Most men whose prostate cancer recurs still survive

REUTERS: Men who show signs that their disease has returned after prostate cancer treatment are still more likely to die of other causes, a new study in US veterans shows. READ MORE>

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Bigger the prostate tumour removed, greater the risk of recurrence

URO TODAY: The size of your prostate tumour may predict whether you’ll get a recurrence of the disease after a prostatectomy – the bigger the tumour, the more the risk. READ MORE>

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Active surveillance may not be wise choice for younger men with low risk prostate cancer

URO TODAY: Watchful waiting may not be a wise choice for younger men diagnosed with low risk prostate cancer, a new study suggests.

Our pathologic findings and risk of biochemical recurrence after open radical prostatectomy question the wisdom of active surveillance in men with low-risk disease who have “long” life expectancies. READ MORE>

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DNA variations associated with prostate cancer outcomes

URO TODAY: Researchers have investigated associations between 29 single nucleotide polymorphisms (SNP) and biochemical recurrence, castration-resistant metastasis, and prostate cancer-specific survival, and found the SNPs are a clue to outcomes. READ MORE>

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Tomography shown to be highly accurate at pinpointing where recurrent prostate cancer has spread

URO TODAY: Dutch researchers testing the use of (11)C-choline positron emission tomography as a way to identify the site(s) of prostate cancer that has spread after external beam radiation say it is 84% accurate. READ MORE>

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Prostate cancer prognosis changes if PSA starts to rise again after treatment

PUB MED.COM: When biochemical recurrence occurs after initial prostate cancer treatment, prognostic factors for survival change, according to a new report from Australasian researchers (including NZ’s Professor David Lamb) who investigated at NZ and Australian patients. READ MORE>

Low initial PSA, short time to biochemical recurrence, and rapid PSA doubling time take over at this point, providing reasons why initial PSA and occurrence of biochemical recurrence alone predict prostate cancer-specific survival poorly.

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Researchers find out prostate cancer survival chances change if biochemical recurrence occurs

URO TODAY: Factors used to predict a man’s likelihood of surviving prostate cancer change significantly if biochemical recurrence occurs – and his outlook is less favourable if he had low PSA when initially diagnosed, the time to recurrence is short and PSA doubling time is rapid. READ MORE>

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New DNA vaccine shown to slow PSA doubling in trial on prostate cancer patients

URO TODAY: US scientists have successfully tested a new DNA vaccine that significantly slows PSA doubling, the signal of a belated return of prostate cancer after treatment. READ MORE>

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Size doesn’t matter – in case of recovery from radical prostatectomy

URO TODAY: Prostate size does not appear to affect biochemical recurrence after radical prostatectomy. However, estimated blood loss and operation time increased with larger prostate size, and positive surgical margins are more often observed in smaller glands. READ MORE>

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MY PROSTATE STORY: Winning the trifecta

PART 23 of My PC Adventure: full story HERE>

I’m not a racing man.

I was put off by my family, who lived horse-racing. As kids, we were dragged to racecourses.

When I started as a cadet reporter 43 years ago this week, I made the mistake of saying I hated racing – so the chief reporter quite rightly assigned me to help the racing editor on race days. I would obviously not be distracted.

So when the urologist said to me this week I’d got “the trifecta”, I knew what he meant. I’d scored three wins on the same bet:

• The tumour removed during surgery last March was low-risk.
• There was nothing at the margins of the gland.
• And now, nearly five months later, my PSA is undetectable.

It was a nice analogy, and the winnings are bigger than any racehorse bet.

It means I’m in good shape, at least for the next couple of years.

From my reading up on all this, it seems two years from now will be another hurdle to jump, because that’s commonly when men in my position can get biochemical recurrence, with the PSA doing a doubling act.

My followup appointment with the urologist couldn’t have gone more wrong (aside from the one big right).

For a start, there was bit of a lead-up that proved quite unpleasant.

I picked at a bit of dry skin on my knee and managed to infect myself with ringworm (presumably from the cat).

I made the mistake of covering it up (as my mother always advised) with water-tight sticking plasters.

Have you ever tried to get those off  (as I needed to do each day to apply anti-fungal ointment)?

Each day, twice a day, I’d tear holes in my leg removing plasters that would have held a space shuttle together – and spread the infection.

It ended up at the top of both inner thighs, and by the time I went to the doc for a more powerful ointment, the proximity to my boys had unfortunate consequences: they proved allergic to the ointment.

My testes swelled to twice their normal size and the old fellah looked like a bruised plum.

In alarm, I did the one-handed cellphone camera trick, captured a couple of dramatic closeups and emailed them to the urologist.

Hmm, looks like an allergic reaction, he mailed back.

He was right. By the time the treatment was completed, the gens returned to normal and my visions of carrying them round in a wheelbarrow had receded.

By the day of the followup appointment, all seemed well.

How wrong can you be!

For a start, we went to his rooms, instead of Wellington Hospital’s urology clinic (if I’d just bothered to read the appointment reminder).

I arrived at the new hospital block to find no sign of any signs in the main foyer, in the lifts or on the appropriate floor (when I found it) that mentioned the words “urology clinic”.

I rushed in late, saw the urologist poring over a big stack of files, sidled up breathlessly, and apologised for holding him up (I was 10 minutes late).

He was suitably gracious. And I was soon appalled – because I found a huge waiting room stacked to the ceiling with other patients, more than a dozen of them, all waiting to see the same man.

Right. The public health system. Of course.

I plonked down in one of a semi-circle of incredibly luxurious, leather, padded (and seemingly electrified) lazy-boy chairs, each assigned a bold number on the wall behind, announcing its status as “Chair 1″, “Chair 2″…the logic was overpowering.

We never got to see what the electrics did because they didn’t seem to be plugged in.

But such chairs! Perhaps a gift from a kind benefactor who had, before us, endured long hours in hard, straight-backed seats in the same waiting room.

A small irony arose when I asked a man sitting beside me in a surviving hard, straight-backed chair if he would mind moving so Lin could sit next to me, and he declared that he couldn’t move because he needed a hard, straight-backed chair.

Looking around, I saw I was the youngest patient by about 20 years, and the least patient. The others sat impassively, quietly, with dignity, while I built up a head of steam thinking about my need to get back to work.

Finally, I got up in a minor fit of pique and declared grandly to the receptionist (who said there were still four ahead of me) that I would be leaving.

“Can we book another appointment?”

“No thanks – I’ll take my chances,” said I with ridiculous pomp.

On the way out, however, the urologist emerged from a session, saw me leaving in a huff, and ushered me in: “You’ve got the trifecta, Jim.” Yeah, Rod, it’s all good. Thanks for doing such a great job.”

We discussed the idea of doing a NZ book on the disease. He grabbed a couple of overseas ones for me to look at, and we’re due to meet up some time to discuss the project.

And, well, that’s it for now.

Except to observe that it’s amazing how quickly the effects of your brush with death wear off.

I declared I would work shorter hours, brook less stress, have a proper lunch hour, give up all alcohol.

The only real change I’ve made in my life is to have sushi for lunch instead of ham sandwiches.

I eat the sushi over the keyboard (lot messier with chopsticks), work longer hours than ever (this blog takes two to three hours every night), and still have a Heinie and a glass of Central Otago pinot noir each evening (the last is good for us prostate patients, of course).

Life goes on as before. But, then, that’s good isn’t it…

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