Sunday, October 25, 2009

Prostate Cancer - be gone!

Well, earlier this summer I was diagnosed with early stage "low risk" prostate cancer. Those annual (well, almost annual) physical exams paid off (in a way) because the last one showed a slightly elevated PSA (Prostate Specific Antigen) level. So, sometime thereafter a prostate biopsy (a rather painful procedure) resulted in the bad news.

This is where the learning and decision making starts. You have to try to figure out what a "Gleason score" is and understand the various cancer stage rankings that are used. Fortunately there is a lot of online information available about prostate cancer. If you're in this situation I would urge you to educate yourself about the disease and the treatment options. Each person is different and your options will depend greatly on your age and your prognosis / test results.

In my case my doctor outlined three basic options:
  1. "Watchful waiting" which is a term used to describe the "do nothing" option. This choice is actually quite appropriate for some people in certain situations.
  2. "Radical Prostatectomy" which is the complete removal of the prostate gland by surgery.
  3. "Brachytherapy" which involves implanting tiny, radioactive capsules (called "seeds") into the prostate gland.
So for me the decision to go with a Radical Prostatectomy was driven by a few key factors:
  • My father died from cancer which originated from his prostate.
  • Given my age (currently 53) my thinking is that the younger I am the better I'm able to deal with the surgery and recover afterwards.
  • The thought if living with the knowledge that you have cancer slowly (or not so slowly) growing inside you and risking having it spread beyond the treatable stage seemed foolish to me. Again my age was a factor in avoiding the possible long term growth of the cancer.
The brachytherapy option was not considered a good choice for my early stage disease because it apparently eliminates the option of performing other treatments such as a prostatectomy thereafter.

So it has now been just over five weeks since my surgery and I'm feeling quite good (almost normal). Just about every aspect of the surgery and the after effects has been better than my prior expectations. I now consider myself to be somewhat better educated about the prostate gland and issues and treatments for prostate cancer.

One thing I think may be worth mentioning is the fact that there seems to be an unbalanced amount of information online about the minimally invasive "robotic prostatectomy". The robotic prostatectomy will likely become more available and pervasive over time but it is not an option in many cases depending on where you live. In my case my surgery was a "radical retropubic prostatectomy" which means it is "open" surgery through a large incision in your lower abdomen. Although the less invasive technique may result in faster recovery times and less discomfort, from my reading one of the most important factors (in both options) is the experience and skill of the surgeon performing the procedure. In my case I was offered my surgery within about one month of my diagnosis and my doctor has performed the procedure more than 500 times. To me the option of eliminating my cancer quickly and having it done by an experienced doctor was compelling and very comforting.

So my post operative pathology results indicate that I am now cancer free. Wow!!! It feels good to know this and I can now continue my life with a much greater peace of mind. If you're in your 50's (or 40's with family history) please consider an annual physical including a PSA blood test. It can mean a longer happier life expectancy.

1 comment:

Anonymous said...

Thinking of you Paul.Glad your over your op and well on the way to recovery.All the best to you Heather and Sam for 2010 . John and Ruth