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letzter PSA vom


27.09.2011 0.04 15.09.11
I was biopsied in Feb 2006 at the Princess Alexandra Hospital in Brisbane and several cores were positive for cancer with Gleason scores up to 9. It is quite stressful to receive this news. The registrar who gave me this news thought I probably wouldn’t be eligible for surgery because I was 55 and had aggressive disease. He did order a CT scan and a bone scan but put a 6 week priority on the request saying that not much happens in the early stages of Prostate cancer. The scans were clear so they did offer me surgery and I accepted right away. I didn’t have private health insurance at the time so the other option of high dose rate brachytherapy was probably out of the question.
I had my radical prostatectomy in May 2006. There was extracapsular extension but the surgical margins were clear and there was no spread to the seminal vesicules so the stage was T3a. I stayed 3 nights in hospital and went home with a catheter for a week and my recovery was uneventful. The hospital had taught me to practise pelvic floor exercises pre surgery and continence has not been a big problem. I still do the exercises every week mainly when driving.
The ED has been fairly total. Ten weeks after surgery my wife informed me that she was going to move on with somebody else in her personal life. So I said that she should do what she wants and I moved into a separate room in the house. So we have been separated since August 2006. In 2011 we finalised separation and have 50/50 split care of our young children, and separate accommodation.
Nine months after surgery in Feb 2007 my PSA was detectable at 0.03ug/L. I think that mentally that was the biggest shock because I knew that once the disease has spread it is incurable. At that point the Urologist indicated that my survival period may be 4 years. I am looking for a couple of years more than that now. My first response was to log on to the internet and order some Prostasol from a place in London. As my PSA was very low I started on the maintenance dose of one tablet per day. Initially there was a very noticeable side effect of painful breast swelling. When my next three monthly PSA was down to 0.01 I reduced the dose to ½ a tablet per day and then ½ tab every 2nd day and the side effects dissipated. The PSA didn’t come back to 0.03 until august 2008 at which point I started taking one tablet per day again. However the PSA continued to climb a point every three months and was 0.09ug/L on 10/02/2010.
Some people would think that it is crazy to use a product that is not approved of by the medical profession, but I think if there is a product that actually delays progression of the disease then why on earth wouldn’t I take it. I have read that Prostasol has been associated with some clot formation problems and some people take a mini aspirin to counteract that effect. I take a daily Mobic for a bad neck which also has some anticoagulant effect.
When I went to Urology clinic in February 2010 the Registrar was surprised that I had not been started on radiation treatment yet. His concern was that my PSA has doubled in less than 12 months, and he said that I should push for it when I go to see the radiation oncologist in March. My ratio of PSA to tumour volume in cc is 2:1 which is not very typical. My highest PSA prior to surgery was 3.3 and the total estimated tumour volume on the pathology report was 1.6cc. Apparently 90% of guys with PC have low grade or intermediate grade disease where the ratio can be more like 10:1 or 20:1. There is a table of these ratios somewhere on the internet but I didn’t bookmark it.

The PA Hospital gave me the salvage protocol of 32 radiation treatments to the pelvis in April, May and June 2010 and it has had a good effect on the PSA. It has dropped slowly as shown on the Graph page. I stopped taking Prostasol after 2 weeks of radiation.
On 15/09/2011 my PSA is 0.04. As it has started to increment up again I asked to start hormone treatment when I attended Urology Clinic. There was an Irish doctor at the clinic and he responded positively to my request. I am having an anti androgen Bicalutamide 50mg for 28 days to prevent the flare effect, and starting Zoladex 10.8mg implant on the 14th day.
21.12.2012 0.03 04.10.12
In the 15 months since I posted my story my PSA has remained steady on 0.03. No doubt it will be incrementing upwards in the next 12 to 24 months. Initially the Zoladex gave me a number of side-effects; hot flashes, elevated blood pressure, and emotional disturbance. So I went to my GP as suggested and got a script for Androcur and that settled down the effects quite quickly. Merry Christmas!
19.06.2015 0.03 09.07.14
My last PSA in Feb 2015 was 0.03. In March 2014 the Urology service told me to get a bone densitometry scan because I had been on hormone therapy for 3 years. The result was a T score of -2.71 and the comments said I high risk of fracture of femoral necks, and moderate risk of fracture of lumbar vertebrae. So I started on Caltrate with Vitamin D daily and Denosumab (Prolia injection 6 monthly).
05.01.2016 0.03 05.01.16
My PSA incremented higher in Jul and Oct 2015, and they told me that two rises in PSA indicates that the disease is beginning to turn castrate resistant. A medical oncologist recommended that I stop taking the small dose of Cyproterone to see if I get a withdrawal benefit. My PSA in Jan 2016 was back to 0.03 so apparently I am one of the 25% of patients who get a withdrawal benefit from reducing anti androgen treatment. I am told that when the PSA is rising again then I may be commenced on one of the second line anti androgens ( enzalutamide or abiraterone) rather than starting chemotherapy, so it could be an interesting year.
18.04.2017 0.03 03.04.17
My PSA has not been going up for 15 months so I am having a good run at present.