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Surgical Treatments for Prostate Care

The last speaker of the evening presented the most moving story. William was diagnosed with prostate cancer in the spring of 2000, when he was 44 years old. His PSA at that time was 7.3 and his tumor was given a Gleason score of 7. He underwent surgery in early October 2000, and was released from the hospital two days later. A few days later, pathology studies of William's prostate tissue indicated that the tumor was actually a Gleason score 8, which was a sign that the tumor had penetrated the prostate capsule and had the potential to spread to other parts of his body.

William was given hormone therapy to slow the growth of the cancer and recently he began a course of external beam radiation therapy. William said that his energy level is fine and that he does not feel fatigued from his therapy. He is looking forward to resuming his normal activities as soon as he completes his radiation treatments. His final warning to us drove home a point that is often overlooked. "Just because you're not 50 years old yet, don't think that you can't get this disease; it can hit anyone, at any time."

As I listened to these men talk I reflected on my own actions and reactions during my confrontation with prostate cancer. At the very beginning, when my family physician first urged me to consult an urologist, a wave of panic had washed over me. As I stood in his office my doctor gave me his personal telephone directory and pointed out three urologists in whom he had confidence. "Call these three right now," he said, "and see if one of them will give you an appointment this afternoon."

I chose the first urologist who had space on his schedule that day. As I drove to the urologist's office I reflected that I had taken less time to choose a doctor than most Sunday golfers take to line up a ten foot putt - not the best way to make what might be a life altering decision.

Sitting with my support group a few nights ago, I realized that I had been extraordinarily lucky in my hasty decision. The urologist I chose is knowledgeable, patient, experienced and empathetic. He became my ally during our first meeting and he has remained a strong ally throughout my time with him. He is tenacious, too, and this quality has served me well.

During the last seven months I have been reluctant to confront my incontinence head on. I have been content to accept it as a side effect of my treatment that will eventually go away. In each of our meetings my urologist has told me that the kind of incontinence I am experiencing in not a typical side effect of the radioactive seed implant procedure. He tells me that by now, I should have seen some improvement, and that he believes the incontinence has another cause. I listen to these talks, and then I try to bury my head in the sand. Each time, my ally pulls me back to reality.

I have finally decided to follow my urologist's advice. In a few days I will have my second cystoscopic examination. My urologist believes that one of the radioactive seeds may have migrated out of my prostate and is pressing against or has penetrated the wall of my urinary duct. If this has happened, the seed would irritate the duct and cause the incontinence I am experiencing. A second possibility is that there is a small amount of scar tissue within my ductwork or in my urinary bladder - either of these could also cause the kind of incontinence I am experiencing.

I do not look forward to the cystoscopy. The thought of the optical fiber snaking its way through my plumbing once again is decidedly unappealing. I feel that I have been poked and prodded and skewered enough during the past seven months. I'd like to take a breather, but I would also like to urinate like a normal man once again, and I realize that my urologist offers the best opportunity to realize that goal. We'll see. I will keep you posted.

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