Last Modified: November 1, 2001
Copyright © 1999, Edward Eisele
The purpose of what you are about to read is this: If only one person can benefit by anything I did during my bout with prostatecancer, then it will have been worth my effort to share the story.
In May 1999, I went for a routine CATscan, following up on surgery I had in 1995 to remove a cancerous tumor. While waiting for theCATscan, a nurse drew my blood to run a PSA test for me. Since I'd already hada PSA test in January '99, which yielded a 2.7 PSA, I didn't think much abouthaving another test done a mere 4 months later.
Later that same day, I met with my urologist to review the CATscan, which (again) showed no recurrence of the tumor he hadremoved in 1995. But, I was shocked to learn that my PSA had jumped to 5.1! What to do?
My urologist suggested we conduct a biopsy of the prostate as quickly as possible, which we did. The result was nothing more than"pre-cancerous" cells having been detected. Nothing conclusive. He then recommended we conduct another biopsy in 4-6 weeks. Iasked that he do it in four weeks. If there is something wrong in my body, I thought the sooner we can identify what the problem is,perhaps I would have more options from which to select my attack.
The second biopsy was performed in late June. Out of the 12 tissue samples examined, one was positive. Oh, no, I thought. Whatdoes this mean and what are my options?
Following this second biopsy, we conducted a bone scan to see if we could detect the spread of any cancerous cells in other partsof my body. This test was negative, indicating a higher degree of expectation that the cancer had not (yet) spread.
I learned this bad news during the week going into the July 4th holiday. With that weekend totally unencumbered, I did two things: Iwent to a bookstore, bought four books on the subject, and read them. Secondly, I pulled up numerous articles and professionalpapers off the Internet written on the subject of prostate cancer and read them as well, including Andy Grove's Fortun Magazine article from 1996.
In four days, it was clear to me that I most definitely had options. The question I needed to answer was which option would be best forme? To help me determine this "best choice" option, I created a simple grid which forced me to list as many plusses and minusesas I could identify that were associated with these options: radical prostatectomy (surgery), external beam radiation, radioactiveseed implants, cryotherapy (freezing), or doing nothing (commonly referred to as watchful waiting). This last option never became aconsideration.
The week following the holiday, I spoke to my family doctor as well as his predecessor, both of whom were well trained. Based uponmy age/life expectancy, based upon the PSA number of 5.1, based upon my Gleason grade of 6, they recommended the removal ofmy prostate gland. They both felt that, because we had stumbled onto this so early, there was a very high probability thesecancerous cells had not spread outside of the prostate capsule.
I next spoke to another urologist who had been my urologist for years before I encountered the tumor in 1995 while undergoing aCATscan to monitor a melanoma surgery I'd had in 1990. But that's anotherstory. My urologist also recommended surgery forprecisely the same reasons as my other two internists. However, the two major side effects associated with surgery includeincontinence and impotence. Of course, all of the doctors told me there are ways to deal with each of these potential problems. Iwas still having great difficulty digesting the possibility of having to deal with either one of them.
I then scheduled an appointment with a radiation oncologist to discuss external beam radiation as well as seed implants. Among theside effects to these types of treatment: potential damage to the bladder and to the colon. Of course, he said there are ways toaddress these side effects if they occur.
Based upon all that I had read in the short space of two weeks time, coupled with what highly respected doctors were telling me, I hadto make a choice. The good news continued to be the fact that I had options. The bad news was in trying to weigh the risk potentialassociated with each option.
I called my urologist and told him I wanted to have my prostate gland surgically removed for these reasons:
- all indications pointed to the very high probability these cancerous cells had not escaped (yet) from my prostate, since we caught this thing early.
- all of the doctors, including a radiologist, seemed certain about the unlikely possibility of any long-term incontinence or impotence. Today's (nervesparing) surgical procedures seem to be more user-friendly than was previously the case.
- the fact I am in (otherwise) excellent physical condition. I am not over-weight; therefore, little or no fat to have to cut through. I am a long-distance runner and lift weights; my circulatory system should enable a very successful healing process in all respects.
- radiation would pretty much eliminate me from being a candidate for surgery in that part of my body in the future if such a need were to arise, since the tissue, following radiation, becomes almost impossible to cut through successfully.
That call was made on July 15th, and my doctor was able to slip me into his schedule for surgery the following Tuesday instead of anAugust date we had tentatively scheduled (he told me I could always pick up the telephone and cancel the surgery if I wanted topursue a course other than surgery).
Surgery was performed in one hour and I was then moved to a room for 4 uneventful days (good news). I began walking the eveningof my surgery day, knowing that good circulation helps both the healing process as well as the rest of my system, since all of thebowel function had been shut down and needed to get itself restarted again. While in the hospital, I did numerous walking lapsaround the hallways of my area in an effort to help my body heal itself sooner rather than later. I?m a restless patient, I suppose. Thatwalking paid off in spades, since most of my body functions were working two days later.
The pathology report told us this was a diploid tumor (a non-aggressive type), which is the best prognosis of all the tumors. Goodnews so far. The surrounding lymph nodes tested negative. More good news. The tumor was about one centimeter in size (about thesize of a pea), was well contained within the prostate capsule and had not spread outside my prostate gland. The expectation ofrecurrence is virtually zero. The best news I could expect from this experience.
While in the hospital, I watched a videotape on the care and feeding of all the equipment I was about to become responsible for,most importantly, the catheter which was to remain with me for 14 days following surgery. I'll never forget the first time I looked down, after I wasin my room, and saw that catheter coming out of me. My fun meter was not up to a 10 when I realized the catheterwas to be with me for 14 more days! Also, a fair amount of printed material on all of the bacterial risks and sanitation requirementsbegan to make me consider the need for hiring someone who could come to my home at least once a day to help keep me on course. I didn't need to set myself upfor another problem, I thought.
I was fortunate to employ just such a person. She did come to my home daily to clean me up, sterilize all of the equipment, andmonitor the swelling and the scar. Believe me when I tell you this: The peace of mind having a real professional help you take thatnext step was worth its weight in gold. Prevention of the first order.
The 14 days came and went without a hitch. For the next four weeks, no lifting of anything over 10 pounds. And, no running. Sixweeks following the surgery I began my running routine, although at a slightly slower pace, and the following week I found the weightroom again, doing most of my routine at a 50% (of norm) level.
As I reflected upon the fact I'm in my 50's and have now had two bouts withcancer (I don't count the melanoma because that wasself-induced from too much sun when we were growing up), I began wondering what it was in my diet that must be missing? There isone school of thought that believes more than 80% of all human cancers are induced by environmental factors, with 30%-40% of themen tied to a diet that is not providing the body with the multitude of vitamins and minerals that are potent anti-cancer agents. Thishas become a primary focal point as I regain my health.
I began this monologue with the hope it can be of some value to others as they go through the process of evaluating their options,should they find they have this disease. Whatever course of action anyone chooses to take, I have these suggestions:
- Be aggressive. Do not sit back and hope this goes away by itself. It probably won't.
- Create a deadline by which time you force yourself to make a decision. Then, stick to it or move up the deadline. Your clock is ticking.
- Document yourself. Go to a large bookstore and browse the shelves until you find books that are focused on prostate cancer. Also, go to the Internet. You'll be amazed at what you can pull up/print off.
- Seek out the VERY BEST medical experts in your area. This is one of those times in life when you want input from people who excelled in medical school.
- Get yourself into the very best shape you can. (For the 8 days preceding my surgery, I ran 4 days and lifted weights twice.) Not only will you be helping your physical state for a rather major incursion, but you will also gain strength mentally. And most all of us know that having a positive attitude when going into something as serious as this helps a great deal.
- Be certain you have that special person/friend/family member who will be at your side to help you through those two long weeks following surgery since you will need to rest and let your body heal itself. Rather than fight it, why not enjoy it with a good book or two? You?ll be back on your feet before you know it!
I sincerely hope my summary helps you or a loved one take control of a situation that otherwise will be very threatening. By doingso, you can turn this obstacle into a reasonably good opportunity. Good luck!