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BRONZE

Bram V and Trudi live in Netherlands. He was 65 when he was diagnosed February 11, 2008. His initial PSA was 7,5 ng/ml, his Gleason Score was 3+3 =6 and he was staged T1c. His choice of treatment was Active Surveillance. Here is his story.

 THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2011 SO THERE IS NO UPDATE.

After no longer being able to fight the pressure of my loved ones to do a medical check-up, I went to the "Andros Mannenkliniek" in Arnhem, Netherlands in November, 2007. This institute specializes in diagnostics and advice for the "aging male". I did not have any health complaints; I have none now either. The blood tests showed an elevated cholesterol, liver functions slightly too low, and a PSA of 7.5 ng/ml. My weight (95 kg) was too high at a height of 1,87 m. DRE (Digital Rectal Examination) showed my prostate slightly enlarged but otherwise benign.

I decided to do something about the cholesterol, the liver and the weight by removing saturated fatty acids from my diet, eating less and better, stopping drinking alcohol altogether, and walking/biking an hour a day, minimum. So, after 3 months, my weight is 85 kg, my liver ok and my cholesterol still as high as before. As to the PSA, the urologist proposed a biopsy, which I postponed, for holiday-related reasons, to the end of January. When it was done, I had some bad luck because the needle gun broke down during the procedure. At the end of the day, after a new gun had been collected, the procedure was repeated. Twelve samples were taken. TRUS did not show any abnormalities.

I must say that, although the side effects of the biopsy are said to be almost non-existent in all leaflets issued to patients in Dutch hospitals, reality is quite different. Especially the blood in the sperm afterwards ("it is possible that there may be some blood in your sperm"), was quite a scare. My first sample, luckily provided by means of self service, showed to be black. Afterwards I was told that this is quite normal and will continue to be so for 6-8 weeks, gradually returning to normal. So I wonder why it is not told beforehand.

Anyway, the biopsy showed some cancer, which placed me in the T1c category with Gleason Score 3+3=6. Between blood tests and final diagnosis I studied the subject intensively. This site helped enormously and I recommend it to everybody as THE starting point in the study of this fascinating disease. So, when the urologist proposed "watchful waiting", I agreed immediately, this being my preferred option, after having read about the suspected overtreatment and the resulting loss in quality of life that has been going on in the group of PCa patients in my category. I must say that I have no problem with the presence of some cancer in my body.

I will be checked from now on every three months. I know that the cancer will not go away and probably will grow so that someday treatment will be necessary. So I'll continue studying the subject, gather information on pros and cons of the various treatments and the best places to get them in the Netherlands and Europe. I will also study dietary considerations and vitamins/trace elements, and so on. Whatever the future will bring, me being a scientist, study is my way to cope. I'll keep you posted.

 

UPDATED

July 2008

 

 

My PSA was measured again in April and showed an increase from 7.5 to 8.2, which quite scared me. Something was growing, apparently. But when my PSA was checked again, on July 15, it was 6.8, even lower than the value at diagnosis. I can only guess as to the reason for this decrease but it makes me happy anyway. This is what I do since diagnosis:

I live as healthy as possible, no animal fat, lots of fat fish, bake my own bread from biological constituents. Little, and only biological meat, no milk, a lot of soy milk, without added calcium. In general, I try to eat only biologically produced food. I take daily 2 capsules Saw Palmetto Berries (Solgar), 20 mg Lycopene, 30 mg Vitamin E, 50 microgram Selenium, Multivitamins, Fishoil capsules, 1 gramme Vitamin C. All this stuff is suggested in the literature as being beneficial to the health of the prostate. It's certainly not scientifically proven but what the heck.... I exercise (bicycle) at least 5 hours a week, try to sleep 8 hours a day, and try to forget I have prostate cancer.

The next three month I have a PSA holiday.

 

UPDATED

August 2009

 

 

All went well until November 2008. Then my PSA appeared to be 11. because I did not want to decide on a treatment on basis of a single PSA measurement, I did repeat it 3 weeks later. Then it had become 16. So I decided that something had to be done.

On the basis of a lot of reading I did before action became necessary, I decided to go for external radiation, in particular for Tomotherapy. The only place in the Netherlands whre Tomotherapy is available is Deventer. There, they advised to do a combination of Tomotherapy and brachytherapy, my cancer being quite aggressive.

I started with 4 months anti-hormone therapy (Casodex 50 twice a day). Then in April I had 25 sessions of Tomotherapy, totalling 50Gy, followed in May by the implantation of 67 I-125 seeds.

In hindsight, I think the Casodex was the heaviest part. It changed my life quite a lot, being slightly depressive, growing breasts, not being myself. When I stopped, after brachytherapy, this changed although my breasts are still hurting.

The situation now is:

Frequent urination, especially at night which I try to control with Tamsulosine.

No incontinence, no impotence, dry orgasms.

Low energy level but improving steadily.

As to the effectiveness of my treatment, I have no idea. PSA will be measured two weeks from now but my urologist told me that it takes quite some time to approach nadir, sometimes even a year. I'll keep you updated.