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wlobo135 Bocian lives in New South Wales, Australia. He was 68 when he was diagnosed in June, 2009. His initial PSA was 9.70 ng/ml, his Gleason Score was 9, and he was staged T3a. His initial treatment choice was Surgery (Retropubic Prostatectomy + RT + ADT) and his current treatment choice is None. Here is his story.

In June 2009, my blood test showed a PSA of 5.3 ng/ml. Re-examination after two months my PSA was 6.6 ng/ml. A visit to an oncologist after a month of waiting. He did all tests. The CT scan showed that bones and other organs are clean from cancer cells, my PSA is already 9.7 ng/ml.

The Biopsy result were Gleason score 5+4. The cancer has progressed to the neural bundle on the right side. I agreed to a prostatectomy for which I had to wait five weeks for.

After five days of recovery in hospital, just before returning home, my condition deteriorates rapidly. The diagnosis was quick. I have an internal haemorrhage. I was immediately on the operation table again. After six days recovering, I eagerly went home but had 6/10 pain. My pain increased over the next twelve hours to 10/10 abdominal pain so I called for an ambulance and was taken to the local emergency hospital.

I had a second internal haemorrhage. I was taken to the original hospital where I was on the operating table for a third time. Finally, three weeks after the first operation, I left the hospital for good. The abdomen healed slowly and without problems. After three months I stop using diapers and got my PSA checked. The result was 0.7 ng/ml. I had to wait six weeks to see the surgeon, by then my PSA had risen to 0.77 ng/ml. He showed me the results of the post-op biopsy of my removed prostate. Gleason sum of 10, pT3aN0M0. Lymph nodes and seminal tubules were cancer free.

However the cancer had spread to the surrounding tissue (positive margin). I got referred to a radiotherapy oncologist. The radiotherapist proposes radiation of the prostate bed with a dose of 60 Gr. I was also recommended hormone therapy for 3 years. Of course, I agreed to this treatment.

After about six weeks of this treatment, my PSA dropped to 0.003 ng/ml. and I suggested to my oncologist that we try intermittent hormone therapy and I stop it after eight months of use. For about a year after discontinuation of hormone therapy, the PSA is still almost zero, but it is starting to rise. I panicked a bit and with a PSA of 0.13 ng/ml I requested the oncologist to resume hormone therapy.

My PSA drops to almost zero again and after a year we decide to end hormone therapy. For about 15 months, the PSA is close to zero but then starts to rise rapidly, reaching a value of 7.9ng/mL within 7 months.

After researching information about the treatment of prostate cancer, I learned that in the last few months in Sydney, a modern SBRT apparatus has been in use, albeit still experimentally, allowing for precise radiation treatment of cancer cells.

Due to the rapid increase in my PSA, my oncologist suggests standard treatment with hormone therapy. I reminded him about the launch of the SBRT machine in Sydney and asked him to try to put me on the list of first patients. Prior to doing the SBRT the PET/CT detects three lymph nodes attacked by cancer. The nodes are irradiated with the SBRT and my PSA drops to 0.16 ng/ml.

However in 16 months my PSA rose again to 1.7 ng/ml. Repeated short hormone therapy lowered my PSA briefly but then increased again. The PET/CT scan finds that there are still cancer cells in one of the initially irradiated lymph nodes. This lymph node is re-irradiated and the PSA drops to a value of 0.04ng/ml. In February 2021, the PSA suddenly increases to 0.88ng/ml, then three months later to 1.1 ng/ml. A proceeding PET/CT and this time the scans finds prostate cancer in Para Aortic Lymph Nodes. They SBRT irradiated and my PSA fall again to 0.04ng/ml.

As I write this, I am 81 years old and it has been twelve and a half years since I was diagnosed with prostate cancer. My PSA is currently at 0.04 ng/mL.

I must also mention that from the time of my diagnosis I was intensively researching for information on treatment. I came across a Polish-language prostate cancer forum where I received a lot of invaluable information and mental health support. After some months of intensive research, I began to advise other patients on how to deal with their cancer diagnoses. This forum, has a total of over 111,000 posts, I have written over 4,000. But I have been inactive for the last three years. I left this work to the younger forum members.

wlobo135's e-mail address is: wallybocian AT gmail.com (replace "AT" with "@")


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