Case
Study Twelve:
Cancer affects us all differently, likewise the
treatment and results. No one size fits all!
It all started in 2016 at the age of 58. My PSA
had quickly risen to 7.4 and a prostate biopsy confirmed cancer. Further scans revealed it had spread to lymph glands and
pubic bone. My Gleason score was 4+3
How fortunate I was to be
referred to a talented young surgeon Simon Van Rij, a kiwi trained doctor
recently returned from the UK. Simon communicated honestly and with huge
empathy. The options we had now the cancer had escaped the prostate, one of
which was not to have surgery at all and treat with radiation and
chemotherapy. We opted to go ahead with surgery as my strong feelings were
to get rid of the ‘generator’.
After my Robotic prostatectomy my next PSA was 1. Still too high to be out of the woods. My Gleason score updated to be 4+3.
Simon reviewed the
treatment plan going forward with Peppe Sasso a radiation oncologist and Peter
Fong a chemotherapy oncologist. These three brilliant doctors meet weekly and
discuss shared patients. I think their combined knowledge and expertise and
access to a world-wide network of contacts in this field is exceptional. They
told us of a relatively small study that had been carried out in the States
that started men on a course of chemotherapy in the early stages of cancer
spread, rather than as a later treatment option. Initially I was started on
Zoladex, then targeted radiation would follow..
I agreed and had a course
of chemotherapy, which I found to be very tolerable. I was tired mainly, but
continued working throughout. That part of the treatment was managed by Peter
Fong.
Next I had targeted
radiation, which is a very precise treatment and was carried out with great
skill by Peppe Sasso. Again the side effects were minimal.
This treatment, along with
the loving care from my wife got me through until 2019 when a steady rise in
PSA was detected, from 0.05 to 0.5. Off for another round of scans. They
found some lesions in the prostate bed .
COVID lockdown arrived just
as a decision for broad radiation was made. It was concerning, but Peppe
reassured us the delay would not be a problem as I was to restart immediately
on the hormone injection Zoladex.
Also the medical
oncologist Peter Fong reviewed my case during lockdown and suggested I
could try a non-funded drug Abiraterone. He was concerned at the rapid return
of the cancer, and explained that this drug ‘mops up’ any testosterone
(prostate cancer fuel) not captured by Zoladex. The Abiraterone is usually used
at a later stage in treatment, so again the doctors have researched this and
found success when used earlier in cases similar to mine.
After lockdown I completed my second round of radiation, this time 32 lots of
non-targeted but salvage radiation.
So it’s December 2020 , my
PSA is back to 0.05, I have no appreciable side effects from all this
treatment, and my latest scan is clear.
I am certain without the steadfast and strong support of my wife beside
me, my mates to share a joke with, and most importantly these amazing and
dedicated experts I wouldn't be telling you my story.
If I have any advice it
would be to be open to the expert’s ideas on treatment. Don’t be put off or
apprehensive about the regimes they decide is best for you. The side effects
are usually managed and manageable. It might just save your life.
Info:
PSMA
PET CT scans use
a radioactive dye to light up specific regions in the body.
