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Report from Gary Minar Re Prostate Cancer

Prostate Cancer Experience, Fall 2004

This is a story about my recent prostate cancer experience so that other classmates may be informed in case they might be at risk. This is a very brief summary and I will provide a detailed clinical experience and chronology to those who request by email (gary.minar@1958.usna.com). I have had great concern about prostate cancer because a very close friend just succumbed to it, primarily because he delayed doing what the doctor suggested about biopsy after an elevated PSA reading.

As with most of us in 1958 (and hopefully ALL), we have been getting a PSA blood chemistry check as part of our annual physical. There is a lot of material written about why the PSA test is important so not repeated here.

Due to recent atrial fibrillation experience I had received a blood test in early July at 9 months, rather than 1 year. My PSA had been repeatedly in the 2.6 range, but suddenly increased to 4.7. Knowing that above 4.0 was the alarm level for those over 50 years of age, I went immediately to a urologist. He did a repeat blood test, which was exactly the same (4.7), and suggested a biopsy. I scheduled that and began to read extensively about PC. One of the best Websites I found was urology.jhu.edu, and ‘clicked’ on the Prostate Cancer button. JHU is for Johns Hopkins University where the foremost expert, Dr. Patrick Walsh (nerve-sparing surgery technique pioneer) teaches and practices. There I found a wealth of data on every aspect of PC, including a video clip of the surgery itself. JHU data provided me with a lot of background data so that I could converse more intelligently with my urologist.

When they performed the biopsy of the prostate in late July, there was an ultra sound technician (biopsy is guided by use of ultra sound), a radiologist and the urologist present. The biopsy required a Fleet enema just before the procedure. I could hear the biopsy team discussing my procedure and there were some ‘move this way, now that way’ maneuvers for me. The urologist noted a site of interest and then injected some local anesthetic thru the equipment that I was ‘wearing’ rectally to ease the pain. Then they took biopsy specimens with a tiny spring-loaded ‘gun’, inserted thru that equipment. They sampled in a prescribed manner – left, right, then the site of interest. There was very little discomfort due to the local. The entire biopsy took just 50 minutes. I inquired of the ultra sound person and she said they took 11 samples.

The results were back in 2 days, and my urologist informed me that they were positive for prostate cancer, and gave me the Gleason score of 7. I spoke in detail with him at the earliest available appointment, after reading even more detail about PC at the JHU site. The main thing I sought from the JHU site was guidance about the type of treatment to select. Those treatment options range from ‘watchful waiting’ (take no action), cryo killing of the prostate, radiation that comes in about 4 different modes, and removal by surgery (a ‘radical’). I concluded that the best choice for me with a Gleason score of 7 was surgery. The surgery was set for August 31, and then I pursued second opinions and advice form many who have had this same PC threat.

The surgery was performed at a local hospital in Goleta, CA, near Univ. of Calif. at Santa Barbara. I was on the gurney at 0730 and back in the room by 1100. I was sort of woozy and was immediately trained in use of the push-button pain relief gizmo thru the IV, which gives tiny doses of morphine. The doctor saw me not long after I awoke and informed me that he believed that the cancer was small and contained and that he was able to spare both ‘nerves’. The nerves of course are part of the male erection mystery. I was out of the hospital in 3 days, with a bladder catheter to use for 2 weeks, but had to go back for 4 days of more treatment and catheter replacement due to bladder wound bleeding.

After the catheter is removed, your bladder needs to work on its own, and surprisingly I was about 99% in control, which amazed both the doctor and me after all that I had read concerning incontinence!

I strongly believe that early detection and biopsy or treatment is essential to a favorable outcome when PC is discovered. So routine PSA checks are a MUST, and an early treatment decision is also advised. Many of my friends were strong on the various radiation treatments, but I was nervous about the possibility of not killing all the cancer as well as ‘frying’ other important nearby organs with radiation (see the JHU site). The JHU site is especially informative about biopsy, in my opinion. Again I can provide a much more detailed treatment/healing clinical experience memo by email to those who want it. This was a life changing experience for me and I went from no prostate worry to positive detection, surgical removal of a cancerous organ and well into recovery in just a 2-month period. I hope this encourages careful prostate watchfulness for classmates.