THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2016 SO THERE IS NO UPDATE.

At 42 I was having a routine physical exam by my M.D. My PSA came back elevated at 8.66. My MD referred me to an Urologist where a biopsy was performed. Well, I received the phone call from my urologist about 3 days later. I'll never forget this day. I was driving when I took the call. I remember joking with my doctor saying "so what's the good news?". He said, "Well, I am sorry but 4 out of 12 cores came back positive for prostate cancer, I need for you to come in asap so we can discuss treatment options". I remember immediately pulling over and just thinking "how can this be happening". It was sort of surreal.

I visited with him a couple days later and he recommended having surgery (Da Vinci). During this meeting I had a list of questions and just felt he was a young doctor, great guy but if I was going to have surgery I wanted someone with more experience. I asked him if he had to have the same surgery who he would choose. He immediately referred me to a prominent surgeon in Seattle. Well, I did my research and this surgeon was probably one of top surgeons in the country who specialized on Da Vinci Robotics.

I met with him and we scheduled a surgery date. However, before I even met him I was diligently doing research about PCa, treatment options and statistics. I came across proton therapy and after joining a group online and asking many questions plus research I decided to cancel my surgery date. It seemed to me that the 5 to 10 yrs disease free statistics were the same as surgery (for localized PCa). Plus proton therapy treats not only the entire prostate but the surrounding area. Also, quality of life issues were more favorable vs surgery. I am scheduled to start proton therapy at Loma Linda Mid May 2009.

I am anxious but also a little nervous all at the same time. I can't explain my feelings. I have no symptoms, I'm completely healthy. I workout regularly, run, hike, ski and etc... I have led a fairly healthy life style. I was even a vegetarian for about 15 years. My life style is very active/athletic running multiple marathons etc.. I don't feel like I have cancer never mind I am now technically a cancer patient. It's absolutely mind numbing this is happening. What I have realized this disease doesn't discriminate. It may sound like I am complaining here because I sorta am but in real life with family, friends and my employees I am upbeat and I downplay my situation. I don't want my loved ones to worry and I really do think in an odd way if you're going to have cancer this is a better one to have since it has a high cure rate. I am optimistic I will beat this. My link to PCa is probably genetic since my grandfather passed away from PCa years ago.

Well, this is my story to this point. I didn't plan on taking this type of journey but since I'm here I pray and I mean really pray this journey turns out positive. Maybe I can turn this into a positive experience by helping other taking this journey. Feel free to contact me if you wish. I will do another update after my treatment starts. God bless.

Well, it's September 2, 2009 [Maybe when it was written, but it is January 2010 right now!]. My last day of treatment was on August 7, 2009. I had 45 treatments (all protons, no photons, Gantry #3) at Loma Linda Medical University. My doctor was Dr. Bush.

Before my treatment started I was a little concerned about being put on hormones because I took another PSA test at my Urologist office back home. My PSA came in at 11.8 (yikes!) from 8.66 PSA;. I think it was higher because my biopsy was only 8 weeks prior which probably affected the PSA test. When I arrived at Loma Linda for my treatments Dr. Bush had me take another PSA test. My new PSA test now came in at 9.8 (go figure??). I heard that if your PSA is over 10 and GS 7or higher you're a candidate for hormones. I was very pleased when Dr. Bush told me "No, you're not going on hormones".

I have to say my treatments were fairly uneventful concerning side effects. Starting around treatment #15 I felt a slight burning sensation when I urinated but nothing that Ibuprofen couldn't help. I don't have any ED or incontinence issues.

My experience at Loma Linda was a very good one. The staff was very kind and caring. I attended some of the support groups on Wednesday nights which are awesome and entertaining. I was initially the youngest guy receiving treatments but around week 2 I loss that honor to a 37 year old from Spokane :). I spent a lot of time training at the Drayson Center, running and cycling. I met another guy from Germany (also a patient and runner) and we ran every day on the Santa Ana river trail (trail starts about 2 miles from the hospital). Since I'm originally from Southern California it was truly a radiation vacation for me because I was able to visit old places, visit new places, see old friends, make new friends and seeing my father weekly was awesome. Also, Niki (my girlfriend) came to California and was with me for most of the entire treatment and was a great help. Everyday we got up at 5:45 am and drove to the hospital (1hr away) with me for my treatments. Niki was a real trooper. I really appreciate Niki's support more than you can imagine. She was also Detlef & my running partner:).

Besides all the fun I had and you hear about (i.e, radiation vacation). I do realize the seriousness of having PCa and the bottom line is we all just want to be cured and nothing else really matters. My choice of proton treatment over other forms of treatment is a decision I cannot 2nd guess. I don't have any regrets and if I had to do it all over I would still choose this form of treatment. I didn't choose robotic surgery because I wanted not only my entire prostate treated but my margins and seminal vesicles as well. Surgery in my mind would only remove my prostate but what if it's in the margins or seminal vesicles? Surgery per my GS and PSA statistics wasn't enough. This was the reason why I chose proton radiation over surgery not because it's invasive. Secondary decision factors were quality of life issues. Proton has a great record for having low ED and Incontinence challenges. [This is a contentious issue - men who have had Proton Beam Therapy consistently claim low side effects - and quote studies to support their statement. Those opposed to PBT discount the studies and say there is no real proof of better outcomes.] Like all other treatments I will have to monitor my PSA for the rest of my life. My first PSA test (post treatment) is scheduled in December. I'm obviously hoping and praying its low. It can take up to 2 1/2 years to reach your nadir after this form of treatment.

I was thinking the other day about how I should define this portion of my life since having cancer when people ask questions. I've been feeling awkward when people ask "How are you feeling?" "How is your cancer situation?". I didn't know how to answer these questions. I would love to say "Oh, I'm totally cured!!" It dawned on me.....I was a cancer survivor starting the last day of my treatment. Everyday for the rest of my life starting August 7th (my last day of treatment) I am a cancer survivor.

Livestrong.....Go Protons!!

Don Muridan

Later: It's now January 2010 and last month I had my 1st follow up PSA test after my treatment. Before my treatment my PSA came back at 9.8. Now I am very pleased to say it dropped to 3.2. I am not taking any hormones so this is the real deal. I had about a 60% drop. Loma Linda Medical state they like to see about a 50% reduction in PSA at the 4 month post treatment PSA; test. My next PSA in April and I will update then.

On a side note....more great news. Prior to my treatment we were trying to have a baby. I even went to the sperm bank prior to treatment incase we needed to have invitro. Well, we are now 11 weeks pregnant and it happened naturally. My best to everyone and feel free to contact me if you have any questions...

Don M.

I'm a little late getting my 2nd post PSA test after completing my treatment August 7th of 2009.

My PSA 4 months after treatment was 3.2 which is down from 9.8 prior to me starting 9 weeks of treatment at Loma Linda. As of 2 weeks ago my 2nd PSA had a little bit of a bump and came back at 3.56. Even though I understand PSA's can fluctuate and a 3/10 of a % point probably means nothing. [PSA levels certainly can fluctuate - see PSA 28 Day Experiment.] I do have to admit it's still hard not to wonder or be anxious about my next PSA test scheduled in November.

Besides that i'm very healthy, working out a lot and have no other side effects to report.

I'll try to remember and update my status on Yana in a timely manner.

Don Muridan

Sorry for such a long delay since my last posting. I have created a chronological order of my history with prostate cancer:

I was diagnosed at the age of 42 with prostate cancer in 2009. During a routine physical by my family physician discovered my PSA was higher than normal (6.8). I have never had any symptoms of PCa. I've always considered myself a healthy athletic person. Running several marathons and working out at gym on a regular basis, etc…. To this day I still feel very healthy and actually ran 6 miles the day before surgery and during radiation ran every day. Even now 6 months post surgery and again back into my routine of running, working out and just daily life stuff. My point is I never felt any symptoms before and after my treatments. I feel healthy and physically fit to this day. My biggest issue I'm experiencing is stress and I'm worrisome. Here is brief chronological summary of my history of prostate cancer:

February 2009 - had my first biopsy by my local Urologist. Pathology came back positive 4 out of 12 cores positive. Gleason score 7 (4+3), PSA 8.6

• Summer 2009-Received Proton Beam Radiation at Loma Linda Medical University. 45 sessions of all protons, no photons.
• 2 years post proton treatment my lowest nadir was 3.2. My PSA; has jumped around from the 4's to as high as 5.4 since my proton treatment. The concern with my PSA; was the fluctuation and rising PSA. My local urologist believes I had reoccurrence of prostate cancer
• Also prior to protons and post treatment I have had multiple scans to see if cancer could be found (i.e., prostascint, CAT, MRI, Dexa, etc…) all have came back negative for signs of metastatic cancer.

Note: My local urologist and I concern was my PSA was fluctuating and rising which means reoccurrence. Even though all my scans have come back negative for any signs of metastatic cancer my urologist has explained it could be microscopic which the scans are not able to detect. My hope and prayers during my journey with PCa was and still is to find a curative solution.

• Spring of 2011-I had another biopsy performed by my local urologist which all 12 cores came back negative. (The thought was to see if we could find localized and if so remove my prostate in hope of a curative solution)
• Summer of 2011-I flew back to consult with my Loma Linda doctor. He suggested to have a special type of MRI called endorectal MRI with the hopes of having could a better image of prostate/pelvic region and if found to have my prostate removed.
• August 2011- my local urologist sent me to to the National Institute of Health to have this type of MRI and a guided biopsy per the images they got back from my endorectal MRI. NIH found suspicious areas and performed a guided biopsy.
• August 2011--NIH pathology came back with 8 out of 16 cores positive with a new gleason score of 8 and 9 and one involvement in my seminal vesicles.
• October 6, 2011-After speaking with my NIH doctor (Dr. Pinto) we decided to have a prostatectomy at NIH in hopes of maybe cancer was still localized. Dr. Pinto and his team went wide in surgical terms removing my (robotically) prostate, 34 lymph nodes and my seminal vesicles.
• NIH pathology results came back approx 2 weeks later after my surgery showing a gleason score of 10 and out of the 34 lymph nodes 2 came back positive.
• Post prostatectomy PSA- at 6 weeks was .07, at 3 months .07 again, April of 2012 was my 6 month PSA; the results came back at .12 which is a rise of .05. (All PSA;'s have been performed at the same laboratory)

In response to a final reminder Don said:

Sorry guys. I do need to update my story. I've been on vacation this summer. Will try to get to it ASAP

Don Muridan

First I apologize for not updating as I should. Since my salvage prostatectomy at NIH my cancer did come back. Technically I am diagnosed with micro metactic cancer. I am currently for the last couple of years being treated by Dr. Snuffy Myers. My other oncologist is Dr Montgomery at Seattle cancer care. Here are some of the highlights since surgery

• 2012, went to Mayo Clinic for a C-11 pet choline scan in Rochester MN. My scan came back negative. Per Dr. Myers he believes still localized probably in the iliac region
• Dr. Myers has me taking casodex. I took probably for a good year until my PSA; started to climb. We had more scans and this time we noticed suspicious two lymph nodes exactly where Dr. Myers thight the cancer was located in the iliac area
• 2013, Dr. Lin from the UW performs surgery to remove the lymph nodes (in pelvic region) but also removes more as precaution. Pathology comes back and shows out of the 18 removed one was cancerous. My PSA; drops post surgery. Per doctors, my cancer is microscopic. No scan can detect
• I'm still just taking casodex. I have no symptoms. I feel fine
• PSA starts to climb slowly to I believe like a .8
• in May of 2014 Dr. Myers decides to put me on hormone therapy for six months called firmagon which is a shot once a month and Zytiga (4 pills per day). since my cancer is so small and as I mentioned I have micro metastAric which he feels is still localized dr Myers reason for starting these drugs with osa being so low is to basically kill the last remaining cancer cells or put them into remission. he has had other patients where this has worked successfully so this is the hopes. My PSA; is currently undetectable.
• November 2014, The side effects is weight gain and hot flashes. To be completely honest hormone therapy for me is no big deal. Yeah the hot flashes are a little weird. The worse is the extra 10lbs I gained. I have one additional month of this treatment. I feel absolutely fine. In addition I am taking a few over the counter supplements like curcumin, Rosemary, vitamin D3 and eating a Mediterranean diet all per Dr. Myers. I have another meeting with him later this month

Note: I apologize for all the grammar and spelling errors. I'm doing this update via my iPad and trying to update quickly before my four year old wakes up. I'll try to do a better job keep this updated. Please feel free to contact me with questions. I'm doing well and still have and very optimistic.

Don's e-mail address is: donmuridan AT gmail.com (replace "AT" with "@")

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