I have previously posted on another thread but thought that I would put together my thoughts on my diagnosis and treatment partly for cathartic reasons and to keep me focused and partly in the hope that it may be of help and interest to others. This is in return for all the helpful advice I have gleaned from reading the experiences of other posters, for which I am most grateful.
I had been concerned for a few weeks about a weaker urine stream but did not do anything about it until my wife said she had noticed me spending longer in the loo and urged me to go to the doctor. Thank goodness for the wise woman. My doctor ordered tests which came back with a PSA of 7.5. He then did a DRE and found there was something irregular on the prostate and referred me to the hospital.
On the first appointment the urologist examined me and confirmed that the prostate was lumpy. He therefore ordered a biopsy. He said it might or might not be cancer and if it was cancer they might or might not decide to treat it.
The biopsy was not a difficult experience. It was a little uncomfortable but certainly not painful. In fact, whilst the doctor was getting on with the biopsy I was sharing jokes with the nurse. When the results came back I was a little shocked. I had convinced myself that it was just an enlarged prostate but the results showed a Gleason of 3+4=7, 2 cores positive, 7mm and 3mm from the right base, 1 core positive, Gleason score 3+3= 6, 1mm right peripheral zone. I was told that it was probably T2a but there was a 5% chance it was T3. I was booked in for an MRI scan.
Then came my appointment with the oncologist. Her report noted that the MRI scan had shown high grade disease in the right peripheral zone with possible early T3a disease. She did stress that the scan was not totally conclusive that the cancer had broken out of the prostate. She added that a 9.5mm left external iliac lymph node was seen and that I should be staged as T3a N0M0. (Each stage of the diagnosis has seemed a little worse than the previous stage).
She spent quite a lot of time with me. She said that at their MDM they had concluded that radical treatment was best for me and that brachytherapy was not suitable due to the possibility of T3a. She went through what IMRT radiotherapy would involve. When I asked her bluntly what she considered would be the best option for me she was quite clear that it would be surgery.
I had my appointment with the surgeon on 29th May. There was little he could add to what the oncologist had said about the prognosis, though he did say that he felt that, as the 9mm or 9.5mm lymph node was on the opposite side to the cancerous side of the prostate, was under 1cm (pretty close though) and with a PSA of 7.5, there was a very good chance that it was simply an enlarged lymph node. We discussed the Da Vinci surgery and the possible side effects. He told me he has done 700 of these operations. I had already decided to go ahead with the surgery so we were able to book a date there and then. It is booked in for Friday 20th June.
I have since had the pre-op medical and all seems to be well.
So, I am now preparing myself for the operation. I have no real worries about the operation itself but I am not looking forward to the after effects – just hoping that I will be one of the 30% (according to the surgeon’s own statistics) who regain continence within a few days. The other big worry is about the pathology results on the removed prostate and lymph node.
So far I have been very happy with the NHS. Everyone I have seen has been very helpful and patient and I feel well-looked after.