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Bob Conklin and Janet live in Oregon, USA. He was 71 when he was diagnosed in March, 2010. His initial PSA was 5.76 ng/ml, his Gleason Score was 7, and he was staged T1c. His initial treatment choice was External Beam Radiation (Calypso) 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 was not surprised by the diagnosis. My father had died of PCa at age 63 and everyone else in my immediate family (mother and sister) had also had serious (in my sister's case terminal) cancer at much younger ages than mine. So I've long felt that I was living on borrowed time.

The diagnosis did not frighten me as much as I thought it might, largely because I was feeling somewhat fatalistic about it. I did however spend a lot of time doing research and talking to people to decide what treatment to choose. I ended up choosing Calypso® Guided Intensity Modulated EBRT (External Beam Radiation Treatment) largely because my urologist advised that with RP I would be at considerably higher than normal risk of long-term or permanent incontinence due to a combination of my age, the size of my prostate (90 gm), and the fact that I had had a prior TURP (Trans Urethral Resection of the Prostate). I believed that the prospects for controlling the cancer with IMRT were very good, and I did not want to spend the rest of my life in diapers.

I was treated at Oregon Health & Science University, which has a top-flight cancer program with special expertise in prostate cancer. I feel very fortunate to have had such excellent care available so close to my home in Portland.

My treatment was completed eight months ago. I had some mild urinary and bowel urgency for a few weeks afterward, but those are long gone now. I still feel somewhat de-energized, but that may be because I also have very low testosterone and had to discontinue the T replacement injections that I had been receiving for years. I am now in an ongoing discussion with the docs about whether and when I might resume TRT (Testosterone Replacement Therapy) with an acceptable degree of risk. (Answer: nobody can quantify it, but the risk is generally thought to be low.)

At last testing (about a week ago) my PSA was 0.02.

UPDATED

April 2012

It is now a year since my initial report. Shortly after that report, my medical team approved the resumption of testosterone replacement therapy, given that my T was almost negligible as was my PSA. The resumption of TRT has improved things markedly for me in terms of strength, energy, and over-all sense of well-being. My PSA did go up initially from 0.02 to 0.45, but since then it has settled down to about 0.30 and appears to have stabilized there. At age 73, I feel that the quality of life benefits from TRT are worth whatever (unknown) degree of risk of recurrence might be involved.

I continue to be affected by some degree of bowel frequency, although it seems to be subsiding lately. It is entirely manageable. Urination is normal. I have diminished libido and erectile function, although I am able to achieve erections on occasion by using Cialis. I'm thinking of trying injections but have not done so yet. Although I am still very much attracted to my wife, given my reduced libido the ED is not a major source of frustration for me.

I wonder occasionally if "watchful waiting" might not have been a better choice for me, but there will never be any way of knowing the answer to that. I don't think I could have lived comfortably with the uncertainty, given the loss of my father and my brother-in-law to PCa. So on the whole I am satisfied with my treatment choice, the quality of care that I have received, and the over-all results which are not ideal but certainly tolerable.

UPDATED

July 2013

EBRT (Calypso) summer 2010. I'm back on TRT for 2 yrs now. T normal with daily applications of Testim gel. This has restored sense of well-being and energy levels, but not sexual appetite or function. PSA stable in 0.30-0.45 range. Relatively mild urinary urgency, occasional leakage. 1 or 2 episodes of fecal incontinence. Peristalsis seems weaker than before, some constipation, lots of straining. Very weak libido, almost no erectile function. Glad I'm not experiencing this in my 50s. At 75 it's not the end of the world, with an understanding and loving wife. I do wonder at times if I should have been treated at all, maybe should have opted for "watchful waiting," but didn't want to live with the uncertaintly and resulting anxiety. Knowing what I know now, not sure I would not have made the other decision.... but trying not to second-guess myself. Can't unring that bell.

Bob's e-mail address is: bob AT bobconklin.com (replace "AT" with "@")

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


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