Had PSAs from 4.2 to 6.3 in 2003 which indicated enlarged prostate. Took Leviquin 500 mg which lowered PSA to below 3.0. In 2007 PSA went up to 5.0 and dropped back down to 2.65 with no meds. On November 26, 2008 it was 4.07 and I took 30 days of Leviquin. Had PSA test on February 5, 2009 and it rose to 4.4.
Digital rectal exam indicated no cancer but a 12 core biopsy was taken on March 31, 2009. Pathologist's report showed only one core had Gleason score of 7 (3 + 4) involving approximately 10% of tissue. All other cores were benign. Sent biopsy to Bostwick Laboratories for second opinion which was identical to first report.
My urologist is recommending robotic (Da Vinci) laparoscopic radical prostatectomy to remove prostate but wants me to get other opinions. I will be seeing a radiation oncologist on May 13th.
My mind is one of taken care of the cancer now and not watchful waiting. However, I feel a lot is riding on that one core being cancerous. Also I am not keen on resultant ED and incontinence issues if I do something.
Any advice would be appreciated.
Saw radiation oncologist on May 13 and discussed various radiation treatments. Best for me would be image guided radiation therapy. On May 19 had third opinion from another urologist who suggested getting bone and CT scan to confirm cancer had not spread from prostate.
On May 29 CT scan showed small areas in right and left iliac wings that could be metastatic disease or bone islands and recommended correlation with bone scan. Bone scan on same day showed suspect metastatic disease at left iliac wing. To confirm no disease on June 17 had left iliac bone biopsy which was negative for malignant cells. Thank God.
I have decided to have robotic prostatectomy because the cancer is confined and in my mind prostate removal is the cleanest way of dealing with it. I can also use radiation in the future if cancer shows up again. I also have an enlarged prostate (BHP) will no longer have to take flow meds.
I am scheduled for surgery on August 12 with my urologist who has performed over 300 procedures using the Da Vinci surgical system. Operation will be at Morristown Memorial Hospital in NJ known for it care and efficiency.
I have had my pretreatment tests and attended a 1 hour seminar in which a nurse explained the entire procedure in great detail, what to bring and what to expect during the whole operation. Also at the seminar was a member of US TOO, a prostate cancer support group that shared his robotic surgery experience from 3 years ago. It can't get better than this.
My surgery was early in the morning and I was discharged at noon the next day. Then two things occurred. Because my prostate was enlarged, the healing of the urethra to the bladder took longer to heal so by the third week the catheter was still not removed. Further compounding the issue was I had to return to the hospital due to high fever which was caused by a multi-antibiotic resistant organism in the urine called klebsiella. The infection from what I was told was actually hospital acquired, probably via the catheter at the time of my surgery in August!
The only IV antibiotic that the organism was sensitive to was an old medication (used in the 60's) called Colistin whose side effects were very nephrotoxic. So my kidney profile had to be monitored closely. Also during the 12 days I was in the hospital an IV catheter had infiltrated and I developed a phlebitis of the right arm, which required treatment with yet another IV antibiotic.
On September 15, 2009 I underwent a CT scan of the pelvis to see if the small leak of urine from the bladder neck reconstruction had healed, which it had, and finally, after 35 days of having had an indwelling Foley catheter in place it was mercifully removed.
All my urine and blood cultures to date have come back negative indicating that the infection medication did what it needed to do. The pathology report of my prostate showed the cancer had not spread beyond the walls, T3, Gleason of 3 + 4.
Thank God for my wonderful wife. Other than being so supportive she is a doctor which helped me get through this horror story. I am doing advanced Kegels and have resumed biking and hiking activities. I also have gone to the US TOO support group monthly meeting. Really great to share experiences with others. Next week I will go for my first PSA test since surgery.
Later: My first post surgery PSA test taken on Nov. 23 yielded 0.1 ng/ml meaning cancer is undetectable. It was indeed a very Happy Thanksgiving we celebrated.
It has now been one and a half years since surgery.
My PSA was initially 0.1 so my urologist had my next PSA done with the most accurate test method. Results have been <0.1 and I now get tested every six months instead of every three.
I do not need any pads but find I leak a drop or two when lifting or exerting especially outside in cold weather.
As for sex I have tried Cialis and Levitra but results are poor. What really works best is injecting Trimix. I am being patient in this regards and hopefully "time heals all wounds".
I think my decision to have surgery was an excellent decision and happy I choose this path.
It has been over 2 years since surgery. In November had ultra sensitive PSA test that was <0.1 so I am doing great. I have to concur with recent research that the ultra sensitive PSA test could be more error prone than normal test. I am going to review this with my urologist on next visit.
Still need tri-mix needle injection to overcome ED. Recent article in NY Times stated 10 to 70% of men still have ED after 2 years from treatment. This is me. Some doctors don't really warn men about this side effect figuring they may shun treatment. So I am advising men that you may never be home free in regards to ED but it is definitely worth it to be rid of cancer.
Continue to have ultra sensitive PSA tests every 6 months and thanking God the results are <0.1. Use injections for erectile dysfunction but that is a small price to pay for being a healthy 71 year old. Also joined the YMCA (gym) and enjoy staying in shape.
After 4-1/2 years from my surgery the good news remains good. My latest PSA test this month was undetectable. And that was the sensitive PSA test. ED remains but when using injections everything works. Still feel surgery was a good decision.
It has neen 6-1/2 years since surgery and I am now 73 years old. PSA is still undetectable. From taking the PSA test every 6 months, I am now doing it annually. ED has gotten a little worse so now my tri-mix or injection is double dosage. Again a smalll sacrifice for not having cancer.
It has been 7 1/2 years and I am staying the course. Yearly PSA test on 7/14/16 was <0.1.
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