Has it really been 5 years? Just got my latest PSA result and it came in at <0.01 again. So I am finally available to the blood bank again to siphon off some regular 0+ but as I am laid low at the moment by some heinous virus it shall have to wait a week or so.
The journey has been thus:
PSA 2005 at age 57 was 2.8, 2006 3.2, 2007 4.0. Nothing on DRE at all. So it was right on the guideline for the 50-59 age group (4ng/mL). Two months after giving blood for that 2007 PSA test I would have been in a different age category (60-70) where the guidelines indicate 6 ng/mL as a cause for concern ---- even the one year increase of 0.8 was barely over the 0.7 ng/mL per year alarm bell. So neither the GP nor the Uro had a real recommendation. I had never had a problem with the gland nor any problem urinating ---- all seemed in fine fettle. I have no idea whatever made me lean towards a biopsy as a precaution. I am neither a worrier nor normally a terribly cautious person. To cut a long story short 4 of 12 +ve, both sides, some up to 60%, Gleason 4+3=7 with 75%-80% comprised of grade 4 cells. The usual reaction ---- "take it out" ---- with very little research and not much information. The uro was a well experienced
open surgeon with a few thousand ops under his belt but only 100 robotics (contrary to popular belief here). But I felt this bloke knew his way around in there. So it turns out that that fairly innocuous PSA reading and slow rise masked a Gleason 4+4=8, a great deal of both sides of the gland involved with the tumour smack bang on the margin. Prior to the op the surgeon said he would spare the nerves if at all possible. It is the practice at this particular hospital that the gland is sent out for an immediate frozen section during the operation and this indicated to the surgeon that he should take a wider margin, which he did (alas it now included the nerves). A second post surgery biopsy specified the gleason grade of the cells at the periphery of the tumour --- grade 3. I have often wondered whether my outcome may have been different if those cells were grade 4. This is another thing I have never seen much comment on ---- my thoughts would be along the line that a patient would be more inclined to pull the adjuvent therapy trigger if they knew that the more malignant grade 4 cells were on that margin. (I would be interested in others thoughts on that one)
In my time at this forum I have been constantly amazed at how results can and do vary even in the hands of the very best docs. At times what would appear to be straight forward cases have suffered bad setbacks, while others who had an initially bad prognosis have fared extremely well. No rhyme nor reason ---- just a facet of the rotten heartless disease we have all had to contend with.
The lessons I have learned and the knowledge I have gained over the years on this forum have been immeasurable and I have tried my best to repay in kind (although a few may think otherwise
) . I have spoken with many fine members here (both on and off site) and hold quite a few in very high esteem ---- it would give me immense pleasure to meet some of them in person one day.
A good PSA result (after the first year) has always caused me somewhat mixed emotions. While it is of course great news, it always causes me to reflect more deeply on the sometimes tough battles of some my fellow members. Despite the fact that I surely am one non praying, non believing son-of-a-gun, I do think of you often.
Best wishes for all,
Post Edited (BillyMac) : 8/22/2012 6:48:38 AM (GMT-6)