I initially went to the doctor because of a pain in my groin and erectile problems. A blood test December 2005 showed that I had a PSA level of 7.54. Then I went to an urologist and he wasn't happy at the results of my DRE (Digital Rectal Examination), so I had a further blood test in February 2006 my PSA was to 7.82. The urologist said go away and come back in months. Not being a very patient type of guy I sort the advice of another urologist privately. He examined me and said he could do a biopsy the following week, I didn't know at the time in visiting him that he was head of the local hospital urology department and also chief surgeon. The results of the biopsy came back positive 6 (3+3). Being only 57 years old, he recommended a Radical Prostatectomy. I had this in May 2006 Post op Gleason 7 (4+3) T3b.
The surgeon replaced the bladder valve with some kind of metal staple system and didn't touch the lymph nodes. Surgeon advised me to have EBRT (External Beam Radiation Treatment) as a precaution to pick up any dropped bits. Started six weeks of RT in Sept 2006. I didn't have much in the way of side effects during the RT. The only problem which I had at this time was a very weak bladder, I regularly had to stop the car on the road side for a pee.
After the RT the oncologist sent me for a Bone scan and CAT scan - these proved to be all clear. The metal staples show up on the CAT scan. Strange thing is I was never offered these prior to the RP. I did however have a CAT scan prior to starting the RT, this is so they could compare the before and after.
These are my PSA results for the past 3 and bit years
June 2006 PSA 0.01 ng/ml one month after op
Dec 2006 PSA 0.00
May 2007 PSA 0.00
Nov 2007 PSA 0.00
May 2008 PSA 0.00
Aug 2008 PSA 0.01 after operation on bladder stone
Jan 2009 PSA 0.01
June 2009 PSA 0.02
Sep 2009 PSA 0.03 after operation on bladder stone
Jan 2010 PSA 0.06
My blood tests were all taken in Italy and here they seem to be a bit precise with their measurements, but I understand they are bit meaningless below 0.1. [The issue of the accuracy of ultra-sensitive PSA are discussed here.] Therefore the fact they are rising I'm taking these readings as being no cause for concern.
My condition was complicated in that I have a recurring bladder stone the size of a golf ball. This was the main reason I went to see the doctor in the first place, which uncovered the prostate cancer, which the doctor missed until 2 years later. They never even picked up on this during the CAT scan and in hindsight it's clear to see. I went to my doctors in May 2008 because I was passing blood, peeing was always a difficulty. An ultrasound scan showed up the stone. I had the first one removed July 2008. They blast this away with an impact gun; I only had an epidural for this and could see it all on the TV screen. The epidural injection was the most painful thing that have ever experienced.
This stone recurred a year later and I had it removed again, but this time I never felt a thing when I had the epidural injection. The surgeon also used a laser to try and remove some of the scar tissue from the neck of my bladder hoping to allow me to pee more freely. This scar tissue is a result of prostatectomy operation. It only worked for two months and I'm now dribbling again. I'm convinced that the stone has returned I'll no doubt be needing another op some time soon.
I always seem to have this aching feely in my groin; it would be nice to know if this is from the EBRT (External Beam Radiation Treatment), RP (Radical Prostatectomy), prostate cancer or the stone.
In May 2010 I had a ecographia to see if my bladder stone had returned and there is no sign of it, good news for once.
July 2010 latest blood test shows my PSA has had another 3 fold increase to 0.18 ng/ml.
December 2010 Changed diet no red meat and non-dairy
January 2011 Bladder stone 1 cm, too small to be of concern.
February 2011 PSA 0.27.
[In an update, Stu wrote:]
Things are getting a little worse in that my PSA has reached the dizzy heights of 0.94, and the doc started me on Casodex two weeks ago. First treatment in more than 6 years, which can't be too bad.
Urologist gave me an ultrasound examination, which showd no signs of a bladder stone. He also did a DRE and suggested that I have a bone scan, which was also clear. Had a PET scan which shows a possible growth of 5 mm in my prostate bed. But there is no evidence of signs of cancer to be seen in the rest oof my body, which has to be great news. At least I can still continue with the vino.
Discussed the scan results with my Urologist and after another DRE he confirmed the evidence of the tumour. He prescribed Caosdex 150mg taken on alternative days for 2 months then have another PSA test. He didn't believe any stronger treatment was necessary at the moment..
PSA dropped to 0.14. Urologist reckons that I should stay on Casodex fro another 3 months, but reduced to taking 50mg daily.
PSA now at 0.12 still on Casodex 50mg. My Urologist suggests that I keep on them fro a while longer.
PSA risen slightly to 0.15 still on Casodex 50mg and to remain so for at least another 4 months, at the advice of the Urologist. To spoke to him about my man boobs and he said that there was nothing that can be done. A small price to pay in other words.
PSA risen again to 0.18 still on Casodex 50mg. Had my Testostreone checked for the first time, more out of curiosity 6.4 ng/ml (22.2 n/mol). I complained agian to my Urologist about the size of my BOOBS, as he said in October they wouldn't get any larger, but they have. He suggested that I could take a 3 month break from the Casodex and see what happens. I've decided to do this, but to complete the supply of tables that I currently have, which is another 2 months worth.
Last Summer I was on holiday in France and lying by the side of the swimming pool, it was bloody embarrassing when my boobs, were bigger than the 6 ladies also lying around the pool, and now they are even larger, so I guess there won't be any trips this Summer involving swimming pools.
May 2014 Blood test PSA 0.21. Deciced to stop Casodex to see if man boobs will reduce in size.
June 2014 Blood test PSA 0.58 doubled in a month, terrible news. Decided to restart Casodex. Testosterone 4.5 ng/ml
july 2014 went down the path of having a Mastectomy, with all the scans and tests that followed, no troubles were found. As this was classed as a non-urgent operation I'm still waiting (June 2015)
Sept 2014. Had a colonoscopy all clear.
October 2014 Blood test PSA 0.28 Ng/ml Casodex is still working. Testosterone 22.4 pg/ml.
December 2014 Changed Urologist, he recommended switching to Prostap. Had a 3 monthly injection. Also had a PSA test as a reference 0.29 ng/ml.
Febuary 2015 Blood test 0.14 ng/ml Testosterone 0.1 ng/ml. Prostap appears to be doing it's job. However having a lot more hot flushes than I had with Casodex.
29th May 2015.
Full blood test. PSA 0.09ng/ml. Lowest ever since started to climb 5 years ago. Testosterone 0.1 ng/ml
11th Sept 2015
Full blood test PSA 0.16 ng/ml
11th Dec 2015
Flood blood test PSA 0.39 ng/ml Testosterone 0.9 pg/ml. Mentioned to urologist that I was having a bit of trouble peeing. He tried to insert a catheter, which wasn't possible and very painful. He recommended a stricture operation, booked for 11th Jan 2016. 3 monthly Prostap injection.
19th Feb 2016
underwent stricture op on the 11th as planned. Full blood test PSA 0.41 ng/ml. Testosterone 0.3 ng/ml
5th March 2016
Met with urologist as I can't control my urine flow. Had 3 monthly Prostap injection.
Lot more to follow, getting bit b with this update.
Stu's e-mail address is: firstname.lastname@example.org