Before the age of 55 I've had several DRE's done with negative reports so I was not really concerned with PC but in June of 2011 at the insistance of my mother I went to a local clinic for a free PC screening. The DRE was negative but the PSA was high at 36.7 (my first PSA test that I can remember ever having). Due to the high PSA and the insistance of my mother I enrolled for medical care at the Michael E. DeBakey VA Medical Center in Houston. After another PSA test of 38.23 I was fast tracked to the Urology Dept. which performed a Prostate biopsy with a report of 11 of 12 cores were positive with Neuroendocrine pattern seen on 2 cores. After the biopsy and a cosultation with the Uro surgeon I was fast tracked for a RALP DaVinci operation on Feb 13 2012. I was surprised I was given the choice of having a RALP due to the Gleason 9 rating but I thought removal of the prostate was my best choice for treatment.
After surgery the pathology report stated that Adenocarcinoma and Neuroendocrine carcinoma was present in the prostate which surprised the Uro and myself. Neuroendocrine carcinoma is rare in PC and it carries a very bad prognosis of recurrence and survivability; so I was fast tracked, again, to the Oncolology Dept. which recommended I start ASAP on chemotherapy.
Chemotherapy will start this Monday along with a hormone shot of Zoladex and radiation will be considered on down the road. During this time I was given CT and MRI scans which found some small spots (5mm) in my lungs but the the report was inconclusive so the Onco ordered some new scans to compare with the old scans. The new scan showed the spots in the lungs were now 7mm so I think that the chemo is a good treatment path with my PC. My stats are:
Pre-op PSA
36.7ng/-DRE/6-24-11
38.23ng/10-06-11
Biopsy:12-09-11
11 of 12 cores +/Neuroendocrine pattern seen on 2 cores
32.13grams/PNI/+DRE/-Bone scan/CT scan inconclusive (spots in lungs-5mm & prostate area)
G9 4+5
RALP/2-13-2012/60grams
Radical prostatectomy and bilateral pelvic lymph node dissection
Adenocarcinoma and Neuroendocrine carcinoma
Tumor involves 90% of prostate
Extraprostatic Extension (EPE): Present, nonfocal, extensive
Seminal Vesicle Invasion (SVI): Present, extensive
Lymph-Vascular invasion (LVI): present
Perineural invasion (PNI): present
Margins uninvolved by invasive carcinoma including apical, bladder neck & multiple lateral margins
G9 4+5
pT3b
Post-op PSA
5.0ng/6.5wks post op/3-29-12
CT scan-some growth (5mm to 8mm spot in lungs) & Prostate Lymph Node spots
Chemo-Cisplatin & Etoposide 4-09-12
Hormone shot-Zoladex 4-09-12
Uro last visit Apr 11
Almost a week has passed since the chemo started and I was hoping the worst has passed but I'm unsure of when it will pass.
I was given 50mg Etoposide pills to congest on Tues and Wed but the dosage was twice the amount given during the chemo drip of 100mg on Monday, meaning I had to ingest 200mg's (8 pills) Tues and Wed. I think this dosage is wreaking havoc on my system due to the side effects I am now experiencing, also being my first exposure to the chemo and hormone drugs.
The side effects hit hard Tuesday night; urges every 2 hours to get up and urinate, an unquenchable thirst and it appeared to be alot of water retention. The pills (8 of em) seemed to just eat me up from the insides; I started having bad heart burn which resuted in more water intake plus I lost the urge to eat. I know you're supposed to eat but it seems that eating only fuels the fire of those pills.
Friday I started eating more, been waiting for the pills to exit, but sleep seems to be the same; waking up every 2-3hrs with a thirst. Today is Saturday and I started it off with a egg omelet, haven't had any nausea (maybe slightly) so maybe it's back to the old self...been some ringing in my ears, don't have any idea why.....
Current PSA is 1.4ng, hoping it will lower some more. The chemo drop down list for "sub treatment" doesn't have the drugs I'm taking so I'll list them:Cisplatin and Etoposide. I also received a 3 month HT called Zoladex and that's all for now.... Revision: I'm going to to choose my current treatment as "other" since there's conflict with the sub treatment choices......
I forgot to add that the 2nd session out of 4 chemo treatments was yesterday, April 30th, the same day the PSA test was done...
[Sadly, we were informed that Ken passed away on January 18, 2013.]