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Sudhanshu Gour and Neelum live in Mumbai, India. He was 56 when he was diagnosed in December, 2008. His initial PSA was 377.0 ng/ml, his Gleason Score was 4+4=8 and he was staged T3N0M0 . His choice of treatment was hormone therapy - ADT (Androgen Deprivation Therapy) plus EBRT (External Beam Radiation Treatment). Here is his story.

From around April, 2008 I had been experiencing restrained urine flow and had to get up 3/4 times at night to pee. However, in spite of my GPs advice, postponed PSA testing till December 2008. PSA reading was 377.0.

Consulted Urologist. DRE (Digital Rectal Examination) and Biopsy done. 6 cores - all tested positive. Adenocarcinoma prostate Gleason Score 4+4=8.

Consulted Dr H B Tongaonkar, Uro-oncologist at Tata Memorial hospital Mumbai. On his advice CT scan was done which confirmed tumour in both lobes of superior part of prostate with periprostatic fat stranding. Prostate 55gms with capsule intact. Bone scan also carried out which was clear. Chest x-ray also clear.

Dr Tongaonkar advised me that my PSA was very high and CT/bone scans often fail to capture microscopic metastatic spread. He ruled out surgery and suggested hormone therapy and radiation therapy. I agreed. I was given Bicalutamide (marketed as Casodex, Cosudex, Calutide, Kalumid) 50mg (one tablet daily) for 2 months. On the day Bicalutamide was started I was also given Eligard 45mg injection, which is a six monthly injection, and I have been told to have them for 3 years.

After the injection I was referred to the Radiation oncologist Dr B G Goswami at Jaslok Hospital Mumbai. Prescribed 74Gy (37 sessions of 2Gy - reducing fields) Yesterday i.e. April 28, 2009 I completed 22 sessions. Dr Goswami also did a CT scan for planning as well as an MRI. MRI confirmed involvement of both seminal vesicles. I forgot to mention that I was staged as T3N0M0 I have a lot to share about side effects and my internet study and diet experiments. But today I am only posting all facts. In my next post I shall elaborate in detail.

 

UPDATED

June 2009

 

 

I'm coming back after a long time.

My 37 radiation sessions were over on 20th May. No serious problems. Yes, intense burning and struggle whilst urinating. Started after 10/12 days of radiation and intensified during the balance period. I am 22 days past the radiation and can feel the intensity of burning reducing. Have to take a URIMAX 0.4mg every 2nd or 3rd day when the flow begins to get blocked.

The good news is that from a PSA of 377.0, I have dropped down to 0.864. Have to see the doctor now in 1st week of July for my second shot of ELIGARD 45mg This drop in PSA, it is my belief, has been partly due to diet and lifestyle changes and mentor George Hardy's initial advice.

I have been completely off dairy products and red meat. Maybe once a week I've had small portions of fish/poultry.

I get up at 6am. Half an hour of pranayama [breathing exercises].then I extract my vegetable juice. One bottle gourd, 10/12 carrots,2 beets,2/3 cucumbers, a 1 inch piece of ginger,4/5 cloves garlic, a 1 inch piece of turmeric and any other veg I can lay my hands on. I get about 6/7 glasses of juice. Breakfast [which follows 20 minutes of yoga] consists of 2 toasts [brown bread] well layered with tomato sauce and 3 glasses of vegetable juice.[The balance juice is put in the fridge in an airtight jar]

I am in my office at 9.30am and start the day with a cup of green tea. Till lunchtime I have 3/4 cups of green tea For lunch I have about 2/3 tablespoons rice with lots of vegetables and lentils followed by a fruit Evening, on return from office I have a cup of soy milk fortified with flax oil and soy protein powder along with any seasonal fruit.

I look forward to evening. My 3 pegs of whisky are diluted with the veg juice and a dash of apple cider vinegar/aloe vera juice. Dinner consists of 2 small chapattis with vegetables and daal. I sleep by 10pm. After radiation ended my getting up at night to pee is also much reduced- maybe once/twice I will come back and post more later I really wanted to share what is stated above because I give it some credit for my not suffering much during radiation and also for the huge drop in PSA.

 

UPDATED

July 2010

 

 

Sorry for not updating for so long.

My PSA readings have been as follows so far:-

May 25, 2009 - 0.864

September 1, 2009 - 0.866

Janaury 1, 2010 - 0.941

April 2, 2010 - 0.584

July 9, 2010 - 0.350

I have been on six monthly injection of Eligard 45 so far and this month my doctor changed it to Lupride 22.5 which shall be a 3 monthly injection. Surprisingly, I have not had any significant side effects.The hot flushes are there but so mild that most of the time I dont notice them at all. No gaenaecomastia at all. Only mild nausea/ vomiting 2 to 3 times a month-- that too only in the morning.

When PSA had risen slightly to 0.941 on January 1, 2010, my doctor had got serum testesterone checked and it was below 10. So no change in line of treatment. Also an ultrasonography of the abdomen on January 7, 2010 showed post void residual urine as 40cc. Hence prescribed Urimax 0.4mg one every morning. Was hospitalised for 3 days in June 2009 because urination had completely stopped and was in pain because of a full bladder. It was UTI (Urinart Tract Infection). I now have a tendency to develop UTI so take two teaspoons of either Alkasol or Citralka every morning for alkalisation.

Meanwhile I continue with turmeric and a lot of cooked tomatoes everyday. Also Fish quite often. Was saddled with a lot of work at my workplace. Have been working hard and travelling a lot too. I think it helps to keep one mentally strong and positive.Yes, I have not compromised on my 3 to 4 pegs of whisky every evening. I enjoy them thoroughly. Had thought of switching to red wine for its known beneficial effects, but I love my whisky too much.

Am surprised to see how in some countries it is so difficult and time consuming to get an appointment with a good Oncologist/Radiologist. Here in India, especially in Tata Memorial Hospital Mumbai,one can see any doctor of his choice within 2/3 days, and whilst we are charged, the poor are treated free. Whilst I was paying for my radiation/Eligard, very poor patients were getting free treatment sponsored by the government. Even I was paying about tw othirds of the MRP of Eligard because manufacturers have to supply to TATA MEMORIAL at highly discounted rates as per government policy. So far so good. Shall keep everyone posted.

 

UPDATED

November 2011

 

Have not updated for a long time.

Have been on either 6 monthly Eligard 45mg or 3 monthly Lupride 22.5mg since last posting. I suspect whichever was readily available in the hospital was prescribed and given

My PSA chart since my last post is as below:

October 15, 2010 - 0.281

January 24, 2011 - 0.392

April 24, 2011 - 1.330

July 25, 2011 - 0.318

October 12, 2011 - 0.483

Thus have completed 3 years of hormone therapy and was last examined by the doctor on October 18, 2011. He said I am quite asymptomatic and no further Eligard is required. Instead of 3 monthly checkups, I am now to have six monthly PSA tests and checkups.

Side effects are nil now except that I have put on a lot of weight since I last posted. Almost 10 kgs. Also there is a lot of muscle wasted, replaced by flab. However, I retire from service in February 2012 and plan thereafter to concentrate on exercise, weight-loss, yoga, and pranayam for regaining fitness. It had not been possible so far because of excessive travelling and work pressure. With time passing and getting used to my condition, I have often cheated on my diet and still have my daily quota of whisky.

I have recently met someone who was diagnosed in 2006 with a PSA of 4,200 and GS 9. Although he has been on ADT since then, he credits homeopathy for his wellbeing which he was doing simultaneously. His PSA for last 2 years has been hovering between 1 and 1.5. How different each one's experience is.

Shall now post after next PSA and consultation in April 2012 .

Sudhanshu's e-mail address is: sblgour@rediffmail.com