Saturday, February 19, 2011

My Prostate Cancer Treatment Plan

My urologist recommended my recently diagnosed prostate cancer be treated within the next four months. As far as he could tell from his digital exam, it had not yet escaped the gland, and my PSA was relatively low, but the biopsy showed it was moderately aggressive, though not advanced.

My father had prostate cancer and opted for radiation. It messed him up and bowel problems resulted, making the rest of his life pretty hellish. Even if I could get past Dad's experience, it doesn't seem like a good choice. For one thing, if radiation didn't work, the only further option would be hormone treatment, and that just doesn't sound good. Plus, I can't get over the fact that you don't get visual feedback on how effective the treatment has been.

After surgery, you know pretty clearly how clean you are, and radiation is then an option to kill any worrisome outliers that couldn't be surgically removed.

I'm planning on having a robotic laparoscopic prostatectomy, which has been described as the new "gold standard" for treating prostate cancer.

Having it done laparoscopically means much smaller incisions and faster recovery time. The robotic part of the surgery is desirable because it allows for extremely precise excisions.

Since this is a relatively new procedure, it's especially important to have an experienced surgeon, and I'll have someone who's performed several thousand of these surgeries. I read 25 reviews from those he has treated, and they all gave him 5 out of 5 stars, across the board (except for one patient who gave him a 4, for punctuality). He's the guy the doctors go to to be treated, and he both opted for, and was satisfied with, this type treatment for his own recently diagnosed prostate cancer.

The surgery couldn't be scheduled until early May, which my urologist says will be OK, but I'm on the waiting list for moving into a cancellation.

Sloan-Kettering has a nomogram--a predictive model that takes into account different variables--that tells me I have a darned good probability of not only surviving this but living for a good many years yet, most likely succumbing to something other than these damned spots.

At this point, the main thing that scares me is having, for a week, that damned catheter. I've got an idea what's involved, but I can't quite bear yet to fully look into it.

Wednesday, February 2, 2011


"You have prostate cancer," the urologist just told me by phone. Biopsy, et cetera: seven on the Gleason scale of six to ten.

"Oh, shit," is my first reaction, and then, "Well, I can get through this."

And I can, although I was surprised by the diagnosis. When my doctor first told me in December that my PSA, although not exceptionally high, had been consistently creeping up over the past two years, making an appointment with the urologist was more a way of assuaging his and BFF's concern than any alarm on my part.

So...we'll see what this brings, but I'm not too worried. Yet.