UPDATE - Issue 12 - September 2002
Surviving a PSA of 57!
- Bruce Hodgkinson's Story
Men are often hesitant to call their doctor, whereas women will more readily reach for the phone. "For goodness sake, go to the doctor's" exclaimed my wife, tired of hearing me grumble about discomfort in the lower back and groin. My GP ordered some blood tests and suspecting prostate problems included a check of PSA level which, he explained, would be sensible, especially at my age of 59. Two weeks later the worried expression on his face foretold the news he was about to give me; my PSA was a huge 27.4 about seven times the norm for my age!
I was referred to a locally based urologist. My prostate was found to be normal size with no abnormal findings on rectal examination. An ultrasound biopsy followed and there was no evidence of cancer. Strangely, I was suffering none of the usual signs of prostate disorder such as getting up frequently at night to urinate or feeble, erratic or painful flow. I was treated for prostatitis. Ten months later my PSA had risen to 35 and a repeat biopsy proved to be negative.
I would like to draw a veil over these ten months and the next three years of potentially life threatening delay when I alternated between a false sense of security and a worrying undercurrent of doubt. During this period I underwent three further biopsies and was referred to another consultant. All the biopsies, tests and scans were negative or inconclusive - that is apart from an MRI scan which revealed the cause of my original back pain. This was deterioration of discs at the base of my spine! However, by now my PSA had risen to an incredible 57 and I was no closer to having the cause confirmed.
My doctor had retired and I despairingly called my new GP. Now, not before time, I was in a very proactive mood following a family conference and suffering the aftermath of my latest biopsy. Her research and advice led to a referral to Professor Kirby. He told me without hesitation that I was almost certain to have a carcinoma of the anterior zone of the prostate - often difficult to diagnose. He advised further immediate extended biopsies focussed on this area. These were carried out within a few days.
The result of the biopsies - a shock but in another sense a relief after so long was the identification of cancerous cells. A bone scan and MRI scan followed with negative results. The way was now clear for a radical prostatectomy three weeks later. Surgery revealed an unusual 2cm diameter anterior lobe carcinoma, but, defying the odds predicted by my high PSA, the cancer was self contained within the prostate and the surrounding tissue was clear. I would not require follow up radiotherapy.
Now four months on from the operation I am looking well and importantly my PSA is less than 0.1. There are no certainties in life and my PSA will have to be monitored in the future but I appear to be completely cured. What message do I pass on? Firstly, do have a PSA check. If your PSA is high and rising do have very regular biopsies. In some cases like mine initial biopsies may not locate the cancerous cells. Check if your consultant has first hand experience of cases like your own. If not be proactive and don't shrink from obtaining a second opinion; it may save your life.