Month 21 - Undetectable PSA & Surgery Study

My PSA was undetectable (<0.01) at the 18 month mark--still cancer-free!

I'll have to admit that I'm getting better at being less emotional about these PSA tests.  Again, whatever the results are, there's nothing I can do to control them, I can only control my reaction to them. 

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On 19 July 2012, the New England Journal of Medicine published another study that yet again increases the confusion about the treatment of prostate cancer:

Radical Prostatectomy versus Observation for Localized Prostate Cancer

The study followed 731 men over 10 years (mean age: 67; median PSA: 7.8) in two groups: one that had a radical prostatectomy and the other that went through observation.

Over the course of the 10 years, 47% of the men with prostatectomies died and 49.9% of the men just being observed died.  That was statistically insignificant.  Of the men who had had prostatectomies, 5.8% died from prostate cancer or its treatment, while 8.4% of the men in the observation group died from prostate cancer.  Again, not a significant difference in outcomes.

In a related article in the San Francisco Chronicle, Otis Brawley, chief medical officer for the American Cancer Society said, "There is no question in my mind that what we have been doing in the United States for the last 20 years has hurt a lot of men needlessly."

SF Chronicle: Prostate Surgery Fails to Save Lives

So what are us poor schmucks diagnosed with prostate cancer supposed to do?

I'm an analytical kind of guy, and I have to admit that these statistics--while cold, hard, unemotional numbers--are beginning to make me wonder if having had the surgery--with all of its lasting side effects--was the right course of action.

Then the emotional side of me kicks in and the peace of mind knowing that my PSA is still undetectable at 18 months makes me say, yes, I made the right choice. 

Would I have made a different choice had this information been available when I was first diagnosed nearly two years ago?  I don't know.  Really.  Besides, there's nothing I can do to change it now.

We can only make the best decision we can with the information available to us at that point in time.

Until there's a test that can accurately determine whether a guy has the "lazy" prostate cancer that he can live with or the really aggressive prostate cancer that will likely kill him, this will be an ongoing debate, source of confusion, and perhaps unnecessary treatment.   

So if you're recently diagnosed and wondering what to do next, all I can say is research, research, research, and make a decision that fits your own needs and comfort level.

Month 20 - Hiccup

So things have been pretty normal for the most part since the last update.  Except for one little hiccup.

About 10 days ago I was washing dishes after dinner and the sound of the running water got the better of me and my bladder.  I had this sudden urge to urinate (I probably hadn't been to the bathroom in 3+ hours, so I knew that my bladder was getting full.)  I made a mad dash for the bathroom and along the way, enough urine leaked out that I had to change my pants and underwear after emptying my bladder in the bathroom.  Not fun and not expected.  Thankfully, I was at home instead of standing next to some water feature in a crowded mall.

Not sure what was up with that, but it wasn't something to lose sleep over because 98% of the time, I'm dry--even now when I sneeze or cough.

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Next month I have my 18 month follow-up (mid month), so we'll keep our fingers crossed that the PSA remains undetectable. 

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If you've been a close follower of this blog, you may have noticed that I put a new page out there called "Life After Radical Prostatectomy - 18 Months Later."  I just thought it was appropriate to share where I'm at in the whole recovery process.

Month 19 - Support

It's not something that you see everyday, but it's something that made me smile when I did.

In a world of pink breast cancer awareness ribbons and Susan G. Komen Foundation ads, it's refreshing to finally see a glimmer of light blue.

I was recently in a Vons supermarket (part of Safeway) and they are promoting prostate cancer awareness for the entire month of June.  The store had blue ribbons hanging over the cash registers; blue reusable grocery bags for sale (for $2.99 but $2.00 from each bag goes to the Prostate Cancer Foundation); a cash donation box; and a prompt on the credit/debit card swipe terminal asking if you would like to contribute to the Prostate Cancer Foundation.

Apparently the Safeway Foundation has been doing this since 2001 and has raised over $68 million for prostate cancer research.  To be fair, they've also done this for breast cancer research and have raised over $108 million in the same period.

It's both refreshing and encouraging to see a business take such a proactive and highly visible interest in combatting prostate cancer.  You can read more about the Safeway Foundation here:

The Safeway Foundation

Prostate Cancer Foundation - Vons/Safeway Support


While I'm not in the business of endorsing commercial enterprises, I will tell you that, if given the choice between a Vons or Safeway and a Kroger, Ralph's or Piggly-Wiggly, I'd be inclined to support the Safeway chains.

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That whole discussion makes me think of how I can increase and awareness and provide support. 

The American Cancer Society's Relay for Life might be one way, but that's rather broad in focus, and I think that there should be a more acute focus on prostate cancer awareness.  This is particularly true in light of the recent United States Preventative Services Task Force recommendation to do away with routine PSA screening.

PSA Screening Recommendation Story

While I can see points on both sides of the argument, the recommendation only served to further confuse an already extremely confusing situation for men.  My fear is that it will cause men to just ignore the subject altogether out of pure frustration.

To say that the PSA test is harmful is misleading.  It's what you do with the results of the PSA test that can lead to "harm."  And "harm" is defined by each individual's perspective, not a bunch of statistics or a task force.

What needs to happen is that awareness needs to be increased and men need to be thoroughly educated about prostate cancer and its different forms and complexities; about the treatment options available; and to have very blunt and real conversations with their urologists about the risks, side effects, and benefits of each option.

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Finally, the blog reader that I mentioned last month made it through his radical prostatectomy just fine and is recovering with some days better than others, as expected.