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Rudy E lives in Florida, USA. He was 59 when he was diagnosed in December, 2005. His initial PSA was 5.65 ng/ml, his Gleason Score was 6, and he was staged T1c. His initial treatment choice was Surgery (Manual Laparoscopic Prostatectomy) and his current treatment choice is None. Here is his story.

I was having no symptoms when I was diagnosed. My PSA had steadily risen over five years, with it jumping from 4.8 to 5.65 over 12 months. The doctor frowned, looking at the PSA report, and I said "Do you want to biopsy the prostate?" His reply was: "Yes, just to be safe. But we won't find anything." A week later he was telling me that I had prostate cancer. Four of 12 tissue samples were malignant, two were suspicious. The urologist said the gold standard was surgery, and he proposed doing a cut-you-open procedure.

It was a stressful experience because I immediately began to project to worst case scenarios, imaging that the cancer had spread outside the prostate. CT and bone scans said otherwise. I began looking for doctors who could do robotic or laparoscopic surgery. My worst moment was at the Cleveland Clinic near Miami. The doctor said I weighed too much (255 pounds, 5'11'' tall) to have robotic surgery. He also recommended against radiation because the cancer was on both lobes. I found numerous doctors that said I was a good candidate for robotic or laparascopic surgery. I decided to have the surgery at the Moffitt Cancer Center in Tampa.

Dr. Pow-Sang, who had done thousands of laparoscopic procedures, performed the operation. I spent one day in ICU: the surgery lasted longer than normal due to difficulty in removing the prostate (it was very enlarged) and I was slow in awakening. I was discharged home two days later with a catheter, which I had for three weeks. You get used to it after several days. Although I had nerve-sparing surgery, I suffer from erectile dysfunction. Viagra helps somewhat. I am also mildly incontinent. In 2010, scar tissue from the surgery started to block my bladder opening. I underwent bladder neck surgery, an outpatient procedure, to keep the opening from closing. That increased my incontinence. I wear one pad every day.

I'm OK with my decision to have surgery: my PSA remains undetectable seven years later. An important fact: your chances of getting prostate cancer are increased by 50 percent if anyone in your family has the disease. My father had prostate cancer - treated with radiation - as did my brothers Jim (radioactive seeds) and Greg (surgery). My dad's cancer never returned: he died 20 years after treatment from Alzheimer's disease. Jim and Greg are doing well. If you are a Vietnam veteran and are diagnosed with prostate cancer, you are entitled to VA disability. There is a presumption that you were exposed to Agent Orange. I recently learned that I have a small tumor on my right kidney and will need to undergo surgery. There are studies which show a connection between kidney cancer and Agent Orange. The VA, however, has yet to list kidney cancer as a service-connected disease due to Agent Orange exposure. Prior to my surgery, I walked seven miles a day for a month, losing 15 pounds. It helped give me a positive frame of mind. My best advice: advocate strongly for yourself, research the pros and cons of the treatment options, make a decision that is best for you. I don't believe in watchful waiting, although prostate cancer is normally slow growing. To me, you're waiting for the cancer to spread.

UPDATED

August 2014

My PSA remains undetectable, eight years after surgery. I underwent surgery in October, 2013, to remove a small tumor from my right kidney. It turned out to be benign ... I started attending a men's clinic last year in an effort to have an erection. Viagra does not work. I have been giving myself injections of Edex, slowly increasing the dosage over time. It has not been successful. I am not able to maintain an erection. So I plan to try a pump and will consider an implant. I am lucky in that I have a sensitive, understanding, passionate partner. We have an excellent sex life, despite the erectile dysfunction. I am 68; she is 61. But we act like teenagers in the bedroom.

UPDATED

August 2014

Forgot to mention in my original posting that my Gleason score after prostate surgery was increased from a 6 to a 7 (3 + 4). I had a single suspicious cell on the margin, according to the pathologist.

UPDATED

September 2015

I have my PSA checked every six months: a friend had his prostate cancer return nine years after surgery. In the past year, I have undergone two cystoscopies to check on my bladder neck opening. Reports were good both times. I am considering a penile implant - Viagra and injections have not worked. Although I perform well in the bedroom, I miss the physical and emotional connection that an erection brings. We'll see what my doctor says about the situation.

UPDATED

November 2016

My PSA has been mostly undetectable. In June I had a cystoscopy and dilation to widen the urethra and improve the urine flow. It's been more than 10 years since my prostate surgery, and I feel fortunate that I am still alive and kicking.

UPDATED

December 2017

I continue to receive PSA tests every six months and remain prostate cancer free twelve years after my initial diagnosis. My three brothers, who were each diagnosed with prostate cancer years ago, are also doing well. The side effects of my surgery continue to include erectile dysfunction. I have little response to Viagra and VED. But bedroom play remains good.

UPDATED

January 2019

My surgery was done more than 12 years ago. PSA, checked every six months, remains undetectable. I have tried pills, injections and a pump to overcome impotence, but nothing has proved effective. I have learned to live with the condition, partly thanks to a loving girlfriend who is supportive, passionate and creative ... My father (radiation) and two brothers (surgery, radioactive seeds) were diagnosed years ago with prostate cancer and are doing well. A third brother just recently was diagnosed. He plans to treat his condition with radioactive seeds.

UPDATED

February 2020

I had prostate cancer surgery in March of 2006. PSA has been undetectable for the most part. I am tested twice a year. Last test showed a slight increase. No changes in sexual fuction. Considering penile implant surgery.

Rudy's e-mail address is: hardesty5tt AT gmx.com (replace "AT" with "@")


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