David Anderson’s story

Synopsis

Shortly after moving to the far south coast in 1990, I resumed having annual medical check ups, which included a PSA test. In my age range (70 – 79) an upper limit of 6.5 was acceptable. From1998 to 2001 my PSA gradually rose from 6 to 10.1. I had no other symptoms. During this period my GP referred me to Canberra for a whole body scan and a DRE by a urologist, both with negative results. The next PSA was 13.4. A biopsy in Canberra showed that 3 out of 8 samples were cancerous with a Gleason score of 8. I had HDR brachytherapy in 2002 with minimal side effects. Annual PSA results since then have been less than 0.4.

Moral of the story

No matter how healthy you are, have annual medical check-ups which include PSA tests, and continue them when you retire. If you are diagnosed with prostate cancer, research the subject – with support groups and much more publicity, there is now a lot more information readily available. There have also been many advances in treatment options. Try to get a specialist who will give you a personal assessment of the most appropriate treatment options for your particular case and discuss them with you. Above all, discuss it with family or friends so that you have support and are not trying to cope on your own.

Full Story

When working full time I had had annual medical check-ups, but when I retired I worked part time, we travelled a good deal, and moved house twice. I had always been very healthy and it wasn’t till we settled on the far south coast that my family persuaded me to resume annual check-ups. Fortunately my GP included PSA tests in this. As I’ve outlined above, between 1998 and 2001 these showed PSA results gradually increasing to 13.4. A biopsy in September 2001 showed 3 out of 8 samples were cancerous, with a Gleason score of 8.

After the biopsy results the urologist recommended hormone treatment, basing this on the general statistics for my age group (78). One of my daughters, a doctor, felt it would be good to get a second opinion, and my GP gave me a referral to a specialist in Sydney. While waiting for an appointment my daughter gave me a couple of recent articles to read on the treatment of prostate cancer. I followed this up by seeking out information on the internet about up to date treatment of prostate cancer.

At my appointment in Sydney the specialist discussed my general health and family longevity. He then reviewed various treatment options in the light of what he felt was my life expectancy, with the pros and cons of each. My previous research on treatment options helped me greatly in evaluating this information. He concluded by saying it was my choice but he would recommend HDR brachytherapy. He pointed out that it was somewhat expensive, as it was not as yet covered under Medicare. Fortunately this was not an issue for me, so I said I had decided to accept his recommendation. He then arranged for me to see the radiation specialist the next morning, which I did before returning home.

Within a few days my GP had a letter from him outlining the necessary preliminary hormone treatment with 50 mg Cosudex tablets daily for 28 days, and monthly implants of 3.6 mg Zoladex till the commencement of the HDR brachytherapy treatment. I started this immediately in October 2001. While I had some slight flushing symptoms I had no side effects of any significance over the next few months. I also had a CT scan of the abdomen to check for any signs of cancer outside the prostate.

In February 2002 I went into hospital in Sydney. The radiation needles were inserted into the prostate under general and some local anaesthetic and I was surprised when I came out of the anaesthetic how painless it was. I had my first radiation treatment that afternoon and then had to lay flat on my back overnight. It was a long night but the next day I had the second and third treatments in the morning and afternoon, the needles were removed, and I was still feeling quite comfortable as I recuperated. While I found the whole operation almost painless, others may not do so. The nurses kept asking me if I needed painkillers, because some previous cases had complained about severe pain. They were surprised when I said I didn’t need them. The next day my daughter picked me up about midday and we made the 400 km trip back home.

I was very fortunate with the follow up radiation treatment. After my first consultation, I had taken two old friends who lived in Sydney to dinner, and when they heard what I was doing they insisted I stay with them when I was having this treatment. So I was in normal family surroundings for the whole time, which made it much easier to handle being away from home for so long.

Ten days after completion of the brachytherapy, I drove back to Sydney for a day at the clinic so that they could do some checks and design the external beam radiation treatment. The following week I started the treatment on Monday morning, and that was my routine for the next four weeks till the Easter weekend, when I was keen to have a few days at home. When I raised this at the clinic, there was great concern that I might miss a day’s treatment – apparently it was all right to miss Saturdays and Sundays, and Good Friday to Easter Monday inclusive. However they were very cooperative, so I drove in early on the Thursday before the Easter weekend, had my radiation, and then drove home to the south coast. On Tuesday I left home early, drove straight to the clinic, had my radiation in the afternoon, and settled back in Sydney with my friends for another five days of treatment – making a total of twenty five days of external radiation treatment altogether.

Again I was lucky – despite a little tiredness I had no side effects to speak of from the radiation. After completing the course I continued to have three monthly Zoladex (hormone) implants for twelve months, again with no real side effects. Since then my annual PSA readings have been less than 0.3.

My experience highlights some of the logistical difficulties people outside capital cities face when diagnosed with prostate cancer and other serious illnesses. I was very lucky to have such good support from a family which had members with medical qualifications, and from hospitable friends. Since then I’ve been able to help a few people who were not so lucky, and I hope this account may be of help to others.

29 October 2010