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Kent McCulloch lives in Washington, USA. He was 63 when he was diagnosed in October, 2009. His initial PSA was 14.10 ng/ml, his Gleason Score was 6, and he was staged T1c. His initial treatment choice was Non-Invasive (Active Surveillance) and his current treatment choice is None. Here is his story.

THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2014 SO THERE IS NO UPDATE.

I have had a long history of BPH (Benign Prostate Hyperplasia) with attendant high PSA scores. My PSA has been checked every year for the last decade or more. About 8 years ago, because of a PSA of 11 (even though my urologist believed it was because of my enlarged prostate (two and a half times normal) he ordered a 6 core biopsy. It came back negative. My PSA dropped back to 8 and then over time crept back up to 11 a year ago. This year it was at 14.1 which my doc thought warranted another 6 needle biopsy. One of the six came back at 3% (.5 of 17mm) adenocarcinoma. The Gleason score was 3+3=6.

So the Gleason and the stage T1c put be at slow growth, low risk. My PSA of 14.1 is an intermediate risk factor except that at least 3 doctors unanimously suspect that number is driven by my BPH, and not the small cancer. With a normal sized prostate and not one that is two and a half times normal, my PSA might be well under 10, for instance. Which would put me well into an "active surveillance" category by the three factors of PSA, stage and Gleason.

I am now exploring options. To treat or to 'watch'. I am looking for all the data and encouragement I can find for a strategy of "active surveillance".

Treatment seems to boil down for me to going to Loma Linda, California for proton radiation, or Seattle for a robotically performed prostatectomy. I have yet to consult with Loma Linda in person but expect to before the year is over. I have gone to Seattle and consulted with Dr. James Porter, a leading surgeon in robotics at Swedish Hospital. He is not only excellent by reputation but very impressive in person. We thoroughly discussed my case with the immediate upshot being that I will have another biopsy (20 needle) this December 22nd, the findings of which to help fine tune my thinking on "watchful waiting".

UPDATED

January 2010

Went in for my second biopsy in 3 months, December 22, 2009. This was as a result of my consult with a robotics surgeon/urologist who I would consider using for a prostatectomy should a procedure be required. He thought my initial 6 needle biopsy was not a large enough sample - at least he prefered 12 or more. Hence the second biopsy.

It was a 16 needle (sample) procedure with the results coming back as ALL CLEAR! Hurray! Had that been my original biopsy 3 months ago I would have thought myself "cancer free". He also said during the biopsy that my prostate is over 105 c.c. That's 3 1/2 times normal - which from my reading can account for nearly half my 14 PSA score.

So for now...my hopes to watch and wait have been confirmed! I was told that statistically, my odds of ever needing a procedure to remove my prostate is about one in three. I'll take it. Now its blood draws and biopsies forever. I'll take that too. Stay tuned.

UPDATED

March 2011

Had my annual biopsy mid December 2010 which is part of the active surveillance plan.

The doc took 12 samples and two came back positive - TC1's - Gleason 6. Still seemed a rational course to continue on Active Surveillance as I do not want to over-react. And to follow PSA's of course. My PSA in December was 14.0, but remember my prostate is THREE AND A HALF TIMES NORMAL SIZE! Supposedly with this BPH complication, I can subtract 6 or so from my PSA number, putting me at a comparable 8 (maybe).

Well, on a hunch I went to my general health care provider for a blood draw on my own initiative this last February and my PSA was at 16. [It is important to understand that PSA results from different laboratories cannot be directly compared. They rarely agree - see PSA 101.] Ouch! Called my urologist and he said given the erratic nature of my past readings we will wait a month for another PSA draw to see if it comes down. If it does come down, or stays the same and we determine I am still "safe" to continue Active Surveillance. I might ask for a bone scan. I don't know.

My uorolgist is a smart guy who does believe that prostate cancer has been overtreated, and I do fit the pattern of a guy with very slow growning cancer with a long history of BPH, but he certainly has no desire to gamble with my life either. I already have significant ED and feel with prostate removal, the curtain will draw closed on any future sex life. I'll let you know what's up by my 65th birthday in May.

Current score card: 40 samples from 4 biopsies. 3 positives, TC1's - Gleasons 6's. 12 year movement of PSA from 7 to 16. Stay tuned.

UPDATED

April 2012

In response to a reminder Kent said:

Thanks for the prompt Terry, I'll get back to you with an update...which is basically favorable.

UPDATED

June 2012

I am still on a watchful waiting protocol as it has been nearly three years now since my initial diagnosis and there has been little detectable change in the status of my cancer. This last year has been mainly concerned with treating BPH - first with Finasteride, and then with Avodart. Finasteride caused a clear decrease in libido, a condition which improved by switching to Avodart.

My PSA as of a few days ago is 12.4, having decreased from last year's 14+.

The decision against any procedure to remove my prostate has so far been vindicated, as it appears that my cancer is the very non-aggressive type that many men unknowingly have well into old age. I shall remain faithful to every 3 month PSA; exams, and have so far had an annual biopsy. My doctor and I are beginning to discuss the possibility of a TURP for urinary relief, but that is not indicated to be necessary yet by my symptoms.

Active survailance is not for everyone, but I seem to have the temperament for it and the markers have not as yet indicated this to be imprudent. God bless you all in your own decision making and/ or recoveries.

UPDATED

August 2013

I had a TURP in November of last year to relieve my chronic urinary issues. In fact it was because of a large prostate boosting my PSA; that finally led to my first biopsy. As my prostate continued to grow so did my PSA; numbers. Eventually, it was one of these resultant biopsies that revealed the cancer that brought me to the YANA website.

I am not only pleased to report that my urinary problems have been completely alleviated by the TURP but also my PSA; dropped from 14 to 3.5!

My urologist is naturally pleased and sees no benefit for further biopsies unless there is a considerable spike in my PSA; readings which I will continue as part of my active surveillance.

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

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


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