December 12th, 2018: Went to primary care physician .....nurse practitioner saw me, I complained about the following symptoms.......
1. Hurts/burns when I urinate 2. Weak urinary flow 3. Frequent urination
Nurse practitioner did a DRE and said my prostate felt boggy....didn’t mention any hardness or nodule. She then prescribed the following medicine and sent me to the lab to get my psa checked ...results are below.
December 12th: Medicine prescribed;tamsulosin-2 tablet PO x 1 day then take 1 tablet daily continuously.
December 13th results of : PSA- 80.44
The next day my PCP called me and assured me it was an infection..... Prostatitis. He said with age and the high psa, it was most certainly an infection. He never mentioned the possibility of cancer. Remember , I am young and dumb....did t even know what PSA was and what it meant. I am an athletic director, coach and father of two....life in the fast lane....no family history! No excuse , but I dropped the ball.
Moving forward.....
My symptoms didn’t improve much, but it became intermittent.....Since I was diagnosed with an infection I kept thinking my condition would improve.
After I realized things weren’t going to improve I went back on 5/22/19; Again, a nurse practitioner ..... saw me and performed a DRE she said, “your prostate feels inflammed.” She then prescribed the medicine below and referred me to a Oncologist. NP sent me to the lab to get my psa checked again. She also told me that it my conditions improved, I could cancel my referral to the Oncologist.
5/22/19 Medicine prescribed : doxycycline- 100 mg , 2 times a day, 21 days
May 22, 2019 PSA result; Checked Psa after visit and dropped to 74.82.
So I started my doxycycline medicine prescribed on my 5/22 .
June 21st visit to doctor. I never cancelled my referral, but decided to wait and see if the medicine impacted me. I went in to see NP to get a skin tag removed off my back and she ordered yet another for my psa to be re-checked.
Medicine prescribed after 6/21 visit; she put me on ciprofloxacin for 7 days.
June 21st PSA result; 60.60.
Following my 6/21 visit I made an appointment with my Oncologist
6/25 appointment with Oncologist ; He did a DRE in me and immediately said that I have prostate cancer and there is a 70% it has spread to other parts of my body. He also did a cytourethroscopy on my to make sure there wasn’t any obstructions in my bladder. He order a biopsy for July 1st. He prescribed me Flomax.....
6/24 phone call with my PCP.... I called doctor to ask him if it was safe to take the Flomax that oncologist prescribed me since I was already taking ciproflaxin prescribed by NP prescribed on my last visit. He told me that I was ok to take , but assured me that it had to be Prostatitis. I then told him what oncologist said ...... it was prostate cancer. PCP paused.......and said, “Well, I can’t discredit what he said.” Hmmmmmm
6/27 PCP visit; went back to NP to get the rest of my skin tag removed. She asked me how my visit went with the oncologist and I told her about what Oncologist said about cancer. NP was surprised by the results since my psa levels had dropped since December 12th visit. She prescribed me ciproflaxin and ordered another PSA that included a CBC panel.
6/28 Blood work results; 77.8 and my free psa is 5.2 which I was told was borderline by NP
July1st- Had biopsy which confirmed prostate cancer.....Gleason 8
July 3rd- Had a CT and Bone scan- results confirmed that it hasn’t spread too far outside of the prostate.....possible slight extension
July 26th- MRI IMPRESSION:
1. Large mass replacing the entire transition zone is at very high suspicion for malignancy with an overall PI-RADS score of 5. This mass extends into the left peripheral zone at the base and appears to demonstrate extraprostatic extension at the right apex, abutting the puborectalis muscle.
2. No metastases in the pelvis.
Next.....
Surgeon referred me to Radiation Oncologist....Washington University (St.Louis)
Chief Radiation Oncologist recommended that we do External beam radiation therapy (EBRT) He said since the cancer had spread outside of the prostate the only “cure” available was radiation. He said that surgery wouldn’t be successful. However, he said my mri was like looking through a rainstorm due to the biopsy ....8 weeks out. My wife and I prayed About the decision and decided to go with sugery. We felt like at the young age of 44.....this was my best option.
Following surgery my pathology came back.....
CANCER CASE SUMMARY FOR CARCINOMA OF THE PROSTATE GLAND
Diagnosis: A. Lymph nodes, bilateral pelvic, dissection - Thirteen lymph nodes with no evidence of malignancy (0/13)
B. Prostate, radical prostatectomy - Prostatic adenocarcinoma, Gleason score 4+5=9 (prognostic grade group 5) - Carcinoma involves approximately 40% of total examined prostatic tissue - Perineural invasion is present - Lymphvascular invasion is not present - Extraprostatic extension is not present - Bilateral seminal vesicles are uninvolved by carcinoma - Surgical resection margins uninvolved by carcinoma
Prostate size: Weight: 58g Size: 5x4.4x4 cm
Histologic Type: Acinar adenocarcinoma
Histologic Grade: Grade group 5 (Gleason Score 4+5=9)
Percentage of Gleason Patterns 4 and 5: Percentage of pattern 5: 10
Intraductal Carcinoma: Not identified
Tumor Quantitation: Estimated percentage of prostate involved by tumor: 40
Extraprostatic Extension: Not identified
Urinary Bladder Neck Invasion: Not identified
Seminal Vesicle Invasion: Not identified
Margins: Uninvolved by invasive carcinoma
Treatment Effect: No known presurgical therapy
Lymphvascular Invasion: Not identified
Perineural Invasion: Present
Regional Lymph Nodes: Number of lymph nodes involved: 0
2 months after surgery my psa was undetectable.....I am 9 months out and it’s still undetectable.
There is no doubt that I need to get a UPSA, but I am prepared for whatever comes my way and I am ready to take it head on. I get on this board each and every night only to educate myself on the what if’s....and I appreciate and respect everyone’s passion on this board. Honestly, Boards like this has been a life savor for me in so many ways.
The purpose of this message ???? Well, research, consult with family and pray .....the rest is in God’s Hands. If or when I have a reoccurrence .....no need to look back....it will be time to take the enemy on and keep winning!!
Wow. What a story. I do hope you stay cancer free.
I like the way looking at your MRI was likened to looking through a rainstorm. Just shows that MRI where possible should be the best possible - a MultiParametric MRI and should be done before biopsy as too much going on to mess up the picture from the biopsy. Doing the MRI first also shows where best to take the biopsy from as they can target the areas of greatest suspicion.
Make sure you spread the news among your male relatives and friends about getting PSA checks for Men in their late forties and fifties.Remind them also to be proactive with their health care.
