Surviving Metastatic Prostate Cancer – Derek Lawrence

I first learned that I had prostate cancer from my urologist in 1995, and he told me that I actually had a very aggressive cancer.

I had been to my family doctor in 1992 and 1993 for my annual checkup, which was fine; no mention was ever made to me about having a PSA blood test, but I was given a digital rectal exam. Somehow I missed my checkup in 1994, and by 1995, it was a completely different story. My doctor found that there was hardness on the outside of the prostate and also some nodules, but I was told that it was not serious, although he sent me to an urologist for further examination.

The urologist gave me my first PSA blood test, which was 10.4, and he sent me to Sunnybrook for a biopsy – I had a total of nine shots which showed that I had a Gleason Score of nine and a grade of cancer T2C. Because I had a cancerous nodule at the apex of the prostate, prostate surgery to remove my prostate was not an option, so I was put on Andracur, an oral hormone treatment. I remained on Andracur for two years, having blood tests every three months. I was then told that my cancer was dormant and in remission, but in 1997, after changing hospitals, I found that this was not the case.

After having been told by my local urologist that my prostate cancer had not spread, being informed that it had metastasized came as a great shock to me. In fact, the cancer had spread to my spine in two places, lumbars T10 and T11. My oncologist at the Princess Margaret Hospital (PMH) realized the seriousness of my situation, and regularly sent me for CT scans, bone scans and the occasional MRI.

Things went well until 2005. In January of that year, when I was at one of my regular appointments at PMH, I was asked if I had any pain at all. My immediate answer was no, but I did have a very strange “pins and needles” that started below my belly button and travelled around my body to the centre of my back. It was a strange sensation that was not permanent but rather fluctuated back and forth. I was sent to see the head of Neurological Surgery, who confirmed that my cancer had spread, had wrapped itself around my spinal cord, and that if I did nothing but “watch and wait,” I would be paralyzed within six months!

After a 12-hour operation, the cancerous lumbars in my spine were removed and replaced with donated bone. Two metal plates were inserted between lumbars T9 and T12, which were held together with titanium nuts and bolts under compression. I was walking in three days, and have no back pain at all – just a mild discomfort if I stand around in one place for too long.

About three months after the operation, I had intensity-modulated radiation therapy (IMRT) to mop up any remaining cancer cells. My last 30 PSA tests have all been undetectable. Because of the long duration that I have been on hormonal treatment there is a possibility of heart problems, osteoporosis and diabetes, but fortunately, none of these has happened to me yet.

Holland Landing, Ontario
Age 84