I live in Cairns with my current partner and long time friend of 20 something years, I won't say it has been easy for either of us, but this is my story.
I have a family history of PCa the most recent being an older brother picked up at 57 with a PSA of 9 and a Gleason score of 9, stage T3B. He opted for prostatectomy with the removal of the fat surrounding the prostate where the cancer had escaped to. Now 5 years later with annual PSA checks he is doing very well. He was and is considerably fitter than I.
The reason I have included a precis of his story is to show that many there are many reasons for opting for different types of treatment. At the time of my initial contact with the urologist I was 125kg down from 135kg, with a history of an operation to save my right foot after a car accident. The anesthetist from that op told me that there had been dramas waking me after the surgery and suggest that I try and avoid that in future. Hence my choices.
I only had 2 choices after the Gleason score and the stage results were considered (PSA 3.4 Dec 2010,4.3 Nov 2011, 4.8 May 2012, and 7.8 in August 2012). They were surgery or EBRT (External Beam Radiation Therapy). With the consideration of surgery out the choice was EBRT. The radiation oncologist I am seeing lifted this choice by including ADT (Androgen Deprivation Therapy - Eligard).
I started with the ADT (Eligard) on the 8/1/2013 while they worked out the appointments for the rest. My Oncologist arranged a MRI to see if there was any signs of spread, occurred on the 8/3/2013, result negative. Monday 11/3/2013 blood tests then on the Wed start taking antibiotics before another TRUS Biopsy for the insertion of gold seeds on the prostate. This makes it easier for them to be 100% accurate in lining up the target prostate (their word not mine), zero% error factor allowed. Prostate volume at this time was 16.5cc, with an apex distance of 11mm.
Planning day arrived on 21/3/2013 where they permanently mark 4 spots to line up your body for treatment (with crosshairs of the ceiling), also taking a cast of the feet and legs to place the body in a precise position for treatment.
Treatment is 8 weeks, 5 days a week, of six bursts of radiation from different angles aimed to miss vital organs and bones. The set up takes as long as the treatment with most days being over in about 30 minutes including disrobing and dressing at the finish.
I am currently in week six of treatment and have started 2nd 3 month course of Eligard (ADT) very few side effects to me with probably the most noticeable being the slowing of urine from its normal high volume to a sedate flow rate necessitating approx a 40sec stop at the urinal.
I consider myself very lucky to be in Cairns as I only moved here for work 6 yrs ago with the ROQ in Cairns only being finished 2 yrs ago, I was in a rural situation previously, with long trips involved to receive this treatment. So if I have to have PCa this is the place to be:-) Cheers Al
Just an update to say that I have finished the EBRT radiation therapy and after all the talk about possible complications I was "lucky" to have none. I am continuing ADT at this time the second round of ADT last till the end of July. I am having further discussions with my radiation oncologist early in July as she wants me to continue ADT for a further two and a half years. The idea being that this will annihilated any possible free radical cancer cells still floating around in my body. I have concerns about this as I am still working in a very active job including climbing towers and working on high voltage equipment and I feel that any drop in mental alertness is a problem for me.
The extra time spent on ADT will lift my chance of survival from 40% to 50% according to my doctor so I will probably hang in there with the treatment at this stage.
Almost a month ago July 2013 I had my ADT changed to Zoladex as I believed that it was the Eliguard was causing my ability to think clearly and quickly to suffer. I believe that I am already starting to recover these skills for which I am very thankful as it is important in my job. Will see what it brings in the future as alternative side effects. My last PSA test was in April, I have had another one at the change of ADT(July) but have not received the results yet.
I had concerns about my cognitive skills with my job and so when I saw my doctor we agreed to change from Eliguard to Zoladexsome 3 months later I have just started my second course of Zoladex as I have not got problems with my brain now. I have however got NO libido at all, a factor affecting my partner more than myself, but we are trying to work thru that. So be very aware that whatever course you take there will be consequences.
I have just last month been for 2nd annual checkup with my radiation oncologist, and it appears that the Zolodex is doing its job and still dropping my PSA; level. So now we continue this for the next 12 months before the hormone treatment ends. I am happy with where I am now but will be much happier when it's all over.
Last month saw a few dramas, the most significant was my redundancy from my job of 7 years, which brought me to Cairns. As a result of this I had my last visit with Lisa, my radiation oncologist in Cairns ROQ. This is because we have decided to move back down south to be closer to our families. The worst part of this is that it means that I will have to visit ROQ Toowoomba in St Vincent Hospital for future follow-ups.
This PSA test (Nov) showed that my PSA had risen marginally from 0.039 to 0.042, but the Oncologist said that even the way that I had been sitting that day could have caused that small a difference, hence no concerns were shown!!!
So now we wait till May for the next round and see what the new ppl are like in Toowoomba!!
After 2 years and 6 months of Hormone therapy (Zoladex) it has been decided by myself and my new Radiation Oncologist in Toowoomba that is enough. With a current PSA of someone half my age I am very pleased to see the end of ADT. Now we wait, not just for future PSA results, but to me the much more important (at present) sexual performance issues and the ability to perform! Will give a better idea of both outcomes after 6 months wait. Until then!!
After having a bone density scan and a further PSA test in the last 6 months I find that I still have a risk of hip damage due to low density (after being a BIG milk drinker ALL my life) and my PSA has risen slightly in accordance with the removal of the Hormone Therapy being stopped 12? months ago?? So I am so happy to see that I am starting to come back to LIFE! I am happy to comment in this way, as I was really worried that I was DOOMED!!
It has been 12 months since my last visit here. During that time I have stopped further visits back to the oncology dept as it is a 3hr30m round trip to be told my PSA results which I can find out on a regular visit to my doc. I am happy to tell you on my visit today that my PSA is STILL very low & combined with other results fo bloodwork, it has been a great day. So if you are looking into using radiation therapy as treatment for your prostate I have to say I am extremely happy. Mind you it's only been 4 years since my radiation treatment has finished but only 2 years since the end of hormone treatment. So we play a waiting game, but in the mean time we LIVE!!
BigAl's e-mail address is: gbc AT halenet.com.au (replace "AT" with "@")