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Steve Z
  • 61, Male
  • ME
  • United States
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saturation biopsy

Replied Aug 12

saturation biopsy

Replied Aug 12

treatment indecision

Replied Aug 2

 

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Steve Z updated their profile
October 31
Steve Z replied to Kathy Meade's discussion 'After Cancer, Ambushed by Depression' in the group Let's Talk About Survivorship
The current standard of care is a psychological nightmare - take a coin toss as to your furture sexual and urological, and bowel (if radiation) health??? At present, there is a suppressed scream of men who have had their lives changed forever by pr…
October 4
Steve Z replied to Kathy Meade's discussion 'After Cancer, Ambushed by Depression' in the group Let's Talk About Survivorship
Kathy, Thanks for starting this discussion (and so many others). Been there, done that (clinical depression) - after a while I got counseling and it helped some. None of the magic pills worked - that may prove to be a good thing... Prostate cancer…
September 29
Steve Z joined Kathy Meade's group
Let's Talk About Survivorship
Cancer survivors are people who have been diagnosed with cancer and those affected by the diagnosis, such as family, friends, and caregivers. This is a place to talk about the wide variety of issues that are part of the survivorship experience.
September 29

Profile Information

Have you been diagnosed with prostate cancer?
Yes
What brings you to the New Prostate Cancer InfoLink social network?
Dr. Kongrad 's request
Would you help us grow the network? Would you tell others about it?
yes and have told others
About Me:
Diagnosed with low volume Gleason 6 cancer in May of '07. I did not want to accept the risks associated with the RP urologists recommended.

Uncomfortable on Active Surveillance, I underwent a 3-D mapping prostate biopsy on Sept 5, '08 at the University of Colorado Cancer Center in Denver. Of 51 cores, 2 of them came back positive with 10% low risk Gleason 6(3/3) cancer; there was also an area of PIN.

Based on the results, I felt I could stay on a surveillance routine, but I chose to treat the cancer while the biopsy data was current; I went with a low risk treatment for the low risk disease. On Oct 10, '08 about 50% of my prostate was treated with cryotherapy. There were no incisions. I was on a catheter for five days, and came off the catheter continent. I was put on low-dose Cialis and was able to resume sexual activity less than two weeks after the procedure. I stopped taking the Cialis soon afterward; by three months after the procedure, the only side effect was less ejaculate. My three month check-up went well. PSA was 1.7, down from my usual 2.5, DRE was smooth and normal, flow test and urine retention both fine (no surprise).

At the six month point: normal DRE, PSA 2.6 - not what I wanted to see PSA-wise, but not unexpected; it seems it takes about a year for the prostate to sort things out after the trauma of treatment. Things still fine as far as potency and continence.

My one-year biopsy results were not what I'd hoped for: 12 needles found two small (10 and 15%) areas of Gleason 6 cancer again on the right side that either the cold didn't kill or the focal treatment missed. The latter is likely the case: if you do the math on the biopsy data, the areas of cancer were 2mm maybe 3mm at the most, the grid for the mapping biopsy was 5mm; if you move the grid a mm or so you’ll find different small cancers. PSA was a little higher at 2.85. After some amount of time, pain and expense, I’m pretty much back where I was just over a year ago. I'm more disappointed and irritated than scared and angry. Dr. Barqawi (and Dr. Onik) continues to report 90% success rates with this type of procedure - I feel like I drew the short straw. At least it did reduce the size of my prostate from 34 to 27 CCs and almost doubled the amount of uninterrupted sleep I get each night. All in all, I’d rather be posting this than asking for advice on how to deal with ED, continence and/or bowel issues in the forum. Low morbidity treatment is a good thing.

I know now that this is still low risk cancer that I can live with. I'm still not inclined to go for surgery or radiation and will likely try surveillance maybe with Avodart for the next year with PSAs every 3 months and a rebiopsy at one year. This kind of regiment does not seem as bad to me as it once did. Nerve sparing cryo to ablate the entire right side is an option. I’m certainly in no rush at this point, but should the numbers get worse…

My story is on the YANA board at the URL below.
Website:
http://www.yananow.net/Mentors/SteveZ.htm

Cryo Links

There is information on focal cryo at:

http://www.prostate-cancer.org/education/novelthr/Weissman_FocalTherapy.html

http://www.riverside-urology.com/index.php?page=Prostate-Cancer-Cryosurgery-Video (cites 3 studies about 2/3rds of the way through)

http://alprostate.com/ (my treatment choice - good info on 3-D mapping prostate biopsy)

http://www.hopeforprostatecancer.com/gon-lumpectomy.asp (Onik seems to be the first to adopt the procedure).

Comment Wall (18 comments)

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At 9:20pm on February 6, 2009, George A. Brown said…
Hi Steve,
I went to the 19th Vail Symposium on PC last week and had lunch with Dr. Al Barquari.He really remembers you. Said you were the best and smartest patient he ever had. Wished you the best. George
At 12:48pm on February 2, 2009, Jean said…
A lurcher? Well you certainly gave me a much needed smile on that one Steve. Though I normally prefer to listen rather than talk, the only reason I did not participate in the discussion was because I didn't have anything to contribute. There is so much to learn on this topic isn't there? Plus like most things, the more I learn the more I feel I don't know anything at all about this. I am getting the impression though that we are on a cusp of new treatments that eventually will take us away from just opening a body and ripping out a diseased section. Won't that be wonderful?
Wendell had his biopsy and took it very well. He was uncomfortable on the day of the biopsy and took it easy the following day. We will not hear the results until Feb. 5 but are continuing to believe that it will be a localized cancer in one lobe. The doctor did find 3 calcium deposits and commented that one might be the "hardness" that he felt. I don't want to get my hopes up.
At 6:47pm on January 24, 2009, Jean said…
Thank you for inviting me to be a "friend". I am still trying to learn how to use this site so I was unaware that my name would not be attached to my comments. So yes it was me that was asking about HIFU. My husband and I want to look at all possible treatments. I understand that HIFU is suggested for only certain circumstances but the more education the better hmm? Though we live in Idaho, I happen to be a Canadian so it would not scare me or my husband to have treatment in Canada if we really believed that it was the route to go. If you can shed any light on this or the Cryosurgery I would certainly appreciate it. Jean
At 10:30am on January 24, 2009, TV said…
thanks for inviting me.
At 12:55pm on January 4, 2009, Robert Erickson said…
I wanted to add my CD before my Cryo showed PCa invasion into the left seminal vesicle and left superior neurovascular bundle confirmed by biopsy; so the CD seems like a good imaging tool, at least, from Dr Bahn's prodecures.

Bob
At 11:58am on January 4, 2009, Robert Erickson said…
Hi Steve,

George said you would like to talk to other cryo patients. My case was different than yours on account of my GS 9 and pT3bN0M0 stage. I chose cryo over radiation on account of the numerous comments about radiation possibly making the PCa worse in subsequent years.
My procedure was uneventful except I had incontinence issues(urgency and lack of control) for approx 5 months. I have been off pads for 2 weeks now and no problems to date. My follow up appointment with Dr Bahn is Feb 3 for CD ultrasound and possible biopsies. My current PSA is <0.01 but my final Lupron shot was Oct 9, 08 and I quit taking Casodex on Dec 25, 08 so I am still under the influence of ADT. I am remaining on Avodart since my Medical Oncologist has some possible info that it will help.
My concerns are that supposedly high GS does not produce a lot of PSA so I am looking for methods to determine the status of my PCa. Well enough for now; what is it that you would like to discuss with me and other cryo partakers.

Robert Erickson
At 12:05am on January 1, 2009, George A. Brown said…
Steve,
New member Robert Erickson who just joined had Cryo and I sent him your name. Also I believed he joined Cryo Group. I will be sending you some email addresses for guys that had Cryo at the Univ. of CO Hosp, however, I need to contact them first. Have a really New Year George
At 8:54am on December 24, 2008, Steve Z said…
Recovery has gone well. I was off Cialis after two weeks. After six weeks, I realized I wasn't having to get up at night to go.

I'll have my first follow-up PSA next month and get rebiopsied next October back in Denver.
At 9:55pm on December 23, 2008, George A. Brown said…
Hi Steve,
Thanks for the friend invite. I read you story on YANA. What you say about the University of Colorado Hospital and Dr. Barqawi are how I found the Hospital and Dr. to be. Al is a stand up guy and very proficient in Cryo. The hospital is the best I have ever experienced. Al spoke to our Us Too group and a lot of his patients were there including Mike Landis. How are things and PSA's going. Well, I hope

George Brown
At 11:33am on December 21, 2008, Steve Z said…
Mike's story is at http://www.thedenverchannel.com/prostatecancer/index.html

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