At 59, I had just retired. We moved to Florida, bought a nice house on the water, bought a boat and settled down for the good life.
One day, my wife said that she had found a doctor who would be our primary physician. She made an appointment for an initial visit.
During my examination, the doctor routinely checked my prostate. He put on a rubber glove and inserted a finger in the rectum. He probed and palpated or felt the prostate. The prostate is a walnut size gland surrounding the urinary tract, the tube that carries the urine from the bladder to outside the body. The sensation was inpleasant, but not painful. When he finished, he said that the prostate was enlarged. Because of my age and my enlarged prostate, he said he would do a PSA test. PSA stands for prostatic specific antigen. a sample of my blood would be tested. If the test results read more than 4.0, it was possible, but not necessarily, an indication of cancer. His nurse came in and drew some blood.
A week later, the doctor said that the PSA reading was 12! After I calmed down, he said that in order to be sure, a biopsy should be done. This consisted of inserting an instrument, again, through the rectum. The instrument would snip several small pieces of tissue un and around the prostate. A pathologist would then examine the tissue to determine if it was malignant, that is, cancerous or not. Sensing I was a coward, the doctor assured me that that the procedure was painless.
Several days later I found myself at the office of an urologist. I disrobed and put on the usual gown opened at the back. I lay on a table in a fetal position. Then I felt the instrument in the rectum. I heard clicks as several pieces of tissue were snipped from the prostate. The feeling was uncomfortable, but not really painful.
When we returned to our doctor's office several days later, he told us that I did have prostate cancer. "There goes the good life!" I said to myself. The doctor said not to worry. He proceeded to explain the alternatives we had. The first was to remove the prostate gland entirely. This was a bloody process, he exclaimed, and there was a chance that not all the cancer cells would be removed.
The second alternative was to treat the prostate with radiation. This involved many treatments during which I would lie on a table as a stream of radiation would be shot into the prostate in order to "burn" it. There was no cutting. The downside was that there was a risk of burning or actually fusing adjacent internal organs, such as the bladder to the intestines.
There was yey another alternative, but this was still somewhat experimental. Some insurance companies did not approve the procedure. It involved the insertion of radioactive palladium seeds directly into the prostate. Results, so far, were favorable, the doctor said.
The doctor said he would refer us to a local radiologist for further consultation. He also said that if we were interested in the seed implant procedure, he would refer us to a urologist who specialized in the procedure.
Several days later we visited a radiologist who carefully explained the process of radiation treatment. He confirmed what our doctor had told us. He emphasized that the treatment was lengthy and that, indeed, there was a chance of damaging adjacent body organs. There was a chance of recurrence, but considering my age and the fact that I was somewhat overweight, I would probably die from something else before that happened, he joked.
After we left, my dear wife, being forever inquisitive, embarked on a research program of her own. She visited the local library and bought current books on the subject. In those days the internet was not used too much as a research tool. Nevertheless, she educated herself as much as she could on the subject of radioactive palladium seed implants. She found a prostate cancer clinic in Atlanta, Georgia that performed the procedure. It was headed by a Dr. McDonald, a pioneer in the process. It was only a 5 hour drive from our home. My wife called and made an appointment. Several days later, we were in Dr. McDonald's office.
Dr. McDonald and his staff examined me thoroughly, confirming the diagnosis of prostatic cancer. He then explained the procedure. It had a high degree of success, he said. It consisted of inserting radioactive palladium seeds directly. into the prostate. This was done through the perineum, the area between the anus and the scrotum. These radioactive seeds would remain there forever. The seeds had a short half-life, about 17 days. This meant that in 17 days the seeds lose half their s radioactivity and half again every 17 day period thereafter.
The fact that the seeds are inserted directly into the prostate gland means that the radiation is direct and constant and therefore more effective. At that time, 1990, the cost of each palladium seed was about $90.00. Because of the enlarged size of the prostate, I would require about 90 seeds. However, if the size of the prostate were to be decreased, less seeds would be required and the treatment would be even more effective.
Because the procedure was relatively new we were not certain if our insurance company would honor the claim. They called the company and tthe procedure was approved. We decided, then and there, to undergo the radioactive palladium seed procedure!
The doctor began the process by first reducing the size of the prostate. He began by putting me on a regime of monthly injections of Lupron, a type of female hormone. At the time, these injections cost about $900.00 each! Thankfully this was also covered by our insurance company. The doctor gave me my first injection and told us to return in one month to check the size of the prostate and to give me another injection.
After several trips and injections, Dr. McDonald told us that the prostate had reduced in size sufficiently and I would now need about 60 seeds. The procedure was done at the clinic and took about one hour. I was lightly anesthetized and felt nothing. When I awoke, I found that a catheter had been inserted directly through my belly into the bladder. This was so the bladder could continue to empty properly.
That night we stayed in a nearby motel and in the morning we returned to the clinic. After further examination, I was discharged and told to return in one month. With respect to the catheter, we were told it should be removed after several days. All that needed was to simply jerk the catheter out quickly. My wife was instructed onhow to do it. We left and drove back home. With my bladder bag connected,I drove all the way.
The recovery was uneventful. After several days, my wife surprised me by suddenly yanking the catheter tube out without warning. Everything was back to normal. Life was good again.
During the next 16 years, I kept having my PSA checked every 3 to 4 months. My readings remained normal and level, in the range of less tha n 1.0. Then, m y readings began to creep up again. They exceeded 4.0. My urologist said it was now time to initiate another ooption. This was to receive another series of Lupyon injections every 3-4 months. It worked! My readings now are below .01. At 83, 21 years after I was first diagnosed with prostate cancer, life is still good!.
What I say here is based on my personal experience, of course. What is my advise, you ask? After age 50, have your prostate checked yearly. If you are diagnosed woth cancer, don't panic, keep cool. When prostate cabcr is caught early, it can be cured or controlled.