Round 1

Adding this bit of script a month or so after posting the first message. Originally I was blogging to myself but then decided after the 3rd posting to let the address go public. Not sure why, other than to fill friends in, perhaps pick up a follower or two on this journey. It will not be a medical treatise but rather my recollections from the first go round and then my thoughts etc as I go into Round 2. Hopefully all my postings are accurate and I don't screw something up, if I do I am sorry, it is not intentional.


December 2002 I received the news that I had prostate cancer, still very early it was there. This was a blow to my psyche at age 52. However with the support of my family and the medical community I investigated various treatment options and opted for a treatment called brachytherapy. For those unfamiliar with this treatment it involves the permanent placement of a numerous radio-active seeds (rice grain size) directly into the prostate to kill the cancer. This was done in May 2003 and for the first 4 + years it appeared to have been successful. As a follow-up to any treatment my PSA levels were monitored quite closely and appeared to be doing the usual thing until about a year ago when there was significant rise. Was this what is called a 'bump' or was this the beginning of a continual rise in the reading? I should say that while of concern the levels were still quite low - under 2 - but it was doubling every 4 to 5 months so the trend was becoming scary. The interesting thing was that according to the criteria used I was cured. After 5 years my PSA level was not out of the acceptable range for the statistical cure level.

In late May I had a transrectal ultrasound guided biopsy which confirmed the cancer was alive and well in the prostate. In fact it was found in all 4 quadrants and for the most part on the periphery of the gland. This was to be expected the core of the gland was 'dead' as a result of the brachytherapy treatment of 2003. What was not determined was whether this was a second invasion of cancer cells or simply remnant cells from the first invasion. The pathology reports were similiar but there was some difference including the fact that this cancer seemed to be a bit more agressive.

Following the results of this biopsy I have seen the original radiation oncologist, the surgeon who performed the biopsy and a second surgeon to review some other possiblilties - cryotherapy and HIFU (High intensity focused ultrasound). At the end of these sessions it became clear that the leading candidates were hormone therapy, selvage surgery or a combination of both. I should mention that a bone scan did not indicate other sites of cancer beyond the prostate at this time.

By this time tomorrow I will have called the surgeon of choice to make a follow-up appointment and set in course my treatment for Round 2. Stay tuned.