I first learned about Prostate Cancer when my father (and best friend) was told his PSA (prostatic specific antigen) blood test was 70. He had a metastatic tumor on his back originating from the prostate. At the time I was just 27 years old (I’m 57 now). Depending upon age and history a normal reading is usually below 3. My education to this subject was to watch him fight with courage but ultimately lose over the next 2 years. My son Sean was about a year old at the time. I promised myself and him that I would do everything I could to make sure he was not educated the same way I was. The risk for Prostate Cancer significantly increases if someone in your family has had it or if you are African-American. Ever since I was 35 I got an annual exam with my urologist and had my PSA level checked. I know that is earlier than suggested but for me I was doing my “Due Diligence” after my experiences. I also researched everything I could over the years.
In March of 2016 my PSA rose from 1.1 (prior year) to 3.1 in just 12 months. That doesn’t seem like much, but in reality tripling in such a short time is a huge indicator especially with my family history. This is called velocity . That was my hammer blow to the stomach moment. I knew immediately that I probably had cancer. The next 3 months were about getting “Definitively Diagnosed“. Obviously early detection is the key to increasing the odds for survival. I immediately wanted a biopsy. My urologist has been amazing in helping and facilitating the process. Without his assistance and diligence it might have been missed. There are some natural pitfalls. The “standard” biopsy is a “TRUS” (Transrectal Ultrasound) biopsy. It takes 12 random samples from various spots of the prostate. I actually had one of these 12 years ago and it came up clean at the time. The problem with this type is that it does not specifically target where the cancer is in the prostate and can therefore miss the spot. The other type of biopsy, which is not nearly as prevalent, is a Fusion Targeted Biopsy . It uses an MRI that can get a clear image of specifically where the suspected areas are in the prostate. The MRI is fused with a live ultrasound for a guided targeted biopsy. Both the TRUS and the Fusion biopsies are done simultaneously. The TWELVE random samples of my TRUS biopsy came up with no cancer. The ONE targeted sample was diagnosed with prostate cancer. The bottom line is that if only the TRUS biopsy was done the cancer would have been missed and continued to grow for the next year or until my next exam. Today’s positive story might have become a very different story (my father’s story). My cancer was caught early and therefore HIFU (High Intensity Focused Ultrasound) was an option for me. After 10 long years of clinical trials in the US, HIFU was approved by the FDA in October of 2015. I actually heard about it for the first time 9 years before. Since then I have prayed that before I got prostate cancer it would be approved by the FDA. In that regard I was lucky, but not totally lucky. Insurance did not cover it and still doesn’t (I’m trying to change this for others).
I had 4 primary “Options“:
1. ACTIVE SURVEILLANCE : This is keeping an eye on it through additional PSA’s, biopsies, and other indicators. The cancer does not go away. It is monitoring the cancer to see if it becomes more aggressive.
2. PROSTATECTOMY : This is removal of the prostate by surgery. As with any of the options other than Active Surveillance, which for me personally is not an option, there is a great risk of ED (erectile dysfunction) and Incontinence (urinary leakage).
3. RADIATION THERAPY : This also has ED and Incontinence as main side effects along with additional risks. It also means that if the cancer comes back, a prostatectomy would not be an option in the future.
4. HIFU : The prostate is not removed. The cancer in the prostate is killed using high intensity focused ultrasound without damaging specific areas of the prostate or surrounding tissue and nerves. The risk of ED is drastically lower in general and depending on the placement of the cancer even less of a risk. Again, I am very lucky where mine was. Incontinence is roughly only a 2% chance or less. HIFU has been in practice around the world for more than 18 years and is an accepted normal treatment for Prostate Cancer. It is not experimental and is extremely successful. (On September 20th of 2016 I had my HIFU procedure. It was a complete success. I had no setbacks or any side effects. I am cancer free!)
Below are various links regarding the above information. Please do not just take my word or anybody’s word as fact regarding information. Research everything and always judge the source. I can’t tell you how much I have continued to learn as I have gone through this process. I research even the information told to me by the doctors involved. Please pass this along to all that you care about. It is a difficult subject for us guys to address. I can’t tell you how many people I know that don’t realize what they should be doing in regards to protecting themselves from prostate cancer.
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follow on twitter: Josh Lerman@joshlermanDDDDO