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  DIAMOND  
This is his Country or State Flag

Ron Carter and Yvonne live in Virginia, USA. He was 62 when he was diagnosed in January, 2004. His initial PSA was 4.60 ng/ml, his Gleason Score was 6, and he was staged T1c. His initial treatment choice was Brachytherapy (Seed Implant) 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.

Like just about everyone diagnosed with prostate cancer, I was shocked to be told that I had it, having assumed that my elevated PSA was simply a natural function of age. Besides, like many other victims of this disease I have since encountered, I had worked hard to keep myself fit (running, bicycling) and had pretty much stuck to a low fat diet. So not only was I shocked, I was a little angry, thinking about all the good things I might have eaten had I known I was going to get this disease anyway.

Since my diagnosis, I have wavered back and forth between radiation and surgery, buffeted by the conflicting opinions and horror stories that can easily be found on the Internet. I have also gradually come to realize that I am fortunate to have a very low-grade, non-agressive form of cancer (2 cores less than 5%, one core 10%), Gleason (3+3), PSA 4.6.

At this point, it appears that I stand a very good chance of being "cured" no matter which of those two treatment options I ch oose. So I am leaning toward permanent seed implant, that being the less invasive, less traumatic option. BUT there are those side effects. Perhaps a 5% risk of serious urinary problems. Okay, good odds--unless you happen to fall into that 5%. On the other hand, with radical prostatectomy, you run approximately the same chance of serious incontinence. (The odds of impotence seem about equal.) That's what I am now trying to determine.

When I make the final decision, I will update.

UPDATED

March 2004

After much deliberation, depression, agonizing, and frequent flip-flops, I have decided on brachytherapy (SI). Even though my cancer is apparently borderline-significant (Gleason 3+3, two cores less than 5%, one core 10%), I decided against Watchful Waiting, mainly because of my temperament. I would be wanting to check my PSA daily, and if it went up one decimal place, I would succumb to panic. Also, two readings of the slides indicate that there IS cancer. Not much, but it's there. While I might be able to keep it from growing through careful management, I doubt that I can make it disappear.

So early on, I knew it would have to be surgery or radiation. I was under a great deal of pressure to choose surgery from, quite naturally, surgeons but also other prostate cancer patients. Nevertheless, the more I researched, the more I became convinced that brachytherapy is just as reliable as surgery with less risk of debilitating side effects.

I still have some trepidation, perhaps naturally. I have seen some studies suggesting that foregoing external beam radiation is a bad idea, but my radiation oncologist has convinced me that, in my case, any benefit would be outweighed by the additional risk of side effects. I also worry about radiation-induced secondary cancer showing up one day down the road, but the data is inconclusive on that score.

So off I go in a couple of weeks to have the little devils blasted into my prostate. I will post periodic progress reports (hopefully, positive).

UPDATED

May 2004

On Friday, May 7, 2004, Dr. Michael Hagan at the Massey Cancer Center in Richmond, Virginia, implanted 83 palladium seeds into my prostate. The procedure itself was absolutely painless. Almost pleasant, in fact, like having a really great nap. The volume study that preceded it by a couple of weeks was, however, a different story, mainly because of the need to insert a Foley catheter. (A catheter is also inserted during the procedure itself, of course, but at that point, you have been anaesthetized.)

The procedure took just over an hour. Dr. Hagan likes to keep his patients overnight to be sure that everything is looking good, so I spent the rest of Friday and all of Friday night in a very hot, uncomfortable room attached to the catheter, which was pulled at 7:30 a.m. Saturday, much to my relief. I needed no pain medication whatsoever and walked to the parking deck with my wife for the trip home, stopping once for lunch (two hot dogs to compensate me for all the months I've been eating tofu, tomatoes, soy milk, and cereals).

So far, I have had no major side effects. Urinary flow has been slowing a bit with maybe just a bit more frequency than before the procedure, and I am getting pretty sore but ice packs are helping. All in all, having known many men who opted for radical prostatectomy, it doesn't seem right that I am getting off so easy. (I keep thinking about the old exercise mantra: No pain, no gain.) If this indeed is all it takes to defeat the cancer, then I am a very, very fortunate man.

UPDATED

May 2009

I reached the 5-year mark this month with a PSA of 0.04 and am thankful for that. I do have some sexual dysfunction, but I was having problems before treatment. Viagra helps to some degree, but I hate taking the stuff. I also have some bowel problems, but these are minor. No urinary problems. All in all, I am more than satisfied with my choice of treatment and with the physician who performed the procedure--a real artist, Dr. Michael Hagan, of the Massey Cancer Center in Richmond, Virginia.

UPDATED

September 2010

One complication of a radiation treatment, I have discovered, is that you tend to attribute any subsequent problems to that treatment. That said, I am experiencing two problems that are likely to be side effects of my treatment - bowel problems and impotence. Taking the latter problem first, this has been developing slowly ever since my treatment 6.5 years ago. I am now at the point where ED medications are of very little help. The urologist I consulted recently suggested injections and commented that impotence occurs with almost equal frequency in patients who opted for brachytherapy and those who had radical prostatectomy.

The other problem is loose stools and frequent, often urgent bowel movements. For me, this is the more serious problem since I am an avid camper, backpacker, and hiker. It is difficult to go on an overnight trip when you know that you are going to be dealing with bowel urgency in the mornings. I have an appointment with a gastroenterologist to discuss this issue. As I said earlier, I tend to blame the radiation for just about every problem that crops up. It might be that the bowel problem has a different cause.

UPDATED

June 2012

I was purposely delaying updating in order to wait for my 7-year check-up later this month. I will report on my most recent results in the next few weeks.

UPDATED

June 2012

Just had my 8-year checkup. PSA is 0.1. VERY happy with treatment choice at this time despite sexual dysfunction. I had previously reported bowel problems, but a recent colonoscopy detected no evidence of radiation damage. The doctor believes the bowel problems are not related to the cancer treatment. Urinary function has impoved greatly. Getting up once a night with no abnormal urgency or difficulty urinating.

UPDATED

June 2013

Just completed 9-year check-up. No recurrence. PSA of 0.01. Original treatment was seed implant, no external radiation. Side effects: impotence (meds help slightly) and weak urinary stream but normal frequency for my age (72). Still very satisfied with my treatment choice.

UPDATED

July 2014

I just reached the ten-year mark with a PSA of 0.01. I could not be more pleased with my choice of treatment (brachytherapy), my choice of an oncologist to administer the treatment, and of course, the outcome.

UPDATED

August 2015

Cancer-free at 10+ years. Couldn't be more pleased.

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

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


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