Annual check-up revealed a marginally higher PSA than the cut off for my age group (70+), at 7.3. Elected to use the UK private healthcare system (despite lifelong principles) so:
- I could have the surgeon of my choice (Prof Roger Kirby)
- because so under pressure is the National Health System at the moment that cancer detection in the aged (i.e. "those about to die") ranks somewhere below ingrowing toenails.
First biopsy (Feb. 2009---like being shot in the anus with a beebee gun, TWELVE TIMES) came up with one core, 10%, Gleason Score 3+4=7. No pressure. Wait three months, says Kirby, then come back. April, second biopsy, tiny spread next door core, Gleason Score 6.
Spoke to clever physician friend who said do it, unless you really don't want to.
Decided on operation, Kirby + his buddy D Vinci, two hours, only severe pain in the wallet (no "small incisions" there). Lab reports back week later (today). margins clear, volume tiny (0.05), Gleason Score downgraded to 6. I was less diseased than I thought.
What was surprising was that the damn gland had ballooned to 100gms, despite a Greenlight laser TURP (done by Kirby) four years ago. Another four years and it would have been the size of the Goodyear blimp. And, of course, I would have needed another TURP (of the salami-cut kind).
Catheter removed today and I'm leaking like a rusty bucket. but it's easier to live with something that will get better than something which may get (horribly) worse.
My advice to anyone else? Don't let anyone else advise you into something you're not positive about. it's not their prostate.
For me, it was Pascal's wager (believe in God. If He doesn't exist, you've lost nothing. If He does, you're a winner). the operation, of whatever kind, doesn't, one is told, cause or spread cancer. And it does lessen the chance, for most of us, of dying (prematurely) of it.
Thank you for this excellent website and the fellowship it offers.
John Sutherland
I click on Yananow once or twice a week. It has been a lifeline for me. I recommend it to all my friends who have PCa, or fear they have. It's an epidemic in my age group (70+) and, in the UK, a low-priority epidemic, alas. The NHS is strapped for cash and watchful waiting is always the cheapest option. It's not death panels but it is triage. Yananow does a necessary job in getting the facts out.
I elected to have a prostatectomy at my own expense, largely, because I wanted the best scalpel (or robot) money could buy. Roger Kirby. It wasn't that expensive - cheaper than a big funeral. Eighteen months after surgery my PSA registers .003 which is, I gather, effectively undetectable.
Incontinence cleared up, as predicted, after six months entirely. Erectile problems less completely. Caverject is effective, but does rather take the spontaneity out of things. So does cancer, my cheerful doctor friend tells me.
The post operation pathology indicated an either early stage, or not very aggressive cancer: 05 volume on an inflated prostate (96gm) and gleason six. I don't worry about the decision I made - although I do worry when friends of mine discover (once the damn thing has become symptomatic) that it's metastasized or has taken over the whole prostate. But even in these cases (as Mr Megrahi indicates) good things are increasingly available.
Thank you Terry, and thank Yananow,
John Sutherland.
I survive and have had ten years of good, productive, life. I have friends---later than me in being diagnosed---who are no longer here. My advice is get diagnosed as early as possible and read this site exhaustively.
yrs John
When I had successful davinci surgery my surgeon informed me afterwards that he had given me ten years. So far (aged 84) so good.
I've lost friends and acquaintance since my treatment who've left intervention too long. The treatments have improved remarkably---I would have chosen HIFU but it was not available.
My life, saved by surgery, has been good. I'm grateful. Grateful too to yananow.org. Knowledge, and its circulation, is health. Thank you.
John's e-mail address is: uclejas AT ucl.ac.uk (replace "AT" with "@")
