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Geoff Iverson and MarySue live in Illinois, USA. He was 59 when he was diagnosed in November, 2008. His initial PSA was 3.8 ng/ml, his Gleason Score was 6 and he was staged T1c. His choice of treatment was Active Surveillance. Here is his story.

My PSA had been stable at 3.0 for many years. Then it started to rise slowly to 3.8 over about 3 years. On DRE (Digital Rectal Examination) my Internist thought he felt a nodule and sent me to a Urologist. The urologist felt the nodule was a cyst or something like that and not cancer (it has since disappeared) but decided to do a biopsy anyway. The first biopsy result was PIN (prostatic intraepithelial neoplasia) on a couple of samples. Scheduled a second biopsy four months later.

Second biopsy showed cancer, Gleason (3+3) in 5% of two out of twelve cores. The Urologist spent quite a bit of time with us explaining RRP (Retropubic Radical Prostatectomy) (he was a surgeon). He also referred us to radiological oncologist at Northwest Community Hospital (the same one as Roger C.). We had a good discussion with him and for the first time learned about disease progression and that we had some time. Went ahead and scheduled RRP in January.

Through a series of fortunate events found out about UsToo. My wife and I started to research Prostate cancer and treatments. Met with UsToo and talked about active surveillance. Learned more about AS and decided to cancel surgery and educate ourselves further about options.

We went for second and third opinions. My slides were read by two other pathologists confirming the initial diagnosis with no change in Gleason. I began to research PCa and AS through medical journal articles. The more I read the more AS seemed to be a viable option.

I joined UsToo and continued research. Learned about an AS study at Northbrook hospital. In August 2009 joined the study group and had initial appointment. I am now in the study group and am following the protocol. My PSA has been fluctuating, the latest being 3.01.

I decided on AS in part to avoid the side effects of radical treatment. In reading the literature I came to the conclusion that the incident of side effects is greater than that admitted to by most Urologists. In addition RRP is major surgery and has the risks inherent with surgery.

There are risks with AS. The regular check-ups can be uncomfortable as well as the risk of infection from a biopsy (which I was unlucky enough to experience first hand).

Once diagnosed with this disease, there is no perfect treatment or cure. Any path has risks, side effects and possible adverse outcomes. Each person needs to decided which path is best for them. We have chosen this path and for us it has been the right path. As time goes on and advances are made we may change our direction.

 

UPDATED

May 2011

 

 

It has been a while since I updated my story.

We have been busy with several projects and my Active Surveillence has been going well so far. Since I joined the AS study in 2009, my PSA has flucuated. Right after entry it hit a high of 3.55, then dropped to 2.87. It slowly rose to a high of 3.54 in about a years time, then the last PSA was 2.71.

I have my PSA checked every three months and a DRE every six months. My urologist has not noticed any change in the DRE. I was supposed to have a biopsy at the one year mark in August of 2010 however the protocol had been changed and an annual biopsy was not required. I am supposed to have one this year in August but since my experience with the entry biopsy I am not sure if I will go through with the biopsy.

During the last year there was one event that caused me some concern. The lab had changed the PSA assay method about three tests ago. I questioned my Urologist and wrote to the hospital administrator expressing concern over such a change and my feelings. I had the chance to talk to the head of the lab. He assured me that they had run duplicate assays for 3+ months prior to the change had calibrated the two assay methods. He felt confident the results accross the change were comparable. He also stated that they would not be changing methods for the foreseeable future.

To date things have been going well with the Active Surveillence. I have no plans to change unless there is a significant change in my numbers or recommendation from my Urologist.

Geoff's e-mail address is: eitherofus@gmail.com