Rog T's Cancer Blog - Another turn on a bumpy road

For those of you who are regular readers and have read the previous posts on Cancer, you can skip this first paragraph. I write this blog because knowledge is power and if you know what you are dealing with, you have more weapons in the locker to fight it. It is a personal view, I'm not medically qualified. This is for the sole purpose of information for those who are interested. This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life.  For those of you who aren't, here's a quick summary. I'm 53 years old and in October 2011 I  had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gave me a 3+3 on the Gleason scale. I'm now on a program of active monitoring.  In early February, I got the results of the a PSA test - down to 3.5 and an MRI scan which found absolutely nothing, two more tests in 2012 were at 3.5 and 3.9, in 2013 my test was 4.0, Jan 2014 was 3.8, August 2014 was 4.0,  February 2015 it was  up to 5.5  and my latest in August 2015 was down again at 4.6. In October 2015 I had a transperinial Prostate biopsy, that revealed higher grade cancer and my Gleason score was raised to 3+4 (Small mass + more aggressive cancer), albiet with small mass. On 22nd Jan 2016 I had HIFU (Hi Intensity Focused Ultrasound) treatment at UCHL). My post procedure PSA in May was 4.0 which was down, followed by 3.7 in August, which means that the direction is positive . I've no symptoms and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?

It is now just over a year since I had HIFU therapy. I had a PSA test in January. The news was promising, it was down to 3.5. I also had an MRI which is part of the trial protocol. Today I went to see the consultant for th one year follow up. I'd already heard the PSA result, as I had this at Finchley Memorial Hospital and they'd sent the results to the GP. So I was in reasonably positive spirits. But as we all know, this journey is not without its twists and turns. It seems to be the case that whenever I start feeling a bit too positive, cancer gives me a slap to bring me down to earth. And so it was today. It started with the normal questions, How was the leakage situation? It is fine. How is the sexual function? Fine thanks. Do I need viagra? No. All very good. My consultant looked a bit surprised at the last answer. Maybe I just imagined this. I guess that doing well is a good thing?

Then we came to discuss the MRI. This was where the news was not quite so good. Lets be clear, its not bad. It appears that when they zapped the cancerous area in the prostate with a HIFU beam, they may have missed a small bit. Then again, it may be an artefact (scar tissue/debris left by the procedure). There is only one way to tell. I need another set of biopsies , targetted on the splodge exposed by the MRI. Depending on what this shows, its either a) nothing b) something to watch c) Something which requires another round of HIFU or d).........(the unknown unknown). My consultant tells me it is a 30% probability that it will require treatment.

So I feel rather deflated. I was happy with where I'd got to and really wasn't looking forward to another round of biopsys and HIFU. Keeping things in perspective, I'm in a pretty good place. Whatever it is, it is small and very likely to be treatable. 95% of men who have small prostate tumours don't know. I have mine under survelliance. In light of recent changes to the way the NHS approaches prostate cancer, I'd not have had a PSA test and I'd not be in a program. I am lucky.

I just don't really feel it right now. But given the choicem I'd rather be where I am than growing a tumour in ignorant bliss.