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Charlie C and Cathlene live in California, USA. He was 73 when he was diagnosed in June, 2008. His initial PSA was 4.10 ng/ml, his Gleason Score was 7, and he was staged T1b. His initial treatment choice was Non-Invasive (Active Surveillance) and his current treatment choice is None. Here is his story.

I'm a native Californian, growing old in retirement. Started going to a urologist in 1998 at age 63 for BPH (Benign Prostate Hyperplasia) symptoms. He put me on Cardura, which worked well for a while, but with worsening symptoms as time went on. I moved and located a new urologist in 2001. In this time frame, my PSA went from 1.9 in 2000 to 3.0 in 2003. After Cystoscopy in early 2004, the doctor recommended laser - green light - TURP (Trans Urethral Resection Procedure), which was performed in June of 2004. The good side - the procedure went well with an overnight stay in the hospital. Was back at work within 2 days. The not so good side - BPH symptoms slowly closed in over time - just difficulty in urinating.

Cystoscopy in March of 2008 showed re-growth, so the doctor recommended a conventional TURP procedure. PSA at that time was 4.1 The TURP was accomplished on May 28, 2008. 48 hours with the catheter wasn't fun, but tolerable. It took a while at home to get things calmed down - there are skid marks on the floor where I turned in to the bathroom with that urgent need. Unlike the laser procedure, the conventional TURP was very effective in clearing up BPH symptoms.

Five days after the TURP I got the call. "You have cancer!" Based on the TURP chips, the report showed Gleason (3+4) = 7, with 25 % of the 21 grams of chips involved. Staging is T1b. I've read cancer is detected this way a pretty small percentage of the time. Met with the doctor and scheduled a biopsy for September 12 (allowing time for the TURP effects to settle down).

Oddly, just prior to the biopsy, the PSA had dropped from 4.1 pre-TURP down to 0.4 post-TURP. It would seem the TURP cleaned out a good deal of cancerous tissue and a lot of the prostate. Got the 12 core biopsy results back - negative for cancer. All cores normal!

Did follow-up with the doc 16 weeks after the biopsy. PSA was up to 0.8, doubling in 3 months, but biopsy effects may be influencing the result, I'm told. That brings us to the end of January 2009. The next PSA and visit will be in April.

So, here I am, certainly not alone when it comes to PCa, but feeling like an odd-ball with T1b staging and then a negative biopsy. What a combination! The good news, all functions are normal. I can pee again, like a teenager, a real delight for a 73 year-old. Hopefully more PSA results will show better what the trend is. Meanwhile I'm doing a lot of reading, and watching and waiting, which is the last thing I ever thought I would do.

Charlie

UPDATED

April 2009

Had a visit to the Urologist in early April. My PSA has gone back down to 0.4, the same as at 3 months post-TURP. A real roller coaster ride over the last 8 months, from 0.4 to 0.8, now back to 0.4. I'm now on a 6-month re-check cycle. With the negative biopsy after TURP, and the latest PSA at 0.4 again, we are in the active surveillance mode.

I'm pleased I have basically no side-effects from the TURP. Have yet to find others that have knocked out their cancer with a TURP procedure, if that is what has occurred.

UPDATED

December 2009

Had the six month PSA mid-September. Came back 0.5, urologist is pleased with that result (was 0.4 one year ago). Had another 12 core biopsy in late October that came back negative. Will be staying on the 6 month schedule for PSA.

Looking good, so far.

UPDATED

January 2011

Am continuing on active surveillance. Since the September 2009 PSA of 0.5, and negative biopsy in October 2009, I have seen PSA's as follows:

April 2010: 0.7
June 2010: 0.6
October 2010: 0.6

Have minimal, if any side effects from the TURP. I had the TURP residual slides reviewed by a second lab in June. They reported back Gleason 6, 25% of the material, instead of the Gleason 3+4=7 from the first reading.

My urologist is pleased with negative DRE, two negative biopsies, and the PSA holding at 0.6. Recommends staying on active surveillance, testing every 6 months. I'm staying the course.

UPDATED

May 2011

Just completed the latest 6-month checkup.

DRE was OK, latest PSA - April 2011: 0.70

With those results, we are staying the course. No biopsy now, just another testing in 6 months. Urination is still like a teenager (after the TURP).

UPDATED

January 2012

Following my TURP procedure in May of 2008, my PSA moved from 4.1 pre-TURP to 0.4 post-TURP, then to 0.7 in 2 years. It now varies from 0.6 to 0.7. Have been testing on a 6-month interval. The latest reading in October 2011 was 0.6.

The tentative conclusion by my doc is that the TURP procedure in 2008 removed most if not all of the cancer (That's also how it was discovered). So, closing in on 4 years this May, we are now on a 12 month PSA testing schedule. Also, no need for more biopsies at this point.

Side effects of the TURP are nil. Still peeing like a teenager with good single sphincter control. Feel I was very fortunate to have had an excellent urologist, and lucky to apparently have had the cancer removed by TURP! I say "apparently" since we still have to monitor the PSA.

Life is good.

UPDATED

November 2012

Just had my annual PSA test. Came back at 0.7. It varies from 0.6 to 0.7 on an annual testing basis the last few years. DRE is normal and the Doc is pleased, so we are good to go for another 12 months. Cancer removal by TURP is apparently my story, so I'm sticking to it.

UPDATED

October 2013

Just completed the annual visit to the urologist. PSA is holding steady at 0.7 and DRE was normal. Nothing exciting to report, which is good news. The TURP from 2008 is still effective - no BPH symptoms. With the PSA holding steady at 0.7, produced by whatever is left of my prostate after TURP, and no sign of the cancer, will be staying on annual checkups. As I've said before, life is good.

UPDATED

November 2014

Just completed the annual visit to the urologist. Boring! PSA is holding steady at 0.7 and DRE was normal. The TURP from 2008 is still effective - no BPH symptoms. With the PSA holding steady at 0.7, produced by whatever is left of my prostate after TURP, and no sign of the cancer, will be staying on annual checkups.

UPDATED

December 2015

Just completed the annual PSA test and checkup. PSA came in at 0.6 - it hovers between 0.6 and 0.7 each year. DRE was normal, so next checkup will be 12 months from now. No leakage despite living with a single sphincter (the one nearer the bladder was reamed out by the TURP). No BPH symptoms, which is great. Good to go for another year!

UPDATED

October 2017

After maintaining a PSA of 0.6 to 0.7 for a number of years, results from October 2016 testing showed an increase in PSA to 1.1. That's slightly more than 50% increase in one year. Subsequent testing through June of 2017 shows we're holding at PSA = 1.1. No idea why the jump, so we're now on 6 month testing cycle. DRE provides no clues. It was a nice run of 8 years. Now back to PSA test apprehension. At age 82 I'm looking for at least another 15 years, so future treatment may be in the cards. We'll see.

UPDATED

January 2019

My last PSA was 0.98, done in August, 2018. So, I have been holding more or less steady in 0.9 to 1.1 range since October of 2017. Still no explanation of why the change from the previous 0.7 level, but I'm happy with a steady PSA level. The TURP procedure from 2008 resulted in a strong urine stream, which continues to date. No side effects other than I'm left with a single sphincter. Will now likely revert to annual PSA testing.

UPDATED

March 2020

This watching and waiting isn't fun. After the discovery of my PCA by TURP, my PSA held around 0.7 for a number of years. Then in 2018, it started holding level at around 1.0. That held until August 2019 when we went up to an average 1.9. Looked like a new trend was moving upward. Went back to 6 month testing and in February, 2020, it came back down to 1.22. That was good news, so now we continue testing at 6 month intervals. No explanation for why the rise in PSA - banking on the new trajectory. Gonna be 85 next month, so I'm having a good run after the discovery of PCA during the TURP. Life is good.

UPDATED

August 2022

Not much new to report. The PSA hovers around 1 since 2017, doing annual checks. The TURP procedure resulted in long lasting elimination of the urination problems I experienced that led to the TURP procedure.

Charlie's e-mail address is: charlie.pca AT comcast.net (replace "AT" with "@")


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