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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