My journey with prostate cancer began in January 2007. My PSA had risen abruptly from 4 to 7 and a transrectal ultrasound in February showed I had an enlarged prostate. Another PSA test in March showed my PSA had climbed to 17.
In March, a urologist did a digital rectal examination (DRE) and said he could feel something abnormal. A prostate biopsy in early June led to a diagnosis of aggressive prostate cancer with a Gleason score of 10. I was immediately started on hormone therapy – androgen deprivation – 50 mg of Casodex daily and an injection of Eligard every three months.
I was also scheduled for more tests – chest X-ray, blood tests and a CT scan. In late June, my urologist delivered the news that I had enlarged lymph nodes and that he suspected the cancer had spread to the lymph nodes, seminal vesicles and potentially elsewhere in my body.
I was scheduled for another CT scan in mid-September. The urologist said he would only operate if the cancer had not spread. Otherwise, his recommendation was that I just be treated with hormone therapy, which could be effective for as long as five years. At that meeting, he said that I would be considered palliative, rather than someone who could be “cured.”
I was also scheduled to see a radiation oncologist at the Gatineau Hospital. The doctor there said radiation was my best option. I was scheduled to begin seven weeks of daily radiation in September. More tests were ordered: X-rays of the chest and lower abdomen, bone density, abdominal ultrasound and another CT scan.
So at that point I seemed to have two choices – one was hormone therapy for as long as it was effective and the other was radiation, which the radiation oncologist felt was the best option for me.
I was advised by prostate cancer survivors at the Prostate Cancer Action Ottawa meeting I attended in August to consider getting a second opinion. They said surgery was considered the “gold standard,” and that having radiation first would close the door on surgery if the cancer returned.
I did opt for a second opinion, traveling to see the Head of Urology at St. Luc Hospital at the University of Montreal. This specialist stressed that I was dealing with an aggressive cancer and referred me to a doctor who was leading an innovative surgical team dealing with prostate cancer at the hospital. At our first appointment, I was so encouraged to hear him say, “As you appear to have an aggressive cancer, we are going to treat it aggressively and give you a fighting chance.”
In December, another CT scan and blood tests, including PSA, did not show any spread of the cancer and my lymph nodes were back to normal. My PSA had dropped to 0.1.
Surgery was scheduled for February 22, 2008 – a four hour operation – and I spent three days in hospital in Montreal. Stitches came out back in Aylmer and the catheter was removed after 14 days. Things were fine until five days later, when I developed acute urinary retention. I rushed to Emergency at the Ottawa Hospital, in great discomfort. I was re-catheterized by a medical student, who had great difficulty inserting the catheter. We had to make another emergency visit late that day as the catheter was definitely not working.
I later learned from my surgeon that only a urologist should insert a catheter into a patient who has recently had a prostatectomy, to avoid further injury to the urethra. As a result of the procedure that day, I ended up being catheterized for a further 45 days.
But thanks to the second opinion and aggressive treatment of my aggressive prostate cancer, I am still alive eight years later!
Aylmer, Quebec