Chesapeake Urology Associates :: Waking Up To Prostate Cancer

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Waking Up To Prostate Cancer

By Phil Shulka

In February of 2007 I was 60 years of age and had no clue what was in store for me. My family was grown; I had a granddaughter, good wife, good job, and good health.   All except the good wife would be a memory. I felt great and maintained an exercise program of running 15-20 miles/week and lifting weights. How things would change.

A few years earlier there was a blip on the radar screen when I had an elevated PSA of just over 4 and had a biopsy that proved negative. I had BPH (enlarged prostate) and the doctor suggested that I have a T.U.N.A. procedure to alleviate the symptoms- I tried medication, but had an adverse reaction.   I never followed up with his suggestion. I felt great and I felt the problems associated with BPH were manageable. I was probably leery of the procedure.   Many years ago I had been a Navy Medical Corpsman and my wife is a Nurse. I was now in packaging equipment sales and didn't want to interrupt anything. Big mistake! If I had the procedure things may have changed.

So for 3 years after my initial biopsy, I didn't see a doctor. My wife finally convinced me to get a physical. I told the doctor I felt great and he ordered the normal blood tests including a PSA.   He called and said that the results showed a PSA of 20! He said that sometimes the PSA can be elevated and not be as a result of cancer ( I know of someone who has a PSA of over 900- with no cancer-boy is he sick of biopsies!) so we had a retest. Well, it came back a 29! He immediately had me see my former Urologist who felt a lump on the DRE and ordered a biopsy the next week. After the exam, the next day I ran 8 miles on a treadmill. No way can this be anything!

I have always hated the month of February. It's cold, dark and nasty. On the last day of February in 2007 my Urologist told me the very bad news. All the samples that were taken revealed cancer.   The Gleason score of each was 10. That meant I had the most aggressive form of Prostate Cancer. My mind was in a whirl, but the Doctor laid out a course of action that made sense to me. Time was of the essence and we needed to act immediately. A bone scan was arranged for the next day to see if it had already metastasized. Fortunately, it hadn't.

My Doctor wanted me to undertake an aggressive course of action to treat an aggressive foe. He wanted me to get a Lupron shot (to stop testosterone-which is basically food for the cancer cells), followed by a DaVinci radical prostatectomy, followed by radiation.

By this time I had gotten on the Internet to find out who this villain was and became convinced that his course of action was the proper one. All you can think of is "I have Cancer and I am going to die!" I devoured the book "It's Not About The Bike" by Lance Armstrong and it was very inspirational.   My family was so supportive and there for me that it helped allay my fears also.

The first Lupron shot was in March. My older son was due to get married in early June and we decided to have the surgery the week after the wedding. This turned out to be a blessing in disguise since the wedding acted as a wall between me and the surgery.

I remained active, but not as intense as I had been. Since the goal of Lupron is to remove testosterone from the body and testosterone is what provides the male with most of his energizing hormones, I exercised at a reduced pace.

I had recently started my own Rep group (independent sales), so I could take whatever time I needed. During this period I read voluminously, mostly about History and a lot about Prostate Cancer. I found that we fear what we do not know and eventually I gained enough knowledge through books and the Internet to understand what was happening to me and what the nature of the beast was.

My body was undergoing changes. Lupron caused fatigue and hot flashes. I started Kegel exercises to strengthen my sphincter to counteract the effects of surgery.   A month before surgery my PSA was down to 5.7. It was working, but I wanted the prostate out of there.

After the wedding I faced the prospects of surgery. My Urologist came in beforehand to speak to my wife and I and we were both very impressed when he said his only focus that day was to use all of his skills to help me. He was and still is, someone we greatly admired and had confidence in.   The surgery went about as good as expected. Due to the aggressive nature of my Cancer, there was no hope for nerve sparing techniques that would help with impotence issues. Because it had spread beyond the prostate I had positive surgical margins and it had infiltrated the seminal vesicles. That meant that I was not cured, but we pretty much knew that going in. The surgery itself was practically painless. I was out in 2 days and attended a niece's graduation party 4 days later. The only bummer was the catheter that had to stay in place for 10 days.   Man, was I glad to get that sucker out.

I now had to wear an incontinence pad to stave off the effects of surgery. However, my BPH problems were gone and I peed like I never peed before! I received another Lupron shot when the catheter was removed and my Urologist gave me something for the hot flashes that worked beautifully.

1 month later my PSA test was negligible. No sign of Cancer. However, due to the nature of it and the positive margins, I was scheduled for Radiation Therapy. I was still having fatigue and increased urination as a result of the surgery and the Lupron.

I met with my Radiation Oncologist and she told me the plan of attack. On September 21st I started my first of 38 radiation sessions. This took place in a very relaxing friendly environment. My appointment was at 10AM every day. I waited for only a short period of time before being called into the treatment room.   My body had been marked with stickers to help align the rotating arm of the unit. Treatment was uneventful and almost pleasant. You lay on a table while the rotating arm of the IMRT machine zapped you in several places for about 15 minutes. You don't feel a thing. Luckily both the equipment the facility and the staff were World Class. You don't want second best when you're playing with your life.

I finished up 1 week before Thanksgiving.   The effects of radiation were increased urination and fatigue. I was told this would get better in time. I actually look back at this time as a pleasant one in my life. The Lupron and radiation slowed down my normal hyperness and let me enjoy reading on a large scale. I went through almost 2 books a week during this time. I was very fortunate that my wife had a great job with very good insurance coverage to help with the vast reduction in income we experienced.

My Urologist had planned to keep me on Lupron for 2 years. However, my PSA tests were all coming back showing remission.   I did not like the fatigue and changes in my body that it caused and we decided to stop 6 months early.   My last 4 month shot was last February. The effects would last until June and beyond. My testosterone level got below 30. Normally a man has around 400-700, a woman around 70. It was doing its job, but it is not a cure. I wanted to get my energy back.

Eventually, I found my strength and energy level improving. However, I still had both E.D. and incontinence issues. The E.D. issue is one that bothers my wife and I the least. Thank God we have a good marriage. My Urologist had suggested an operation to help with the incontinence issue and at first I balked, but I was able to look at a similar operation on an Internet site and listen to the experiences of men like me and had the operation last November. It hasn't totally corrected the condition (and we didn't expect it to), but it made it much less troublesome. Before, I would go through 5 to 7 pads a day, frequently changing clothes. Now I am about 2 to 3 pads a day, never having to change anything. This has greatly improved my quality of life.

I have used my experience in both Man-to Man and Recovery Coach programs with the American Cancer Society. I feel that my experience is unique. It looked very grim at first and most men discovered their conditions before I did. But I have survived, thanks to my family, friends, and the great Doctors and facilities that are available in this region.

The best advice I can give to anyone who is a man is to get tested often. If found to have Cancer learn as much about it as possible, get the best treatment available, and seek support from others.

You can live with Cancer and it can be a minimal disruption in your life if you don't follow my example.   Today I feel very good. I am not who I was, but I don't dwell on that. I accept what I am and have learned to make the best out of it. I look at every day as a gift!

If you wish to speak with Phil about his experience with prostate cancer, please email him at philshulka@hotmail.com.