highlight sme of the issues with Ultrasensitive PSA tests]
In 2011, I jumped from a PSA reading to 0.02 to 0.04...then three months later to 0.08 (October 2011).
Now, December 2011, I am at PSA of 0.04!
I had three episodes, post SRT, of urinary tract blockage, a series that was resolved with an antibiotic given in Thailand. Two years of "No Problem". No leakage, etc.
Then, Fall, 2011, I was experiencing pain and a little blood in the urine, and a very weak stream. The strictures were back! The second cystitis and urine analysis showed an E.Coli infection, which antibiotics cleared up quickly. [This seems to coincide with the high PSA result mentioned above 0.08 (October 2011). It seems likely the two events were related.]
That stricture problem has left me with mild leakage (a damp pad daily). I use Viagra, or its Indian clone, Kanmagra-gel. Generally no problems there.
I will note that I was dysfunctional for a few month during this last "bump" in PSA. Reasons: chemical or psychological, or a combination. A week or so back that problem was erased, so to speak and with a Viagra dose, and starting the day after the leakage problem was gone too.
SO, I am now almost exactly seven years post-op and alive. I have no doubt that with a three month doubling rate, I would have been a goner, had not my family doctor scheduled me for a physical.
I continue to experience weak urine flow and minor leakage. There has been no blockages in the tract and my PSA remains below 0.05 with variations. My urologist and I agreed that surgery to remove they tract's scar tissue is possible, but with a possibility that I would lose most urinary control as a side effect, we've agreed to "hold steady."
It takes me about six extra minutes per day to pee. Oh well...
As a salvage radiation side-effect, I suffered scarring at the bladder/urinary tube boundary. Over a two-year period, it was serious for a couple of ER room vists (catheter inserted...problem fixed till the next time). (2012-13)
Then I had an extended period of low flow/dribbling. My urologist suggested two paths: surgery (not recommended) or a 3 month period of self catheterization (3x/week, 2x/week, 1x/week.) At the end, full flow back, without surgery. I am now 3 months free of self catheterization, and no flow decrease.
Self-catheterization was psychologically difficult the first coupla' times. Then, it was a routine as morning coffee. No pain at the first, middle, or last few times.
Intermittent self catheterization about 1x/week. I have found the brand Coloplast to be best for me. #28484 "J" end. Size 14 or 16 (14/16mm).
By the way, the intermittent self catheterization is with a 5.3 mm Coloplast (J tip) not 11/14 mm (OMG).
~12 years since radical prostatectomy, followed by "salvage radiation." I stopped in in October 2015 to see the doctor who performed the radiation treatment. We talked a bit about my urologist's being opposed to the treatment, even though my PSA was climbing at the same rate (doubling every three months) and was at 4-5 just before radiation. He explained that about 2010, the urologists and the radiologists got together and issued a joint statement recommending such treatment in cases where PSA is climbing again.
Now 70 yo using Viagra and self intermittent catheterization 1-2x/week. Tested 2x/year PSA.