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Hello all, here's my story, hope it will assist in helping others come to terms with their prostate cancer and treatment of this disease. I was in reasonably good health apart from hypertension (high blood pressure which is treated with daily medicine) and was diagnosed with Prostate Cancer in April 2012 after my PSA doubled in 12 months. I was also experiencing urgency and frequency, which had never occurred previously.

To step back a bit, I am an Aussie but live in the US, and have doctors at both ends (which is I guess a kind of a prostate joke), both my docs had done rectal exams and felt nothing unusual, however as I was 55 my doc in Sydney (the good looking one) suggested I have a PSA test. It came back a little high at 4.0. She suggested that when I return to the US I have another, which returned a 3.6. I've gathered since that variation of 10-20% is common in PSA testing. My US doctor wasn't too concerned, but said we needed to keep an eye on it. A year passed, and when back in Australia I had another test, this time it came back at 8.8. My doc said that as soon as I returned to the US I needed to speak to a urologist. My US doc suggested that I first take a course of antibiotics to rule out prostatitis (good move) and then take another PSA test. This one came back at 9.

Now concerned, off to the urologist I went. He did a pretty good job explaining the disease and the various treatment options (he was a surgeon) and let me know that due to the difficult location of the prostate, the only way to confirm the existence or otherwise of cancer was via biopsy. This is a process where 12-15 samples are collected from the prostate via needle biopsy, using a gridlike pattern.

I remember walking into the small room for the procedure and seeing 12 little jars and some bloody long needles sitting on a tray. I thought - they can't be for me, they must have been left over from the last procedure. Nope.

After donning the backless gown and assuming the position, the Doctor administered some local anesthetic and then proceeded to get the samples. Although I couldn't feel the needle going in, each time he snipped off a sample it felt like having a rubber band snapped on a sensitive part of me internally, after 14 of these I was ready to call it quits!

Feeling a bit shaky I went home with my wonderful girlfriend, who had gamely watched all of this. There wasn't too much in the way of side effects- some blood in the urine, but that quickly passed.

The folowing week I received the call from the urologist, three of the cores were found to be cancerous. Although a bit of a shock, I felt surprisingly calm, I guess I kind of knew something was up. He suggested I come in to discuss next steps. He said I was a Gleason 6, a tricky spot for physicians, it's not super urgent to treat but shouldn't be left alone either. He also added that if I was 75 they probably would do nothing, but since I was 55, they really needed to treat.

Having done a fair bit of reading, I felt confident that the urologist in our original discussion had taken a fairly even handed approach to the various options. However in the second meeting it was clear he was strongly recommending robotic surgery as the best way to treat my condition.

I kind of get it. These guys have several million dollars worth of hardware and can't afford to have it sitting idle, and it is an effective treatment with quick recovery time. But I wasn't convinced. I guess I was left thinking of the old saying that when you have a hammer everything looks like a nail.

So off I went in search of options, and after a fair bit of investigation ended up in the hands of Dr Ron Ennis, Director of Radiation Oncology at Roosevelt Hospital in Manhattan, and his excellent team.

Although there may be some post-treatment rationalization at this point, I guess 'felt' rather then knew that I had found someone who would help me through my 'bump in the road'. Dr Ron explained that he had many times worked on working committees made of both surgeons and radiologists, and that he was continually exploring ways to achieve better outcomes for patients. That was what I wanted to hear, someone with a broad overview not necessarily just a method. The following comments are from my treatment diary.

"I have now started my radiation treatment. This consists of 25 rounds of radiologic therapy, known as IMRT. This will be followed shortly thereafter by brachytherapy- the implantation of seeds into the prostate. Today I put a line through treatment No.7 on my wall chart. So far not much to report in the way of side effects, am peeing a bit more than usual but an also drinking more water than usual, so it's hard to tell. Otherwise all seems to be OK. The worst part is the waiting each day. The women seem to want to talk (a lot) and the men just want to sit in silence".

My days at this point consisted of cycling to work, then cycling over to the radiology centre and waiting for my turn, then back to work. I cycled every day (it was summer) and was fortunate to feel none of the side effects, no skin rash, no tireness, and my erections and waterworks still seemed to be functioning as before.

A two week break, then we resume the diary in September 2012.

"Last Friday I had 53 seeds implanted into what remains of my prostate. After the radiation, this procedure completes the treatment of my prostate cancer, hopefully for good. The doctors, nurses and support staff were wonderful and I have nothing but praise for them and a feeling of being very fortunate and grateful for the treatment and care I've received.
In practical terms this part procedure involved me going to Roosevelt Hospital last Friday and meeting with Dr Ennis where we discussed the placement of the seeds. I had asked that as much healthy tissue as possible be spared and that the seeds were placed around the tumours rather than evenly over the entire gland. Ther placement was to be guided by a mix of CAT, MRI and X-ray scans.
I was then taken to a ward to be readied for surgery, met with Dr Weiner (another urologist and surgeon), given an IV line, then wheeled by him into the operating room, where the patient anaesthetist (named Hugh Sharp) put something over my face and the next....
Thing you know I am waking in the recovery ward, feeling OK but very groggy.
After another hour and the best cup of tea I've ever tasted, Amy helped me into a taxi and we headed home.
I should add that this is a newish development of the procedure, but makes sense to me. I have learned over the past months that that there isn't much that is concrete about the treatment of this bewildering disease. So much of the clinical information and research is confounding and conflicting. I think you need to read a lot, get plenty of opinions and then trust your judgement.
Day three today, still peeing a lot, feeling a bit tender around the region and with a little pain when urinating, but back at work and basically feeling pretty good.
Thanks to everyone."

Shortly after this I had to return to Sydney for my daughters 30th birthday, I was a bit uncomfortable and getting up at night a lot, in pain, with a weak stream and I sometimes used to run the shower to get things going. I got used to wearing pads as the urgency is difficult to manage if you are out and about.

On the return journey, my seeds set off some alarm at LAX, despite an explanatory letter from doctor Ennis I had to wait while they scanned my crotch 4-5 times and then had to call a lab for the results.

Not much fun all round, if you can stay at home post-surgery, stay at home!

Jan 2013

Had my PSA test- a wonderful 1.25! All good at this end. My erections are OK, penis seems to look the same, I have used Cialis a few times, but don't always need it. Feels more like enhancement than medicine!

Am taking Flomax twice a day, it certainly helps. Managed my first sleep through the night, what bliss!

Coffee seems to irritate things, so I try to only have one cup per day. Green tea is good.

Am keeping up my exercise routine, trying to walk 10000 steps per day and not use the elevators at work.

Feb 2013

Reduced Flomax to once per day, still getting up during the night, ususally just once, sometimes not till the morning. There's a bit of pain when urinating, it seems to occur near the head of my penis and feels like a vague burining. For some reason I have figured out that air travel seems to irritate my urination, it's like taking a few steps back, maybe it's the continual pressure over the long flights to Australia. I have been 'caught short' a couple of times and pee'd in my pants. I guess this is nromal, not great, but I need to manage the urgency better.

May 2013

Feeling well, have stopped Flomax and have noticed a thinner stream than previously, but am keen to see if it improves by itself as I am reluctant to keep taking medicine if I don't need it. Still have the Cialis, but not using it much as my erections are pretty strong in the morning when I get a good night's sleep. My blood pressure is a bit high a the moment, so will need to watch the salt and step up the exercise. Am doing the Kegel exercises when I remember, I have no idea whether they're helping. Still a bit of pain on urinating, but it's not terrible. Basically I feel great and am still doing all of the things I love.

Hope this helps, hang in there guys!

Rob's e-mail address is: rob.rogers AT sudler.com (replace "AT" with "@")

NOTE: Rob has not updated his story for more than 15 months, so you may not receive any response from him.