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Ron Shaffer and Lila live in Arizona, USA. He was 71 when he was diagnosed in October, 2010. His initial PSA was 10.20 ng/ml, his Gleason Score was 7, and he was staged T1c. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

Have had increasing PSA over the past 6 years. Starting at 3.9, then 6.9 and currently 10.2. Have had three biopsies. Biopsy 6 years ago was negative at PSA of 3.9. 2008 PSA was 6.9 and also negative 12 point biopsy. October 2010 biopsy with PSA 10.2 was positive for PC in 2 of the 12 samples on right side, both near perimeter of prostate.

Oncologist suggest Active Surveillance (AS) and research on what would be my best option. Freezing, surgery or RT. Read "Invasion of the Prostate Snatchers" by Scholz & Blum, "Guide to Surviving Prostate Cancer" 2nd ed. by Walsh and Worthington, and "Surviving Prostate Cancer Without Surgery", by Hennefent. Spent many hours for two month doing my research.

In the office of my oncologist is a Da Vinci "certified" (150) oncologist (Call him Dr. Sam). Made appointment with him and he said his mentor told him that one should VERY carefully consider one's options and that the first "decision" is often not best one.

Dr Sam recommending Avodart daily to reduce the PSA and slow the PC growth. I went in for my annual physical with Dr. Wilford Miller and found that my PSA had gone up to 10.6. At that point I felt that AS wasn't working for me and that the percentage of possible PC outside gland was 45%. I decided to go with robotic surgery over IMRT/IGRT.

I'm scheduled for surgery February 1, 2011.

UPDATED

February 2011

Had Da Vinci robotic surgery February 1 2011. Went home Feb 2. Catheter out Feb 11.

Post biopsy show Gleason 3+4 cancer in right lobe, some in left. Cancer contained within prostate. No further treatment required!!!!

Now two days after catheter leak readily as soon as I stand up. Mostly dry at night, but I get up and void three to four times. Have started Kegel exercises, but see no marked improvement in retention when I stand over the past two days.

Would like to ask community about experiences following RP. Does it just take time for healing to allow for better control?

UPDATED

April 2012

Following surgery my PSA was less than .03 at 3 and 6 months. At 9 months was .05 and also. .05 at 12 months. Test for PSA every 3 months, but only see my surgeon every 6 months.

Sexual function is pretty much no existence. Can get 70% erection, but not enough for intercourse. Have penile pump but find the process to burdomesome to use. Lack of sexual activity has not been a big factor in our relationship. We'll celebrate our 50th this summer with our family in Seattle.

Dr. Ramakumar removed the nerve net on the right side, but saved the left. Am hoping to recover sexual activity in the future.

Have to urinate a lot, but sleep with no dripping.

UPDATED

May 2013

After robotic surgery my PSA figures at 3 month intervals were as follows: <0.03, < 0.03, 0.05, 0.04, 0.05, 0.09, 0.12.

At that point my radiation oncologist recommended True Beam radiation therapy. 10/15/12 to 12/6/12 I had 38 treatments. At 2/25/13 PSA was .14. Will get another reading next month. Hoping PSA results are downward.

UPDATED

June 2013

Latest PSA reading .25. Three months ago was .14.

Check again in three months.

UPDATED

July 2014

Last two PSA readings were .40 and most recently 1.0. Having PSA checked again. If still in the 1.0 range will discuss with urologist Dr Sanjay Ramakumar treatment options. Most likely Lupron will be at the top of the list.

UPDATED

August 2014

Have a recent PSA done. Was 1.3, following a 1.0 a month earlier. Urologist/surgeon Dr. Sanjay Ramakumar recommends I see him as soon as his new medical practice approves my Health Net carrier. Most likely will recommend Lupron or some such T blocker.

UPDATED

February 2015

My PSA continued to climb after radiation. Last fall my Urologist/surgeon Dr. Ramakumar recommended that I start on ADT. Starting December 2014 I started on taking Degrelix (Firmagon) to zero the testosterone and XGEVA (Denosumab) to help with bone development. Sleeping was an issue as I would be awakened by heat flashes 6-8 times. Was getting only 4-6 hours sleep. Tried several drugs to help with heat flashes and dropped them to more recently taking Ambien, but after 10 days or so wasn't very effective. Now I try do deal with the residuals on my own. I awake numerous times but generally go back to sleep in a short time.

I get monthly injections of both the Degarelix and XGEVA. Dr. Ramakumar tells us that so long as I have the monthly shots I should be good for lengthy life. Said with no treatment I'd have 1-3 years to live.

With the monthly injections my PSA <.05.

UPDATED

February 2015

I had forgot an important point in my recent update. The reason I started on a more agressive treatment, rather than Lupron, was my prostate cancer has metastasized the T5 vertebrate.

UPDATED

January 2016

Have been on ADT Firmagone for past year.

Ron's e-mail address is: rongv@cox.net


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