I was diagnosed with prostate cancer on 20th November 2017. Prior to the diagnosis there had been blood in my urine. I went to see my GP who referred me to the Urology department at Guy’s Hospital, London Bridge. A physical exam suggested something was up (not just the doctor’s finger) and a biopsy confirmed everyone’s suspicions.
My initial PSA blood test was 5.03. My Gleason score was: 4+3 = 7. The maximum cancer length was 10mm. My prostate cancer stage was: T3a N?1 M0.
Prostate Cancer Stage Definitions
T3a – Penetration of prostate capsule on one or both sides.
N1 – Cancer spread to one or more lymph nodes measuring less than 2cm.
MO – Cancer that is confined to the prostate, surrounding tissues and pelvic lymph nodes.
I then started attending the Cancer Centre at Guy’s. Initially it looked like I was having my prostate removed but an MRI scan indicated the tumour was very close to my bowel and the surgeon didn’t feel an op was the right way to go. He mentioned possible colostomy bags, so I bailed on that course of treatment. Soon after I started on Hormone Therapy. Within a month my PSA was down to 2.61. Six months later, in June, it was 0.8.
On 11th September 2018 I started a course of 39 Radiotherapy treatments or fractions as the docs call them at St Thomas’ Hospital. That finished on 7th November.
A PSA blood test and subsequent visit to an oncologist at Guy’s Cancer Centre on 17th December 2018 revealed that my PSA is now virtually undetectable at 0.07. For it to be entirely undetectable it has to fall to 0.03 or lower.
My PSA level will now be checked every four months prior to seeing an oncologist. If it rises to two or more, then further treatment is likely.
I have another two years on hormone therapy which finishes in December 2020.
In May 2019 during an appointment with the oncologist I learnt my PSA score had risen slightly from 0.07 to 0.1.
In November 2019 I was told by my oncologist that my PSA reading had fallen to 0.03 meaning my cancer was virtually undetectable and I was part of the NED squad (No evidence of disease). Since then, I’ve had 6 monthly checks and so far there has been no change.
In August 2020 I had my final hormone therapy jab but at the time of writing (March 2021) most of the side effects remain. I’m currently receiving no treatment and my next check is in August 2021.
The consultation on 4th August 2021 also brought good news. My PSA was extremely low (0.02) which means that for almost two years I’ve had no evidence of disease.
Come January some of my side effects have started to depart. I was concerned that this might result in a rise in my PSA level. This proved to be the case when I learnt during my consultation on 2nd February 2022 that it had risen to 0.23. It may continue to rise but it’s impossible to say how far and how fast. I also had my testosterone level checked: 18.6. In men the range is generally somewhere between 9 and 30. Next PSA test is in August 2022.
Helpful information about Prostate Cancer
What is the Gleason score?
Cancers are graded from 1 to 5 based on how much the cells in the cancerous tissue look like normal prostate tissue under the microscope. This is called the Gleason system.
- If the cancerous tissue looks much like normal prostate tissue, a grade of 1 is assigned.
- If the cancer cells and their growth patterns look very abnormal, a grade of 5 is assigned.
- Grades 2 through 4 have features in between these extremes.
The first number assigned is the grade that is most common in the tumour. For example, if the Gleason score is written as 3+4=7, it means most of the tumour is grade 3 and less is grade 4, and they are added for a Gleason score of 7.
What is a PSA Test?
The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood, and the amount rises as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.
What is your Prostate Cancer Stage?
Your prostate cancer stage is set after testing. Stage describes if the tumor was detected or felt during the digital rectal exam. The prostate cancer stage also indicates whether or not the cancer may have spread to lymph nodes or other organs. Clinical stage is based on all information available prior to any treatment. For more information click here.