Bill
Lambright and his wife Judy live in Greenville, South Carolina. He was 65 when
he was diagnosed in January 2004. His PSA was 2.99 ng/ml, his Gleason Score 7
and he was staged as T2c.
THERE
WAS NO RESPONSE TO AN UPDATE
REMINDER
IN 2007
SO THERE IS NO UPDATE.
Here
is his story up until then:
My
name is Bill Lambright and I'm a 65 year old man in my 40th year of marriage to
a wonderful, supportive wife who has made me the grateful father of three children
and six, soon to be seven beautiful GRANDchildren!
I
was also diagnosed with PCa on January 19, 2004.
THE
FACTS:
My
current PSA is 2.99; my PCa is stage T2c with a Gleason score of 7 (4+3). A biopsy
of my prostate done in early January of this year and a diagnostic report by Dianon
Systems showed PCa at the R-apex 100%- 2 of 2 cores- Gleason -7; R-mid 89% -2/2
cores G-7; R-base 79% 2/2 cores - G-7; L-mid 9% 1/1 Gleason -6. Perineural invasion
(PNI) is present.
A
biopsy done February 23, '04 on Right Seminal Vesicle showed: "NO prostate epithelium
identified, No evidence of malignancy". No other tests or scans were recommended
by my urologist.
Partin
Nomogram Tables for PSA<4.0 and Gleason of 7 for Stage T2c: Organ confined = 38%;
Capsular penetration = 45%; SV involvement = 12%; Lymph node involvement = 5%.
My PCa is considered at a "high risk" "Perineural invasion is associated with
an increased likelihood of capsular penetration at radical prostatectomy."
EARLY
RECOMMENDATIONS:
My
urologist told me when he gave me the diagnosis that "I'm biased; I'm a surgeon
and radical prostatectomy (RP) is the 'gold standard' in treating prostate cancer."
I asked him about other treatment options and he told me about brachytherapy and
along with external beam radiation (EBRT). When I asked him about cryosurgery
he began to tell me the "horror stories" of the early use of cryo in the 1970's.
Fistulas in the rectal area etc.! He did mention cryosurgery was being done at
Allegheny Hospital in Pennsylvania and He knew of ONE prostate cryosurgeon in
South Carolina, my home state.He told me to read about PCa and he would discuss
my treatment decision in a follow-up meeting in 3 weeks.
I
began to "eat healthy" (low/no saturated fats; low/no refined sugars) and exercise
more - I've lost 30+ pounds and never felt better since I was 35! It took PCa
to motivate me to do what I should have been doing all along! Ignorance is NOT
bliss! My prostate was "mildly irregular" 10 years ago but because my PSA was
"in range" I did NOTHING! The PCa continued to grow until it is at a rather large
volume today.
INITIAL
INVESTIGATIONS:
After
my diagnosis I seriously considered RP and began to investigate the least invasive
form of RP - robotic assisted RP- being done in MI, TN, TX and other locations.
I also investigated radiation (brachytherapy with EBRT) at the Radiotherapy Clinics
of Georgia.
With each investigation I had more "input" from friends and family and then I
learned about: A PRIMER ON
PROSTATE CANCER: "The Empowered Patient's Guide" by Dr. Stephen B. Strum and
Donna Pogliano.
I will be forever indebted to these two dear people who have written a "classic"
for the PCa patient who truly desires to "take charge of their disease"!
I
began to follow the GREAT advice offered on page 72 of "The Primer" :
"The
best outcome for any individual patient is achieved by:
+Obtaining
the best understanding of the biological 'truths' of each patient's disease.
·
Matching those 'truths' with the appropriate treatment strategy.
·
Selecting an "artist" to deliver the chosen therapy(ies)".
I
spent the months of February-April following the above 3 steps until I arrived
at the following..
DECISIONS:
I
asked for the biopsy of the right SV because my urologist suggested that would
give a good indication (nothing is 100% certain) of capsular penetration ( R-base
where R-SV is located is 100% cancerous). When I determined that the PCa was localized
I considered the "truths" of my disease and decided on the least invasive treatment
and the ONLY option for localized PCa that could be REPEATED if necessary - Cryosurgery-
also know as Cryotherapy, Cryoablation of the prostate- or just Cryo - for short.
:)
Of
the 7 patients referred by Dr. Strum for cryosurgery in the early 90's; 6 have
had evidence of stable PSA levels with 10 years of follow-up. That was good enough
for me! Hundreds of more men have had cryo since 1993 with good results, Medicare
approved Cryo as a primary treatment for PCa in 1999. Cryo has been a "salvage
procedure" for failed radiation treatment for some time.
I
then talked to two colleagues who had cryo recently. Both highly recommend the
procedure and are doing well (stable PSAs for 2+ years -clear biopsies)! Both
of my work colleagues recommended an "artist" in Florida, Dr. Gary Onik, listed
as one of the 9 "premier cryosurgeons" identified in the US so far by Dr. Strum.
I contacted Dr. Onik and received much help from him but learned that "he accepts
no insurance of any kind". His office did refer me to Dr. Richard Brunelle in
Tampa, FL who did accept insurance and had "trained and worked with Dr. Onik since
1997".
I
also exchanged email with one of Dr. Onik and Dr. Brunelle's early patients (1999).
He spoke highly of both doctors and offered invaluable help to me in a detailed
account of his surgery and recovery period. This information is posted on the
web and is well worth reading! Thanks Larry!!
I
visited Dr. Brunelle's office in Tampa and after a through exam and consultation
decided he was the "artist" I needed to deliver my chosen therapy. He injects
saline in the Dannonviller's Fascia area to give an added margin of protection
to this vital area near the prostate.
My
cryosurgery is scheduled for May 19, 2004 just 4 months after diagnosis! I give
thanks to God, good doctors, friends and family and a GREAT book - A PRIMER ON
PROSTATE CANCER: "The Empowered Patient's Guide" all were part of guiding me into
what I trust will be a "cure" for my PCa.
The
friend who introduced me to "The Primer" is also considering having -Focal "Nerve
Sparing" cryosurgery- done by Dr. Brunelle should he be a candidate for this approach
to "preserve potency". His PCa is confined to one lobe of the prostate - mine
is not! When PCa can be positively determined to be confined to ONE lobe of the
prostate "nerve sparing cryo" can be done to preserve potency. One more reason
why early detection is important!
CONCLUSION:
If
you have read this far - thank you. If you have comments, questions, observations,
corrections or advice - I welcome them! I'm newly diagnosed, I'm still learning
but I'm not a "novice" but an "empowered patient" when it comes to PCa.
I
feel great about my decision. My life and PCa is in God's hands and the able hands
of Dr. Richard Brunelle. PCa is one of the better things to come into my life.
I am looking forward to May 19 when Cryo will remove my PCa!!
My
wife and I are at peace! Warm regards and prayers for all
This is a personal account sent to our "friends and family" mailing list
who have supported us in my "journey as a newly diagnosed PCa patient".
SHORT VERSION (FOR THOSE IN A HURRY)
Just a week ago yesterday I had
Cryosurgery (freezing) in Tampa, Florida for prostate cancer. Dr. Richard Brunelle
told Judy we froze what we should have frozen and didn't freeze what we shouldn't
have." He told me in recovery: " fantastic"! He is a man of few words but lots
of skill for which I am thankful!! I am now under the care of a local medical
oncologist and will be checked every 90 days. My catheter comes out on June 4!
I am doing GREAT and want to thank the Lord for many answers to prayer
over the past 4 months since the cancer was diagnosed. Thanks to so many of you
who have prayed and encouraged us over these very busy 4 months! God has been
so good to us and we want to praise Him.
My wife, Judy, drove over 625
miles from Tampa - we arrived home late Tuesday, May 23 and are still in our routine
of "eating healthy and exercising" only now at "home".
Prostate Cancer
is in epidemic proportions in the US and we hope to encourage other men/couples
as we have been helped and encouraged by so many of you all! THANK YOU!!
MORE DETAILS (FOR THOSE OF YOU WHO CARE TO READ ON)
I came to the
decision to have Cryosurgery after carefully considering all the "biological truths"
about the cancer. I considered the cancer an "unwelcome intruder" in my body the
presence of which I encouraged by my unhealthy eating habits and attitudes.
God told me to "eat healthy" and He would care for all the rest! I am not
on a diet. He has showed me a couple of simple guidelines to follow: low/no fat
food (especially diary) and low/no refined sugars. By sticking to this pattern
I have dropped from 235 lbs. to about 196. Where I will level out weight wise
I don't know - nor do I have a "goal" except to be obedient to Him.
My PSA was (before Cryo) 2.99 which is not all that high. Current reports/news
is that PSA screening misses Prostate Cancer in about 15% of men and doctors are
debating how to interpret PSA and other tests to enhance earlier detection on
Prostate Cancer. See the NCI/NIH
report
THE SURGERY
The pre-op at St Joseph's Hospital for the surgery was pretty straight forward;
vitals, blood tests (including baseline PSA) with forms to sign and instructions
given. The morning of the surgery, May 19 dawned bright and clear and at 7:15
AM Dr. Brunelle greeted me and minutes later I was "asleep" and in God's and the
doctor's skillful hands. At 10:15 AM I was awake hearing Dr. Brunelle say "fantastic"
and in less than 24 hours I was leaving the hospital - walking to the car - no
wheelchair!
This was the "best hospital/surgical experience" I have
ever had and I've had a few! The nursing staff at St. Joseph's were also "fantastic"!
I could have used a little more "instruction" on getting "friendly" with the Foley
catheter.
POST OP
I was "flat for four" (flat of my back
for four days) with the exception of a trip to McDonald's on the day I was released
from the hospital. Missionary colleagues, home from Mozambique came from Orlando
for a brief visit with their four beautiful children! McDonald's was for them!!
Thanks to them for coming, the card - and the balloon! I have indeed had a "Happy
Healing"!!
I have had NO complications from the Cryosurgery for which
again I give Him praise!
Swelling (which could have been bizarre) was
minimal, no pain pills (except for what turned out to be gas - and hot towels
relieved that) and no infection! I have become "friends" with my Foley catheter!
:) I had some difficulty at first with the tubing and bag positions but God even
showed me what to do about that (I'm not just being super-spiritual when I say
this) -I woke up Sunday AM with an idea of what to do about the "catheter problem"
(I'll spare you the details :) and it has worked smoothly since! Ask if you wonder
about my "Foley engineering! :)
I was feeling so good Sunday morning
and needed to make a "test run" for our trip back to SC on Monday that I went
to church with Judy.We were introduced to the congregation by the daughter of
our Florida hosts who plays the piano and organ for the church.
What
a wonderful outpouring of love and encouragement from the Family of God in Tampa!
Believers from Jamaica, Puerto Rico, Cuba and the US gathered around us to welcome
us and encourage us. The pastor even asked me to pronounce the "benediction/blessing"
at the end of the service and Judy and I stood up front and later greeted everyone
as we were "overwhelmed" with their outpouring of love. This was just the "medicine"
we needed!!
LAST DOCTOR'S VISIT
We were in Dr. Brunelle's
office for a "follow up" which consisted of mainly an examination of the stitches
(6 small openings for the Cryoprobes) and an irrigation of my bladder to make
sure there were no blood clots- "hook him up" were the last words of Dr. B to
his nurse as a new catheter "leg bag" was fitted to me and we with a "pat on the
back" from Dr. B (funny how much that 'pat' meant to me!) we were sent on our
way "home to South Carolina".
THE TRIP HOME
On Monday afternoon Judy insisted on driving ALL the way- (625+ miles) home.
She is fanatical about obeying doctor's orders! I navigated from a sitting or
sometimes reclining position.
THANKS AND FINAL THOUGHTS
A BIG THANKS goes to my dear wife, Judy! What an encouragement and help she has
been to me through these past four months! Really, for the last FORTY years -
we celebrate our 40th anniversary on July 16, 2004.
Thanks too for everyone
who have supported us in so many ways on our "PCa Journey". The next phase has
just begun. The Foley comes out on June 4 and I see a new doctor here in Greenville
for follow up PSA testing in the coming weeks and months. Continue to remember
us in our "times of testing"!
Twenty
four days after surgery and about a week after the Foley catheter was removed
(uneventful although I did learn that urologist who do the diagnosis but not the
treatment are sometime reluctant to do "follow up" so I stopped seeing my local
urologist) I suddenly began to experience "night sweats".
I was on Flomax and having no problems with urination. I contacted medical authorities
who recommend that I drink nothing eight hours before bedtime. The night sweats
lessened and finally disappeared after about a week.
Three months after
surgery I had my first PSA - .03 ng/ml. Dr. Brunelle's protocol is to check PSA
every 3 months for two years and then every 6 months until 5 years- post surgery-
and then if all is well PSA checks annually. So far my PSA tests have been from
.03-.05ng/ml! I and my doctors are happy.
One year after surgery - in May
of 2005 I noticed I was getting up more and more in the night to urinate. I contacted
one of the few urologists in South Carolina who does Cryosurgery, Dr. Scott Sweazy
did tests to determine the function of my bladder and urethra (some flat scar
tissue where the prostate gland was).
Dr. Sweazy "prescribed" drinking
64 oz. of water daily and told me to not drink much 4 hours before bedtime. This
advice "cured" my frequent urination problem. Water is the best/low cost drug
on the market! :)
I'm doing great now over two years post Cryo! I am still
eating healthy (low amounts of saturated fats and same for sugars). My continence
is 100% and my potency is 0% (which I knew going in - "dead men don't have erections"
:). My wife and I do enjoy "intimate times" - just less frequent but just as satisfying
at age 68!
God and life is good! I'm enjoying retirement by working around
our "log cabin" on the banks of the Saluda River in Upstate South Carolina.
I'm
also rejoicing over the good medical advice and treatment I've received over the
past two years. Dr. Sweazy told me "Mr. Lambright, you still have PCa - it's encapsulated
in scar tissue and hopefully you are on your way to being "cured". I'm hopeful
too, but remember these wise words: "When it comes your time to die, make sure
that all you have to do is die."
Right now I'm enjoying life to the full!
Sincerely,
Bill Lambright, Greenville, SC
