THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2015 SO THERE IS NO UPDATE.

I'm Barbara, writing for Chris.

Chris is overweight, classified as obese, has an enlarged prostate and had rising PSA levels over the last few years. Two years ago, the doctor prescribed Cipro, Chris took it, and his PSA levels dropped.

When he had a PSA of 7.28 ng/ml, our primary care physician recommended him to a urologist, who decided a biopsy was in order.

The biopsy revealed no cancer in the left side, but 1 of 7 cores in the right side tested positive, with 10% of it being cancer.

We immediately began exploring options and learning things about PC. YANA was a tremendous help to us in that regard.

We'd initially thought that radioactive seeds would be the way to go--quick, less life-disruptive, effective. But the more we learned, the more we realized that it was not the way Chris wanted to go. One of my first cousins has had brachytherapy and is still concerned about his PSA levels when they rise. He didn't want to go through another time of wondering what rising PSA levels meant. And then we found out that a good number surgeons are not willing to operate if the brachytherapy was unsuccessful, so that sealed the decision for us on whether to do radiation therapy or to get an operation.

Our diagnosing physician indicated that he thought laprascopic surgery would be a good protocol for Chris, so we did more research into it. He said that Chris' weight might be an issue, but didn't take it any further at that time and did not say, "Get your butt in gear, buddy, and lose some of that weight." This was toward the end of June. We made an appointment with the surgeon recommended by the urologist--three weeks later we were to have the meeting.

In the meantime, research into monster who had invaded our lives continued. We found out about the results of studies with tomato-sauce and the diet began to shift toward eating at least one tomato-sauce based dishes a day--spaghetti and chili became some of the 'daily breads'. We also increased the consumption of broccoli and other vegetables--red meat disappeared from the diet. I also contacted some of the top-rated hospitals and began to get an inkling that Chris' weight would be a real obstacle for many surgeons doing Chris' preferred type of surgery after talking a person from the Vattikuti Urology Institute who said for his height, 200-210 was about the maximum weight.

The meeting with the surgeon was delayed due to his having to free his schedule to do surgery. We scheduled an appointment with another surgeon--just in case and to get another opinion.

And we restarted exercising on a regular basis. The first two days, we walked in the commuter parking lot where I leave my car for the daily commute to work. As the weather got wretchedly hot, we switched to walking in the pool.

The weight is coming off--just like it should--slowly, but steadily. Last night, we were talking about me having to hem some smaller-sized pants that Chris has.

We met with one surgeon on 12 August and another on 15 August. We found out that each of them had done a high number of Robotic-assisted surgeries and we liked both doctors. They both practice fairly close to home and very convenient to my workplace in Washington DC. We are fortunate in having them nearby. We haven't decided definitely which one will do the surgery but will see one of them later this year and get it scheduled.

If the weight continues to drop, the surgery will be done in January; if it stops falling, then we'll schedule for October. We are going on a two week vacation and hope it is active enough, with restrictions enough on the diet to keep the weight dropping as we have a good time together.

Although we've read a lot about what to expect, talking to the surgeons helped to allay some of our fears. The surgeons felt the waiting a few more months would not change the outcome, but that the weight loss would definitely help. And, with the changes in his diet and exercise regimen, we hope they are right. No looking back, though, and second guessing any of it.

We are hoping for clean margins--I'll put in more info as we progress through this.

We just returned from a 2 week vacation in Ireland. I made a big batch of chili on our return, bought fish and broccoli, so we are eating right.

Chris ate lots of fish with side orders of broccoli and he dropped more weight while in Ireland because we kept on the go from dawn to dusk. He's at 220 now (one pants size smaller) and we are aiming for 190 by mid January. If he continues to progress at the current rate, he will reach that. No matter where he is with his weight, though, the operation will occur then and by spring, he should be well enough for us to open the pool and resume aquatic exercises there. I'll continue to update YANANOW as we get through this.

I know that the next 6 months won't be the 'best' of our lives, but we'll be fine, I think. It's always easier to get through a tough time with someone else to help drag you along. I just hope it's like a big hill with flat areas and downhills on the other side, but we won't know that until after the operation.

Thank you for maintaining the site. I really needed to get more info from the patient's perspective--to learn the negatives on different treatments from the patients--rather than read the same old stuff about radiation therapy and operations written by doctors and others in the medical profession. They somehow left out a lot of the important things and our diagnosing physician didn't hit the details that were essential for making the 'right' decision for us.

Chris is great about researching whatever we need to buy for the family in the way of electronics or vehicles, but seemed reluctant to do research on this subject and left it to me--which is fine as I conduct research as part of my profession so it was not a problem.

I'm Barbara, Chris' wife and I'm updating his story. When initially diagnosed with prostate cancer in June, 2005, Chris' PSA was between 7 and 8. He weighed about 235. A DRE showed an enlarged prostate (as it had for a few years), but nothing else. A biopsy was ordered to 'be on the safe side'. The biopsy showed one core of 14 with about 10% cancer. In some ways, we are both glad that it showed up--if it's there, better to deal with it than to go along in blissful ignorance.

I searched the web for information so we could find the 'best' treatment. I printed reams of paper on different aspects of prostate cancer and we finally decided that laparoscopic surgery was 'the way to go', given the pros and cons of the alternatives.

Much of the information that helped in the decision came from the people who had shared their stories here, on this website. I then went about trying to find the 'best' doctor for the surgery (I'm a researcher by profession, so it was natural for me to do this part, plus he's my partner of 34 years and I'd like to spend at least another 34 with him).

I read about and had some email correspondence with a surgeon in Florida, but Chris didn't want to a) go to Florida for an operation and b) spend the money to go to Florida for the operation. Like many skilled surgeons, the one in Florida does not accept insurance so the fee would have come from our pocket.

We are members of Kaiser Permanente and sometimes there is a wait to see the doctor; when one is diagnosed with cancer, a wait can seem endless. So I persisted in my search and found information about the Vattikuti Urology Institute and called and asked them about Chris becoming a patient. The positives on 'outpatient' surgery just seemed wonderful and their track record was great too. And the surgery price was about half the price of the person in Florida. Of course, Chris did not want to: a) go to Detroit and b) pay to go to Detroit for the surgery. But I investigated it anyway because it bothered me that he had a cancer in him. I talked to one of the people at Vattikuti and found out that they probably would not him as a patient because of his weight.

Well, this is the first time we knew that weight reduction would be helpful. We still hadn't met with the surgeon at Kaiser, so we started on changes in diet and an exercise regimen. We also booked an appointment with a second Kaiser surgeon.

When we talked to the second surgeon, he didn't see a problem with waiting until after our scheduled vacation because it appears to be a slow-growing cancer and, yes, getting the weight off would help.

We met with the first surgeon--the one to which he was initially referred and decided he would be the one who will perform the surgery. He also agreed that it should not greatly hurt the odds of getting all the cancer to wait.

All this occurred over the summer; Chris is now at 220 (fully clothed); 215 otherwise. His PSA has dropped by a little over one point, too, so we are optimistic that the cancer is as contained, if not more so than when it was diagnosed. Surgery is scheduled for 12 January--less than a month away. I had thought we both were in touch with reality until the date for the surgery was 'set'. We both felt like we were walking down a railroad track and that the train was almost upon us. Thankfully, that feeling passed in an hour or so.

To assist those of you who also try to manage the cancer either by watchful waiting or during a period when you are trying to accomplish a goal, such as weight loss before surgery, one thing we found in a seminar conducted by the American Cancer Society and through some online readings and from our surgeon is the following:

1. Prostate cancer likes to live in overweight men. So if you are overweight, start losing it, but in a sensible manner--diet and exercise.
2. Prostate cancer seems to love red meat--drop red meat from the diet and the cancer will not grow so aggressively.
3. Lycopene in the form of tomato sauce or tomatoes cooked in some oil (like olive oil) has shown some success in shrinking prostate cancer--eating raw tomatoes won't do the trick. The researchers think the lycopene needs to bond with oil to be absorbed into the body. Chris has been taking a lycopene supplement and I've cooked a lot of chili and soups and pizzas and spaghetti in the past few months. Fortunately, we like that kind of food.
4. Fish oil and adding fish to the diet is a good thing. So we have fish about 3 times a week now and take fish oil supplements.
5. Don't forget the green vegetables and the fruit in your diet. Many of them contain antioxidants.

There's other changes we have made, such as working out 4 to 6 times a week, an hour at a time--either walking on the treadmill, outside, or in the pool.

I wish you all well and hope that this is helpful to someone out there. I'll give an update when the surgery is history and Chris is recovering.

Chris checked into the hospital (Fairfax Inova) on 12 January and had robotic-assisted laparoscopic surgery to remove his prostate later that morning. Dr. Steven Guarnaccia, one of the Kaiser Permanente surgeons in the Virginia area, performed the operation. The operation lasted about 4 hours.

Chris did not get up and walk that day. Basically, he was in too much pain from the CO2 gas that was used to inflate his abdomen to get up. That pain was there on and off for about 3 days. Chris didn't have any pain at the incisions.

Although I had read a lot about people's experiences with surgery, I had not read anything about drains and what they mean for the patient or anyone assisting the patient, like me. I had read extensively and was expecting most of the things that occurred in the last 3-½ weeks, but the drain was a surprise. Thus, I'll focus for a little while on the drain to let you know our experiences and what to expect. I go into detail that you might not appreciate; skip to the next section if you want to know about any other phase of the post-op period.

THE DRAIN

The morning after surgery, when I saw him, I checked the bottle for his drain and found that it was about completely full--half of fluids and the rest air. The dressing around the tube that entered his body was bloody and wet. I thought it would be a good idea to get some of the air out of the bottle so it could fill with more fluid. So I took the plug out of the drain bottle and the fluids immediately filled the bottle and it began to overflow. I grabbed the wastebasket and held it under the bottle until I was able to get the plug back into it. So...if you have the operation and have a drain, either you or the person at the hospital helping you learn something about that as soon as you can. The nurses were not too happy that they had blood in the wastebasket liner*they had wanted to carefully measure everything that came out of the drain and having part of it unmeasured was not what they had anticipated.

Chris went home with the drain and, when I drained the bottle, I'd measure the contents and record the date and time and amount of fluids. The fluids were bright red initially and would make one think, "Is there something wrong*was something not stitched up?" Then the fluids became more yellow and that made me think, "Is there something wrong*was something not stitched up*are they fluids from the bladder?" When Chris would walk around, the red tint would return to the fluids, but by 3 or 4 days after the operation, they were starting to remain yellowish. The quantity of fluids at that time was about 100 cc. in a 24 hour period*which was considerably less than the 200+ cc the 24 hours after surgery. Now, I don't know for sure, but I think there was nothing unusual about the amount of liquid being discharged through the drain or its color. Ask your surgeon or a nurse what to expect if you want more information.

When Chris was in the hospital, one of the nurses said they don't like to remove the drain until there's about 30 cc of fluid being put out in 24 hours. We returned to the doctor the Monday after the operation and he left the drain in place and sent some of the fluids off to be tested to determine their content.

We called on Friday and he said to come in and he'd remove it. Chris was discharging about 60 cc daily at that point. We found out that Kaiser had sent the fluids to an outside lab in San Diego for testing and it would take about a week. It was a surprise to the surgeon and to us. I was concerned about the drain's removal because I'd also been told that some of the chemicals in urine cause the bowels to cease functioning and we had no assurance that it was not urine. Needless to say, all was fine and the bowels continued to function well.

After the drain was removed, fluids continued to seep from the incision for a few days. The first night, as I was getting ready to put a bandage on the area, I asked Chris to lift upward on the entire area so I could tape on the bandage more easily. He inadvertently separated the incision by lifting the top part of it up and pushing the bottom of the part down. It began to drip quite a steady amount as I yelled, "Stop!!!" Again, it didn't hurt him at all, but it made me very nervous. Every time that I re-bandaged it, I put on antibiotic/antibacterial cream, gauze and tape after swabbing the area with damp Q-Tips. After a few days, the area scabbed over and I quit bandaging it.

STAPLES

Chris did not have external dissolving sutures, but had staples. The staples were removed a little earlier than possibly they should have been*8 days after the operation. We were at the doctor's appointment for the removal of the drain and he went ahead and removed the staples at that time. The primary incision bled some the night after the staples were removed. Removing the staples was a painless undertaking for Chris, so if you wind up with staples, don't worry*their removal is really not painful.

THE PRIMARY INCISION POINT

The incision that occurred slightly above Chris' belly button was the primary incision. Although it has been almost 4 weeks, we still keep a bandage on that area except at night. The area still oozes to some extent because it is larger than a normal laprascopic incision and is taking a little longer to develop a dry scab.

As I mentioned earlier, the incision bled some the night after the surgery. We think that bleeding was due to Chris putting his arms above his head to put on a shirt. Needless to say, he didn't do that for a few days and there was no subsequent bleeding.

PATHOLOGY RESULTS

We received the pathology results 8 days after the surgery. His Gleason score is a 3+3, with cancer in both lobes. The prostate was 95.5 grams, about 3 to 4 times larger than the average prostate. The pathology report showed the results from 20 slides taken from the prostate and indicate that the cancer was contained within the prostate. We'll know more after the PSA results which will be taken about 6 weeks after surgery.

CATHETER

The catheter was removed 20 days after surgery and the only residual problem at this point is incontinence. The incontinence has shown some lessening since the day the catheter was removed and we hope to report to you in a few weeks that he has full continence. I was advised by another PC survivor today that, when the flow is greatly lessened, he should switch to some ultra thin pads (designed primarily for women) as they are less bulky and uncomfortable in clothing. I'll let you know how that goes, but for now, he's wearing jockey shorts with a heavy pad during the day and briefs at night. There's been no noticeable leakage outside of those garments. We are taking life a day at a time, with Chris avoiding alcohol and caffeine and other things that seem to contribute to incontinence and looking forward to a dry day. We'll deal with other issues, such as impotence a little later. I'm just so glad to have him doing so well at this point and, hopefully, cancer free.

If you have questions or want more information, please let me know.

I'm Barbara, updating Chris' story.

We returned to the doctor's office on January 3. It's been almost a year since the surgery and the current PSA is <.001. YIPPEE!!!

Well, life is not all a bed of roses, but we are not complaining.

There's still some incontinence to deal with, although it is slowly, but surely improving.

And there's still impotence. Cialis has been tried, but didn't work. We will try that again for a couple of weekends, but are scheduled to go to the doctor on January 30 for a penile injection and training on how to self-administer the medication.

If anyone has any experience with this, I'd love to hear from you--good or bad. I specifically want to know if there's any good medical reason for taking this step and what your experience was regarding the needle/injection part. (We don't need you to describe your sex life post-injection...)

Chris is not feeling good about this (and I sure as shooting don't blame him as I'd not like the idea of having to inject something somewhere in me every time we decided to have sex). So I don't know that it's "the best thing" for us to do. I'm 54 and just pleased as punch that he's cancer free. If the sex happens, great; if not, then that's ok, too. It's not the end of the world.

And I want to thank you again, for being there, YANA. It helped us get through some experiences much more easily than if we'd been totally unprepared.

Hi, This is Barbara, updating Chris' story.

I am remiss in putting in an update, as life continues and we are most happy with where we are at this point, although life is not quite as it used to be. Still, the cancer appears to be gone (although we cannot say he's cancer-free for another 5 years according to Chris' surgeon).

Chris' last PSA test was in February, 2008, and we celebrated his good news.

Chris continues to have some problems with incontinence. It's not a big deal and is part of life now. He wears a pad during the day to keep from staining clothes and really only has a problem if he waits too long between bathroom visits or if he gets in a position (primarily squatting) that puts pressure on his bladder.

Chris is still on blood pressure medication and between that and his operation, he is not getting erections. Although we had tried the injections, he had problems with hemorrhoids, which we think was brought on by the prostate surgery and has been using a nitroglycerine-based ointment as medication. He was told not to use the two in conjunction, so we have discontinued the injections.

I urge any of you who have been diagosed or who have a loved one who was diagnosed to seek treatment. There are a wide range of options and you need to find the one that is 'right' for your situation. We think we made the right decision. Should you have any questions, do not hesitate to contact us.

May your days ahead be brighter.

Hi, This is Barbara updating Chris' story.

We're getting ready for a wonderful vacation in France to celebrate his 63rd birthday and our 38th wedding anniversary.

Chris' last PSA test was February 28, 2009 and it was <.01. There remains a problem with incontinence, but it is not worrisome. Perhaps if he spent some time on Kegel exercises, it would help, but that's just not a priority. Chris had one night this year that he slept too soundly and we got up to a wet bed. At first he thought he'd sweated... But it was no big deal.

As for sex, we cannot blame the surgery or the prostate cancer on his impotence. Chris is taking two Tenormin tablets daily for blood pressure and that has squelched his sex life. We tried the injections and the pills, but they could not fully overcome the power of the Tenormin. We miss those times together, but it's okay--we have each other and that's wonderful.

We are both glad that Chris is not having any other problems related to prostate cancer and, to be quite honest, prostate cancer has not been on our minds very much during the past year. I think there will always be a smidgen of anxiety while waiting for the PSA results, but it's only a smidgen.

I know we both went through a lot of angst when Chris was diagnosed with prostate cancer, with questions of, "What should we do? How quickly do we have to do it? Why did he get prostate cancer? What are the odds?" The last question was easily answered by doing research into the types of treatment and using the Partin tables to see the overall success for his stage and grade. The next to last question was sort of dumb for us to ask and the answer was, "what does it matter--you have it, so deal with it."

We found that there are no easy answers to the first question and, thankfully, Chris had some time to decide what to do (which was the answer to the second question--he didn't have to respond and 'do something' immediately). When it came time for surgery, we were optimistic and remain so for a life without prostate cancer. We are very pleased that his success to date has helped to boost the probabilities of success a little.

Good luck to all of you in your struggles with what to do and how to approach this. Both Chris and I would advise you to do SOMETHING other than watch and wait if you are younger than age 60. If you are older than that, weigh your options. There are a variety of treatments and we would be the first to say that surgery is not for everyone. But neither of us regret for one second the decision that Chris made to get surgery.

If you or your wife have questions, please don't hesitate to contact me. If you prefer for Chris to answer, I'll prod him and he'll do it!!!

Chris still has a PSA of <0.1. He still wears a pad daily and Depends at night, although he's not really had any incontinence problems at night (it's a precaution).

He is still in remission from his lymphoma, but his recent treatments caused him to develop a persistent cough. Coughing makes the incontinence worse. But all in all, we remain pleased with the results of the surgery and glad not to have to think about prostate cancer!

Thank you for the site and all you are doing. Occasionally, I do get emails from people asking about Chris and the treatment. So we remain glad for his info to be there and glad to help.

People should feel free to email me.

Barbara

Update from Barbara shows Chris with an undetectable PSA at age 65.

This is Barbara, Chris' wife, with an update to Chris' story.

Chris continues to do well with prostate cancer. All PSA readings continue to be 0. In general, we are very pleased with the outcome of the surgery. Would he choose a different treatment given what he now knows and what his life has been like after surgery? No. We have discussed it at length and there is a certain degree of relief that has accompanied the receipt of his <0.001 results on his PSA tests. He would not have had that relief with some of the other alternative treatments, such as radiation. So, while they might be 'right' for some people, we do not think they would have been right for him.

Two troublesome side effects persist: 1) incontinence and 2) impotence. As for the incontinence, on most days, Chris wears pads and that works satisfactory to contain any leakage. He sometimes has sneezing spells (sneezing 10-14 times in quick succession), which puts more pressure on the bladder and causes a larger problem. Coughing can also cause a larger problem. Larger problems sometimes mean he has to change his slacks or jeans during the day, which can be cumbersome. But those occurrences are quite rare. Does Chris do his Kegel exercises, you may ask? No and he never did them very much. And Chris is also overweight. So if he was the ideal weight and if he had done his Kegel exercises all along in the recovery process, I might not have this side effect to mention. But we sometimes have larger issues in life.

As for the impotence, Chris has high blood pressure. We believe the medications to control his blood pressure are the main cause of the impotence. We tried Viagra and shots early on (and I probably wrote about them), but they were not successful. So, for better or worse, that chapter of our lives is closed.

And, on a more somber note, Chris noticed a lump under his arm last summer and mentioned it to his oncologist. After a CT scan, he found his follicular lymphoma had decided to grow again at a higher pace than his doctor and we would like. Chris has shown no other signs of the lymphoma, so it's been a 'treat before it's a real problem' this time around. Chris went through 4 rounds of immunotherapy treatments and is now going through two years of maintenance treatments. Let me stress that this has nothing to do with his prostate cancer--it's just part of what is happening in his life. As a result, we seldom even think about the prostate cancer now. And, when we do, we think how fortunate he was to have had an excellent surgeon and to have caught it early. Many times people are glad to get negative results from a biopsy. In retrospect, we are glad his reading was positive. The cancer was there and the biopsy found it. By finding out at that time, Chris had to decide 'what to do', but had time to make the decision before the cancer got too far advanced. Although he does deal with the side effects daily, he has now pretty much closed the chapter on prostate cancer.

We wish you well. Chris and I have been through this and if we can help you in any way, we'd like to do so. If you think we can help answer any questions, please let us know.

Hi, Folks!!! This is Barbara updating for Chris.

All is continuing to be well with Chris. He continues to have incontinence issues when he coughs a lot or sneezes a lot. He has had more sinus infections since he has been on treatments for follicular lymphoma, so there's been more of the sneezing and coughing this winter than usual.

Other than that, there's no issues with prostate cancer. It is history. When Chris had his annual physical this year, the doctor did the normal exam to feel for lumps or bumps and said later, "We really don't have to do that anymore." He didn't have a PSA check and neither the doctor nor he felt a need for it. I would have liked to have had a reading just so I could wave it around and shout YIPPEE!!! I still say YIPPEE!!! As it is great that we don't have that concern in our lives.

If he had to face the decision again on what to do, would he do the same thing? Probably. If there's some newer treatment that would work as well, he'd probably check that out. But it's definitely better for him than radiation would have been simply because there would still have been a prostate and a possibility of any residual cancer cells surviving and growing. We'd both still wonder this many years out whether there was anything to think about and he'd feel the need to have a PSA check every year. And his recovery was very well. Yes, the occasional incontinence issues are annoying, but it so beats the alternative!

I don't know Kaiser's current policies in our area (Northern Virgina) regarding robotic assisted laparoscopic radical prostatectomy. They no longer use the hospital (Fairfax Inova) where Chris' operation was performed. I hope they do still allow the operation as, from what I've read, it is a better choice than the traditional surgery.

All the best to you and yours; if you want more information, please let me know.

Christopher's e-mail address is: spec4lover AT yahoo.com (replace "AT" with "@")

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