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Al Dilger and Rita live in Bakersfield, California, USA. He was diagnosed in April 2008. His initial PSA was 7.0 ng/ml, his Gleason Score was 6 and he was staged T1c. He is undecided as to his choice of treatment. Here is his story.

I need to start treatment soon and am leaning toward hormone but worried that it does not kill cancer only shrinks it Would like feedback from anyone who has been through it.

I was first diagnosed in 2008 because it had been awhile since I had my cholesterol check so I had a physical and had them do a blood test. My PSA showed up at 6.2 - wow!

I was shocked so I had it checked again and it was 7.0. Went on Cipro for two weeks (should have been four weeks) and it went to 5.9. Went to urologist and he said biopsy. Results were 1 out of 12 cores with less than 2% Cancer - Gleason of 6. He actually said " You have cancer we'll do robotic surgery and put you in a penile implant"

I saw another doctor - this time Prostate Oncologist - and he suggested Active Surveillance which I did until March 2010, with Avodart, MRI-S, PCA 3 urine tests and ultra sound all OK, until March when my PSA went from 2.7 to 3.2, 30 days later 3.5, 30 more days 3.59. Oncologist said time for another biopsy, this time 4 cores of 7 with 20-25% cancer Gleason 6 on 1 and 7 (3+4) on the other 3.

All other factors ok DRE (Digital Rectal Examination), ok, PSA Velocity <1, Density 47cc, Cancer less than 35%, PSA < 10 all suggest Active Surveillance except for Gleason score. Its the old " I only missed it by one" So now options are the usual, we narrowed choice to seeds [Brachytherapy] or Hormone therapy [ADT (Androgen Deprivation Therapy)].

I am interested in getting more info on the Temporary seeds [HDR - (High Dosage Radiation Therapy)] , I think I know what I need to know about the permanent seeds, but the Hormone therapy information is all over the place which is frustrating me to no end. I need to find out the truth about it before I proceed.

Hormones shrink but do not kill Cancer [although this is the general belief, there are also numerous individual cases where men in intermittent ADT do not have a recurrence of the disease - one of the interesting examples being Platinum Member Doug Adams] and sounds like after you go through nine months of Menopause it's luck of the draw whether or not your manhood returns. Scary !!! True it is least invasive and unlike the seeds you can stop. Once you do seeds the outcome is irreversible.

 

UPDATED

September 2010

 

 

I went to Seattle visit Dr Grimm for seed implant then went to UCLA to visit Dr Demanes for temp seed HDR . I like UCLA because of proximity to home but Seattle seed treatment is "easier" (if there is such a thing). Two days you go home: HDR you go in hospital two days 3 x treatment over two day period - implant first day and radiation in afternoon; overnite then two radiation treatments morning and afternoon then go home, but return one week later and repeat process (bummer) - that's it.

That's the way I'm going, really liked Dr Demanes, he used to do permanent seeds but switched to HDR. I have MRI scheduled 13 Sept (I'm going to try and change that to this week) then procedure approx last week in Sept

Just had a guy call me about DART treatment do you know anything about that? [DART is an acronym dynamic adaptive radiation therapy a sub-set of EBRT - External Beam Radiation Therapy]

I will keep you posted

Regards for all your time and hard work

Al.

 

UPDATED

November 2010

 

 

Just finished first of two treatments of HDRT at UCLA on November 10 2010. I must return for second next Tuesday - November 16 - and I have to say I am not looking forward to it. It was quite miserable, not the actual procedure but the time in the hospital. I got terribly sick from the pain meds and did not sleep for more than one half hour in two days and the food! What I could manage to get down was sub-standard as well (You figure how bad can juice, fruit cups be)

The procedure was considered a success by the docotr. I had lots of bleeding in bladder (from cystoscopy and catheter) and the removal of the catheter was the most painful part but only momentary.

The jury is out, I am still hopeful I chose the right procedure but if the outcome is no different than the guys who have had the permanent seeds that would be better due to this more invasive procedure. I'll update after next week.

Al's e-mail address is: avdilger@yahoo.com