WinterSolstice said...
Since my prostate cancer diagnosis in early November 2011, I have been a silent member of this discussion board and have found it tremendously useful. I feel it is only fair that I give back a little and share some of my prostate education.
Thanks to the gentle coaxing from my wife, at age 50, I had my first physical exam in 10 years. The DRE by the GP was negative and he offered that I get a PSA blood test. Coincidently, there had been some anti-PSA testing articles in the news that day, and since I have no cancer symptoms and am in good health, I was very close to refusing. After some discussion, I accepted. I guess passing on the test would have led to a few years of blissful ignorance, but now, after the shock has worn off, knowing is much better. Much respect goes to the doctor.
A week later the GP calls me back with the bad news that my PSA is very elevated at 42. I am at work, so it is very hard to digest this bombshell. I am in shock for the rest of the day. Honestly, I am in shock for the next two weeks. I am referred to an urologist and my real journey begins.
PSA: 47
DRE: slight firmness on right side.
Biopsy:
Right side, 6/6 cores, 80-90%, GS7 (3+4)
Left side, 1/6 cores, 5% volume, GS6 (3+3)
Right side seminal vesicle, 1/1 core, 40% volume, GS7 (3+4), (no definite seminal vesicle identified)
Left side seminal vesicle, negative, (no definite seminal vesicle identified)
Bone scan, negative
CT with contrast, lymph nodes negative, soft tissue mass posterior to prostate, appearing to arise from anterior wall of rectum. Not absolutely sure if this is PCa, but it must assumed to be so.
Discussing the test results with my urologist, I decide upon robotic radical prostatectomy, which will very likely be followed with radiation and hormone therapy, depending on the post operation pathology report. I meet a very capable surgeon with 1200+ robotic surgeries and he is very convincing that de-bulking the cancer with surgery and then following it with all the other available treatments, RT and HT, is the way to go. We schedule the surgery, but he strongly suggests that I meet with a medical oncologist and/or a radiation oncologist.
My wife and I meet with a medical oncologist at the Seattle Cancer Care Alliance and we discuss all the options available. We also discuss a clinical trial which may be available me. This trial includes abiraterone acetate along with the standard HT+EBRT. One of the most frustrating things with prostate cancer is the number of options available and the game of picking your poison. After much reading and soul searching I have decided to join the clinical trial. My decision is not based on the fear of surgery or its side effects. I know there are plenty of possible side effects to go around no matter what the course of treatment. From my test results and the statistics, it seems very likely that the cancer is out of the prostate. It is either in the seminal vesicles or broken the capsule and is pushing against the anterior of the rectum, or both. The CT scan is not definitive and it could be in the lymph nodes as well. So, for my stage of cancer, surgery/EBRT/HT versus EBRT/HT seems close to having the same outcomes. Adding in the new androgen blocker abiraterone to EBRT (Calypso)/HT (Lupron) tips my inclination to the clinical trial.
Wish me luck and thank you all for sharing you experiences here, they have been very helpful.
Good luck and yes this this Forum is a very useful tool......most men just don't want to
openly discuss such personal matters and when you're first dx it can be very a overwhelming feeling......you won't be sorry for becoming a member here!