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Joel Nowak and Wendy live in New York, USA. He was 50 when he was diagnosed in August 2001. His initial PSA was 7.3 ng/ml, his Gleason Score was 4+3 = 7 and he was staged T2bNoMx. His choice of treatment was Laparascopic Surgery. Here is his story:

I was Diagnosed at the tender age of 50 years. I always knew that I would get Prostate Cancer as my father had it; his only brother died from it; my paternal grandfather and his father died of "prostate problems." Needless to say I started monitoring my PSA at about age 40.

I decided to go the route of Laparascopic surgery, however at that time this procedure was relatively new in the U.S. I live in New York City (Brooklyn) which had just experienced the 9-11 and so it was extremely difficult to move around the city and very difficult to get appointments with doctors. I was able to identify a few surgeons who had been trained in the procedure, however none of them had performed the surgery more then 10 times. This was not acceptable.

I did finally find a surgeon who had just left Worcester Medical Center (Ma.) and started a practice at Mass General Hospital in Boston. I was his 96th surgery.

I continued PSA monitoring which was always undetectable. Then in January of 2006 my PSA jumped up to a high of 87.9 ng/ml with a doubling time of under two weeks!!! I had a complete battery of scans and tests including an MRI and bone scan. The bone scan was negative, but the MRI showed that I had micro-mets in the lymph nodes and it also showed a tumor of over 10 cm in my left Kidney.

I was referred to a Kidney specialist who removed the Kidney. I was now a triple Cancer guy; recurrent PC, Kidney Cancer and Thyroid Cancer (dx in the summer of 1998).

Because of the significant PSA velocity I started Hormone Blockade while still hospitalized from the kidney surgery. My PSA tumbled as quickly as it had doubled and soon the PSA was back to being undetectable.

I stayed on the blockade for about eight months and then elected to go take a vacation. I have now been off the blockade for four months. My PSA still remains undetectable.

I will add that I was one of those guys who had every possible side effect, plus some I invented, from the HB. Being off of the blockade has really made a major QOL improvment. It is only now I realize how terrible I had been feeling.

 

UPDATED

December 2007

 

 

I have just completed my first year of being intermittent. My PSA remains <0.04 and am feeling very well. I pray for the PSA to stay down for a long time.

 

UPDATED

August 2008

 

 

In March 0f 2008 my PSA again began to increase - it is now 0.11 ng/ml. It is doubling in 4.2 months, a similar velocity as when I had the initial recurrence. Additionally, some of my kidney functions are beginning to decrease. I am arranging to see a nephrologist to figure out if I can do anything to slow the decline.

In the mean time I continue to write my blog at and monitor the PSA rise.

 

UPDATED

December 2009

 

 

Joel reports a PSA of 0.58 ng/ml but makes no other comment.

 

UPDATED

March 2011

 

PSA climbed to 4.46, so in February of 2011 I started Casodex and added Degarelix (GnRH antagonists) in the beginning of March 2011. I elected to try Degareix instead of returning to Lupron to hopefully avoid the horrendous negative side effects that I experienced.

I was aware that by day two I was either castrate or well on my way as I began to experience warm flushes and a rare hot flash. The flushes and an occasional flash continue, but I have not yet experienced the severe problems I had with Lupron. I did have some neuropathy in my hands when I initially started the Casodex, but it is rare and tolerable.

The one concerning issue I have experienced with the Degarelix is an injection site problem. Initially, a loading dose is given which involves two separate injections of 120 mg each and then one injection of 120 mg every 28 days. I developed both two lumps under the skin (a commonly reported side effect) along with a painful and very red band across my entire belly. My doctor put me on an antibiotic which has calmed down the color and the sensitivity of my belly.

Joel's e-mail address is: JoelTNowak@gmail.com