My Health

I know enough about prostate cancer to realise that a 'radical' (curative) prostatectomy, the removal of my prostate gland would result in chronic morbidity. The post-operative complications would seriously prejudice my quality of life. This would also be true for standard beam radiation (RT). In the words of my oncologist: 'I guarantee long-term severe damage to the bladder and bowel.' My prostate gland size also prohibits radioactive implants (brachytherapy) or freezing (cryosurgery) treatments.

Three options remain. First: have no treatment at all. Men die of prostate cancer when the cells move from the gland to the bones; this is known as metestatic prostate cancer. I've been caught early: the cancerous cells are not in my bones; nor are they too numerous; and they are at the low end of the range described as 'aggressive' (the possibility of progressing over time). One debit though: these cancerous cells must have been in my prostate in 1995 (the start of my problems); possibly even earlier.
Second: continue with hormones. This month I changed from Zoladex (goserelin) to the newer Casodex (bicalutamide). (By stopping the body making testosterone Zoladex turned me into an eunuch!) Casodex is an anti-androgen, blocking testosterone from the prostate. The side effects are less onerous. One debit: men in their mid-60s do not normally have to rely on hormones as a monotherapy for the rest of their lives. In addition, cancerous cells in the prostate often become resistant to hormone therapy, the latter often becoming ineffective ('hormone refractory').
Third: have 'conformal' radiotherapy. Using computer software a 3D image of the prostate is created ('conforming' to the tumour) which, together with many physical 'shields' (special robotic leaves) made to protect, as far as possible, other organs, allow radiation beams to be directed more precisely.

Conformal radiotherapy is in its early days in the UK; my case will be very difficult - because of the large amount radiation needed to kill the cells in my oversized gland. Low doses of radiation would be used each day for six to seven weeks; but even so my prostate would become extremely inflamed.
Despite the shields I would have problems with both my bladder and bowel: reductions in my present excellent voiding patterns with the former (retention even); and both bleeding and diarrhoea with the latter. In my consultants' words: 'possible problems'; to be charitable that means 'probable'; to be realistic read 'definite'. It is likely I would have to have an operation to bore out the prostate centre. Any problems arising before treatment is completed would be seriously prejudicial to its 'success'!
I have four to eight weeks to make a decision. There is one final treatment 'variation' open to me: I could decide to continue with hormone treatment and delay the start of conformal radiotherapy.

August 2002
I chose the latter option, to continue with Casodex (a palliative treatment) - basically to give me time. Recent scans confirm my prostate is still huge (140gm!) Of the radical (curative) treatments conformal radiotherapy remains the only option - but with the certain morbidity described earlier. Some months ago I met Prof. Steward at Leicester General Hospital to discuss the merits of angiogenesis inhibitor drugs (which prevent new blood vessels forming near cancerous cells); but this palliative treatment is currently only available for patients with 'advanced' cancer. I'm not there yet; but I am on his waiting list. A further new radical possibility is ultrasound transducer treatment; clinical trials have yet to start.

I continue with my self-researched 'good prostate health' regime (I started in the summer of 2000). I am convinced that my new Far Eastern and Mediterranean eating habits, plus a number of pertinent supplements, all on the website 'Diet' page, should give the cancerous cells zero help in their attempt to proliferate. Certainly I feel, and look, fitter than I have for decades. I continue to be 100% positive.

August 2003
My PSA readings (a blood test 'marker' for how the cancer is progressing) have gone down! I am convinced this has come about because of the soya isoflavones/lycopene supplements I started in March 2002: the isoflavones and saw palmetto act as oestrogen-blockers, as does Tamoxifen. Soya also acts as an angiogenesis inhibitor, as does Thalidomide (used at Leicester Hosp.). My oncologist and I have decided to stop Casodex and see what happens if I stay with just the regime! Cross fingers!