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Mike U and Anna live in Virginia, USA. He was 71 when he was diagnosed in March, 2010. His initial PSA was 5.97 ng/ml, his Gleason Score was 10, and he was staged T1c. His initial treatment choice was Surgery (Retropubic Prostatectomy) and his current treatment choice is None. Here is his story.

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

In late 2009, at my annual physical, the DRE (Digital Rectal Examination) seemed okay, but my PSA had risen to a new high level (5.97). I saw a urologist, who had the PSA test was repeated and the result was 5.76.

I had a biopsy on March 3, 2010. The next week, the nurse called since my urologist had gone on vacation. She said the biopsy was positive and that the doctor wanted me to get an appointment with a radiation oncologist, whose name she provided. (When she didn't volunteer any specific information about the biopsy, I had to pressure her and she finally told me there were four positive readings (out of 12) and all had a Gleason of 5+5 for a 10!) I saw the radiation oncologist later in that week and he laid out a treatment option with hormone treatments over a two-year period with external beam radiation treatments after the first month or so. He said there was no "plan B" and that this was the right option for my situation. Because of my high Gleason score, he ordered a bone scan and a CT scan which he thought would be negative since a fairly large mass was necessary to be detected. Both tests did turn out to be negative.

At work the next week, I discovered that one of my co-workers (in his mid-60s) had prostate surgery at the end of 2009 and I went to talk to him. He told me his story and strongly recommended that my wife and I go to a Multi-Disciplinary Prostate Cancer Clinic that was offered each week for newly diagnosed prostate cancer patients at Walter Reed Army Medical Center. As a retired military member, I was eligible for this six-hour clinic and signed up for the next session. At the clinic, my wife and I were seen by a number of doctors including a urological surgeon and two radiation oncologists. They reviewed my medical records and test results and reached a consensus that their recommended treatment was a radical prostatectomy. The recommendation based on my general health (no current chronic diseases), recent test results, etc. even though I was nearly 72. After some soul-searching, I decided to go ahead with the surgery. My decision was helped some by the fact that my surgeon does about 100 prostate surgeries a year with half using the Da Vinci robot and half being the radical open procedure. He recommended that I have the open procedure since he wanted to have a wider view and take my lymph nodes to determine if the cancer had spread beyond the prostate.

My wife and I went through the prostate surgery training session at Walter Reed and I had the surgery on April 22nd. The surgery went well and on his visual look, the surgeon thought the cancer was contained within the prostate. I recovered well, but did need one unit of blood prior to my release from the hospital. The catheter period was disconcerting due to blood in my urine most of the 2 weeks the catheter was in. However, my doctor was generally not concerned, and once the catheter was removed, the urine returned to normal.

Six weeks after the surgery, I received my pathology report and the cancer had not penetrated the capsule. The main tumor as fairly small, but two additional, very small tumors were in the other lobe. The post-surgery Gleason was still rated as a 10. My first PSA test was at six weeks and the PSA at that time was undetectable. I am working on the incontinence which my doctor warned me would be more difficult for me at my age than someone who was 50 or 60.

I am glad that I did not go with the first doctor's recommendation to do external radiation. If a multidisciplinary clinic is available, it is a big plus to help one in thinking about the best treatment option. The Walter Reed clinic and training program were excellent. (It included a look at a catheter and training for catheter care prior to the surgery. This was a confidence builder and reduced my anxiety concerning the catheter period.)

UPDATED

May 2011

[Mike's updates went missing in cyberspace when he sent them in but he finally got them through.]

Update on March 1, 2011

Here is my updated status at 10 months after my RP.

Since then I have had four PSA tests (June 14, August 20, November 19, and February 25). All were undetectable. Now I go to having the PSA test every six months.

On the side effect situation, my incontinence has progressed at a rate better than my surgeon had projected. I was originally told that due to my age (RP surgery when I was almost 72) that I would have a more difficult time with incontinence. For the others on the site, here are some details on what I experienced.

When the catheter was removed, I had almost no control and was unable to retain enough fluid to demonstrate my bladder was capable of filling and relieving. This situation continued for a few weeks, maybe four. Then one day I had control while sleeping and fairly good control when sitting. If I worked at my desk for an hour or two, and got up to urinate, I had fairly good control while sitting. If I was walking around or standing for a long period, then I did not have control. All during this period I was following "the rules" (limited coffee and tea, etc. and regularly did the Kegels). I was told to do 3 sets of 10 quick Kegels, twice a day and 3 sets of 10 slow Kegels, also twice a day. I did many more quick Kegels than this and probably fewer slow Kegels than I was instructed. Gradually, my control while standing and walking improved.

Today, at 10 months, I have almost complete control except for some post urination leaking of some dribbles and some stress incontinence while doing some exercises. Even with this situation, my doctors told me to continue the Kegels since additional improvement is possible. As a side issue, I was given a prescription of Sudafed as a way of tightening my sphincter. I tried it and it was clear that a tighter sphincter was the result in those situations and on those days where I needed such assistance.

On the subject of ED, I have had no improvement. I was given a prescription of Levitra and tried that for a period of time, but it had no benefit. Having examined range of other options available, I have decided to not try any of these and to wait and see if there is any improvement.

UPDATED

May 2012

I am now having PSA tested every six months. At my last test in April 2012 my PSA was still undetectable.

UPDATED

August 2013

My PSA was checked in April 2013 and was still undetectable.

UPDATED

October 2014

I am continuing to have PSA taken every three months. My Urologist recommends that I continue the tests at three month intervals due to my Gleason 10. As of September 2014, my PSA tests still have undetectable results.

Mike's e-mail address is: mmuu2000 AT yahoo.com (replace "AT" with "@")

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


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