Everyone I want to thank you for the prayers, smoke, and consideration. As Randy mentioned, I am a follower of Christ, and believe in the power of prayer.
My wife and I decided to open up about my condition, because hopefully it will inspire others to monitor their own health. We cannot rely solely on "common medical wisdom" or doctors for this. Please let me explain why I feel this way: People with a family history (first degree relatives..like your father having had the disease) are encouraged to start getting checked at
age 40.
I am age 36, and have at least stage T2C cancer. Post surgical pathology will give me a "final" stage classification, but the staging can only "get worse" as I have palpable tumors (T2) and full prostate involvement (C). If the cancer is currently contained within my "prostate capsule" then the staging will remain as is. If it is outside the "capsule" then the staging will change.
Here is a little of my chronology...
In 2009 my father was diagnosed with Prostate Cancer that had already spread into his bones (metastatic disease). He was 56 years old at the time. His oncologist recommended that I get screened at age 33. My Primary Care Physician thought it was a waste of his time (due to my age), and basically disregarded my PSA of 2.1. At 33 my PSA (prostate specific antigen) should have been 0.0. My PCP recommended that I wait until I was 40 before having my PSA checked again.
I told my PCP that...
My paternal grandfather died of metastatic prostate cancer at age 40.
My paternal uncle died of cancer at age 50.
My paternal aunt died of liver disease and cancer at age 44.
My father has prostate cancer at age 56.
This didn't change "conventional medical wisdom".
December 13th, 2010 - I finally broke down and called my PCP because I had been urinating blood for six weeks. I had waited because I've suffered through kidney stones for the past eleven years, and knew this was another stone. I thought I could pass this one without surgery, but the pain had grown unbearable. My Urologist had just retired, and I was given a referral to a new Urologist.
December 14th, 2010 - I met with the new Urologist (whom I instantly liked). She scheduled me for my eighth round of extracorporeal lithotripsy the very next day. XL is "shock wave" surgery to break up stones. I had a 14mm stone in my left kidney.
December 15th, 2010 - I had extracorporeal lithotripsy surgery.
March 17th, 2011 - My father passed away at age 59 from complications related to metastatic prostate cancer.
March 23rd, 2011 - I was at my father's funeral 5 hours from home. This was the day I was to have my 3-Month extracorporeal lithotripsy post-op meeting with my urologist.
March 30th, 2011 - I attended my rescheduled extracorporeal lithotripsy post-op, and told my urologist of my father's passing. She seemed concerned when I mentioned that I had a PSA of 2.1 at age 33. Therefore:
* She performed a DRE (Digital Rectal Exam) and found that my prostate was "hard" and had "tumor nodules".
* She ordered a new PSA test that day.
* She scheduled a TRUSP (Trans Rectal Ultra Sound of the Prostate) with Biopsy for April 18th.
* I received my PSA results the same day. My PSA had increased to 2.5. (My father's PSA was 5.6 with full metastatic involvement of his bones, lymphs, etc)
April 18th, 2011 - I had the prostate ultra sound and biopsy. I also had a severe allergic reaction to the anesthesia.
April 26th, 2011 - My wife and I met with my urologist to discuss the results:
* 3 of the 12 biopsy cores were positive for cancer.
* My Gleason score is 6. Gleason ranges from 1 to 10. Scale 1-4 is "moderate" growth cancer. 5-7 is "moderately aggressive" cancer. 8-10 is "aggressive" cancer.
* Cores from both lobes (sides) of my prostate have cancer as well as the "apex" (center).
* My urologist said my best course of action will be a Robotic Laparoscopic Radical Prostatectomy.
* My urologist stated that due to my age she does not want the surgery performed locally and recommended Barnes-Jewish Hospital (St. Louis), IU Medical Center (Indianapolis), Vanderbilt University Medical Center (Nashville) all of which are within 3 hours of my home.
* I mentioned to my urologist that I've been having increasingly intense lower back pain and fatigue. Therefore, she scheduled a complete Bone Scan and CT Scan to check for metastatic cancer (cancer spread).
I spent the next three weeks researching options, vet'g various doctors, etc. More importantly, I spent A LOT of that time fighting my insurance over treatment locations.
I scheduled with a top surgeon at Barnes after my insurance stated they would not pay for the surgery to be performed at Vanderbilt (my first choice). After discussing my treatment options, scheduling surgery, etc insurance informed me they would not pay for the operation to be performed at Barnes and recommended that I try Vanderbilt (after they rejected Vanderbilt before).
So it was back to Vanderbilt (my first choice). I scheduled with Dr. Joseph Smith who is internationally recognized as a pioneer and expert in this type of surgery.
May 5th, 2011 - I had a pelvic CT Scan and Full Bone Scan to check for metastatic cancer.
May 6th, 2011 - THANK THE LORD, because as far as they can tell the cancer has NOT spread into my bones.
Unfortunately, they did discover "Degenerative Disk Disease" between L5 and S1 which accounts for the back pain I've been having.
May 6th to Current, 2011 - Many trips to Vanderbilt latter (pathology review, consultation, pre-surgical consult, insurance issues, and classes to teach me about the intensive rehabilitation program that I will have to engage in) I was scheduled for surgery.
As a side...
All of the doctors that I've spoken with, met, etc have ruled out other treatment options. Due to my family history, and extremely unusual nature of my condition (age, extensiveness of disease, etc) we are saving Radiation as a "salvage therapy" when/if the cancer returns. My surgeon informed me he typically allows 6-12 months after diagnosis for surgery, but in my case he wanted the operation performed within 4 months of diagnosis.
Therefore, my surgery date is 7 July 2011.
We agreed upon a "nerve sparing" operation with the understanding that once inside my abdominal cavity I will allow the removal of my "nerve bundles" if required by what the surgeon observes. In short, they will try to salvage as much of my chances of eventually regain "function" as possible.
After surgery a pathologist will examine the removed tissues and lymph nodes to determine if the cancer was contained within the removed material. This is called "checking the margins". They will also check my final Gleason score, and give a more determinate "staging".
Post surgical rehabilitation will be intense, but I pray that I will eventually regain bladder control and "other functions".
I have been specific and graphic in this post, because this is a forum dominated mostly by older men. My entire purpose for "coming out of the cancer closet" was to educate people about a topic that is uncomfortable to discuss. If the cancer is contained within my prostate, my prognosis is very very good. I can be effectively treated, and possibly even "beat" the cancer. Unfortunately, so-called "sexual cancers" (prostate in men and breast in women) tend to be much more aggressive in younger people. This makes sense to me, but I'm not letting the prospect of the cancer returning elsewhere discourage me.
Many people incorrectly believe that once the prostate is removed the cancer cannot return. This is incorrect. Once a prostate cancer survivor - always a prostate cancer survivor. This is why periodic PSA tests have to be performed AFTER surgery. The goal is to keep the PSA as "undetectable", but if the PSA becomes detectable or starts to rise - this means the prostate cancer has become active in a different part of the body.
Please don't feel like you need to say anything. This isn't a "poor Gary pity party".
I am asking for prayers for myself and my lovely wife Brittney. At 31 years old, she has been AMAZING throughout this terrible year. However, I'm worried about her. Therefore, I'm asking that you pray for her too. After all, God's power is unlimited so why not ask Him to comfort her? <img src="/ubbthreads/images/graemlins/thumbup.gif" alt="" />
Please take control of your own health care. Don't be intimidated by your doctor - if you think something is wrong then push the issue! Nobody knows your body better than you do.
Prayers are always accepted and appreciated,
Gary
Post Script - Many have said that the timing of my father's death is "uncanny" at best. Many more have suggested that God took my father to save me. I don't know, but I do know that God works in mysterious ways.
