Gleason Score 0.02

Wednesday January 20th 2021

Celebrating my fifth year of remission, yes it was a little more than five years ago was when I heard those most dreaded words “You have Cancer.” Let me just say that those three words are all you really hear that first day, its kind of like your brain just shuts down, I recall there was lots of discussion and some explanations and of treatment course options. But you just can’t process them at the time. That is why you need to have family for support, to help you sort your way through the next few life changing weeks.

So I just want to take a little time today to tell all the men out there that this is a issue that just kind of sneaks up on you from behind, if you are not taking some precautions.

Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer that’s detected early — when it’s still confined to the prostate gland — has the best chance for successful treatment.

In my case I had been reasonably good at getting yearly physical exams and those of you over a the age of 50 will know that it usually includes a gloved finger to check the prostate for any tenderness or swelling referred to as Digital Rectal Exam (DRE). And if you elect to spend a few bucks more during your bloodwork you can get a PSA test. Prostate Specific Antigen (PSA) is a protein produced by cells in the prostate. It is normal for PSA to be found in the blood in small concentrations. The amount of PSA can rise as you age or if you have a problem with your prostate.

While the DRE may well detect the formation of cancer in the prostate it has no accurate reference point which is why I would recommend a PSA test because it will give you a Gleason score number.

Most men have cancers with Gleason scores of 6 or 7, and less commonly 8, 9 or 10. Pathologists rarely, if ever, assign Gleason scores of 2, 3 or 4.

I can remember that my original test at or around 50 was in the 2.? something range and being told not to worry that I was well in the “normal range.”

Then sometimes life gets in the way I found it had been a few years since a physical check up or any blood work, and the changing of a Doctor because of a retirement and when I finally went to met the new doctor he had a whole list of things that we wanted to check – I of course thought it was like a process to build a vacation fund, thinking he was being a little over zealous.

But I finally went and got prodded and poked, did all the blood tests and I remember it being early in June of 2015, usually you get those test done and you never hear from any body for weeks or maybe not until your next visit. Now I have always had a little issue with my cholesterol being a little high but usually if I behave myself for a few weeks before the test I can usually get by without much more than a light lecture. But when you get a call from the doctors office within a couple of days I was pretty sure that it wasn’t going to be good news. The problem was it wasn’t a problem with my cholesterol that brought on the call.

So within a week of having my physical and bloodwork done, I was back in the office to hear that my PSA reading was 7.2, not a number that was good so another PSA test confirmed that the first reading wasn’t an error. Now of course I am thinking this is going to be bad, because I remember my old doctor explaining to me that we all have cancer but only for a few people does it become a problem. So from there I set up appointments with a whole group of physicians that poked and prodded me until we had a confirmed biopsy that proved yes I indeed had prostate cancer and then they make calculation that take into account my age, my health, the severity of the cancer then the team lay out a number of options.

These options vary depending on all the factors, but the quick view was that I was young enough and healthy enough. That most likely the cancer would be the cause of my death if not treated, which meant they they would have to explain the treatment options to us, and here are the basic choices.

OPTION 1: Basically do nothing right now, just fall into a routine of a PSA test every three months and track the changes. The thought was that it may not get worse too quickly and we could check the other options in some time and determine how to treat later. The problem with that was the testing every three months, all the appointments and if it took six or nine months to decide it was aggressive that it could spread to other areas. We knew from the biopsy that it was reasonably aggressive because of the twelve sample that they took seven were cancerous, had that been four or less it may have been a good option, but in my case it was not.

OPTION 2: Radiation which consists of directing concentrated radiation to the prostate, done in a series of visits over an number of weeks, The hope is to use high energy to kill the cancer cells to stop it from spreading and was one of the options that we looked seriously at. It was also explained that if it did not work that surgery would be very difficult after radiation because of the scaring of the tissue. Again because of the biopsy results it was not the recommended option from the doctors.

OPTION 3: Radical prostatectomy or the removal of prostate gland, surrounding tissues, and lymph nodes by making small incisions in the lower abdomen, not really what we were hopping for but if the surgeon was able to get all the infection that I could be cancer free almost immediately. The down side to this and all the other options are pretty much the same and include balder control, ED, and the like, none of which were desirable but seemed like better than the death option, the degree of the side effect vary from patient to patient but with the right surgeon and a little luck life could be pretty much back to normal.

So late July 2015 it was decided that I would chose to have a radical prostatectomy, next was to schedule the procedure as soon as possible, and knowing that my need was serious we were told that my surgery could be bumped if a more serious case came along. A date in early October was picked the surgeon scheduled and the preparation started. But with around a week to go I received a call and my surgery was bumped to late October and we just marched on a little further.

Early on October 28th 2015, I checked into the hospital for the surgery, from there till late that fall afternoon the process was just a blur to me. Apparently the surgery went as planed, but I had a number of issues in recovery, unlike my father who was cursed with high blood pressure in his later years I have been blessed with low blood pressure and apparently that was an issue a number of times, causing undo stress to the nurses in the recovery ward, me, I really never knew anything until Miss Laurie told me later that evening.

Well that is pretty much the story of my go about with cancer, I feel very blessed to still be free of prostate cancer, but at my age it was also a real wake up call, it was one of the reasons that we chose the life to travel, explore and enjoy life a little more than most people. And as I sit here this evening finishing off this blog I realize that I have now out lived my father, he passed just a few month after his 69th birthday of a massive heart attack, most likely something to do with that high blood pressure.

Here are the common signs and symptoms of prostate cancer:

• Difficulty urinating
• Urgent need to urinate
• Frequent urination, especially at night
• Burning or pain when urinating
• Inability to urinate or difficulty starting or stopping urine flow
• Painful ejaculation
• Blood in the urine or semen

All you fellows get a PSA test done to give yourself a benchmark. And do it sooner rather than later, such a simple test and it saves a lot of lives!

As always stay strong, keep well, and be well!