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Jake Hannam and Paula live in Maryland, United States. He was 56 when he was diagnosed on March 15, 2010. His initial PSA was 5.98 ng/ml, his Gleason Score was 8 and although he does not know his staging, it seems likely he was staged T1c. His choice of treatment was Focal cryotherapy. Here is his story.

My PSA readings went from just over 1.0 in 2006 to 5.98 in December 2009 so my primary doctor recommended I visit a urologist. The urologist (Dr. Stephan Werner) did a DRE and found some enlargement but no suspicious lumps or hardness. He initially thought it was prostatitis and gave me an antibiotic.

A subsequent total and free PSA test showed the reading down to 5.3 but not enough to satisfy him. So, he recommended a biopsy which was done on 5 March 2010. He told me on 15 March that I had some Gleason 6 (40 percent) and some Gleason 8 (3 percent) on the right side. He took 18 samples during the biopsy. His concern, of course, was the Gleason 8 and suggested aggressive treatment (e.g. radical prostatectomy) but was willing to consider all other alternatives. Next step was a nuclear bone scan (no metastasis) and an MRI (confirmed suspicious areas). Since I had been considering radiation as my therapy, he performed a cystoscopy to see the extent of urinary constriction. Based on his findings, he said radiation would NOT be a good option for me because it would probably aggravate the constrictions and might require some preliminary procedures (TURP, TUNA) and possible hormone treatment. We agreed radiation was not the way to go for me.

Because of my interest in preserving some chance at future potency, we began discussing focal cryotherapy to treat the right side only. He informed me it was still investigational but he thought it a feasible alternative. I also liked the idea that it was out-patient and required less hospitalization and recovery than RP. Due to my age (56) and existing heart issues (mitral valve prolapse and left branch bundle block), I needed to get a cardiac clearance by taking a nuclear stress test and echocardiogram. This scared me more than the cancer so I balked for about a month but eventually realised I had no choice. Radiation was not an alternative for me and hormone-therapy has a number of health risks I preferred not to take. So, I took the tests (not so bad after all) and got clearance from the cardiologist.

I had my focal cryotherapy on 13 July 2010 at Doctor's Hospital in Lanham, MD. At present (18 July 2010) I am in the process of recuperating. I am on a subra-pubic catheter and pain meds as needed. I still have dark and occasionally bloody urine but the biggest issue right now is the bladder spasms. I have some rectal soreness but it is not bad.

All in all, I think I am well on the way to post-operative recuperation and I think everything is as expected. I have an appointment with the urologist on the 21st and I hope he will remove the catheter at that point. Only time will tell whether the focal cryotherapy got the cancer completely (there is a risk that some cancers can be missed with sub-total ablation). I am hoping to regain normal urine flow after my prostate and urethra heal and I am hopeful, in the long-term, to retain my potency. I know there are no guarantees but the potency issue was my main reason for selecting the focal cryotherapy in the first place.

 

UPDATED

November 2010

 

 

Jake sent in a very brief update. His PSA is 2.2 and he has his checked every three months. He makes no mention of potency or continence issues.

 

UPDATED

February 2011

 

 

I am a little bit concerned because my latest PSA (January 2011) has increased to 2.9 from 2.2 (October 2010). Urologist says he is not too concerned but did say that if it went up again in 3 months that I will need another biopsy. Ugh! He says he does not know what a "normal" PSA should be for someone who has had half of the prostate removed.

ED is still hit-and-miss using Viagra (sometimes it works, sometimes it doesn't).

No incontinence.

 

UPDATED

May 2011

 

Awaiting visit to urologist on 23 May 2011 to discuss rising PSA (2.2 to 2.9 to 4.4)

My PSA on 7 May 2011 (10 months after focal cryotherapy) was 4.4. Percent free was 20 percent. I am very concerned that the PC has returned and am dreading the thought of another battery of tests (biopsy, bone scan, nuclear cardiac stress test, etc.) and, of course, the next PC treatment.

Focal cryotherapy (right) - 13 July 2010

PSA: July 2010 - 7.98 (pre cryotherapy)

September 2010 - 2.2

February 2011 - 2.9

May 2011 - 4.4 (20 percent free).

Jake's e-mail address is: jake.hannam@verizon.net