I thought this needed a bump....somewhere around the next week marks 3 years since I moved out of the consultation phase and towards a decision. For those who have read 'my story' in my sig file, thank you. To recap some of the basics....
The backstory is that my dad died of advanced metastatic PC in 2004, at the age of 78. He was originally diagnosed in the early 90's--at the beginning of the so-called PSA era. I have no information about
his initial PSA, any diagnostic criteria, or anything else. He chose to be treated with whole gland cryosurgery, which was a new tool at the time. He was attracted to the research angle. Long story short, he had a number of good years after that.
2002, the found spots on his ureters that they treated with external beam, then in the spring of 2004 he had a fall and the diagnosis was a cracked tailbone. We know now that the pain from that was bone mets in his lower spine. He passed in October of 2004.
At his urging, I started getting annual PSA and DRE at the age of 40. I had a string of zeros until age 55, when I got my first positive reading. I had also been taking saw palmetto for minor BPH for several years. At 55, my PSA was about
1, at 56 was about
2, at 57 was 3.3, and went to the urologist.
The first thing he told me was that saw palmetto (like finasteride) suppresses PSA about
50%, so a better PSA for me was probably around 6. With it doubling every year, and with a positive DRE, he recommended biopsy.
After it came back positive, I started my research. At the time, we lived in rural central Illinois, roughly midway between St. Louis and Indianapolis. I decided almost immediately that my treatment choices were going to be limited by time available and distance. IMRT, with it's 40 treatments, was ruled out immediately because of this. 40 trips of a 2 hour drive each way? Nope. A second immediate decision was 'nothing experimental'. I wanted a tried and true treatment, which put me in the decision mode between standard brachy and RALP.
Honestly, the idea of having an permanently implanted radiation source inside me creeped me out. Maybe I'm the only one who had that mental block, but I doubt it. Which led me towards surgery. I looked into AS--and I could have pursued it. Based on what came later, I believe I wouldn't have been on AS for long.
For my surgeon, I went with one of the most experienced RALP surgeons in the US--and one that no one outside of the midwest has ever heard of. I had the surgery on Feb 17, 2015, and came out very well on the other side. I had a post surgery pathology upgrade from localized G6 to G7 (3+4) in multiple
locations in all 4 quadrants. I absolutely believe that this would have been discovered in a followup biopsy had I gone AS, so while I may have treated 'early', it was certainly not unnecessarily.
So, that's the short and sweet version. I have my 3 year follow up appointment scheduled in early March, and I have every reason to believe my next PSA will confirm me in the zero club. Life is good. All my parts work just fine, thank you very much.
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA 3/10/15: 0.10
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024