Which Number Do You Know – Your Odometer or Your PSA? Prostate Cancer survivor Chuck Gallagher Raises New Question

In talking with a friend of mine the other day, he make an interesting observation – he said, “You can walk up to most any guy in America and ask him his odometer reading and within read he can tell you the number. But if you follow up with a question – ‘What is your PSA number’ the guy will look at you dumbfounded.”

I must admit…I was taken back by that astute observation.

So today…I decided I’d try it. After all, what did I have to lose?

I stopped by this hamburger joint today for a quick bite. (I know those who are into nutrition will chastise me for poor eating habits – I got it.) As I sat there a man with his wife and two children came into the restaurant. He looked to be in his forties…maybe pushing 50…maybe. Anyway, they sat down, looked at the menu and placed their order. By this time I was having lunch and mentally debating whether I would have the guts to conduct my experiment.

I finished. As I stood up to pay at the counter…I went for it. In a nice manner I approached this family. I directed my attention to the man and told him that I was conducting a survey – could I ask him a quick question. With a look of skepticism he responded – “O.K. – I guess.”

“Sir, do you know how many miles is on the odometer of your car – say within 2,000 miles?”

“Yea. 32,000 or there abouts. Say what’s this about,” he responded.

“One more simple question Sir, do you know what your PSA number is?”

His wife then chimed in and said, “Yea, what is your PSA number?” Somehow she was more aware than he of the importance of being checked and being checked EARLY!

He didn’t know – you could tell that by the look in his eyes. In order to help him out…I told him that I was a prostate cancer survivor and that one thing that I could do is help men become aware of the importance of regular checkups and early detection. Since one out of ever six men will develop prostate cancer sometime in their life…early detection just makes sense.

Attached is an e-mail (with identifying information removed) that a friend of mine sent me today. It illustrates the CRITICAL IMPORTANCE of early detection. Once you read the following … you’ll understand why this might save the life of the man you love!

I have been a reader of the mails and I cannot tell you what a blessing they have been to me as well as a help. I too, feel so much sorrow, pain and anger at what this cancer does to all those who whose lives get touched by it.

I am the wife of a man who has Type IV PCs. He was diagnosed last year (June), at the age of 51. Three years prior to that, he had a PSA done and it was 2.8. He was told it was well within the normal range. Feeling healthy and being busy, he skipped his physicals at 49 and 50. Then, only because he got sick with pnuemonia and a bladder infection at 51, did they do a PSA. It came back at 19.8

Long story short (if I can do that), the did a biopsy. Came back positive. Gleason 4+3, now PSA at that time up to 23.5 We were told that there was an 11% chance it had gone outside the prostate.

We read up on all the options and were going foward with HIFU in Canada. To ensure that we were not depleting our savings for something that would not work if the cancer had spread, we had the lymph nodes removed and biopsied. Well, HIFU was no longer an option as the cancer was in the lymph nodes.

My husband first went on Casodex and Lupron, then went for 25 tomotherapy treatments and finally had an HDR done last November. After two lupron shots, my husband elected to stop them (side effects were tough on him). It has always been our prayer that the tomo and HDR killed all the cancer. From what I have recorded since May of his PSA, I don’t think so.

May ‘08 – 0.05
Sept ‘08 – 0.28
Oct ‘08 – 0.51
Nov ‘08 – 0.67

He knows that going back on Lupron is going to have to happen. He just hates his life so much these days. From the lymph node removal, he has lymphedema and it is believed by his doctors that that surgery also caused some nerve damage. He has severe right heel pain and left leg spasms as well as back and hip pain. He has tried Cymbalta and Lyrica and cannot tolerate what they do to him mentally. He lives on Oxyncontin twice a day, supplemented by Vicodin when needed. He has never been able to completely empty during urination and holds 500cc-800cc in his bladder AFTER he has gone. So…he self catherdizes 2x a day. It hurts me so much to seem him in pain. He wants some sort of quality of life back.

I just do not know what, if anything, I can do. I help with the diet and supplements but it seems so insignificant. It is just so darn hard to hear doctor’s tell us that it is there job to keep him alive for as long as possible because there is no cure for him, just palliative care.

My heart breaks when I hear stories like this. While early detection won’t work in 100% of the cases…it will work in most.

So which number do you know – your odometer or your PSA?

Male Erections and Ejactulation Following Prostate Cancer Treatment – What’s the Real Deal?

I must admit it is a bit unusual when taking on the task of writing a book about a subject that – through personal experience – and now research – I have become a subject matter expert. I have to be honest and say up front, I never really wanted this knowledge – for that matter I didn’t want to find out that I was diagnosed with Prostate Cancer at age 47. But, everything happens for a reason…and I guess that mine role is to be open about the experiences and provide a reality check for men and their families.

Now…some three years later as a Prostate Cancer survivor, I am conducting interviews with men from all around the world about their experience with prostate cancer. My goal…to produce a book and perhaps CD or audio recordings that will explain the realities about Prostate Cancer – what options are available and what you can really expect when it comes to treatment and side effects.

Let me caution – I am not a doctor, not involved in the medical community and don’t represent any drug company that may be trying to persuade you or someone you love to seek a certain option. I am a professional speaker who, just by chance, found out he had prostate cancer.

So, the purpose of this blog is to provide up to date information to men and their partners about Prostate Cancer and the emotional issues that you may face. You may not want to hear what is written, but I promise that it will be practical, useful and accurate. That said…let’s talk about prostate cancer, erections and sex.

Before I began tonights blog I was on the phone with Richard S. – he gave me permission to use his name – although I can’t begin to imagine how many Richard S’s there are in the world. Sorry, I digressed! Anyway, Richard was diagnosed less than a year ago with Prostate Cancer and in May had his treatment of choice – HIFU (High Intensity Focused Ultrasound) a treatment I considered.

Like most of the men I’ve interviewed for this book (I am still conducting interviews if you would like to share your experience contact me), if nerve sparing techniques were used and the prostate cancer was localized, the ability to gain an erection was reasonable. The problem is very few will define for you want an “erection” is after surgery. Now I can hear some folks now saying – “What’s he talking about, I know what an erection is?”

FACT: Not that my research is complete, but thus far no one I’ve talked to has told me that the erection they achieved following treatment was as satisfying of substantial as before their treatment. I ask this question: “On a scale of 1 to 10 with 10 being an erection like you had when you were 17 years old, what number would you assign as erection strength before treatment?” Most men answer between 8 and 10. Then I ask the same question, but this time assign the number after treatment. The answer from Prostate Cancer survivors who have had nerve sparing treatments varies between 3 and 7. Rarely do I find any one who will suggest that they are able to achieve an erection like before.

REALITY CHECK: It is true, an erection can be achieved, but more than likely it will take more stimulation to achieve and maintain or it will take medication or pumps to enhance the erection effort. One does not have to have a #10 erection in order to achieve an orgasm or to achieve penetration during sexual intercourse. However, it is practical to say that while an erection may be possible, do not expect things to be the same – based on my research they generally are not.

SIDE NOTE: As most will tell you the ability to achieve an erection is as much psychological as it is physical. As a Prostate Cancer survivor, if you are stressed about sexual performance, you will find that stress, anxiety, and other emotional strains will hamper your ability to perform and hence challenge your healing. For that reason, I elected to use Hypnotherapy and it worked. If you have questions about that, feel free to contact me – I’ll be happy to share the details.

EJACULATION: Gentlemen – after surgical or, in some cases HIFU, treatment you will not have a ejaculation – you have an orgasm, but nothing generally comes out. Richard S. shared with me that no one told him nor did he find out this fact on the internet. I suppose I was luck as my Doctor prepared me for that fact. He said that orgasm was likely but that it would be a “dry orgasm.” I asked him what that meant…to which he replied nothing would come out. It would feel the same, but there would be no semen released.

Guys…prepare for this. Some men have reported that it was not an issue for them. Other men have shared that they have yet to get over the lack of an ejaculation. I understand that. Now I am quite confident that some will be less than happy with my next comment, but I have made a commitment to be frank and candid in the entries I write. For all our lives since we reached the age of sexual maturity, we have had a ejaculation when orgasm was achieved. Whether that orgasm was released internally (through sexual intercourse) or externally, it was released. Some have said that the release or ejaculation was like “marking one’s territory.” It is quite natural. The inability to continue to “mark the territory” is disconcerting to many and something to prepare for.

In other words guy – you won’t need one of these (unless you are using it for other purposes).

CAUTION: I have reported in other blog entries that some men experience the release of urine during sex. This may occur before or during orgasm. It seems, from my research, to be limited in scope – most men are not reporting this issue. But there are some of us, myself included, that have experienced this – and I am told from the Doctors that it is not that unusual. Interestingly enough, most women that I have interviewed were not put off by that – the issue with urine release was more a problem for the man. If this is a problem, one practical thing is to avoid heavy drinking immediately before sex and certainly empty one’s bladder before sex is practical.

As always…these entries are intended to stimulate discussion. Please feel free to comment as your comments will certainly help others.

Prostate Cancer Treatment Using the daVinci Robotic System

Unlike normal blogs dealing with Choices, Ethics, and Consequences – my topics as a professional motivational speaker – it seemed appropriate today to speak of my complete recovery from prostate cancer hoping that it might help others who are faced with decisions on prostate cancer treatment.

Discovering I had prostate cancer at the age of 47 was almost an accident and certainly not something that in any way I expected. I had no symptoms – none whatsoever. In layman’s terms, everything seemed to work fine. So the discovery of prostate cancer was quite accidental. It seems I had gone to my doctor simply requesting a pill (propecia – a drug to reduce hair loss). She required I have a blood test, as this drug would have an effect on my PSA. Frankly, all that was greek to me…as I didn’t know what PSA was and had never had it checked. I hated needles – had always said I was allergic to them – hence I avoided being stuck as much as I could. But on this day in November 2004 I decided to take the plunge – have my blood checked – and get the prescription.

Two days later I got a call while out of town saying that all the lab work was fine except that my PSA was a bit elevated – it was 4.58 and for someone my age that was high. My doctor referred me to a Urologist. The appointment was set.

Of course I had some concern, but after all, all the plumbing seem to work fine and I had no symptoms, so surely there was no problem. The Urologist’s exam was routine – in fact he said he thought I had nothing to worry about as he felt nothing abnormal. But, to be on the safe side he schedule a biopsy. Being fearful of needles (and a biopsy is the ultimate needle) I asked if it would hurt. His response, “Most men don’t really feel a thing.” That was a lie! Looking back, I would have asked for good drugs as that was the most painful experience I can recall.

Several days following the biopsy I received the results. Prostate Cancer! I had a Gleason score of 6 and 30% of one side of my prostate was cancerous. My heart sank as I received the news. How could I, a 47 year old healthy male, with no other medical issues have prostate cancer? And, how amazing that it was caught by a simple test that my well versed female doctor required. Looking back, her diligence saved my life.

What next?

My local doctor wanted to schedule surgery immediately. He said I had four options: (1) Radical prostotectemy (traditional surgery); (2) Radiation; (3) Hormone therapy and/or (4) Watch and wait. Again, he recommended surgery. My immediate question was how many of the surgeries that he was suggesting did he do weekly or monthly. The number was low. In the back of my mind I thought, “Hum, maybe I need someone who isn’t so surgery happy and who does this delicate removal frequently.” I was like learning to play golf – I would prefer to learn from someone who plays daily than learn from a weekend hacker. Maybe that analogy seems harsh, but after all the decision made would have lasting and profound effects.

Following the meeting with the Urologist, and after telling my family (who thought I was joking), I spent some time in research. First thing I found – based on my diagnosis – I had time to consider carefully my options. Not that nothing should be done, but I didn’t have to rush into any hasty decisions. Prostate cancer generally is slow in it’s progression. CAUTION – do not use my experience as a crutch to avoid treatment (I witnessed my father-in-law die from complications from prostate cancer), rather, seek competent medical help in making your treatment decisions.

Options Considered:

Watch and wait. Well for several months I did just that. I researched – changed my diet – considered the possibility that I could reverse what existed and even reduce the cancer. I began a regiment of daily intake of cottage cheese and flax seed oil. For a short time I actually saw a decrease in my PSA; however, that was short lived. What I did learn was that diet was important – not only for general well being – but an effective tool in promoting a cancer free body. This was valuable time in that it gave me the opportunity to consider all my options.

Radiation Therapy. Not really an option for me. While I talked with a man in his late 60’s to early 70’s who had outstanding results using focused radiation (proton therapy I think it was called), the reality is – once you opt for radiation and the tissue is destroyed, if prostate cancer returns, it cannot be surgically removed. Hence the best advice I received was, in my case, this would not be a practical option. By the way information on proton treatment can be found at www.protons.com or at www.llu.edu. The people I talked with who had used this treatment were extremely pleased with the level of care they received and the overall outcome.

High Intensity Focused Ultrasound (HIFU). In my search for the right treatment, I spent much time in considering this alternative. There were three practical objectives I wished to accomplish with whatever treatment I selected: (1) Cancer elimination, (2) Minimal issues with incontinence (preferably none) and (3) minimal issues with erectile function (again, preferably none). Based on my Gleason score and prostate cancer diagnosis, it seemed that this treatment would be viable. For research information visit www.ushifu.com. As part of my consideration I met with Dr. George Suarez, Medical Director for USHifu. He reviewed my medical background and was kind in taking the time to discuss with me my options using this new prostate cancer treatment. Dr. Suarez took the time to explain all my options and how, if I elected, HIFU could be effective while meeting my three objectives. My only resistance was, at the time, it was not an option yet approved by the FDA in the United States, hence I would have to seek the treatment outside the scope of my medical insurance outside of the country. While I gave this serious consideration, I ultimately decided to go another route.

Radical Prostatectomy. All of the possibilities above, brought me back to the original suggestion – SURGERY. The issue I had was what kind and who would perform it. Since I had the time to research I discovered (through the wonder of the Internet) this, then, new procedure called a robotic-assisted radical prostatectomy. Hum…seemed that needed more study. Of course, at the time, Johns Hopkins Brady Urological Institute was recognized as one of the best in the world for prostate cancer research and study. After careful consideration I contacted Johns Hopkins inquiring about this seemingly new procedure – using the daVinci Surgical System. www.urology.jhu.edu/MIS/daVinci/ The folks at Johns Hopkins could not have been more caring and helpful as I sought all my treatment options. Of course, they reviewed my file carefully and spent all the time I wanted and needed to evaluate my options. Dr. Li-Ming Su was my surgeon and my hat is off to him and his skill and patience. In the end, one thing was clear – all other options being equal – surgical removal was still the “gold standard” in the fight against prostate cancer. Likewise, it appeared that this robotic assisted laparoscopic radical prostatectomy would meet my three objectives.

The surgery went fine – of course I don’t remember a thing – so all I can base it on what the Doctor’s report. Initially the report indicated that the cancer was contained in the prostate and the removal should yield me “cancer free.” Of course this was to be confirmed later from lab reports. The first several days following surgery were not pleasant, but tolerable. Within three days, I boarded a plane and flew home to North Carolina – travel was not a big issue. The most discomforting thing following surgery was the catheter – which remained in for three weeks.

Outcome. Within four weeks following surgery I boarded a plane to Dallas, TX to begin a new job. My energy level was back and I had minimal incontinence isses with subsided within another three weeks. Within seven weeks of surgery incontinence was not an issue. Erectile function returned within three months (with the aid of medication) and returned to full function (without medication) within twelve months.

Now it’s been three years since surgery and all three objective have been achieved. Life is normal. I am cancer free. My sincere thanks to all who were there for me as I sought out the treatment that was right for me. I would not have the opportunity to function as a motivational speaker today if it were not for the skill and help of the fine folks at Johns Hopkins. While printing such personal items for all to read may seem (to some) out there! I feel that, perhaps, others who find themselves diagnosed with prostate cancer may learn from my experience. If you find this helpful, but still need to talk – please visit my web site: www.chuckgallagher.com and contact me through that portal. I’ll be happy to talk with you via e-mail or phone.

Chuck Gallagher is an international speaker and author who shares his life experience in a way that is meaningful for his audiences. For information on Chuck’s presentations or how to subscribe to his free ezine…visit http://www.chuckgallagher.com