My continued fight with cancer

 

 

 

Today has been a big day in my battle with cancer. It is exactly two months since my surgery to remove my prostrate and various other associated bits and bobs in that general area of my lower abdomen.

I was diagnosed with locally advanced cancer back in April 2011, after having had a a PSA blood test return a score of 21 ( <0.1 is where you want to be).  After a biopsy procedure, CT and MRI scans  and  it was assessed as being T3B and Gleason 7 ( 4+3) which basically  means that I had a pretty serious prostrate cancer which had advanced locally outside of my prostrate into my seminal vesicles and possibly had broken out of the prostrate capsule into my lower abdomen).

Anyone who has had , or knows anyone with prostrate cancer, will be aware that there is no free lunch with any form of treating it – every treatment comes at a cost as far as the quality of life is concerned.  The standard treatment in the UK for T3B prostrate cancer is long term hormone therapy together with an extended course of radiography. Surgery is not offered as an option because of the potential impact on quality of life .

Now to my mind surgery is the place to start – to de-bulk the cancer and hopefully remove it all. If I had gone to a US hospital that would have been the prefered course of action. So why couldn’t  I have a prostatectomy  in Scotland. After much pressing of the NHS Scotland, fully supported by my GP( bless him), I managed to gain approval to have a second opinion from Mr Allan McNeill the top Urology surgeon in Scotland based at Edinburgh Western General Hospital, home of the Scottish Cancer Research Centre. Allan is one of a handful of surgeons in the UK skilled in performing laparascopic prostratectomy and has been at the forefront of the surgical treatment of prostrate cancer for the past 5 years. He agreed to take me on as his patient and on the 2nd September 2011 he performed a  laparascopic radical  prostratectomy on little old me.

Today, 2 months after,  I went to see Mr McNeill to receive my pathology and PSA report conducted after the surgery and to receive an assessment as to how the fight is progressing.

The good news is my PSA is down from 21 to <0.03. This is very good news as it reflects the level of cancer related activity in my body currently and  <0.03 is as low as it goes. How much of this success is as a result of surgery and how much is as a result of  the hormone treatment I received over the summer is unclear and will only become clear over the next 6 months. The pathology report also showed that the cancer was more prevalent than the biopsy had suggested. My Gleason Score had been increased to 9 ( 5+4) rather than the 7 suggested by the biopsy. Since 9 is as high as it gets then it shows that my prostrate was pretty shot with cancer. The cancer had spread into the seminal vesicles but not the lymph nodes ( that’s really good news as the lymph nodes can readily transmit the cancer around the body to other organs). The not so good news is that the surgery pathology  had what is known as a positive margin. i.e. there are a couple of areas where the surgery has dissected the cancer. This would indicate that there is some likely hood that some cancer remains in the bed where the prostrate was, and that this will need a course of adjuvant radiotherapy at some stage. Not the news we wanted but not unexpected as a result of the extended nature of the cancer.

So for the time being its time to watch and wait and enjoy ourselves. We will monitor the PSA every 3 months and hope that it remains at <0.03. If  it remains at that level for the next couple of years then we can say  with some certainty that we have won the battle ( if not the war). If the PSA starts to climb then its down to the Clinical Oncologist to have a go and give me a course of radiation therapy and back onto the hormones.

I would just like to thank my family, friends and colleagues who continue to give me the upmost support. I am extremely grateful for your thoughts and prayers. I would also like to thank Mr Allan McNeill and the staff at Western General Hospital who have given me  an excellent standard of care beyond my expectations. Finally, but not least,  to my wife and soulmate Zee who puts up with me during my grumpy moments and provides the love and support I need.

I am grateful to all of you.