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

I am a 54 yr old male (duh) chiropractor. I'm a little up on this stuff. Much to my surprise a screen PSA showed me at a 34.0 ng/ml. I thought a fluke because I was totally asymptomatic. Exam by my GP who found a normal size and smoothness was reassuring. He suspected a possible inflammation, three weeks Ciprox (nasty stuff) brought about a PSA of 43.0 ng/ml. More likely due to his prostate digital exam! (just a side note I thought digital was electronic not manual) - sorry for the joke. )

His suggestion was one of two local urologists for further workups. I decided on a teaching hospital at a University, Madison two hours from me. My first meeting was from Dr Jerrard (I will forward his awesome credentials to all who ask) following his advice two weeks later I had in one day bone scan, CT scan abdomen and pelvis, and prostate biopsy. ( Anyone contact me on this on. I heard so many horror stories of pain that are easily overcome as mine were, i.e. 0.5 on a scale of 1-10.)

CT and bone scan were negative for cancer spread to anywhere. Whew. Biopsy was positive 4+3=7 Gleason. Bad! I am awaiting my next appointment. Dr Jerrard has suggested open abdominal removal with radiation to follow. Surprising as he has done over 250 robotics. I meet with the nuke doctor the same day. Three choices active surveillance, his suggestion or laying out the cash to go for HIFU outside the US. The surgery and radiation would keep me out of work for six to ten weeks basically bankrupting me. Wait and watch seems the only viable alternative. I have some awesome nutritionalists forwarding me personal won battles.

Feel free to contact me.

Rick

Thanks all of you for your support and suggestions.

I met five days ago with my urologist. He had scheduled me to meet a radiation oncologist first. I was biased against radiation from my research. The rad doc read me like a book and eased all of my negative expectations. His suggestion was five zaps per week, half hour at a time for five weeks along with androgen replacement therapy, basically chemical castration which is reversible. The outcomes for urinary incontinence and erectile dysfunction is less than with any form of surgery. [This statement, which appears to have been made by the radiologist who Rick consulted is not necessarily correct. Readers should satisfy themselvs on this point because there are studies that demonstrate very similar outcomes.] (can't be sure about HIFU). Those two side effects in surgery of any kind, are due to nerve damage. Nerves seldom grow back or if so very quickly. With radiation the side effects are due to blood vessel shrinkage. That is why Viagra works in all males good prostate or not. I took Viagra once, the pill got stuck in my throat and I got a severe stiff neck. Sorry, humor is helping me cope with the c word. The best technology for radiation out there is IBRT [Again this statement might be disputed by those men who have undergone Proton Beam Therapy which has some excellent outcomes reported.], hopefully a tomographic unit.

The surgeon said he'd do the surgery but if he felt that there was spread to lymph nodes I'd get the rad therapy anyway.

Leaning toward getting nuked. Praying for you all. Rick

Since my last posting I have been doing much research, mainly outcomes on options that I have.

I did find a hospital near-by that has an IMRT (Intensity Modulated Radiotherapy) unit that is fifteen minutes from my town so that off times from business would be minimal. Reading outcomes from this type of therapy have been a bit disappointing for a person of my age.

Still doing my homework and will keep you posted. Highs and lows are being addressed by all of you.

Thanks for the help. I'll keep you posted.

Love to all.

I am doing OK.

Prior to radiation therapy the doc wants me on Casodex. As far as I can tell the cost is around $450 per month. Somewhere on this site someone had related that DES (diethylstilbestrol) was an alternative and 10% of the price. Does anyone have those numbers? [DES (diethylstilbestrol) was a standard treatment some years ago but was replaced by more modern drugs at a very much higher cost. Many doctors are reuctant to prescribe DES because of the potential problem for strokes and other heart conditions associated with blood clots which studies showed were associated with DES. If DES is used it is wise to also take Warfarin to thin the blood.]

I'll keep ya posted. Keep the faith! Thanks to all for their support.

Rick

Since my last posting I haven't set up a schedule for my EBRT. I will probably will do it this June. So many unanswered fears.

This web site is so all inclusive and really lets people see experiences both good and bad. The question is who am I most like? My motto is "Leap and the net will appear". Here goes.

On other side note. the body is a miraculous battler against inner abnormalities. My libido has been zero and I'm 55 and on no ADT (Androgen Deprivation Therapy) my innate system has probably shut down testosterone production because of the feeding of cancer which it does. Good for me, bad for my dear wife of 28 years.

Check out Randy Paluch on YouTube for a refreshing look on what cancer unfortunates do to cope.

Love ya all.

Rick

Since my last update in May I have made the choice to undergo EBRT (External Beam Radiation Therapy). PSA went from 43 to 63 in 8 months.

Had my fitting this morning, meet with the doc and the dosimeter specialist on Thursday, and get my first zap on Friday. worked out well time wise. 6:30 am then off to work. I work half days, I go in at 7am I work until 7 pm. that's a half a day right? Gotta keep up the humor.

Great staff and doc, looks like 5 a week for 8 to 9 weeks. I'll try to give a more diarized version than my past entries. I saw a young woman probably 25 entering the facility today as I was leaving, heading for the EBRT wearing a hat that was surely covering her bald skull. made me think about how fortunate I am.

Oh! by the way if anyone wants to know how radiation therapy might be played out, rent on dvd "The Doctor" starring William Hurt. Ya, it's Hollywood's version but it ain't too far off.

Later: I was scheduled for trial run on July 10,'08, but the machine went down. Rescheduled for 6:am the following day. Showed up, lightning had taken out the cooler for the unit. Next shot on July 14. Hurry up and wait! I think my tattoos for the beam placement will wear off. I'll try to keep my entries now on a daily basis if they are not too repetitive. They have suggested that I see a dietitian to advise on what my intake should be. I'm sure with the probable rectal irritation that tacos are a no-no. Maybe hydration suggestions also.

Also on the agenda is a visit with a psychologist in the facility. I think no matter how well you think you are handling things, your time would be well spent to at least sit through a session. The c word is a slam in the head for even the people who think they are tightly wrapped.

Good night and your god bless all.

Later - July 14 2008: I had my first session which was a dry run to get the machine and my body acquainted. Had the active radiation administrations in the next two days, these consisted of various x-ray head/ ray angulations lasting from 1 to 8 seconds in length for a total of 24 to 28 seconds of total exposure per day. There were no side effects except the discomfort of laying on the hard table for 8 minutes.

I have experienced significant fatigue possibly from the treatment and rising earlier than usual to make my appointment at 6:30 am. I'll have to deal with both. Blood work was run to get a baseline for the expected next 8 weeks of treatment. My total blood profile cbc, ie red, white, platelet cells, liver and kidney function were all excellent. My PSA which had been 64 dropped to 60 after only 3 treatments. I found that astounding in such a short time.

This is Sunday and I've had a 2 day holiday from having to get up early and have a bit more energy today. Tomorrow I go on the same one per day treatment for the next 7 weeks. Tomorrow also includes another CT scan to make sure of alignment.

Later: July 28 2008

Hello to all,

Tomorrow I start treatment 10. That will be the one quarter mark of treatment. I am noticing some rectal burning as was expected. I have a lack of appetite issue which I need to focus on as I am only 119 pounds. I am pushing fluids especially power drinks. Fatigue starts at 1 PM and lasts for about 4 hours, then I'm fine, get home from work and do physical labor without a problem until bed at 11.

In doing my homework I discovered that in my case only 10 percent of cancer cells are splitting at any given time, that's why the length of duration week wise for radiation.

I'll keep ya all posted.

Today I passed the one third way of my 40 probable radiation treatments.

Symptoms of appetite loss, rectal burning and diarrhea are escalating. I am coping with them fairly well. The hardest side effect at this point is fatigue which starts at 1:00 pm and lasts later in the day, originally 5 o'clock, lately 6 to 8. During that period I feel like I have a stomach and lower colon flu.

Still able to be fairly active but with the rectal discomfort I have realized that riding my bicycle is out for a while. At the two thirds stage as the beams are narrowing from the outer pelvic cavity inward we get to the "boost" phase which focuses on the "Walnut" itself. Maybe at that point it will spare my colon.

Keep the faith, this thing is beatable.

Later:

Well I hit my halfway radiation treatment number 22 today.

I was forced to take a week off as I had a twelve foot fall from a scaffold while painting my house. The worst part was that I hit a concrete bird bath in the last three feet of the fall. Four days in the hospital, seven fractured ribs, and a punctured lung put me on my back.

Resuming radiation eight days later proved painful, as getting on and off the hard table and laying still for eight minutes was excruciating. Fortunately the lapse only added one treatment to the total expected. I was grateful for the diarrhea that the radiation produced as bearing down for a bowel movement with multiple fractures was less unpleasant. It's hard now what to blame my symptoms on.

Next Wednesday I will begin the boost phase where the dosage will narrow to the seminal vesicles and prostate solely.

My best and keep up the fight no matter what gets in your way.

Rick

Today is Friday August 29, 2008. I finished my third boost treatment. All of the treatments prior to boost were at 90. 180, 270 and 360 degrees. The angles are now seven in total. A bit more time under the ray.

The ribs are not much of a problem until I lay belly up to sleep. I probably get 3-4 hours a night. Fatigue is a huge problem but I can still get in a forced 45 hours per week at my office.

I've lost 10 lbs in six weeks due to the effect of the radiation kicking the hell out of my appetite and digestive system. The Doctors and the nutritionist in the facility are aware and have me in their sights as far as optimums. They suggested a product called Vegemite [Vegemite is an Australian iconic food. It resembles the British Marmite and is most often eaten as a spread on toast for breakfast. It is rich in Vitamin B. Very few non-Australians take to it.]. Maybe someone could advise me on such.

Later: September 9, 08. Thirty four radiation sessions and ten to go. Fatigue is incredible, I even fell asleep during a nap yesterday. Still waking at 6 am to make my treatments. Every hour after that is like two hours. I'm ready for bed by two in the afternoon. Still working 40 hours with difficulty. My lovely wife has come into the office to cover so that I might get in a nap if there is a lull and to take over some of my chores.

Weight is up three pounds now to 115 with forced feeding. This too will pass. My radiation oncologist says that he will be comfortable handling my care from here on out as I lost my GP and urologist. After treatment is over I will be seen every three months for eternity.

My last CT showed a nodule that had sprouted since my last scan. Not welcome news. Rib fractures and pain are resolving. Sleeping is still difficult.

My best to all of you warriors.

Rick

On my final radiation treatment, September 22, 2008, my PSA had dropped from 64 to 9.5. Astounding! The reading as I understand will continue to decrease in the next twelve months to hopefully near zero. Looks like we killed off the bad guys. My next reading of PSA will be in three weeks following my 1st DRE.

Later: I had my one month post radiation re-exam with my radiation oncologist on October 14th. He reported a significant "flattening of the prostate and nodule" previously detected by DRE. We didn't do a PSA but will wait until my next exam at years end. I am free of all of the effects of radiation therapy with the exception of some fatigue at times. I have regained my 20 pound weight loss, a low of 109 pounds, and am near my pre-radiation weight. The rib fractures are healed and I'm back on the scaffolding.

My best to all.

Rick

I had a PSA blood draw today prior to my first recheck with my radiation oncologist next week. My original PSA of 32 fifteen months ago went to 43 to 64 during my radiation sessions. On my last treatment nine weeks ago it was PSA of 9. Today was my early Christmas present at 4.10. As I understand it should continue to drop for several more months.

I hope for every one of you and your loved ones, all the joy for the holidays that I am blessed with today.

I had not planned to log in again until my six month re-check following my final IMRT session which would have been in early April 2009.

About six weeks ago I noticed a tenderness under my left nipple. I didn't give it a lot of thought, maybe I had bumped something I thought. The tenderness continued, with acts such as pulling a sweater down over the area. Two weeks ago upon self exam I could feel a firm lump directly under the nipple. It seems to have become the size of a small olive and is tender. This has forced me into re-scheduling an earlier than expected visit to my radiation oncologist. ( Side Note: his name is Dr Smoron, but he is brilliant).

I am aware that breast cancer can occur in men, however rare and that is not in my paradigm.

I'll keep you all posted.

Later: Update, I met on March 3, 2009 with my radiation oncologist. His impression was that the lump under my nipple was gynecomastia, with a guess of high 90 percent that it wasn't breast cancer. In his 35 years of practice he has seen on average of one case every three years of male breast cancer.

Hot compresses have decreased the tenderness by 80 percent and the size by 25 percent, and the mass has become very much softer, in only two days.

Great news also that my PSA had fallen from my rollercoaster ride from day one of 32 - 43 - 64 - 9 - 4.1, and March of 2009 DRUM ROLL********* 2.5. I can LIVE with that.

Bless you all and every one of you bless Terry for his time and talent for providing us with this valuable site.

Rick

I just had a blood draw for my upcoming 1 year, post EBRT treatment. Great news was in store for me and hope the same for all on my same path. A reading of 1.30 which is down from six months ago, 2.8, and my high a year ago of 64.

This was without any ADT or any other remedies in the past year. I will get back next week after my "DRE-EEK".

My best to all of you crusaders in your own battles. I feel blessed and bless you all.

I just had my latest post IMRT exam. I am 18 months post treatment.

My Radiation oncologist felt a flat and normal size prostate, I felt PAIN. No more than the usual FUYA (finger up your ass).

Great PSA also 0.93. Hell of a lot better than that 64 which was my high.

I am sorry to be this late in my posting as I forgot and I took it for granted that I am a survivor and that that there might be others that may want to see my story of good fortune. Never give up or be dismayed.

Contact me. I will try to help you through this winnable battle.

Rick Goins

I just had my two year post radiation regimen exam today. Physical exam, no problems, taking no medications of any sort. Fit as a fiddle for a young dude of 58. Nothing on DRE except the usual discomfort.

PSA down again from 0.98 to 0.69.

Thanks to all at YANANOW and to all of you who have contacted me, I am here for you.

Rick

My latest PSA in April 2011 was 0.43. Amazing that it is still dropping after three years.

I met up with a survivor in my area who I met through your site and we keep in touch and have met and gone to events with. Thanks for the new format which makes this easier. [Rick is referring to the fact that men's stories can now be accessed by State or Country of residence.]

Thanks, Rick Goins

My most recent PSA was this month with a reading of 0.58. Up a couple of hundredths which is probably lab variant.

Since my last posting, I had an episode of bloody drops at the end of my urine flow. This lasted four days, stopped and returned for two days a week later. I put a message out to the Yananow bulletin board and got some great advice and similar stories. Seems this is not extremely uncommon years after invasive treatment of the prostate. There have been no episodes since (four months), and urinalysis for aberrant cells was negative. I pray that all of you can be blessed with the outcome that I have experienced so far.

Rick Goins

Well I'm nearing my six year anniversary since my last EBRT. My most recent PSA last month was 1.4. I',m not too concerned about the slight rise as lab variants are common. I have no side effects. I had my last PSA done at a health screening which was done at my local Sam's club. This is a monthly event for cholesterol, vision, hearing and blood sugar. The PSA is offered every 4-6 months I believe. By the way, the testing is free and open to the public. Keep on fighting one and all. Rick Goins.

Rick's e-mail address is: rickgoins1 AT yahoo.com (replace "AT" with "@")

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