Monday, October 26, 2015

Part 2 - Adeno-Carcinoma of the Prostate

I walked into my initial visit with the urologist, thinking that it was only going to be a consultation. Based on my high PSA level, he advised that I should have a biopsy of my prostate done. I agreed, because I'd rather have a biopsy done and find out that everything was okay, than to not have one and find out later that it wasn't. Just to be sure, he wanted the PSA checked again. Then he told me to "drop trou" and turn around. We all know what happened next. Right?  He said it felt totally normal and that he wanted to do one more thing. That "thing" was to get a sample of the bacteria in the lower areas of my large intestine, using what looked like a large, long Q-tip. He explained that they get the biopsies by going through the intestinal wall directly into the prostate, and want to make sure that I'm already on appropriate antibiotics when the procedure is performed.  Oh joy of joys...

Ultrasound Assisted Needle Biopsies
I wasn't watching, but it felt like they drove a submarine up my bum and then fired torpedoes though the intestinal wall, into the prostate, and then retrieved the torpedoes. TWELVE times. Of course they were needles, not torpedoes, and each time they came back, they had a core sample of tissue. The submarine injected lidocaine first to deaden the area, but each biopsy still felt like a small bolt of lightning. Not much pain, but very uncomfortable.

Biopsy Results
Four of the twelve biopsy samples were malignant. They were all on one side, but both sides still had to go. Prostate cancer is rated (from five to ten) using a measurement called the Gleason Scale. Five is the least aggressive and ten is the most aggressive. Most of mine were in the middle, but unfortunately, two of them were aggressive.

Options
Do Nothing:
Prostate cancer is initially pretty slow growing, and if none of it is at the aggressive level (and subject to spreading), then it is fairly common to only monitor it while frequently checking your PSA.

Chemo:
Generally used if the cancer has metastasized (spread). Mine was advanced, but had not spread. Not for me.

Radiation:
The nerves and other items that control many of the body's functions either run through, or are immediately adjacent to the prostate. Radiation damages, and sometimes destroys them. Not for me.

Traditional Surgery:
Very invasive. Done either through the area from the navel to the groin, or in the "taint" area. Both surgeries are difficult, not easy to recover from, and have the potential of leaving you incontinent (both #1 and #2) and/or impotent.  NOT FOR ME!

Robotic Surgery:
The Da Vinci Robot is used for several types of surgeries now. It changes prostate surgery to something that is minimally invasive and totally eliminates even the tiniest tremors in a surgeon's hands. It seems like something that is totally science fiction. Here is a link to a video about the robot. If you are interested and have the time, check it out.


 This was the ONLY choice for me. Minimal, if any side affects. 

One night in the hospital, was all I needed. I had a follow-up appointment with the surgeon 10 days later. He told me to come back in three months. That was nice to hear, BUT the best news was that the 14 lymph nodes, bladder sample and assorted other bits and pieces of the margins he removed, were all biopsied, and all were NEGATIVE.  That means, no chemo, no radiation, no nothing! I've now dodged the big "C" bullet twice and am very thankful for it. My surgeon's name is Moses Kim. Another stroke of luck for me, because he is one of the pioneers and most respected surgeons performing surgery with the Da Vinci Robot.

There is clearly a lesson to be learned here...

 My PSA level was pretty high. I've had the PSA blood test done before and also the more traditional "digital" exam several times. Many doctors (and even some countries) don't believe that the PSA test is necessary unless there is some irregularity detected by the "digital" exam and/or some other indications. Both my doctor and surgeon said that my prostate felt normal during the traditional exam. Without the PSA test, I'd still be walking around with an aggressive cancer, that would eventually kill me.

If you are a male, or in a relationship with one, MAKE SURE that you/they get a PSA test done whenever they get a physical, or have blood work done. It could save your/their life.

For those of you who already know about what has been going on with me, I thank you for all the prayers and positive thoughts.   The next article you see here will be a normal one!



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34 comments:

Alex J. Cavanaugh said...

What a blessing everything came back negative and the robotic surgery worked!
Yes, I do get tested every year.

Brian said...

Yep, that's scary stuff and we're sure glad you took it seriously!

Wayne said...

I am glad you are well and thank you for sharing these most personal experiences. It will benefit others, as awkward as it might seem. You have done an excellent job explaining the options. I firmly believe attitude has lot to do with staying well. I have my levels checked regularly.

robin andrea said...

Really glad it all worked out well for you, Pat. So interesting about the robot surgery. A stunning advance in such procedures. Roger was diagnosed with colon cancer in 2010. Cancer diagnoses turn life upside down for all the time spent in dealing with it physically and emotionally. Ah, but the time after, when the reports come back with good news, that happiness lasts a long, long time. Enjoy every moment of it.

Sylvia K said...

Yes, I too, am so glad all went well for you, Pat, and that the reports came back with good news! Now make the most of every day and enjoy every moment!!!

Pasadena Adjacent said...

yikes - you have been having a hard year. I wonder if they use the robot in breast cancer surgeries.

genie said...

Bud had his physical in Jan and I am gonna write our doctor a little note and ask her to have the PSA test done. Thank you are the self advocate that you are. I certainly am about myself. I would like to get all the info up front and not play around in the dark taking my chances. So thankful you got those good reports. Keep an eye on it as I know you will...just as I do with my blood checking every three months that it is still acute iron deficiency anemia and has not gone into MDS. I don’t want that one. Take care. g

Betsy Adams said...

Hi Pat, I have been wondering and wondering about you --and praying that you were okay... Glad to hear that you had the best doctors possible and that the surgery went well with good results... Awesome report --and one that all men should read....

My brother died from the big "C" in 1985... He had had cancer many years before then ---but when the cancer came back, his doctors missed it totally. Otherwise he wouldn't have died at the young age of 55.

Jim was having trouble with pain in his leg... The doctors kept checking the leg and not the hip (where the cancer was growing)... He went through months and months of horrible leg pain --and not one doctor thought to check whether his pain was coming from somewhere else.... When they realized it, it was too late. He died soon after....

Hugs,
Betsy

Pat Tillett said...

Alex J. Cavanaugh - The more I learn about the robotic surgery, the more I'm amazed.

Brian - Very scary and I guess I had to take it seriously.

Wayne - Thanks Wayne! To many folks die because they don't get these tests done. The same goes for colonoscopies.

Robin Andrea - Hi Robin! Thanks so much. I plan on enjoying it. You are right about how life changing a diagnosis of cancer can be.

Pat Tillett said...

Sylvia K - Thanks Sylvia! I certainly plan on making the most of it all.

Pasadena Adjacent - Yikes is right! I'm not sure if it is utilized for breast cancer.

genie - Thanks so much! It's hard to believe that some doctors still don't use PSA testing yet. You take care of yourself!

Betsy Adams - Thanks Betsy! I agree about men knowing this information. That is a terrible thing that happened to your brother. So sad and needless.

They Call Me Lady said...

Damn I'm mad that happened to you.
But damn I'm even happier that you are going to be OK.
Long Live Patrick Tillett !!

Liz said...

Hi Patrick,
I'm happy to see you back blogging! That's great news about your cancer too.

Ms. A said...

I knew someone that had one of the surgeries and ended up in diapers. This was many years ago and I don't know if it was permanent, or not, I've lot touch with that side of the family. Glad yours went well and I know your family is thrilled, too.

Karen Jones Gowen said...

A good news post and filled with helpful information as well. I'm glad you're doing well now, Pat.

sage said...

Glad things went well and look forward to more of your adventures.

Pat Tillett said...

They Call Me Lady - Thanks Vickie! My sentiments exactly!

Liz - Thanks Liz! I am very happy on both counts.

Ms. A - That type of a side effect is fairly rare using the robot, but it depends on advanced the cancer is also. Thanks so much my friend!

Karen Jones Gowen - Thanks Karen! I am pretty darn happy about things so far.

Sage - Thanks so much! I am also looking forward to more adventures. I still have quite a few of them that I haven't got to post yet also.

Bouncin Barb said...

Hope you're doing 100% again soon. Can't wait for a "regular" blog post because that will mean you're fine!!

Betty Manousos said...

happy halloween!

Sallie (FullTime-Life) said...

Again, so happy things turned out well. We have been there (and it really is a "we" thing, making that decision. Although not the pain of course). Like you, Bill came through just fine thank you (his surgery was fifteen years ago, so there have been even more advances since then; he was lucky to have an excellent experienced surgeon (with steady hands ;>) ).

Al said...

I'm glad it worked out for you. My doctor doesn't believe in digital exams any more, apparently they give too many false positives, but he's a believer in the PSA test after you turn 50 or if you have a family history. A PSA test saved the life of a friend!

TexWisGirl said...

really, really, really glad to hear it had not spread! good for you! and onward to 65!

visualnorway said...

You have my greatest sympathy and hopes for the future. A cousin of mine had the robotic procedure done five or six years ago, and is still alive and very much kicking, and I suppose so will you be in five or six years time.

I have my PSA taken a couple of times a year, but that is partly because I had a heart transplant in 2004 and lives on heavy immunosuppresive medication. All normal values as of now.

Take care!

PerthDailyPhoto said...

Hi Pat, early morning here in Perth. I've just been catching up with your news. I have to say you remind me so much of my sister in the way you deal with your health issues. I admire her and yourself so much for having such a positive AND pro-active way of dealing with things. As for yourself and your love of the outdoors and hiking your choices were perfect. Very happy to hear that you're 'coping' and just going up to check out your latest adventure.. You take care of yourself right!

DEZMOND said...

sorry to hear you had to undergo all that, Pat! I hate it when we get sick! Will send you positive healing energy!

altadenahiker said...

So glad I didn't read the earlier post first; I love going straight to a happy ending. (Don't you find that, on the happiness scale, the feeling of relief after a great worry is right up there at the top?)

Pat Tillett said...

Bouncin Barb -I'm not at 100% yet, but I'm working on it. Thanks Barb.

Betty Manousos - Thanks Betty! Same to you.

Sallie (FullTime-Life) - Thanks Sallie! It really is a "we" think and I am thankful that my wife was there with me at every step. I'm glad that your husband's surgery turned out so well.

Al - Me too! I'm glad to hear that about your doc. I'm all about PSA. Thanks Al...

TexWisGirl - I am also SO GLAD about that. I also had my birthday, so I made it!
Thanks so much...

Pat Tillett said...

visualnorway - Thanks! I hope to be "ticking" for a long long time. Glad to hear that you are doing so well. Congrats to you!

PerthDailyPhoto - Thanks so much! I appreciate your nice words. It seems to me, that negative thoughts and actions, just make things worse. We are out right now, but the weather isn't cooperating very much. Rainy and cold... Thanks again.

DEZMOND - Thanks so much, I'll take all the positive energy I can get.

altadenahiker - I totally agree and am feeling really good about it all. I really am not much of a worrier though. My granny used to that "worry is advance payment, about things that seldom happen."

altadenahiker said...

I like your granny.

Anthony J. Langford said...

Im sorry I missed this post Pat but Im so glad you're okay. Its a worry though huh. What a trial. You've pulled through so that's pretty damn awesome. I had a very good mate just pass away. Only 44. Pancreatic. Poor guy never had a chance.
But yr right, us guys have to be very careful with this one. It kills more people than breast cancer yet you dont hear about it that much. Thanks for the reminder. I should get a checkup.
Cheers my friend and once again, so happy that youre ok.

Pat Tillett said...

altadenahiker - She was a real piece of work.

Anthony J. Langford - Sorry to hear that about your friend. That pancreatic cancer is a bastard... Thanks so much my friend!

Baby Sister said...

Phew! What a blessing and relief! I'm so glad everything went okay and that you were given good news.

My husband's paternal grandfather died of colon cancer when he was still quite young, and my father-in-law just called my husband to inform him that he might have colon cancer. He's getting tested this week so we can know what we're dealing with, but as soon as I was told the news I was quick to inform Aaron that we would be staying on top of that one, because if I have any say he is not dying early from colon cancer. He has enough health problems that could prove to be problematic, that is not going to be one of them. And that's that. :)

Pat Tillett said...

Baby Sister - I'll double that! Phew! Phew!
You are so right Amanda, there is no sense getting colon cancer, when it can almost always be avoided. You stay on him about it!

Chuck said...

Hey Pat, I have been gone for a while but happened to get a wild hair tonight and jumped on my blog roll. I scrolled down the list until I found yours and scrolled through your most recent posts until I read the one about your doctor recommending months of taking it easy...I had to go back until I found the issue. When I read this post I was so glad you make it through okay and gave a good PSA (public service announcement) to boot! Take care my friend and so very glad you are doing well.

Pat Tillett said...

Chuck - Chuck! Really nice to see you here. I hope you and your family (including the pooches) are doing well.