Thursday, November 6, 2008

biography of a prostate

Here's my history, mainly focusing on the time up until salvage radiation began. I was only 38 when we found I had a PSA that was out of range. My uro tried an antibiotic (Cipro) and high dose Motrin with some success. We then tried Avodart in an effort to prevent cancer (chemoprevention) without luck. I had 3 biopsies over the years, and a few urine analyses here and there (urinalysis never found anything).

Age 38
8 Dec 2000
bothered by frequent urination, went to primary care phys.
PSA 4.5
PCP said prostate was boggy
referred to Urologist
Biopsy Ordered

Jan 2001
Biopsy: negative for cancer, findings consistent with prostatitis
Start hytrin for blood pressure control; drug also provides some BPH relief

Age 39
16 Jul 2001
PSA 4.1

20 March 2002
PSA 6.1
START Cipro 500mg daily for 3 wks, Motrin 800 mg daily

Age 40
30 May 2002
PSA 5.7
Free PSA 11.9%
Urologist believes probably prostatitis

30 Sep 2002
PSA 7.3
Free PSA 11.3%
START Avodart
STOP Motrin
ORDER Biopsy

November 2002
BIOPSY: negative for cancer, but PIN III found

31 Jan 2003
PSA 2.2
STOP Avodart

Age 41
03 Sep 2003
PSA 4.9
Restart Avodart
Urologist thinks PSA is elevated from BPH

23 Jan 2004
PSA 2.2
Continue Avodart

Age 42
24 July 2004
PSA 2.5
Continue Avodart

26 Jan 2005
PSA 3.3
Continue Avodart

29 Apr 2005
PSA 2.9
Continue Avodart

Age 43
11 Jan 2006
PSA 4.8 (on Avodart)
Abnormal DRE
Biopsy ordered

7 Feb 2006
Biopsy finds cancer
PIN also found
No perineural invasion
Gleason 3+4
20% on right
5% on left

24 Feb 2006
Pre surgical CT scan of pelvis and abdomen, and whole body bone scan. No mets evident. However, it looks like my shoulders are starting to wear out! (Degenerative changes in both AC joints showed up in bone scan). Plus a bulging disk in my spine at L5-S1.

17 March 2006
Pre-surgical chest x-ray is normal.

Age 44
14 April 2006
Robotic prostatectomy
Positive margin at apex and left lobe
No perineural invasion identified
Extension into capsule, but not through
Gleason 3+4
70% of gland involved
Prostate was 22.5 grams
Bundles on both sides were preserved.
stage t2c NX MX

24 April 2006
Catheter out

16 May 2006
PSA less than 0.1

15 Aug 2006
PSA 0.2

14 Dec 2006
PSA 0.6


Day before radiation commenced, PSA = 0.7

Radiation Jan-Mar 2007. PSA quickly fell to less than 0.1 and remains there as of late 2016. Note from radiation oncologist to urologist: looks like assumption of local-only recurrence was valid, judging by PSA response.

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