Lessons learned in prostate situation
by William Arnold - Dec. 22, 2008 10:26 AMSpecial for The Republic
When I went for my post-prostate surgery consultation with Mayo's Dr. Paul Andrews, I got both good news and bad news. Good news, the catheter was removed, and I was given a supply of adult pads because incontinence will be a factor - only for a few weeks I hope.
The bad news was that the entire prostate contained cancer, not just the 3 percent as determined by the biopsy. How could this happen?
Let us assume that biopsies can be taken in 100 different points in the prostate. Each biopsy collects just 12 of those hundred, and I had cancer in one biopsy sample. Unfortunately, there could and probably was cancer in the 88 samples not taken. I had no outward symptoms and a small, smooth prostate. If that one cancerous sample had not been found, I might have gone on to believe I was cancer-free.
Lesson to be learned: Work very closely with your urologist and keep tabs on your PSA and digital rectal examination.
Given all of the biopsies taken during my surgery, there is a real possibility that some cancer remains at the edge of the urethra. Only monitoring and testing will provide the answer. In the meantime, I have an additional three months to deal with the unknown.
Waiting on the unknown can be an issue. With each waiting period, I had time to think. I tried to think positive.
Is it scary? You bet it is, as you have an invader in your body, and you do not know what it is doing. Perhaps it is also a wakeup call to help you enjoy the rest of your life. As Dr. Andrews suggested, "Do the things you enjoy. Take some long walks and enjoy nature."
I cannot conclude this series on prostate cancer without saying that there are numerous treatments for prostate cancer not included in this four-part series. I will come back to the topic in a few months.
Many stories from my readers are posted on my blog. Go to: http://prostatecancersupport.blogspot.com/. Hopefully their stories can give you inspiration to deal with your situation should you face prostate cancer. Their stories and mine are my Christmas present to you.
Here is a wife's perspective: Jennifer Szakach of Scottsdale remembers: "The diagnosis was a shock to me because while we knew John had a high PSA reading, his brother had had false readings in the past, and we thought that would be the case with John.
"Dr. Darson was emphatic that John have the surgery within 2 months, so everything happened very fast. I was only involved with one meeting with the doctor and relied mostly on John's explanations for what to expect. . . .
"You can imagine my concern when 3 1/2 hours went by, and he still wasn't out of surgery. It was about 5 hours before Dr. Darson came out to tell me that John was fine, but the cancer had been more widespread that he expected, and it required a lot more work to remove it all. He said that we were very lucky to have had the surgery when we did."
For the rest of her story, go to the blog.
William Arnold can be reached at william.arnold@asu.edu.
More on this topic
Prostate cancer resources
• Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life by Rabbi Ed Weinsberg and Robert Carey, M.D. provides detailed coverage of the issues related to prostate cancer and survival. The subtitle lets you know that it is more than surgery. Published in October, it comes with 13 pages of references. Available at Amazon.com.
• Promoting Wellness for Prostate Cancer Patients by Mark A. Moyal, M.D. is another good short book that can guide you from diet choices through prostate surgery. Ask your urologist for a copy of this book.
Tuesday, December 23, 2008
Wednesday, December 17, 2008
More Unpublished stories
These have not appeared in my column:
I too had PC and had it removed by the Da Vinci Robotic Prostatectomy Surgery. My PSA levels were between the range of 1.5 to 1.9, but my physician felt something while doing the DRE and sent me to an Urologist. Dr. Bombino who has done more than 200 of these types of surgeries did my surgery. Mine was done in April of this year. A friend of my also had his done two weeks before mine. We both concurred that the two weeks after the operation is the hardest time because of the catheter. Had the operation in the morning and was up walking around by five in the afternoon, the operation itself was a breeze!
The incontinence, as the Dr. said, it is going to take a year or more. So get a good supply of men’s guards to help. I still play golf at least five times a week , work out in a gym three times a week and play softball twice a week in a league.
Bob Colli
From a reader who does not have prostate cancer:
It has been my experience that the subject of prostate cancer commands immediate attention in any conversation among men over, say, 40 years. I have noticed that it gets every guy’s full attention regardless of how macho they perceive themselves. I am fine with you sharing anything I could offer, but I am not certain I bring anything of value since my latest PSA test was 1.2 and my digital exams have all been unremarkable.
I will add that my brother, 59 years old, underwent massive prostate surgery (removal) about 18 months ago and it was pure hell for him. Not only was the surgery painful and debilitating, but the post op follow up was very time consuming. Likewise, I have two friends who both opted for radiation seed implants and their procedures were very successful. Finally, my 87 year old father was diagnosed with prostate cancer approximately two years ago. He elected to do nothing and is fine, with no negative effects other than a high PSA count. We no longer have him checked since it is certain that he will not die from the prostate cancer but eventually something else.
Bob Slider, Mesa
A source of information:
A friend of mine had the traditional operation in 2003. He (Norman Susser) documented his experience in a book titled AT FIRST YOU'RE AFRAID, published in 2005 and available at www.iuniverse.com . The reason I know about the book is because of my own background in writing and editing. Norman asked me to look it over before he submitted it for publication. To be honest, I read it through superficially at the time, pointing out minor errors. After getting a catheter and following my operation, I read parts of it over and over again. He didn't have the same operation that I had and you will have soon, but he did have many insightful experiences and observations that I found more than useful. I don't even know if the book is still available and a sale of it is not my intention here, but believe me that parts of it would be useful in your post-operative period.
Mel Cebulash, Scottsdale
I too had PC and had it removed by the Da Vinci Robotic Prostatectomy Surgery. My PSA levels were between the range of 1.5 to 1.9, but my physician felt something while doing the DRE and sent me to an Urologist. Dr. Bombino who has done more than 200 of these types of surgeries did my surgery. Mine was done in April of this year. A friend of my also had his done two weeks before mine. We both concurred that the two weeks after the operation is the hardest time because of the catheter. Had the operation in the morning and was up walking around by five in the afternoon, the operation itself was a breeze!
The incontinence, as the Dr. said, it is going to take a year or more. So get a good supply of men’s guards to help. I still play golf at least five times a week , work out in a gym three times a week and play softball twice a week in a league.
Bob Colli
From a reader who does not have prostate cancer:
It has been my experience that the subject of prostate cancer commands immediate attention in any conversation among men over, say, 40 years. I have noticed that it gets every guy’s full attention regardless of how macho they perceive themselves. I am fine with you sharing anything I could offer, but I am not certain I bring anything of value since my latest PSA test was 1.2 and my digital exams have all been unremarkable.
I will add that my brother, 59 years old, underwent massive prostate surgery (removal) about 18 months ago and it was pure hell for him. Not only was the surgery painful and debilitating, but the post op follow up was very time consuming. Likewise, I have two friends who both opted for radiation seed implants and their procedures were very successful. Finally, my 87 year old father was diagnosed with prostate cancer approximately two years ago. He elected to do nothing and is fine, with no negative effects other than a high PSA count. We no longer have him checked since it is certain that he will not die from the prostate cancer but eventually something else.
Bob Slider, Mesa
A source of information:
A friend of mine had the traditional operation in 2003. He (Norman Susser) documented his experience in a book titled AT FIRST YOU'RE AFRAID, published in 2005 and available at www.iuniverse.com . The reason I know about the book is because of my own background in writing and editing. Norman asked me to look it over before he submitted it for publication. To be honest, I read it through superficially at the time, pointing out minor errors. After getting a catheter and following my operation, I read parts of it over and over again. He didn't have the same operation that I had and you will have soon, but he did have many insightful experiences and observations that I found more than useful. I don't even know if the book is still available and a sale of it is not my intention here, but believe me that parts of it would be useful in your post-operative period.
Mel Cebulash, Scottsdale
Tuesday, December 16, 2008
A wife's perspective on prostate cancer
Jennifer Szakach of Scottsdale provided a wife’s perspective on prostate cancer.
“The diagnosis was a shock to me because while we knew he had a high PSA reading, his brother had had false readings in the past and we thought that would be the case with John. Dr. Darson was emphatic that John have the surgery within 2 months, so everything happened very fast. I was only involved with one meeting with the doctor and relied mostly on John’s explanations for what to expect. As you can imagine, he kept most of his deepest concerns to himself. We did not know how widespread the cancer would be. You can imagine my concern when 3 ½ hours went by and he still wasn’t out of surgery. In all it was about 5 hours before Dr. Darson came out to tell me that John was fine but the cancer had been more widespread that he expected and it required a lot more work to remove it all. He said that we were very lucky to have had the surgery when we did.”
John was very uncomfortable when he came out of surgery and it was difficult for me to see him in such a vulnerable state. Little did I know that he would be needing my help for quite some time after the surgery. Because of the catheter, John wasn’t allowed to ride in a car. He couldn’t move around very well and getting out of bed was very difficult and painful for him. He couldn’t lift anything, which was good for him because we had moved into a new home 3 days before the surgery! He recovered on schedule and was back to work in a few weeks.
John’s first reaction when he received to diagnosis was to keep it to himself. He is an extremely private person. I told him that I understood and respected his choice but I hoped he would reconsider. In his current job he is one of the oldest in an office full of mostly young men. I encouraged him to think about all of the good he could do by talking openly about this to the people that he works with, especially emphasizing the importance of the PSA test. Also, I thought it would be important to have the support of our friends and family while we went through the experience. To my surprise, he did think about it and embraced the idea. He told everyone at work about it and became a mentor of sorts to friends of friends who were also going through the first scary stages of the diagnosis. As you know, he also rewrote a “what to expect” type brochure for the doctor’s office. I truly believe that being helpful to others has been therapeutic to him during his recovery. We have a close friend who is a testicular cancer survivor and he once told us that he didn’t feel right getting involved in cancer support groups because he didn’t feel like he had a “real” cancer. When there are no outward signs, no chemotherapy, hair loss, or weight loss, I think that men tend to downplay the seriousness of these cancers. It’s easy to pretend that you didn’t just have a brush with mortality when you didn’t feel sick to begin with. I’m proud of the way John has helped others and in turn has helped himself. The recovery process is not an easy one and it really helps to know that there are others out there who have walked down that road before.
“The diagnosis was a shock to me because while we knew he had a high PSA reading, his brother had had false readings in the past and we thought that would be the case with John. Dr. Darson was emphatic that John have the surgery within 2 months, so everything happened very fast. I was only involved with one meeting with the doctor and relied mostly on John’s explanations for what to expect. As you can imagine, he kept most of his deepest concerns to himself. We did not know how widespread the cancer would be. You can imagine my concern when 3 ½ hours went by and he still wasn’t out of surgery. In all it was about 5 hours before Dr. Darson came out to tell me that John was fine but the cancer had been more widespread that he expected and it required a lot more work to remove it all. He said that we were very lucky to have had the surgery when we did.”
John was very uncomfortable when he came out of surgery and it was difficult for me to see him in such a vulnerable state. Little did I know that he would be needing my help for quite some time after the surgery. Because of the catheter, John wasn’t allowed to ride in a car. He couldn’t move around very well and getting out of bed was very difficult and painful for him. He couldn’t lift anything, which was good for him because we had moved into a new home 3 days before the surgery! He recovered on schedule and was back to work in a few weeks.
John’s first reaction when he received to diagnosis was to keep it to himself. He is an extremely private person. I told him that I understood and respected his choice but I hoped he would reconsider. In his current job he is one of the oldest in an office full of mostly young men. I encouraged him to think about all of the good he could do by talking openly about this to the people that he works with, especially emphasizing the importance of the PSA test. Also, I thought it would be important to have the support of our friends and family while we went through the experience. To my surprise, he did think about it and embraced the idea. He told everyone at work about it and became a mentor of sorts to friends of friends who were also going through the first scary stages of the diagnosis. As you know, he also rewrote a “what to expect” type brochure for the doctor’s office. I truly believe that being helpful to others has been therapeutic to him during his recovery. We have a close friend who is a testicular cancer survivor and he once told us that he didn’t feel right getting involved in cancer support groups because he didn’t feel like he had a “real” cancer. When there are no outward signs, no chemotherapy, hair loss, or weight loss, I think that men tend to downplay the seriousness of these cancers. It’s easy to pretend that you didn’t just have a brush with mortality when you didn’t feel sick to begin with. I’m proud of the way John has helped others and in turn has helped himself. The recovery process is not an easy one and it really helps to know that there are others out there who have walked down that road before.
Monday, December 15, 2008
Other prostate stories
Prostate patients offer insight
by William Arnold - Dec. 15, 2008 11:26 AMSpecial for The Republic
Not every prostate procedure is perfect. You are warned that there can be side effects. Here is what some of my readers report:
Andy Tedesco of Scottsdale makes a very important point about PSA scores.
"Twelve years ago at age 67, my PSA was 0.7. The next year it rose to 1.1.Then to 2.0 followed by 3.4 and then 4.0. At that point my doctor sent me to a urologist. A 12-point biopsy revealed 12 positives and a Gleason of 8. I opted for radiation and seed implant surgery which required seven weeks of daily radiation treatment.
"Fortunately, I did not have any problems with incontinence. Five years later my PSA is steadily rising although it is still only 0.7. I will probably outlive the prostate cancer which still exists.
"The problem is that most physicians believe that there is nothing to worry about until the PSA reaches 4.0, when in reality it is the steady annual increase which indicates the cancer.
"It is the annual increase in PSA that really indicates the problem exists and not the magic 4.0.
"One concern with the seed/radiation treatment is that there is no visual examination of the prostate/bladder area."
Mark Kucera of New York City says “I'm 59 years old, had a Gleason score of 3+3, 6 total, and a PSA of 4.9.
“I had my prostate removed on August 6thof this year and was out of the hospital on August 7th. I was up walking about 7 hours after the surgery. I felt good enough on August 8th after being released to walk around New York for about an hour, per doctor’s orders.
“The catheter was removed after only 7 days. I had minimal incontinence at first during the day, but that went away after a couple of weeks. And I've had some leakage at night on 3 nights in the 2 weeks since taking out the catheter.
“By six weeks I have regained bladder control completely.
“I've been able to achieve erections sufficient for intercourse and had orgasms. But the erections are slower to develop and take more stimulation than before. I've talked to several of my physician’s patients, and they all have similar stories of excellent results.
“It hasn't all been easy or fun, but I'm thrilled with the results so far because I've heard so many tales of men fighting incontinence and struggling with sexual function for long periods after prostate surgery.”
Mel Calabash of Scottsdale recalled: "I had the robotic procedure at Mayo Nov. 5, and I can say it was a great success. My physician was Dr. Andrews, and I sing in praise to him every day.
". I had a PSA over 30 for better than three years and had 3 biopsies before cancer appeared. Because my prostate was so enlarged and stopped my ability to urinate, I had to wear a catheter for over 60 days prior to my operation. Today, I go like a 12-year-old."
Jim Blum of Scottsdale said: "I was operated on Nov. 22 at Mayo by Dr. Paul Andrews who performed the robotic procedure. I was released after one night's stay. My recovery has progressed well every day, and I received the great news that the pathology report confirmed that no cancer had entered the margins or outside the prostate.
"I also had an enlarged prostate that would have required 2 to 3 months of hormonal treatment before seeds and radiation could take place. I have also heard some not too pleasant examples of problems with seeds-radiation. For example, I have a very good friend who had the seeds, but had to keep his catheter in for 7 months.
Jerry Zuba of Scottsdale said: "I never felt during the post-prostate surgery that I was improving. It was like Groundhog Day every day. I had to wear a Foley leg bag for months even at work. Talk about embarrassing, and then I graduated to pads which I seemed to use at least 3-4 a day.
"Here it is 3 1/2 years after surgery and I still wear a pad because leakage still occurs on a small scale. I have been to the doctor many times, and unfortunately this is the best I can hope for. What a nightmare.
"I do feel doctors gloss over the fact that there might be a 10 to 20 percent risk factor. That might be OK for the 80 to 90 percent that things go OK, but if you are in the other category you really suffer mentally and emotionally. I think (doctors) truly believe that because of their skill level problems will not occur. This surgery was tough, and (I) would not wish it on anybody."
Next week: My postoperation review.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
Information and support services
• www.ConquerProstateCancer.com. Rabbi Edgar Weinsberg, who wrote Conquer Prostate Cancer, has numerous stories and helpful guides on this site.
• www.yananow.net/Links.html can give you useful information on procedures and treatment. You can order a free booklet, "A Strange Place," on the site. It's an information guide written by Terry Herbert, a longtime prostate cancer survivor who operates the site.
• For peer group support through UsToo, go to Mayo Hospital Room #MCH1-212, 5777 E. Mayo Blvd., Phoenix 85054, or call Ted Hinderman at 602-569-7536 or Chuck Voinovich at 602-953-4000. There are other UsToo support groups in Arizona and the rest of the country. More information: www.ustoo.com.
by William Arnold - Dec. 15, 2008 11:26 AMSpecial for The Republic
Not every prostate procedure is perfect. You are warned that there can be side effects. Here is what some of my readers report:
Andy Tedesco of Scottsdale makes a very important point about PSA scores.
"Twelve years ago at age 67, my PSA was 0.7. The next year it rose to 1.1.Then to 2.0 followed by 3.4 and then 4.0. At that point my doctor sent me to a urologist. A 12-point biopsy revealed 12 positives and a Gleason of 8. I opted for radiation and seed implant surgery which required seven weeks of daily radiation treatment.
"Fortunately, I did not have any problems with incontinence. Five years later my PSA is steadily rising although it is still only 0.7. I will probably outlive the prostate cancer which still exists.
"The problem is that most physicians believe that there is nothing to worry about until the PSA reaches 4.0, when in reality it is the steady annual increase which indicates the cancer.
"It is the annual increase in PSA that really indicates the problem exists and not the magic 4.0.
"One concern with the seed/radiation treatment is that there is no visual examination of the prostate/bladder area."
Mark Kucera of New York City says “I'm 59 years old, had a Gleason score of 3+3, 6 total, and a PSA of 4.9.
“I had my prostate removed on August 6thof this year and was out of the hospital on August 7th. I was up walking about 7 hours after the surgery. I felt good enough on August 8th after being released to walk around New York for about an hour, per doctor’s orders.
“The catheter was removed after only 7 days. I had minimal incontinence at first during the day, but that went away after a couple of weeks. And I've had some leakage at night on 3 nights in the 2 weeks since taking out the catheter.
“By six weeks I have regained bladder control completely.
“I've been able to achieve erections sufficient for intercourse and had orgasms. But the erections are slower to develop and take more stimulation than before. I've talked to several of my physician’s patients, and they all have similar stories of excellent results.
“It hasn't all been easy or fun, but I'm thrilled with the results so far because I've heard so many tales of men fighting incontinence and struggling with sexual function for long periods after prostate surgery.”
Mel Calabash of Scottsdale recalled: "I had the robotic procedure at Mayo Nov. 5, and I can say it was a great success. My physician was Dr. Andrews, and I sing in praise to him every day.
". I had a PSA over 30 for better than three years and had 3 biopsies before cancer appeared. Because my prostate was so enlarged and stopped my ability to urinate, I had to wear a catheter for over 60 days prior to my operation. Today, I go like a 12-year-old."
Jim Blum of Scottsdale said: "I was operated on Nov. 22 at Mayo by Dr. Paul Andrews who performed the robotic procedure. I was released after one night's stay. My recovery has progressed well every day, and I received the great news that the pathology report confirmed that no cancer had entered the margins or outside the prostate.
"I also had an enlarged prostate that would have required 2 to 3 months of hormonal treatment before seeds and radiation could take place. I have also heard some not too pleasant examples of problems with seeds-radiation. For example, I have a very good friend who had the seeds, but had to keep his catheter in for 7 months.
Jerry Zuba of Scottsdale said: "I never felt during the post-prostate surgery that I was improving. It was like Groundhog Day every day. I had to wear a Foley leg bag for months even at work. Talk about embarrassing, and then I graduated to pads which I seemed to use at least 3-4 a day.
"Here it is 3 1/2 years after surgery and I still wear a pad because leakage still occurs on a small scale. I have been to the doctor many times, and unfortunately this is the best I can hope for. What a nightmare.
"I do feel doctors gloss over the fact that there might be a 10 to 20 percent risk factor. That might be OK for the 80 to 90 percent that things go OK, but if you are in the other category you really suffer mentally and emotionally. I think (doctors) truly believe that because of their skill level problems will not occur. This surgery was tough, and (I) would not wish it on anybody."
Next week: My postoperation review.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
Information and support services
• www.ConquerProstateCancer.com. Rabbi Edgar Weinsberg, who wrote Conquer Prostate Cancer, has numerous stories and helpful guides on this site.
• www.yananow.net/Links.html can give you useful information on procedures and treatment. You can order a free booklet, "A Strange Place," on the site. It's an information guide written by Terry Herbert, a longtime prostate cancer survivor who operates the site.
• For peer group support through UsToo, go to Mayo Hospital Room #MCH1-212, 5777 E. Mayo Blvd., Phoenix 85054, or call Ted Hinderman at 602-569-7536 or Chuck Voinovich at 602-953-4000. There are other UsToo support groups in Arizona and the rest of the country. More information: www.ustoo.com.
Thursday, December 11, 2008
Men tell stories
Prostatectomy patients share surgery stories
by William Arnold - Dec. 8, 2008 11:03 AMSpecial for The Republic
In response to my recent column on prostate cancer, I decided to do a follow-up using the responses I received from the men who have had some form of treatment or are contemplating a treatment.
Let me begin with the choice that I made. Remember, it's a personal decision, and the choice is up to you.
Why did I select the robotic DaVinci procedure? First, I wanted a proven treatment that would be less invasive.
Second, I wanted a treatment that was available locally.
Third, I wanted a treatment that my insurance would cover.
Finally, I wanted the cancer removed as soon as possible. As you read this, I will be post surgery.
What do my readers have to say?
Rusty Dennison of Scottsdale recalls, "Being 47 years old, with no family history of prostate cancer and otherwise healthy, both my wife and I were shaken to the core by the diagnosis.
"Given the stage of my cancer, 90 percent on one side, stage 3a, Gleason score of 7 and my age, surgery was the only option that seemed reasonable. Surgery went fine. although I found the recovery process was far more protracted and difficult than I had understood.
"In the first few weeks after surgery, I was at times discouraged by what seemed like my slow recovery process, including general lack of stamina and an initially free flowing bladder. It was really quite quick, but didn't seem so at the time.
"I can remember my initial dismay at trying to figure out what kind of 'diapers' to get from the pharmacy, and then laughing through my tears when my wife brought home one package of every type Walgreens had so I could have my choice - I had no idea there were so many styles!
"By six weeks post surgery I had decent bladder control and only dripped upon physical exertion. I credit this pretty rapid resolution to the quality of my surgeon's skills and to yoga, which does wonders on the muscles that help with bladder control.
"It was close to 12 weeks before I felt generally safe not wearing some type of pad, but this was more for my peace of mind than for true need."
John Szakach says, "I was 53 years old. Never been in a hospital. Ever. I am an early retired airline pilot, and I've had PSA tests religiously since my mid-40s. My PSA has never been an issue until last year when it jumped from less than one the previous year to almost four.
"During the six months preceding the biopsy, we tried antibiotics and other measures to hopefully reduce the readings or attribute them to benign prostatic hyperplasia or some other cause. No such luck.
"My readings continued to climb at a fast rate, eventually reaching almost 9. The biopsy confirmed the reading, and I was a Gleason 7.
"I was incredibly impressed by my surgeon, Dr. Micheal Darson and his staff. I was also extremely impressed with every single person at Scottsdale (Healthcare) North. They made the entire process as comfortable as possible given the circumstances.
"After all, men don't talk about this stuff. Men always say everything turned out OK, because who wants to admit an incontinence issue or an erectile dysfunction issue?
"Somebody told me that if you want to know how men really recover, ask their wife."
Next week: More men respond.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
More on the topic
• For more information on the DaVinci robotic procedure, visit www.davinciprostatectomy.com/index.aspx.
• In addition, Gene Felker of Mesa, an 11-year prostate cancer survivor, created a non-profit organization to provide information and screening for prostate cancer. Visit www.prostatecheckup.com.
by William Arnold - Dec. 8, 2008 11:03 AMSpecial for The Republic
In response to my recent column on prostate cancer, I decided to do a follow-up using the responses I received from the men who have had some form of treatment or are contemplating a treatment.
Let me begin with the choice that I made. Remember, it's a personal decision, and the choice is up to you.
Why did I select the robotic DaVinci procedure? First, I wanted a proven treatment that would be less invasive.
Second, I wanted a treatment that was available locally.
Third, I wanted a treatment that my insurance would cover.
Finally, I wanted the cancer removed as soon as possible. As you read this, I will be post surgery.
What do my readers have to say?
Rusty Dennison of Scottsdale recalls, "Being 47 years old, with no family history of prostate cancer and otherwise healthy, both my wife and I were shaken to the core by the diagnosis.
"Given the stage of my cancer, 90 percent on one side, stage 3a, Gleason score of 7 and my age, surgery was the only option that seemed reasonable. Surgery went fine. although I found the recovery process was far more protracted and difficult than I had understood.
"In the first few weeks after surgery, I was at times discouraged by what seemed like my slow recovery process, including general lack of stamina and an initially free flowing bladder. It was really quite quick, but didn't seem so at the time.
"I can remember my initial dismay at trying to figure out what kind of 'diapers' to get from the pharmacy, and then laughing through my tears when my wife brought home one package of every type Walgreens had so I could have my choice - I had no idea there were so many styles!
"By six weeks post surgery I had decent bladder control and only dripped upon physical exertion. I credit this pretty rapid resolution to the quality of my surgeon's skills and to yoga, which does wonders on the muscles that help with bladder control.
"It was close to 12 weeks before I felt generally safe not wearing some type of pad, but this was more for my peace of mind than for true need."
John Szakach says, "I was 53 years old. Never been in a hospital. Ever. I am an early retired airline pilot, and I've had PSA tests religiously since my mid-40s. My PSA has never been an issue until last year when it jumped from less than one the previous year to almost four.
"During the six months preceding the biopsy, we tried antibiotics and other measures to hopefully reduce the readings or attribute them to benign prostatic hyperplasia or some other cause. No such luck.
"My readings continued to climb at a fast rate, eventually reaching almost 9. The biopsy confirmed the reading, and I was a Gleason 7.
"I was incredibly impressed by my surgeon, Dr. Micheal Darson and his staff. I was also extremely impressed with every single person at Scottsdale (Healthcare) North. They made the entire process as comfortable as possible given the circumstances.
"After all, men don't talk about this stuff. Men always say everything turned out OK, because who wants to admit an incontinence issue or an erectile dysfunction issue?
"Somebody told me that if you want to know how men really recover, ask their wife."
Next week: More men respond.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
More on the topic
• For more information on the DaVinci robotic procedure, visit www.davinciprostatectomy.com/index.aspx.
• In addition, Gene Felker of Mesa, an 11-year prostate cancer survivor, created a non-profit organization to provide information and screening for prostate cancer. Visit www.prostatecheckup.com.
Cancer Diagnosis
Prostate cancer diagnosis allows choices for columnist
Nov. 24, 2008 10:44 AM
Perhaps because I was an academic researcher, my initial response was not one of "Why me?"
I did every thing that I could to stay in shape - eat the right foods, take the right supplements. But the fact of the matter is, prostate cancer can hit every man if he doesn't die from something else.
My cancer doesn't cause me to fear that my life is over. I have a 3 percent cancer in the For me, it's time to face what to do next.
What are my options? I can do nothing, or find a treatment that works best for me. From the time of diagnosis to a visit last week with a Mayo Clinic urologist, I had time to think it over.
No one can make the decision for you. As I did, you have to weigh the available options.
You also can listen to what your friends did when they confronted the issue. Five had the traditional radical prostatectomy, two the robotic procedure, one had radiation implants and other had the proton treatment. All treatments had their pros and cons.
Surgery and other treatments might leave you with some incontinence and erectile dysfunction that can last for a year or more. Permanent problems can occur, but the outlook is better every day. Again, for me, these were less of a concern than getting rid of the cancer first. Later, I will face what comes after.
So what did I decide to do? I selected the less invasive robotic procedure by a physician who already has completed more than 500 such surgeries, as well as more than 1,200 radical prostatectomies.
Men are advised to get a regular prostate-specific antigen (PSA) test and digital rectal examination (DRE) after age 50. Do you? As unpleasant as it might be, I've been faithful in getting the examinations. Hence, I got an early diagnosis.
What does your physician look for in the examination? The PSA blood results will provide a number from 0 to the thousands. It's not uncommon for patients with advanced prostate cancer to have high PSA levels.
Fortunately, diagnostic procedures have improved over the years, so urologists look for more than a high number. They look at the fluctuation of the score. Does it go up and down over time?
I was fortunate that my physician and urologist both felt that the fluctuation in my PSA warranted an ultrasound and biopsy. Over a period of 18 months, my PSA went from 4.1 to 3.9 to 4.1. I'm thankful that they made the recommendation.
There will be a column after my surgery, so I can share my experiences.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
Just the facts
• Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. The American Cancer Society estimates that 28,660 men in the U.S. will die of prostate cancer in 2008.
• Prostate cancer is the most common cancer, other than skin cancers, in American men. The American Cancer Society estimates that during 2008 about 186,320 new cases of prostate cancer will be diagnosed in the U.S. About one male in every six will be diagnosed with prostate cancer during his lifetime, but only one in 35 will die of it.
• The American Cancer Society recommends that both the PSA and DRE should be offered annually, beginning at age 50. Men at high risk, such as African-Americans and men with a strong family history of the disease, should begin testing at age 45.
Source: American Cancer Society
On the Web
For information about prostate cancer, visit:
• www.mayoclinic.com/health/prostate-cancer/DS00043/DSECTION=symptoms
• www.prostatecancerfoundation.org
Nov. 24, 2008 10:44 AM
Perhaps because I was an academic researcher, my initial response was not one of "Why me?"
I did every thing that I could to stay in shape - eat the right foods, take the right supplements. But the fact of the matter is, prostate cancer can hit every man if he doesn't die from something else.
My cancer doesn't cause me to fear that my life is over. I have a 3 percent cancer in the For me, it's time to face what to do next.
What are my options? I can do nothing, or find a treatment that works best for me. From the time of diagnosis to a visit last week with a Mayo Clinic urologist, I had time to think it over.
No one can make the decision for you. As I did, you have to weigh the available options.
You also can listen to what your friends did when they confronted the issue. Five had the traditional radical prostatectomy, two the robotic procedure, one had radiation implants and other had the proton treatment. All treatments had their pros and cons.
Surgery and other treatments might leave you with some incontinence and erectile dysfunction that can last for a year or more. Permanent problems can occur, but the outlook is better every day. Again, for me, these were less of a concern than getting rid of the cancer first. Later, I will face what comes after.
So what did I decide to do? I selected the less invasive robotic procedure by a physician who already has completed more than 500 such surgeries, as well as more than 1,200 radical prostatectomies.
Men are advised to get a regular prostate-specific antigen (PSA) test and digital rectal examination (DRE) after age 50. Do you? As unpleasant as it might be, I've been faithful in getting the examinations. Hence, I got an early diagnosis.
What does your physician look for in the examination? The PSA blood results will provide a number from 0 to the thousands. It's not uncommon for patients with advanced prostate cancer to have high PSA levels.
Fortunately, diagnostic procedures have improved over the years, so urologists look for more than a high number. They look at the fluctuation of the score. Does it go up and down over time?
I was fortunate that my physician and urologist both felt that the fluctuation in my PSA warranted an ultrasound and biopsy. Over a period of 18 months, my PSA went from 4.1 to 3.9 to 4.1. I'm thankful that they made the recommendation.
There will be a column after my surgery, so I can share my experiences.
William Arnold is a professor emeritus at Arizona State University. Reach him at william.arnold@asu.edu.
Just the facts
• Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. The American Cancer Society estimates that 28,660 men in the U.S. will die of prostate cancer in 2008.
• Prostate cancer is the most common cancer, other than skin cancers, in American men. The American Cancer Society estimates that during 2008 about 186,320 new cases of prostate cancer will be diagnosed in the U.S. About one male in every six will be diagnosed with prostate cancer during his lifetime, but only one in 35 will die of it.
• The American Cancer Society recommends that both the PSA and DRE should be offered annually, beginning at age 50. Men at high risk, such as African-Americans and men with a strong family history of the disease, should begin testing at age 45.
Source: American Cancer Society
On the Web
For information about prostate cancer, visit:
• www.mayoclinic.com/health/prostate-cancer/DS00043/DSECTION=symptoms
• www.prostatecancerfoundation.org
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