John Burke's story

Synopsis

PSA tests done from age 60 (current age - 68). PSA's only about 1. However, prostate cancer was detected in tissue removed during a TURP. Urologist suggested consideration of a range of treatment options. Second opinion sought and after further tests I decided on active surveillance: PSA testing annually; biopsy every 3 years.

Full Story

I have had routine annual PSA tests from age 60. PSA levels have been low - about 1. I had a TURP (Transurethral Resection of the Prostate) operation on 29/11/2011. Such operations involve (among other things) removing a small portion of the prostate to create more space for the urethra thereby allowing the bladder to empty more readily. A biopsy of excised material revealed that I had prostate cancer. Gleason score of 3+3.

My Canberra urologist advised me to consider all options from active surveillance to radical prostatectomy and he made it clear that all options were open to me. He gave me virtually no guidance on which treatment to take.

The initial diagnosis that I had prostate cancer left me in a state of shock to an extent that surprised me. I had believed that I would be able to come to terms with the concept of death reasonably well and fairly quickly, but that was not the case. I was stunned by the potential pain and discomfort associated with all of the invasive treatment options (not to mention the pain and discomfort of death from this particular illness). It was difficult to face up to the ever present potential of death and the very unpleasant side effects of all available treatments.

A second opinion was sought from an eminent Sydney urologist. Scans and further biopsies indicated that my cancer is of a slow growing nature which, in his opinion, may not be a problem for 30 years. His suggested treatment was an annual PSA test plus 3-yearly biopsies. I have accepted this recommendation, so at the time of this writing I have not had any operation or other treatment for my prostate cancer.

I believe that my decision to adopt a surveillance approach is correct in my case (a slow-growing non-aggressive cancer). I expect that I will only be mildly anxious at the time of my annual PSA tests as the shock experienced at the time of the initial diagnosis has largely desensitised me. It is time to move on with life again.

I cannot thank the support group enough for the information and words of wisdom provided to me following my initial diagnosis.  While showing calm on the outside, I could not manage to escape from the issue. Being with others who were dealing with similar issues and who had taken various courses of action was of immense help to me.

Moral of the story

As with some other personal stories, after diagnosis of prostate cancer I strongly suggest seeking a second opinion. You may think that your initial urologist may take offence at this but if this were to be the case it would reflect poorly on the specialist's professionalism and maturity. For you, there is too much at stake to risk proceeding with an inappropriate treatment. There is no room for taking the easy option of accepting what your first friendly/skilled/knowledgeable/confident urologist recommends even if you just want to get it over with - fast. I did not seek emotional support from the prostate support group but I did seek and received helpful information about the illness, its treatments and what to expect in terms of pain while being treated. So after diagnosis, discuss your situation with members of a support group. Take your time (months) in making a treatment decision as you are likely to change your mind often as you learn more about this disease.


John Burke
November 2012



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