Case Study One:

 

My story starts with the results of a routine blood test. For several years my PSA was steady at 4.5 so when it jumped to 10 my doctor's advice was, although a PSA count of 10 is not abnormal for a man of my age (75), a sudden increase should be monitored.  Another blood test in a month's time showed a PSA count of 15 and although I had no symptoms his advice was to seek the advice of a specialist.

Michael Mackey was the urologist I was sent to, and after various examinations and tests an ultra sound showed a tumour in my prostate. The next step was a biopsy, which was not a particularly pleasant experience, and this showed the tumour was cancerous.

Michael then gave me options, one of which was to do nothing immediately and monitor progress. As the tumour was quite small there was a reasonable chance I could live the rest of my life with it. The other options were an operation to remove a part or all of the prostate or brachytherapy which involved inserting radio-active seeds into the prostate to get rid of the tumour with radiation. Brachytherapy was by far the most costly treatment (around $27,000) and the least disruptive. I had health insurance with Southern Cross who just recently extended their cover for brachytherapy so Michael's advice was that was the best option for me. I then had a volume study performed in theatre with a short anaesthetic to determine the exact size and position of the prostate gland.

 All the information from the tests and ultrasound were sent to the Radiation Oncologist –  Dr C S (Benji) Benjamin. He gave me a briefing on what the treatment involved and calculated the number and type of seeds to be used and the placement thereof.

The Mercy Hospital in Epsom was the only one in Auckland capable performing brachytherapy so I went there one morning, had the procedure performed by Michael Mackey and Benji Benjamin under a general anaesthetic and left the following morning. I was a bit sore in the nether regions for a day or so, other than that no lasting effects. On my post op visit to Michael he gave me a handful of Viagra samples but happily I didn't really need them.

 The seeds were Iodine-125 which are low energy radioactive materials that lose their activity over about four months. During that time there are precautions I had to take, such as keeping a safe distance (six feet or more) from children and never allowing a pregnant woman to sit on my lap! I did set off a Geiger counter at JF Kennedy Airport, New York about four months after the procedure which created a bit of a stir.

 I had a blood test approximately three months later and the PSA count was 1. Subsequent annual PSA  counts have been between 1 and 4 so overall, seven years later, I am very happy with the results and the choice I made.