David
Martin and Kathy live in Texas, USA. He was 59 when he was diagnosed on
22 November 2006. His initial PSA was 3.2 ng/ml, his Gleason Score was 6 and he
was staged T1c. His treatment choice was Surgery. Here is his story:
I
had my yearly physical in Sept 2006. I have had my PSA checked since I was 50
as my father had prostate cancer. He had it at a much advanced age, and died from
complications of Parkinson's, not the PC at 89. In any case I was always concerned
and had it checked every year.
At the physical, the DRE didn't show anything
and the PSA came back 3.2 ng/ml. OK I thought, still in the "normal" range. The
Doctor that I went to for the physical (I will be eternally greatful to him!!)
recommended that I see a Urologist. I thought why, but decided to go anyway a
few weeks later. I later found out about "velocity". My PSA had been 1.2 ng/ml
about 5 years ago, then two years ago 2.1 ng/ml and now 3.2 ng/ml. I went to the
Urologist, Dr. Kwatra, Conroe, Texas, on 8 Nov, for an initial exam. He did a
DRE and said he didn't feel anything but that we would do a biopsy the next week.
I had the biopsy on 15 Nov, with the follow up for results on 22 Nov, the day
before Thanksgiving. On the 22nd, he gave me the results. You have PROSTATE CANCER.
The cancer was in one quadrant of the prostate, showing up in four of the twelve
cores that he took.
Like almost everyone, the days immediatly after the
diagnosis were a depressing blur. I started doing a lot of research and found
this wonderful site along with many others.
I had a follow up CAT scan
and Bone scan to see if there was any evidence of spread. The wait for the results
were really stressful. Luckily everything came back negative, except that they
found a hemangioma (mass of blood vessels) on the liver. The Urologist said that
most likely was not a problem, but we would get an MRI to make sure. So another
week of waiting and worrying. The MRI came back with the results that the hemangioma
was indeed benign and not to worry about.
In the mean time, I had decided
to get that sucker out of there and that my best choice was a regular radical
prostatectomy. I looked into the Robotic procedure and decided that I might be
someone that they would be practicing on and that I did not want that.
I
had made a very complete list of questions for Dr. Kwatra which he answered to
my complete satisfaction. I found out that he had been and Engineer before becoming
a Dr. That suited me fine as I am also an Engineer.
We set up the date
for the operation for 27 Dec 2006. As I sit here on Christmas Eve, I am very grateful
that from every indication, we have caught this very early and that removal will
be the cure. I of course am still nervous and not really looking forward to the
surgery, but still think it is the best course and am very optimistic that all
will be well.
I have found it very helpful to openly discuss my condition
with many friends, who have all been supportive.
I will follow up after
the operation to report on how it went.
This
is a follow up report on 31 Dec 06.
Well,
the surgery is over and I am home. Don't let anyone tell you different, this is
a major surgery and there will be some pain. I woke up in the recovery room with
the words that everything went well. The compression leggings were compressing.
They actually felt good, kind of like a constant massage. The first full day on
Wednesday (after the surgery Wednesday morning), is pretty much of a blur. I did
have a morphine drip with a PCA pump. There was really no pain to speak of and
it was fun to push the PCA button, although I knew it did not give me any extra
except every ten minutes. The nurses said I was very entertaining and my wife
said I was the most talkative that she had seen me in a long time. The 1st night
on Wednesday was OK, the morphine did the trick and I was able to sleep most of
the night. One thing that really helped me was to have EAR PLUGS. I found that
they blocked out the sounds of the IV drip pump, the blower for the leg compressions,
and just general hospital noise. Having it quite really helped me sleep better.
They
made me sit up and walk just a bit on Thursday morning (2nd day). That first sitting
up and the cough made me think that my insides were going to come out. The walk
actually made me feel a bit better. The morphine came off Thursday evening. I
was a bit apprehensive about that, but as it turned out, this was not a problem.
I was put on Toradol with two Vicoden every six hours. That combination was great
and I had a good nite.
On
Friday, I got up and walked around several times. The walk seemed to wear me out,
but I would actually feel better once I got back in bed. Dr Kwatra pulled off
the bandage over the main incision. The row of 18 staples is impressive. Dr. Kwatra
and I agreed that I would go home on Saturday if everything kept going well as
it seemed to be. I slept well again Friday night.
On
Saturday afternoon, they pulled the drain line. That was interesting!! I didn't
realize that it is over 6 inches long. (It seemed about 6 feet long as they were
pulling it out!!) I took a shower before I went home. That really felt good and
made the short ride home seem very comfortable. They gave me what I guess are
the standard instructions about wound care and catheter/urine bag care. The Velcro
leg strap (to hold the catheter line) is a really esential piece of equipment.
I think that you just have to work out what works good for you. My first night
at home worked OK. I made a nest with two pillows for my head and one under my
knees. That along with two Vicoden and two Ibuprofen every four hours seems to
keep the pain under control.
As
I sit here on New Years Eve. I am grateful for what seems like a good outcome.
My wife, Kathy, has been excellent as a care giver. I will follow up again in
about 1 week when I get the catheter out.
Update
as of 8 Jan 07.
Had
the follow up appointment today to have the staples and catheter removed. Both
of those removals were fairly quick and relatively painless, one little wince
for each staple and a big wow!! when the cath came out but no lingering pain.
I have had a lot of blood in my urine over the last several days. I was concerned
about this, because even though everything I read says it is normal, I started
off with very clear and unbloody urine. The blood only showed up the last several
days. In any case, Dr. Kwatra said not to worry that it was completely normal
and should clear up in a week or so.
The
pathology showed that the Gleason score was 7 (3+4) which was higher than the
intial indication, but from what I see it is very common for the Gleason to be
rated a bit higher once they can look at the complete prostate. The cancer was
in about 1/4 of the prostate and the margins were negative so I am highly optimistic
that it is completey gone. I will have the follow up PSA test in 3 months and
will update my story then.
The
last week has not been great, but of course it could have been a lot worse. I
started off with two Vicoden and two Ibuprofen every four hours, by last night
I only needed the Vicoden when I went to bed. I've had some real problems with
constipation and haemorrhoids. I know that the Vicoden helps cause the constipation
but at the same time there was still enough pain that I needed them. Some milk
of magnesia helped. It is really nice to get the catheter out and being able to
cut back on the Vicoden should get me going again.
I
guess I was a bit over optimistic about the speed of my recovery. Although I am
in pretty good shape I did not bounce back I quick as I thought I would. This
is all relative as it has been only 12 days since the surgery. So far there has
not been a huge amount of leakage and the pad had only a few drops on it. Hope
it continues that way.
I
will be happy to talk with anyone about my experience.
Had
my three month follow up visit after the surgery. The PSA level was UNDETECTABLE!!.
I
was sure that was what it would be, but it was really a relief to get the results.
I have felt fine and have resumed all activities including treadmill and some
weight lifting.
Next
PSA check is at the six month point.
I
had my latest PSA check last month and it is still at ZERO. I consider myself
cured but as my doctor says keep checking. I have been very lucky to have found
it early and not to have had complications.
The
one problem that I have had is insurance. Even though I am completely cured with
a PSA of zero for over two years. I am still considered a high risk. The only
insurance that I have been able to get is the Texas High Risk Pool. Lousy insurance
and very expensive but I guess better than nothing. I am wanting to be old enough
to get on Medicare but dreading the thought of being that old.
The
American Medical System is severely broken and will take a huge amount of work
to fix. We need some kind of single payer everyone covered system. (end of rant).
David's
e-mail address is: martin42@cebridge.net
