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Lee Gemmill lives in Pennsylvania, USA. He was 67 when he was diagnosed in May, 2005. His initial PSA was 1.46 ng/ml, his Gleason Score was 6, and he was staged T1c. His choice of treatment was Non-Invasive (Active Surveillance). Here is his story.

Earliest PSAt=0.6 - age of 56 - PSA density of 0.021 - 12/1993.

During the next eleven (11) years my PSAt varied from 0.7 to 1.1 - density varied from .021 to .038.

A doubling happened 0.70 to 1.46, Oct/2004 to May/2005. This lead to my first biopsy in 7/06/2005, which showed GL 6 in 2 of the 12 cores (40% & 10%). This was with a local urologist who sent the slides to Johns Hopkins histology for confirmation.

After finding Hopkins via the internet I applied and was accepted into the Expectant Management program at Johns Hopkins. The first biopsy at Hopkins on 9/21/2005, was negetive. The second biopsy at Hopkins on 10/04/2006, was negetive. The third biopsy at Hopkins on 9/27/2007, showed a GL 6 in 10% of 1 of the 12 cores.

DREs & fluid tests were also done every 6 months @ Hopkins. The PSAt stayed between 1.1 and 1.6. the percent free PSA stayed between 23% and 30%. Because of an insurance program I had to leave Hopkins, the last lab tests were done in March of 2008.

From then until June of 2012, I rotated between three physicians, two urologist and one GP. No biopsys were done. PSAts slowly trended upward from 1.6 to 3.2.

On 3/20/2013, I was hospitalized with prostatitis, HTN. The PSAt had increased from 3.2 to 3.49 resulting in a biopsy done on 5/24/2013. Five of the 12 cores were positive. Four were GL 6 (3+3) with core %+ varying from 9% to 25%. One core was 40%+ with GL 7 (3+4). The 40% segment of the GL7+ core was 25% 4 & 75%3. Staging was still T1c.

I had the histology slides sent to Johns Hopkins histology for confirmation. They confirmed GL7 and found additional GL7. At this time I don't have info on the new GL7 found by Hopkins. I also received a telephone consultation with H.Ballentine Carter, M.D., on 7/09/2013, who had done the Expectant Management biopsys. He recommended that radiation treatment, no mention of ADT, because I was 75 years old, too old for surgery.

On 7/19/2013, I had a cat scan & a bone scan done.

I received my 6-month injection of Lupron on 8/27/2013 and am scheduled for attachment of the 3 marker tags on 9/06/2013. Radiation simulation is scheduled for 9/20/2013.

UPDATED

September 2013

9/06/2013, tag markers attached. Went smoothly.

UPDATED

September 2013

Sept. 20th, 2013: Radiation simulation went well. I recently received the 2nd opinion slides reviewed by Johns Hopkins histology of my 5/24/2012 biopsy. A new Gl 7 (3+4), "discontinuously involving 10% of one of two cores" in the left apex, that previously was diagnosed as only Gl 6 (3+3), was found. Set-up planning is scheduled for Oct. 7th.

UPDATED

October 2013

October 8th, 2013. Received my first daily 79Gy dose of radiation via Chester Co. Hospital's brand new True Beam IGRT machine. 43 to go.

UPDATED

November 2013

Nov. 01, 2012. 19th dose of radiation this morning. The ADT injection is about 2 months old.

UPDATED

December 2013

December 09, 2013: Received the last (44th) radiation dose. Two months left on the 6-month Lupron injection. Urologist visit scheduled for 12/26. No PSA testing since the 3.46 taken last April. Next PSAt testing around 12/20. Gained 5 lbs. during the radiation.

UPDATED

January 2014

About the same since last update. Next visit with urologist will be in mid March with the first PSAt test, since April of 2013. The 6-month ADT injection runs out in at the end of February with, hopefully, a return of potency?

UPDATED

March 2014

My current PSAt of <0.06 ng/ml is as low as possible (nadar). Another PSAt is scheduled for 3-mos. The OAB symptoms require wearing adsorbent padding, one per day. A prescription and a 7-day sample of Toiaz (4mg) was provided but for now I am holding off because of their constipation side effect. Effects from the 44 radiation doses were nil except for a one-time significant crimson blood discharge possibly related but could just be related to my chronic constipation situation. Effects from the ADT 6-mos depot injection was only the antifipated hot flashes, increasing in frequency towards the end of the 6-month period plus becoming less frequent till now, 7 & 1/2 - mos. later. Next update planned in 3+ mos.

UPDATED

March 2014

Oops, I forgot about the radiation side effect of erection non-function. Yes it was total. "Was", because the "morning" erection has returned about 3-weeks ago. This might be why I forgot to include it with today's original update. The temptation part has not returned, a good thing?

UPDATED

June 2014

June 19, 2014, Urologist visit included the finding that previous blood in my urine resulted not from kidney stones, largest is 4 mm, but from the proximity of the gold markers that were attached to my prostate prior to the radiation beam treatments. I had been doing strenuous workouts prior to the bleeding. This conclusion was reached via a cat scan (wo/w) contrast dye & a camera insertion up & into my bladder. The January PSA of <0.06 is now 0.15 ng/ml.

UPDATED

October 2014

September, 2014 PSAt was 0.32. 3 months ago it was 0.14. The MD was not concerned.

UPDATED

December 2014

12/11/2014, Blood sample PSAt was 0.30. Medication for the urinary side effect was changed from VESIcare (5mg) to Myrbetriq (50mg, extended release) with better results.

UPDATED

March 2015

March 2015 MD visit. PSA of 0.39 was good news. Next visit is scheduled for September.

UPDATED

October 2015

My Sept. 2015 PSA was 0.89. Next PSA test is during March, 2016. No treatment at present.

UPDATED

April 2016

The recent total PSA test was on 4/13/2016. Health is very good.

UPDATED

October 2016

A PSA blood test on October 17, 2016 was 0.69 ng/ml. Doing well.

Lee's e-mail address is: lee73@verizon.net


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