Posted 9/17/2011 8:03 PM (GMT -7)
When I first found out that I had cancer (3/29/11) I was scared I thought every pain I had was cancer and sure I was going to die soon. I had trouble sleeping. I lost weight. I could think of little else. It was a shock. Looking back, this was my lowest point...the days after being told I had cancer.
I got good advice here such as not rushing into anything, exploring all my options, educating myself, keeping a journal and taking someone with me on doctors appointments. You think you will remember what the doctors are saying, but it's great to have the notes to look back on and results of tests in one place. I asked advice on this forum on what questions to ask. I would write them down in my notebook and be sure that I got answers on my appointments. My wife and I got tired of going to doctor’s appointments. It's exhausting, but worth it.
Initial Meeting after biopsy (4/14/11):
6/18 areas positive - 2 in left base, 4 left apex. G6 (3+3). 33cc. T1c. Bone scan neg.
Urologist said 2 in left base, 4 left apex, but looking at the path report, I see:
L apex anterior, L apex mid, L apex posterior, L apex lateral, L base mid, L base lateral
Seems to me that the whole left side in involved including the mid, but the Urologist drew a prostate, divided it into 6 sections and put 2 marks in top left and 4 marks in the bottom left.
He recommended surgery (and would not wait longer then 6 months), although says that radiation is an option also. He does not do robotic, but has Docs in his office who do. He does not recommend AS due to my age (61 – I like this…I keep getting told how young I am!). I did ask how long I would live if I did nothing and he said that "they" say 17 years average. I did like the thought that if you do AS, who knows what advancements may come about while on AS. The Urologist I saw had RPS 5 years ago and everything is back for him (no ED and he is continent, although may leak a bit if lifting something heavy).
Second Opinion with Urologist 5/4/11:
I saw Dr. Wehle, a Urologist, at the Mayo yesterday. He was recommended by another doctor at the Mayo that we know. He has done over 500 Robotic prostate operations. On the ride down with my wife, I told her that my preference right now is seeds: less time out of work, less evasive, less side effects and about the same cure rate.
First his PA came in looked at the biopsy and said that surgery would be the best choice for me and they probably would not be able to have to spare the nerves on the left side because that is where most of my cancer is. He also said that he wanted me to know that at the Mayo, they are not paid by how many operations they do and they want what is best for the patient. I have a tendency to think some PA's are PA’s and not doctors so I take them with a grain of salt.
Then Dr. Wehle came in. He said that AS is not an option for me with a G6 and that surgery is the best option for me. Most important: 1) take care of the cancer 2) incontinence 3) ED; in that order. He said that radiation never bests surgery and there are fewer problems with surgery. Radiation may have as good a survival rate, but never is better. He said that he can fix problems caused by surgery, but not problems caused radiation. He said once the radiation is complete, the radiation oncologist's job is complete and they do not have to deal with the problems. The urologist is the one the patient sees if there are problems (and that makes sense to me) and he sees a lot of problems from radiation (3 patients a week - is what I think he said). If things go wrong with radiation such as radiation burning through the rectum, I'll be peeing out my butt or if radiation hitting the bladder and there is nothing he can do to fix it. If surgery fails, I would have radiation as a backup. With radiation only have HT as a backup. They have my slides from the biopsy, but have not read them yet and he will call me when they do.
Surgery: Hospital stay 1-2 days. Catheter out after 7 days. 2% need transfusion. Can save nerves 80% of the time and said that probably can save nerves on both sides with a G6 (contrary to what the PA said). 90% of patients are continent within 6 weeks. Spontaneous erections could take up to 1 - 2 years (and I did not write down the % of total ED if nerves are spared). I asked about ejaculating urine and he said that can be the case, but not in most cases. I asked about penis shrinkage and he said that can be true, but that comes from lack of use and the sooner you use it (PT) the less that would be a factor.
My next appointment was with Dr. Buskirk at Mayo (5/17/11):
My wife and I met with Dr. Buskirk at the Mayo. He was referred by the urologist (Dr. Wehle) I saw a week and a half ago at the Mayo. We really liked him and thought Dr. Buskirk was knowledgeable, took his time with us and presented what he saw as my options clearly.
He did not suggest AS because of my age. He said that surgery or seeds would be his two top choices for me.
He went on to explain that at the Mayo they do mostly IGRT, which is a nice fit for someone older than me. He went on to clearly explain IGRT which he said would be his third choice for me.
As far as seeds he suggested that I see Dr. Turk at the FROG (Florida Radiation Oncology Group). He said that he knows Dr. Turk and Dr. Cesaretti very well and both trained with the Mt. Sinai group (under Dr. Stock?) and do hundreds of seed procedures a year. I have heard other good things about Terk from people who have been treated by him. He said that the seed procedure is highly operator dependent as is surgery. I asked about the fact that Dr. Wehle said that he sees the problems caused by radiation that can not be repaired and Dr. Buskirk said that is why you want someone performing the operation that is highly skilled and has performed many seed procedures. He also said that people come to the Mayo and Dr. Wehle (who he knows well and say is an excellent urologist and surgeon) sees case from all over the county that have had procedures done at facilities that are less than stellar and hope to have them fixed by Dr. Wehle.
He said that they had problems with seeds early on (when they started doing the procedure), but they have refined the seed procedure and placement over the years and now have a better template for insertion of the seeds. He said that 15 years out surgery has about an 80% "cure" rate and seeds have a 90% cure rate. If surgery fails I have radiation as a back up. If seeds fail I have HT as a back up (although there other drugs in the pipeline - please excuse my spelling but some of them were Casadax, Kedochomosole, Provenge). When I asked why seeds over IGRT he said because of my age, size of my prostate (33cc), I don't have any urinary flow problems, no flow problems after the biopsy, my PSA <10, Gleason 6 and they can put a higher dose of radiation with seeds than IGRT. He said that leakage is not a problem and does not get worse over time. He said that ED can get worse over time because the radiation constricts the blood vessels over time and is accelerated by aging, but ED drugs usually do the trick if that does happen. He said there would be some possible burning and urgency at for a period.
Bottom line is that he thought my chances were very good with either surgery or seeds. I asked him what he would do and he said it would be a tough choice and both would be good with my stats. I came away feeling good about my choices. Now my next step is to see Dr. Turk at FROG. I am leaning towards seeds at this point because: 1) less invasive (outpatient procedure similar to biopsy), 2) same (or better) "cure" rate over 15 years, 3) no incontinence problems, 4) little or no ED problems, 5) no catheter after procedure, 6) back to work quicker, 7) don’t ejaculate urine when you have an orgasm, 8) no penis shrinkage . I will wait to make my decision until I see Dr. Turk.
Then I met with Dr Turk (6/13/11):
My wife and I met with Dr. Terk of FROG (FL Radiologist Oncologist Group) Monday. He was referred to me by the radiologist oncologist tat the Mayo. He has done thousands of implants (hundreds each year), teaches and writes. He is the last doctor I wanted to see before making my decision on my plan of treatment. He said that I have three basic options.
1) Surgery 90% success rate after 10 years
2) Seeds Alone 93% success rate after 10 years
3) Seeds, wait two months, then 5 weeks (5 times a week) IGRT 96% success rate after 10 years
You may want to dispute the percentages, but all are above 90%, so all good choices and I will not dispute them. His first choice would be seeds and IGRT. A close second choice is seeds alone. Third choice is surgery (as you might expect).
He said the side effects can be burning and frequency when urinating (because the urethra gets a full dose of radiation) for a month or so and while doing the IGRT. Four percent will need a catheter after the procedure. No incontinence. ED in less than half of patients. It's an out patient procedure very similar to a template biopsy. He said that out of all the procedures he has done he has only had one where there was a major problem.
He recommends the seeds and IGRT for me because of the location of the biopsy findings (4 apex and 2 base - out of 6 positive) near the edge of the prostate. He said that he would be comfortable with either choice though. If I went for seeds alone, then I would get a higher dose of radiation in the seeds. If I went for seeds and IGRT then a lower dose in the seeds, they would plant gold markers and then get the IGRT in two months. I have liked the idea of seeds from the start. My wife liked the idea of surgery after meeting with Dr. Wehle at the Mayo, but after meeting with Dr. Buskirk at the Mayo and Dr. Terk, she is now in favor of the seeds also. My reasoning is this. The cure rate is about the same and there are less side effects and it's a less evasive procedure.
My only decision at this point is seeds alone or seeds and IGRT. The IGRT treatment would be an hour commute to and from the center, so that is quite a commitment time and gas wise. Also I trust Dr. Terk to do a good job on the seed implants, but worry about additional radiation done by a radiation team. It seems that I have read stories here about IGRT gone wrong. I decided on seeds only.
I saw and met with the urologist, Dr. Pruden on 8/4/11. I wanted to meet him before the procedure. He and Dr. Terk have worked together many hundreds of times.
The day of the seed procedure (8/5/11):
Thursday night (day before my seed implantation) I was thinking, this could be the last good piss I have, this could be the last good sex I have...the simple (and free) pleasures of life taken away. I said to my wife, everything is working so well right now, maybe I shouldn't have the procedure. She said to me "You have cancer. You need to have this taken care of while you can". I was brought back to reality. Most of the time over the past 5 months (except when I was preparing for a doctors appointment or going to a doctors appointment) I really have not thought about having cancer. With no symptoms, after the initial shock and mind racing in the first few weeks, it's easy to forget.
I arrived at the surgery center at 9:30 for a scheduled 11:30 seed implantation. Seeds alone with no radiation follow up. I was told that they were running about an hour behind. No problems, just taking longer than anticipated. I was glad that they were taking their time with each patient and not rushing to get them done. I had not eaten for 24 hours and not drank anything for 12 hours. My wife and I spent the time together with me laying in the bed and her sitting next to me. You never know what might happen, so I wanted to enjoy our time as much as possible. Surprisingly, the time went rather quickly.
Both doctors (Terk the radiation doctor and Pruden the urologist) came to visit me separately 15 minutes before they took me to the operating room (as did the anesthesiologist. I had selected Terk because he is supposed to be one of the best in my area. I told them I was counting on them.
They put me under and the next thing I knew I was in recovery. My prostate size was 39 and they implanted 87 Iodine (I-125) seeds. I felt fine. No catheter. My penis hurt at the tip and my butt hurt a bit. It was a very similar feeling to my template biopsy, except that I had to go home with the catheter after the biopsy. I had three days of painful burning after my biopsy and was expecting the same after this (or more so considering that I now have seeds in me). I had a bit of blood and burning with my first piss (the nurse told me the taking a piss was my "get out of jail free" card). My wife drove home and I had a urinal with me, because I had heard about the frequency problem and I live an hour away from the surgery center. I did not need it.
When I got home I took the meds they gave me (antibiotic, Flomax and pain meds), had something to eat (not as hungry as I thought I would be) and drink. It took a while before I had to piss, but it was surprisingly uneventful. Maybe the skill of the person inserting the catheter determine the pain and irritation after it is removed (as some phlebotomists are better at hitting the vein on the first shot)? No burning and no blood. I took it easy and laid in bed, but did not had any problems getting up and walking around. I went to sleep around 11:00 and slept through the night, got up in the morning and took another pain free and blood free piss.
I'm thinking this went as well as it could have. I don't know what awaits me as the seeds kick in over the next days, weeks, months, but for now I'm a happy camper. I just have to hope that the seeds do their job and rid me of the cancer. I also know with seeds there can be effects further down the road, but for right now, one day at a time.
It’s been a long strange journey over the past 5 months gathering information and making decisions. I’m happy that this phase has come to an end. I have an appointment in two weeks with the urologist and another in a month with the radiologist.
One Week post seed:
It's been one week since I had my seed implants. Just the past couple of days I have started to notice some urgency/frequency. Typically this happens in the late afternoon. I have to see if something is triggering this or just the normal process. The past few nights I have had to get up for a piss in the middle of the night. No burning yet. I seem a bit tired and have been going to sleep earlier. I don’t know if it’s the treatment or my imagination. I am enjoying the extra sleep though!
Two week meeting (8/22/11):
I saw the urologist today. It’s been a little over two weeks since my seeds were implanted. I notice a bit of urgency, but find if I take Acetaminophen it’s okay. Most nights I sleep through the night and then some nights I get up once. No burning yet. The doctor looked at the bruising, which is mostly gone and was happy with my progress. He scheduled a 6 month appointment and said that he would test my PSA then. He would hope that it would be cut in half.
I have an appointment with the radiation doctor in two weeks. At that time they will do a CAT scan to look at the placement of the seeds. So far so good (knock on wood).
One month appointment (9/7/11):
I met with Dr. Terk today for my one month follow-up after having seeds implanted. Everything was fine in his opinion. He said that I should be at the height of my SE about now. The radioactivity of the seeds has a half life 2 months. 2 months – 50%, 4 months 25%, 10 months 3%. He said that symptoms should decline around the 4- 6 month time-frame.
I had a CT scan and he will read the results in a week or so, but he has never seen a problem and it is just for the records. I saw a photo of my prostate with the seeds in.
My side effects have been slight. I may feel like I need to "go" more frequently, but that might just be in my mind and I think it's something I need to stop thinking about (I never in my life thought that I would be so obsessed with my urinary habits!). I sometimes get up once early morning to pee. I've experimented with getting an erection, and having an orgasm. I don’t seem as erect as before, but not by much (maybe 90% and hey, I’m old!). I’m hoping that improves a bit. Terk said that I was not squirting our radioactive fluid (yes, I did ask!).
When the PA asked if I had burning or pain I said “Not really either one, just a “different” feeling”. (Ibuprofen seems to help) She commented that many men say the same thing.
I have an appointment with the Urologist in 6 months (I’ll get my PSA tested) and the radiologist in a year. I will continue to take Flomax for another month and then see how it is without it.
I just hope the seeds are doing their job. No more, no less! In the meantime, I really don’t dwell on my PCa. While I was walking on the beach last night with my wife, I saw a beautiful sunset and I was glad to be there to see it. She commented that this would be my last cancer appointment for quite a while. I hadn’t really thought of it like that. It made me smile. It’s been a long journey and I feel like I can put it behind me for a while. I know that there will be tests and worries in the future (and not all of them from PCa), but for now, life’s good.
At 6 weeks out (9/17/11), especially in the past few days, I do not have hardly any SE. Everything seems to be working fine (urinary, bowel and sex). No more “different” feeling. There is about half the amount of juice after an orgasm. I let myself go a bit when I found out I had PCa. Maybe I felt sorry for myself, maybe I thought “I have cancer, what does it matter”, maybe I thought I could eat anything, because I couldn’t gain any weight because of my nervous energy from being so obsessed in the begining…so I stopped exercising and ate what I wanted. I am back to exercising and eating better now and feel good.
I am happy with my decision to have seeds. My life is pretty much the same as what it was before all this started 6 months ago. I just hope that my 6 month PSA is down to half of what it was. One of the good things that came out of this is that I now realize from a first hand view, that life is finite and I appreciate more moments during the day now.
I had hernia surgery. It was laparoscopic and caused some issues with my bladder. I had much frequency and it was hard to urinate for a couple of days (and actually it hurt too for a day). It could have been from the anesthesia or from the hernia repair (the doctor did say that he was near my bladder). I called the doctor and he increased my dose of Flomax and now, two weeks out from the hernia surgery I am back to where I was before the surgery…maybe better.
I just got the note to schedule my PSA test for February. That put a bit of a scare into me. I am hoping for a low reading.
After 6 months my PSA went from 7.1 down to 3.9 The doctor was happy with this and said that they look for the original PSA to be cut in half, but everyone drops at different rates. As long as it is dropping, that's a good thing. He said the first two years the can be crazy as far as the PSA is concerned. He said that he would be worried if he saw three consecutive rises.
He did a DRE and that was normal...he did not feel anything out the ordinary (and that's a good thing).
I had him check my hernia repair as long as he was in the area and that is fine. I asked about having a Colonoscopy and he said that would be fine, but, let them know before hand that I have had seeds implanted for PCa and if the doctor sees anything unusual over the prostate, that it should not be biopsied.
He wants to see me again in 4 months (although I suspect it would have been 6 months if I had a bigger drop), keep taking the Flomax if needed. I'm fine with it, no frequency. I'd like to stop taking it though and he said to try one every other day and see how that goes.
All in all, I feel good. No frequency (except for sometimes when I hear running water- that can make me want to go!). No burning. My orgasms felt "different" for the first 4 months or so, but are now very pleasurable and have returned to the same feeling I used to have (but with less juice). So now I get a 4 month break from PCa. Then two months after that I meet with my radiologist that did the seed implant for a yearly appointment.
It's been one crazy year since all this started! I appreciate all the help, suggestions, education and support I have received here at HW and for that I'm grateful. There are a few of you who have been very influential in my decision making process. I'm glad that I explored all my options.
PSA came in at 3.0, continuing the downward trend. Not as fast a drop as some, but not too bad, all things considered. All in all, I feel very well. No real problems or SE . I have my yearly checkup with my radiologist next month. I have been very lucky on this journey. Happy with my decision to have seeds. No bowel problems, urinary problems, sex is as good as it was before, orgasms just as strong (or stronger if that is possible - I do remember that for a couple of months after the procedure, my orgasms were different, not really hurt, but not as pleasant as before - they are back to "normal" now), erections are same as before. The only thing different is that I don't put out as much fluid with an orgasm as I did before the procedure and as funny as it seems, I do miss the "spurt" at the end! All in all, life is good.
On a day to day basis, I don't really think about PCa at all. No real reason to. I'm glad I got to "meet' many of the other contributors here at HW. It's really a good bunch of people. My concern is that new people will not look at all the options available to them before making a decision (I'm not sure I would have without this site and the input from the people that went before me). I know that most are happy with there decisions, but for now, seeds seem to be such a good choice, not only from the SE but also a much simpler procedure. I watched a prostate operation on YouTube and it's not a simple operation, although I know many have had good results with it.
PSA 2.9 for my appointment with seed doctor scheduled for September 10th.
One year after having seed procedure. PSA 2.9
I have my one year appointment today with Dr. Terk. Some people do not like his manners, but I get a kick out of him. I let him know that I had a lot of questions and he took his time with me and answered all my questions...as all doctors should. He said that everything is "peachy" and I could not be doing better. I have no Urinary, bowel or ED problems. I asked what long term SE I ma have from the radiation and he said that pretty much where i am now is what i should expect for the future, but he does not have a crystal ball. Every PSA reading has gone down (and did say that it could bounce around a bit in the first two years).
I asked if it is going down too slowly and he said it going down every reading is what you want to see. It should continue to go down for two years. I asked if the radiations has pretty much worn off at this point, why would it continue to go down? He said that is just the way it is and that is what happens. Not a real technical answer, but honest.
I asked what percent of people choose radiation or surgery and he said it's about 50/50 and depends where in the county you live. Thant most people will not travel very far to be treated. He said if people will only see one doctor, their urologist, 80% will choose surgery. I'm pretty sure thats what I would have done had it not been for HW. Surgery just scared me, the way radiation scares other men.
I asked about continuing to take Flomax and he said that I could stop taking it. I told him that after the trouble I had after my hernia surgery, I was reluctant to take it, but he said that was from the anesthesia. He suggested that I wen myself off and see how it goes. It really doesn't give me any SE, but I will try it and see how it goes.
He said that I should have my PSA tested twice a year and see the urologist twice a year and Terk of I have any problems or see the urologist once a year and Terk once a year. I will see each one of them once a year.
I appreciate all the diverse opinions, suggestions, support and knowledge that I received here at HW. I concidered every bit of information I received and it all entered into my decision. I was fortunate to find this site. It has been a valuable tool for me. What a great group of caring people. Thank you all.
Life is good and I wish it was so for each and every one of you.
Went off Flomax. No problems
9/16/13 - Two Years after Treatment
I had my meeting with Dr. <span splc="splc" state="edited" word="Terk">Terk (the radiologist that implanted the seeds) he basically said that everything is perfect. <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="PSA">PSA going own, expect it to bounce around, started at 7 and it's down to 2.6, <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="yaddah">yaddah, <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="yaddah">yaddah, <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="yaddah">yaddah....
My PSA bounced around a bit (as you can see from my signature) and is going down slowly. Don't know if that's good or bad, but it's on a downward trend.
I guess I should be pleased. Two years post treatment and I have no SE, everything is as good as it can be for a person with <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="PCa">PCa. Funny, I started watching Breaking Bad on <span class="squiggly" title="To see spelling suggestions, click this word" splc="splc" state="new" word="Netflix">Netflix and the man guy has cancer and is going through treatment. I think I might have to stop watching, because it reminds me that I have cancer. On the other hand I grateful that that is my only reminder.
Next checkup and PSA test 6 months with my Urologist. With PCa, you're only as good as your last PSA test, no matter what your treatment.
For now, all is good.
What a difference 6 months makes! Well, my urologist seems concerned. He thinks the PSA should be down much lower by now. Near 0.3 or close. Says another biopsy might be in order, or a bone scan or a CAT scan to see what we are dealing with. But they could all come back clear and still with the PSA up, there is something going on somewhere. He gave me the option of checking now or waiting 6 months and getting another reading. I chose to wait the 6 months and see what that reading is. If I have the biopsy and it is still local, in the prostate, then Cryotherapy, freezing the prostate though needles, would be a possibility. If it has spread and my PSA goes up, then hormone therapy may be in order. So not good news, really. I'm hoping that my next reading is lower of course, but I'm not really counting on it when I look at my numbers for my past readings. Not really going steadily up though if you throw out the 2.1, but including it, it has. If it does go up next time, I'm not sure i would do anything though. Should I have chosen a different treatment? Who knows with this disease? You can't go back, so why look back? I'm happy with the treatment I had. I've have had a great three years and I'm not going to die today or tomorrow. No matter what the outcome, I'm happy to be alive and enjoying life. Funny thing is, I'm in the best shape I've been in for a while. Something to ponder for a bit.
I just got my 3 mo PSA...at 33 months...and it went down to 2.5 from 2.8. Not much of a drop, but at least it's down. My radiologist says it's fine, my uro at my last visit was concerned. The Uro's question is where is the PSA coming from? My radiologist says he does lots of these, sees lots of slow declines over years and that's just the way it is sometimes. He also reviewed my post seed dose and was was happy with the results, said I got a good does and coverage. This was also confirmed by another radiologist. We'll see what it is in 3 months.
I had a blood test for my upcoming appointment on November 12th with my urologist. My PSA in July was 2.5. My latest reading was 1.1 which is the lowest it's been. Down is good. It's been a very slow downward trend.
My rad doctor (Terk) did not seem too concerned at my slow drop, but my urologist was. It will be interesting to see whart he thinks in November.
Just as a note being out over three years...no problems with ED or contenence. I'm still kickin' on both counts. Although maybe not has hard or as high as I did when I was 21.
Meeting with urologist after 1.1 PSA
Everything went as well as it could. Took me on time, quick appointment. He was vey pleased. BP 134/75 which is good for me. He did a DRE which was fine. Everything else is going well for me. Everything working as it should. I feel well and have no complaints.
I have decided not to see my urologist or radiologist unless my PSA goes up. I just don't need to incur the expense to be told that all is well. I will get my PSA checked at my annual physical and maybe once more during the year. If it starts going up, then I will go back to the urologist. That being said, I had my family doctor order a blood test and it came back at 1.0 Down, but not much, from the 1.1 PSA of my last reading. It's not going up, so I am pleased. I'm just about four years out from getting seeds at this point and I am happy with the results and my life. Not much has changed from my life before I found out I had cancer. I don't get much juice when I have an orgasm, and I miss that, but other than that, I can't complain.
I had my annual physical a month ago and had switched my GP, because I'm still trying to find a good one. After he examed my prostrate, he said "Has anyone ever told you you have a nodule on your prostrate?" This is after I had told him that I hVe prostrate cancer in my meet and greet appointment two weeks previously. I said no and he said I should,have it checked out. I told him I have PCa and had been treated with seeds. He said oh, maybe that is why it feels small. Really?? So I was concerned and made an appoint with my urologist. I was due to see him in November anyway. I just came from the exam.
My PSA is down to 0.5 and he did not feel anything. So Yay!
Best of luck to all the newbie and those of you that are still posting and playing it forward as Yooper would say (and does). It's a great group of people here on this site and is valuable resource for those with journeys
who are simple as mine is, those who have a more difficult journey and for the newbies who's heads a spinning when they hear the words .you have cancer" as mine was.
Over four years out and life is good. Everything still works as it did before this mess!
9/2016 - 5 years out
Had my annual physical and PSA was 0.3
12/17 - 6 years
All is good. Latest PSA is <0.1 I feel well. The only question I ask myself is did I do the right thing by treating PCa? If I had it to do over, with a G6, I would like to think that I would have done nothing. But that is easier to say in hindsight. And I am one of the lucky ones that have had little to no SE. I think this disease is way over treated and therefor we over react. I sometimes think it's just a money making machine. I think most men will die with PCa and not because of it. It is just terribly difficult not to do anything when you hear the word cancer and everyone tell you that you must do something about it!