Brian's story - not a textbook case

[Guest Brian]

Introduction - if you wish

I'm not a Text Book Case

Month and year of diagnosis.
Had initial TRUP done in April 2008. In March 2012 I had a check-up with my Urologist and mentioned that of recent times, I was having 'wee walks' 3 or 4 times at night. Urologist suggested that I would benefit from a procedure called a BNI (bladder neck incision). This was done in May 2012 along with another TURP as tissue from the first operation had regrown. These scrapings were sent to pathology and result came back with Gleason score 4+4 = 8 PSA 3.0. 

Age at diagnosis.
64

PSA at diagnosis.
3.0

Gleason score at diagnosis. (from biopsy)
TRUS biopsy X 12 done on 16/07/2012 with Gleason score 4+5 = 9

Biopsy details.
12 prostatic TRUS biopsies:
- prostatic adenocarcinoma'
- component of acinar/usual type, a component representing intraductal carcinoma, possible ductal type and focal squamous differentation present in one biopsy.
- all biopsies positive for carcinoma
Gleason score 4 + 5 = 9
- perineural invasion present
- lymphovascular invasion present
- no extension into extraprostatic fat
- invasion of structure representing either ejaculatory duct or seminal visicle present

Bone scan result at diagnosis. 
Metastases in both sides of pelvis and back of right hip

Highest PSA before treatment.
3.0

Initial treatment - radiation. 
Commenced 25 sessions of radiation therapy on 8/05/2013 - completed on 14/06/2013.

Initial treatment - hormone therapy. 
Hormone therapy - Zoladex injection every 3 months since August 2012.

Initial treatment - other. 
Due to commence chemotherapy end of July 2013.

Lowest PSA after initial treatment.
.08, then 0.4, then 0.7 and on 6/06/2013 1.3 (during radiation) 

Current treatment status. Examples: Continuing ADT OR Monitoring PSA each 6 weeks
Zoladex injections every 3 months for the rest of my life as well as monitoring PSA every month. 

Final paragraphs - anything else you wish to say
In February 2013 I had repeated CT and bone scan to assess the response to treatment. Unfortunately, this showed progression of my bony metastatic disease with a new lesion in the right ilium and slightly more sclerosis within the known disease in the pubic ramus particularly. The bone scan correlated with these CT findings with likely progressive bony disease.

Given that my PSA has NEVER been higher than 3.0, I've been told that I'm not a text book case and being referred to as A-typical.

Nevertheless, I consider my glass half-full as opposed to being half-empty and have great support from family and friends. Every day is a bonus! 

Date updated.
9th July 2013

 

I'm now on a time-line.  Due to the cancer advancing to both lungs I've been promised this Christmas, but not Easter 2015.  However, my aim is to prove the time-line incorrect and survive long past the expert's predictions!

 

I'm currently on a different chemo from previous - it's called 'Cabazitaxel' - every 3 weeks until I'm cured!  I was expected to be given 'Enzalutamide' tablets which is not as yet on the PBS, but apparently we have a compassionate arrangement with the country of manufacture.  But unfortunately when the results of my recent CT scans and MRI were examined, Cabazitaxel was the way to go.

 

I'll keep in touch regarding my progress.  All the very best.

 

Updated 13 November 2014