Prostate Cancer Treatments

Canada is covered by Universal Health Care and each province provide coverage for many procedures and drug plans for its seniors.

Your country of residence may over different approaches than those outlined here.

What's offered should not be taken as medical advice by a health professional. The opinions expressed are those of an individual diagnosed with prostate cancer T1 early stage and a Gleason of 6.3 and as such may not be applicable to your situation.

This hub deals with the personal decisions for my future after hearing those dreaded words, 'You have prostate cancer.' ...

After five years of PSA tests from blood sample and the embarrassing yearly 'fingers up the butt', a further humiliation awaited me. It seems that my PSA numbers although low were slowly increasing over the years. This year's 1.38 was what lead my family doctor to suggest that I go to see a specialist, even though the rectal test had not indicated any large growth in the prostate.

• [A hub that provides more on PSA & Health]

The rationale, cancer had surfaced in her, a year or two earlier, and made it's mark on 5 of the current small number of staff members. "Why take a chance? It's likely nothing."

So off to a Urology Specialist, I went a few weeks later. His office exam, showed an enlarged prostate and something in the urine test. I was given a requisition for yet another PSA test. Of note on this was the test was to be covered by the Province, rather than the $30 - $50 tests that I had done through the family doctor. Directed to pick up a book on Prostate Cancer, 'written by a colleague', I was sent home to accomplish the next quest.

• Ontario Health covers the cost of a PSA test only for those diagnosed
  with Prostate cancer or
  those with a family history of the disease.
  Many doctors and labs are not aware of this distinction
  between a screening test and treatment,
  which is required to be checked on the blood requisition.
  Confirm your position before hand with the doctor or lab.

Returning once again, to the surgeon, the PSA showed another slight rise. The end result was a date for me to appear in Day Surgery for three separate test procedures - a prostrate biopsy, a camera placed down my penis to view the prostate and bladder and another simple test to confirm the strength of my urine flow.

On the appointed day, I had gotten involved with working on a web site and had to hastily make the drive to an unknown hospital. Here I was at 63, running down the sidewalk to make the arrival time for preparation for the tests. I was only five minutes late and a little overheated as I entered the prep area.

I was directed to a cubicle and told to remove everything from the waist down with the exception of my shoes and socks and don the gown with the opening to the back. I removed the key from the locker where I had stored my remaining clothes and pinned it to the gown. I was led to a long room and to my surprise found about 20 people sitting in recliners in those lovely hospital gowns with the open backs, all wearing shoes and socks and sporting a variety of arm coverings.

One by one a team of nurses interviewed each patient and took their vitals, BP, pulse and oral temperature, while taking a short medical history. There was enough spacing between each of us, that only parts of the process were heard. The next step in pre-op was to explain what was awaited us within the hour. This was then reviewed for each test as a measure of comprehension and an assurance that when asked to sign the release, we would not delay that legal process.

In the midst of these interviews, there was a slow parade of individuals who had undergone their procedures, and led back into the room. Was it to serve as a sign that there was hope for survival?

Those who entered and those arriving in this staging area, showed only two common traits. We were all well past adolescence and dressed in a gown while wearing shoes and socks. There was a mix of male and female but a heavy predominance on male numbers. A few were easily in their 70's and beyond. I guessed that I was one of the younger participants.

Before I wanted it, seven minutes past my appointed time, my name was called and I led to a small surgical area complete with gurney and a variety of medical apparatus. " Place your behind on the edge and lift up the back of the gown." was my welcome to day surgery.

The surgeon, who I had previously met for two office visits, entered through a curtain in the room. He confirmed my name,while a nurse checked the arm band for other details. From this point on, he addressed as 'Sir'.

"Place your feet in the stirrups" he said, "I'll start by giving you a quick wash down." Unceremoniously, he flipped my gown unto my stomach and then proceeded with what appeared from my angle to be a utensil similar to a toilet brush. Then something cooling was applied to the area as well as parts of my buttocks.

He settled in between my legs with the nurse off to the left of him. My eyes were now strongly fixated on the drab ceiling and I hoped that the nurse at least had hers focused on the instrument tray in preparation for the prostate biopsy.

A tug as his digit entered my anus. "I am just going to loosen the area before I begin. Just relax and then I'll begin the samples."

I felt a series of endless snaps, akin to someone using elastic band to torment me. The biopsy had begun as he inserted some device into my anus and use now shooting a hollow core needle into the nearby prostate gland. This turned out to be an endless number of samples with increasing moments of pain. I lost track, but it was probably less than a dozen probes piercing my anus walls and removing cores samples from different areas of the prostrate.

During the process, the pair carried on a conversation about the renaming of the hospital. I hope that it meant that my ass and penis were not their concern and that their focus was elsewhere. Part way through the sampling the doctor tried to include me in their conversation, "Sir, what do you think of remaining this part of the community? Do you believe in the new name or retaining what has been here since the Henderson family first donated money to build?"

Strangely enough, although I had attempted to detach both my gaze and attention from what was going on below me, the term 'sir' diverted my focus. Looking back now, it was likely being accustomed to thirty years of students using that term to address me, their teacher in either grade or secondary schools. So I heard the question and responded somewhat hesitantly, lacking the confidence of someone with their feet in stirrups and ass exposed to their listening audience.

"Yes it doesn't seem fair." This was all that I was able to muster. A few more snaps and the tray was pushed back. One test down and two to go.

The nurse then handed the doctor, a syringe, which fortunately lacked an attached needle. "Just relax now, I'm applying something to numb you for the camera." With that, he took hold of my penis and squirted some liquid inside. I immediately felt the need to urinate and as he took hold of a tube attached to a hanging plastic bag and this was inserted as well as was some type of camera. Without a word he concentrated on fishing the components inside of me, until they reached their destination, which I thought to be the prostrate. I felt the sensation of it moving within me and after what seemed an eternity, which was less than two minutes, he slowly removed the apparatus and turned off the liquid. I now didn't have a clue whether the moisture between my legs was the results of the overhead bag or whether I had indeed urinated.

"Well that's it for here, Sir. Slowly sit up." he directed as the gown was flipped down to cover the assaulted area. "You will go with the nurse for a measure of your flow in just a few minutes and then you are done. My office will phone you for a follow up appointment in a few weeks." He then headed through the same curtain, he has entered moments before.

The Wizard had left the room, leaving the nurse and I alone. She handed me some towels. "Clean up and we will down the hall for the last procedure."

Knowing that I may have urinated in front of her, I quickly got to my feet and started to dry as rapidly as possible, always having my back to the nurse engaged in labeling the samples from the first procedure. I noticed that a pool of blood had accumulated, in the area in which I had first sat. I figured that it was normal, for the nurse obviously had seen it, as she made sure that I had made it to my feet within passing out.

We then trudged down the hallway. "I really need to go to the washroom", I directed to her as she walked in front of me.

"That is part of the next test.", she said as she turned her head to give me a reassuring smile. "It's because the scope and liquids make you feel that you have to go. We'll soon be there."

The final test was little more than urinating into a funnel attached to a toilet. Following her instruction on what to do, I was relieved when she left the room with the admonition, "Just close the door, don't lock. Let me know when you are done."

Happy to be able to pee in private, I accomplished the task as the computer measure the both the flow amount and elapsed time.

I had survived as the nurse gave me a smile and said, "That's it. You can go and get dressed. Return to the waiting room and I'll let you know when you can leave."

• Prostate Cancer Biopsy Procedure Risks
  Hub by torkinhedd

Several weeks later I returned to the surgeon's office and got the results his directed tests.
"Your flow was adequate, but you have a slightly enlarged prostrate, but we knew that going in.You have a slow growing cancer in about 50% of the samples taken. It's early and there are several way to deal with it."

The doctor went on to confirm what I had read from the written text of his colleague. There were basically 3 options for me and a repeat that this slow growing form of cancer, provided me the luxury of not having to make a quick decision. These options are dealt within other hubs, so a quick overview follows here. Your situation determines options available to you.

I could just wait and watch to see if the PSA numbers rise. The book suggested that some changes in diet may have an effect, but it seemed to lack much support with the end results.

This left 2 more options. The first of these was a series of radiation which was quickly summarized as spending a few minutes each day for several weeks and hope in the intervening days that the cancer was knocked back. There was no reassurance that it would not resurface and possible scaring would jeopardize the final surgical option.

The surgery yielded high success rates with many resulting in total removal of the cancerous areas. It would mean a couple of days in hospital and then a recovery period.

He could schedule open surgery within 6 weeks if that was what I decided. Or he could send me to another colleague who did laproscopic surgery. It would do the same thing and would likely require the same hospital stay and leave slightly smaller scars. The choice was for me to decide, once my cardiologist gave his approval for the surgery.

As luck would have it, my wife and I had discussed this option and rather than have the open surgery with severing of the abdominal muscles to gain access to the prostrate, we asked for the laproscopy appointment. This was clearly the right type of surgery for mo to select.

My Related Hub Pages

• Prostate Cancer Treatments

• Minimally Invasive Radical Prostatectomy
• Urinary Incontinence following Prostate Surgery