A Friend of Stu Pertz Offers Good Advice

This is going to sound a little bit preachy, so, if you’re not prepared to be sermonized, save reading this for a later period when you are better able to digest the info. . or, delete it now.
My father died with prostate cancer. . my father-in-law died due to prostate cancer. You noted the difference? In that statement? My father died of old age, and a very tired heart and he lived a full and very happy 86 plus years. And, he had prostate cancer.
My father-in-law, on the other hand, lived not quite as long and died solely due to prostate cancer which had spread throughout his body after he had been mis-diagnosed as clear of cancer following a prostate biopsy.
I was aware of prostate cancer and decided to keep a watchful eye when I went through the 60 years old plateau.
I’m told now that I should have become watchful at age 50. That’s what the AMA suggests now.
My doctor, my GP that is, did not believe in PSA tests. They did then and do now produce quite a few false positive readings indicating prostate cancer when cancer is not present.
So how did I get to take a PSA test if my Doctor did not believe in them?
While my regular doctor was away in Australia or Africa, his replacement was faced with the task of my annual physical. And Graeme believes in PSA tests.
They’re just a drop or two of blood.
So, he requested a full inventory of blood tests, and my PSA came back as a slightly elevated 6.
I do not know what a normal reading for PSA should be.
But given that my PSA was slightly elevated Graeme decided to pass me along to a urologist for a further more complete examination.
Let me digress here for a moment to talk about the evolution of prostate testing.
For the longest period of time the only method was the DRE. . .digital rectal exam.
You know what I mean? The bending over the examination table while the doctor sticks a gloved and hopefully well-lubricated finger up your rectum and probes around your prostate which can be felt through the walls of your rectum. He’s looking for lumps and bumps and anomalies.
And this method is nearly 100% effective in detecting changes in a normal prostate. . .but degrading for both the Doctor and the patient . .and if not degrading, at least unpleasant to perform or have performed on one’s anatomy.
I think the marketing guys at whichever drug or chemical house came up with the PSA test were motivated by this apparent lack in a Doctor’s arsenal of tests. . and anything that could relieve the Doctor from having to perform a DRE was welcomed with open arms by the medical community.
But then the issue of false positives arose. And they dealt with that by measuring the velocity of change in PSA readings.
As an example of what I mean here, in my case, in 2004, I scored the previously mentioned 6 on my PSA. . so I was scheduled for a couple of extra tests by my urologist. The first was a urethral examination. . yeah, just as ugly as it sounds, where a fibre-optic device is fed up the ureter and the doc looks around at the inside of the bladder and ureter for any anomolies. . there were none.
A second scheduled examination was a biopsy. In January 2005 we went to the local hospital for this ultra-sound plus biopsy test. The idea is that they stick an ultra-sound wand into your rectum and capture reflected sound images of the size of your prostate. . .which is probably enlarged if you are over 50 years old. . but the device is used more for aiming the 10 or so needles that are fired into various portions of the prostate through the rectum’s thin wall and from which biopsy examples are taken.
In my case they were unsuccessful in performing this test. . .it just hurt too much or the doctor was having a bad day. . so we put that test off until the following summer and only if it was deemed absolutely necessary following a second PSA test.
The second test showed some velocity. My PSA had risen to over 7.
Graeme said. . "You have prostate cancer." He did this matter-of-factly and that’s OK ‘cause that’s the nature of my relationship with Graeme. He’s a straight-shooter with a terrific sense of humour.
This past summer, during my physical exam he asked me when I last had weighed less than 200 pounds. When I said 1975 he said. . ."Me too!"
But the reading meant I had to get back to my urologist for that biopsy.
And here’s where my luck turned for the better.
My old urologist had retired. He was good but I lucked out and got even better.
I was recommended to a new urologist, Doctor I. Cagiannos, and he was a treat.In our first meeting he performed the dreaded DRE (digital rectal exam). . which caused him to schedule a biopsy which was performed in late August.
We met him again in September and he announced that the tests had found prostate cancer, which measured 7 on the Gleason scale and he offered a number of different options for its treatment.
But he steered the options by relating which were most successful and which were not and which ones should be tried first. . and in my case we both arrived at the removal of my prostate.
And, he also recommended a nerve graft to restore erectile dysfunction which would be caused when the nerves for that function were severed in the operation to remove the prostate.
But first, we had to reduce the size of the prostate. . . prior to surgery. And I was given a three month shot of Lupron. This stuff causes testosterone to reduce which stops or reduces the cancer growths fed by testosterone. . . shrinks the prostate, and has a host of side-effects which include aching joints, sore bones, lack of sex drive, and, get this ladies, hot flushes. They continue by the way, nearly four months after the shot. . and will continue for another five or six months. The surgery itself was lengthy.
Doctor Cagiannos is extremely careful and very good at his job. He’s trained at some of the best institutions in the world including Sloan-Kettering. In addition to his role as a Urological-Oncologist and skilled surgeon, he is a Professor of Urological Medicine at Ottawa University. And the most striking feature of his personality is his shear exuberance at doing the very best he can for his patients. . his attitude is so incredibly positive I cannot help but think that this too aids in his patients’ recoveries.
Normally he would have taken 4 ½ to 5 hours to perform this surgery.
Instead, it took over 6 hours. . started at just after 12 noon on Friday and finished around 6:15 PM that evening.
A couple of litres of blood were required and I was in recovery until 11:30 PM when they moved me to my room.
A nerve graft was not required. . .the nerves were spared in this complex and time-consuming operation.
On the upside the Doctor said that everything looked clear following the removal of the bad body part. . but the biopsy report will tell that whole story in a week or so.
I was up and walking on Saturday, had the drainage and IV removed on Sunday and was home Monday morning.
Still catheterized I am able to walk around, eat, sleep, enjoy the computer and internet plus we have satellite TV, a telephone, lots of food and Ronnie and I can enjoy each other’s company and also get to see the panorama of wildlife and birds that are so plentiful here at the farm. And the catheter comes out next Wednesday. . .hallelujah!
Before I forget the entire purpose of this note let me once again remind you that getting a PSA test regularly will help your doctor detect prostate cancer at its earliest stages. . ..sure, there are false positives, but any indication of a possible cancer should not be fooled with.
As the Cable Guy on the Blue Collar Comedy Tour says. . ."Get er Done!"