Case Study Eight:

 

Having passed regular medical checks all my working life with no issues I expected the same at age 69 when I renewed my pilot medical. The Doctor had been my GP for over thirty years. He had routinely carried out a digital prostate examination with no indication of a problem.

 

I had taken little interest in PSA results. After all, I had no indication of physical problems. As before the digital examination result also seemed fine. However, in the 24 months since the previous check my PSA had risen from a long standing 3.4 to 6.3. As the notes say. ‘A change beyond the normal variation.’ A second opinion from a Urologist was recommended.

 

The Urologist carried out a digital examination which seemed normal then decided a scan should be the next move. The ultrasound scan revealed a large contained tumour in the prostate. A biopsy returned a high Gleeson score and the cancer was classified as aggressive. As mentioned, I had no physical indications of any problem up to this time, so the result was very much a surprise and a concern.

 

After a great deal of reading, considering the options and discussions with the Urologist we agreed surgery would be the appropriate action as soon as the prostate recovered from the biopsy. Radiation treatment, as it was at that time, would result in some damage to surrounding areas and limit further options if not successful. The tumour was assessed as not suitable for Brachytherapy.

 

The post op report states ‘Routine surgery, good recovery ‘. From my own point of view, the surgery was a major event. However, recovery progressed well and eventually all functions returned to normal. The recovery exercises proved very beneficial and not to be neglected.

 

Seven years later all seems well. A small amount of urinary incontinence is evident with heavy physical activity, easily contained with a small pad. For two years after the operation my PSA check was below the detectible level. At the seven-year post operation mark my PSA is 0.20. Possible action beyond monitoring has yet to be decided.

 

At the time my cancer was revealed there was an opinion among some that prostate cancer was something you died with rather than of. In my own case not a mindset I could live with.

 

Discussion with friends who have dealt with prostate cancer has been a great mental help to myself and revealed different treatments are appropriate for individual cases. The discussions with the Urologist were invaluable in considering treatment options.  Developments in radiation and surgery over recent years have been a positive, improving treatment and options.