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| Each man's Journey is listed under his BASIC treatment. When you click on one of the names to read a particular Journey, you may see one or more different treatments in bold lettering immediately above the Journey text. You will see (Recurrence) if they are due to a recurrence. Otherwise, they will be treatments used in conjunction with the basic treatment, i.e. Lupron with External Beam Radiation or External Beam Radiation with HDRT/Brachytherapy, etc. | |
Active Surveillance Alternative (Natural) Therapy Cryoablation - Freezing Hormone Therapy Radiation - Brachytherapy Radiation - External Beam Radiation - HDRT Surgery - Open Surgery - Robotic |
Warren Buffett and I share just two things. We were both born in 1930 and we are prostate cancer patients. All comparisons end there, but I am sure Warren and I will survive our cancers. In April of 2011, I had my annual physical done by my doctor in Reedsport, OR. As an internist, my primary care doctor was focusing on my liver and other high co-morbidities. His blood tests were very broad since I have had two heart attacks and several bouts of bleeding ulcers. He added a PSA test without my knowledge and, as it turned out, very likely saved me from dying of something I was not prepared to deal with or could understand. Our interview, following the tests, was a mind blower for both of us. He simply asked if I had ever had a PSA test done and I answered "no." He was very careful with his findings on that test since it did indicate a very high possibility (even probability) of prostate cancer. My PSA score was 104. Surprisingly, that was a much higher number than he had ever seen in his twelve years of practice. He told me a score of 20 was considered very high. His advice was firm and rather scary based on his explanation of what the test implied...I needed to see a urologist. For a novice in that field of medicine, I was learning very quickly just how and what the prostate does and how many of us develop cancer in that area. My doctor made an appointment for me that day with Dr. Douglas Hoff at the Oregon Urology Institute in Springfield. So in just a ten day period, from initial blood test to consultation, I went from being normal (my interpretation) to a probable prostate cancer patient. You do have a sudden feeling of doom when a qualified physician tells you, in so many words, you might be dying. I wasted no time in hitting the research buttons on my computer. Too many options and too many legitimate sounding suggestions were waiting for me online. One did stand out, however, reporting that the English medical establishment stated that PSA testing alone is not recommended for screening in the UK, as the evidence of its reliability is still very unclear. Of course, as I have since learned, the PSA test doesn't diagnose prostate cancer - it only indicates there may be a problem that requires further attention, usually by a urologist. I had learned during my research that prostate cancer can be so slow-growing that some patients elect to avoid active treatment and instead closely monitor it, called active surveillance, with their urologist. I was also in denial that I could have cancer. Even if I did, at my age, I decided that I could survive without treatment. I cancelled my appointment with Dr. Hoff of the Oregon Urology Institute. At my next appointment with my primary care doctor, roughly a month later, he was not at all convinced that I was doing the right thing and used his best bedside manner to convince me to at least listen to what Dr. Hoff had to say. My primary care doctor did explain that he had at least twenty patients that were living very normal lives years after their cancer was discovered. He convinced me to sit down with Dr. Hoff and hear him out. After all, he is trained in urology and deals with prostate concerns day after day. So, I made another appointment and kept it. Dr. Hoff's manner was calming while he explained my potential treatment options if a biopsy proved that I had prostate cancer. It was comforting to learn that the dreaded chemo stories I had heard were not going to happen to me. But, first, there would have to be a biopsy taken from the prostate to determine if I actually had prostate cancer and, if so, where and how much cancer was present. All of this work was to be done at the Oregon Urology Institute's surgical department in Springfield. They have a large staff of medical professionals trained to do what I needed so I would not be required to go to a hospital. I prefer to avoid hospital stays, if possible. Using an ultrasound instrument, Dr. Hoff was able to show me my prostate which he then proceeded to biopsy. That consisted of removing bits of tissue by shooting a needle into it. He used 12 different needles to remove tissue from different areas of the prostate, guided by the ultrasound. Those bits of tissue were then sent to a lab for analysis. Oregon Urology Institute uses a lab in Texas for that which ONLY examines prostate tissue tests. To me, that would make their analysis more likely to be accurate than labs that do all parts of the body. In my case, the results indicated that I did, indeed, have prostate cancer. The pathologist's report from the lab gave Dr. Hoff the areas of the cancerous tissue, the volume (amount of cancer in each biopsy specimen) and the aggressiveness of the cancer (the Gleason Score) which was a very aggressive 9 (10 being most aggressive). Without more extensive testing, which isn't necessary at my age, we do not know for certain if the cancer is organ-confined or maybe in the lymph nodes, seminal vesicles or elsewhere. Taking that into consideration and based on the lab report, Dr. Hoff and I considered three options: radiation, physical castration and chemical castration (hormone therapy). Physical castration is a permanent surgical procedure whereas chemical castration achieves the same goal (lowering the testosterone), but can be reversed by stopping the treatment. I decided hormone therapy would be the most appropriate treatment for me. Hormone therapy does have side effects. The worst of those is hot flashes, which I had never had but my wife endured. That did seem to be a workable issue when you consider the alternative. By the end of June, another PSA test was given and it had dropped to twenty. Considering my score had hit 124 in early May, they gave me a new rank of "remission." It required only one treatment of a drug called Firmagon to lower my PSA by 100 points. Only one month following the shot to my abdomen and my cancer was under control. Not cured but controlled! As of May of this year, my PSA has dropped to 5 with the hope and expectation it will drop even lower. I can continue to live with this dangerous disease that, at least in my case, has been shut down, though not killed, with hormone therapy. Learning more about prostate cancer comes easy these days with the internet (need to find reliable sites) and Us TOO for sources. The actual experiences shared at our Us TOO Florence meetings twice a month with other patients and the doctors that are specialists in this field, has been enlightening as well as comforting. There is light at the end of this tunnel and the PSA test is the light! |
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