Friday, June 27, 2008

The Countdown

Well, I wasn't going to post anything until after the surgery but I decided to blog the weeks events before my surgery on Monday. I was hoping to have an uneventful week and should have known that it would be one of the busiest weeks I have ever had in my lifetime! I had two major reviews at work with my VP and the Pre-Op appointment along with trying to finish everything including responding to 400 emails since I will be out for three weeks. The reviews during the week took a lot of my time and went really well, it was a little more stressful this week knowing I will be out a while. I have a great boss and enjoy my job very much so this helped. My pre-op appointment was on Tuesday and had to go and meet with the a lot of folks. They asked my family history, height, weight, blood pressure 3 times, listened to my chest, hit my chest, legs and arms, ran EKG for my heart, Chest x-ray, more history, insurance cards again, sign a liability form in every department (somehow the technology has to make this better), I saw one doctor, one physicians assistant, two nurse practioners, five technicians, one financial consultant, one radiology tech and a very nice shuttle driver who was telling people on the bus where to go and get a job at the hospital. I wish everyone in the world had his great attitude. Back for more, they took blood, more history and told me my pre-surgery instructions, which is a light breakfast on Sunday morning and then the remainder of the day is a liquid diet along with drinking something that will clean me out for surgery. I guess they want the surgeon to have a clean surface to work with (LOL). After a long week of long hours and anticipation its finally the weekend before my surgery. I plan on doing some relaxing things this weekend which include eating solid food on Saturday, going to the movies and NOT working around the house. I am sure my wife will love that one. My last event is going to church on Sunday and being thankful for all the blessings that I have in my life. I am totally ready to move forward. See you on the backside of the surgery.

Friday, June 20, 2008

The Scans

On Tuesday June 17th I went up to the Shands Radiology department for a bone scan and CT Pelvic scan to see if the cancer had spread into these areas. From what I have read, prostate cancer can spread to your bones and we wanted to make sure I was clean before my surgery. This was one of the longest days of my life and thank God my wife was with me to lean on. It all started with an appointment in radiology at 9:30am for my bone scan. In this appointment an IV port was put into my arm so they could inject some radioactive material in my arm and I was asked to return at 11:45am for the actual scan. I sat in the lobby with my wife and worked from my laptop on this day to help pass time. I returned at 11:45am and had the bone scan done. Before I left the office I was given a large bottle of a well known drink sports drink (to mask the taste)that had some type of contrast in it that was to prepare me for the pelvic CT scan. I had to drink one cup every 30 minutes up to two hours. At this point I felt sick from the stress of it all and hadn't eat anything since early that morning. We took the shuttle over to the hospital from the medical plaza and reported to radiology in the hospital. Once I drank the last drink around 2:15pm they immediately brought me back for the scan. This scan was interesting because they told me I would feel a warming sensation in my pelvic area and have a metallic taste in my mouth and they were correct on both accounts. I was done with the scan around 2:50pm. Our next mission was to go to Dr Parakettil's office as soon as possible. He was working us in so we could get the actual results of both scans. We were not leaving his office until we knew the results. They took us back to a room around 3:15pm. I was the last patient of the day and he was running really late but we refused to leave. The nurse practitioner (Lisa)was really great, she kept checking on us and found out we hadn't eaten anything and brought us some juice and crackers to hold us over. We sat in this room for a few hours and so many thoughts were running through my head from the earlier bone scan. My wife told me a bible verse that came into her head while we were waiting and I felt a calming peace come into my heart. Finally, Lisa the nurse practitioner came in the room and was able to give some good news on the bone scan, it was negative. My wife asked her to say it again for reassurance. We both looked at each other and grinned from ear to ear. The doctor came in a short while later and told us both scans were negative. That was music to our ears! After a long day it finally ended and we went to Cracker Barrel and had some great comfort food and celebrated a great victory on this day. After all, this means my cancer has not spread outside of my prostate and after the surgery on June 30th, my surgeon says I have up to a 95% chance of being totally cured. When was the last time you heard anyone use the words "cancer" and "cured" in the same sentence? Well my surgery is 1 week and 1 day away. My next blog entry will be several days after the surgery when I get enough strength to blog about that day. I am at peace with my decision and am ready to continue my life's journey.

For more information on Bone Scans please click the following link:

For more information on a CT Pelvic scan please click the following link:

Sunday, June 15, 2008

My Decision on Treatment

After the research and many prayers I have decided to go with the Robotic Radical Prostatectomy treatment. This means complete removal of my prostate. Being so young, I didn't see any other option than to be agressive in making sure I chose the treatment that gave me the best long term option. Dr Parekattil recommended this treatment to me when he first told me about the prostate cancer and I also talked with my local family PA who had many years of oncology experience and she recommended the same treatment (without knowing what my surgeon recommended). Some of the other options for me seemed like they were buying time rather than having a great chance to be cured if the cancer was contained inside the prostate. I also didn't feel good about some of the newer treatments becuase there was no long term data to support them and I need a more proven long term solution with the best chances to be around to see my grand kids. I also feel great about Dr Parekattil as my surgeon to perform the surgery. He has done over 400 robotic surgeries including over 200 radical prostatatectomy since joining Shands from the Cleveland Clinic in March of 2007. I also like the fact that he had an engineering degree before he was a doctor. I also learned from someone else that he was the co-developer of a nerve sparring technique called ERBE Hemostatic Hydrodissector. To learn more about this technique, please visit his web site below. My only concern about having my prostate removed is the side effects. There are two major side effects caused by the removal of the prostate. These are temporary loss of bladder control and temporary loss of male sexual function. The nerve sparring success is critical in the male sexual function returning becuase the web of nerves on the outside of the prostate act as the communications back to the brain about the male sexual function. Obviously if these are damaged then there would be a breakdown in communications to the brain, thus problems. In doing research and learning about my surgeons success rate I feel very confident that my bladder control will return soon after the surgery and the male functions will return within 3-4 months or so depending on the outcome of the surgery. These side effects are very scary, but I have deep faith that my outcome will be really good. My surgery is scheduled for June 30th at Shands Hospital at the University of Florida and expect to be out of work for 3 weeks. My next milestone is on Tuesday June 17th. I will be having a bone scan and pelvic CT scan just to make sure the cancer has not spread into the bone or outside of the prostate. I will post my results in my next post.

To learn more please go to the following links:

Dr Parekattil's Web Site on Robotic surgery:

Information on the robot being used for the surgery:

Thursday, June 12, 2008

Message to my Wife

I just wanted to take a few moments to talk about my wonderful wife Peggy. Cancer has really effected her life over the years and I am sure her first thought could have been here we go again or why me, but I have to tell you I am the luckiest man alive to have her in my life. She didn't say anything like that, she was so understanding and wanted to do everything she could to reassure me and for that I am so grateful and thankful that God brought her in my life. This October we will be married 17 years and we used to kid around and say "17 loooong years", but know I totally realize that its really "17 short years" and appreciate every second I have with her and my son. She has been my rock for so many years and I love her with all my heart and want everyone to know how precious she is to me and also want her to know that this is only a short journey in our lives together and by faith God will guide us through and we will be stronger as a result. I ask her not to worry because I will be fine, especially because she is by my side and look forward to a long wonderful life together.

With Love,

Wednesday, June 11, 2008

The Treatment Options

This was an overwhelming process at first. I had to do my homework before I made a decision. There were several options, but I had to research each option and look at all pros and cons of each. I used many web sites, also talked to several people who went with different options and went to my local family physician to get her opinion as well. There are newer options that may not be posted below and every person diagnosed with Prostate Cancer should research and review ALL options available and pick an option that is best in your situation. In my next blog I will go over the option that I chose for my situation.

Here are some of the options available for the treatment of Prostate Cancer:

- SURGERY - Radical prostatectomy
Robotic prostatectomy
- Cryotherapy (freezing the prostate)
- External Beam Radiation Therapy
- Proton Beam Therapy
- PRAYER (This can be used with each option)

To see a primer on treatment options please go to the following link:

Inaugural Athletes for a Cure Triathlon to raise money for the Prostate Cancer Foundation

I work with some really great people. When my friend Lori Bredemeier found out that I was diagnosed with Prostate Cancer she told me that her family was participating in the inaugural Athletes for a Cure Triathlon that will take place at WALT DISNEY WORLD® Resort near Orlando, Florida on September 21, 2008, to raise funds for the Prostate Cancer Foundation and that she would like to raise money for the Prostate Cancer Foundation in my name. I was very touched and really appreciate her, her husband Michael and sister Jenne Frisby for their participation in the Triathlon that will benefit the fight against Prostate Cancer.

Please go to the "Team Frizbee" web site below to join us in the fight against Prostate Cancer by your donation in my name to the Prostate Cancer Foundation and support Michael, Lori and Jenne's participation in the Triathlon for this great cause!

Sunday, June 8, 2008

The Results

The morning of Thursday May 29th seemed like just another ordinary day, it was another beautiful Florida morning, the birds were singing and the sun was already shining. I did not realize that on this day my life was about to change forever. My wife took the day off to go with me to my appointment at 11am to find out the results of my biopsy, we both were a little nervous about the possibility but were very optimistic about the results. She drove me to the appointment and we arrived right on time. Time stood still as my appointment time was 11am, but the doctor was running late and I could hear every second tick of the clock on the wall as we waited. We were finally called back around 12pm and waited for 20 more minutes. When Dr. Parekattil came in along with his Nurse Practitioner, Lisa, my heart began to race. After a quick hello, the doctor said the words that nobody ever wants to hear in their lifetime. He said my biopsy came back with a positive result for prostate cancer. Needless to say at this point, I was doing everything I could to not let me emotions explode, I was also doing my best not to make eye contact with my wife because I knew I would lose it. My wife said I turned ghost white after he told me the results. The doctor was just as shocked with my results as we were. It seems that I am an anomaly, being 41 years old, PSA level in the normal range, with a semi-firm prostate with a few nodules and no prior history of prostate cancer in my family. I am not sure if I heard everything the doctor said after hearing the words that you have prostate cancer, but he did explain several treatment options, including hormone therapy, radiation seeds, newer therapies and robotic radical prostatectomy. My actual pathology report came back showing out of the 12 biopsies that 2 of the quadrants both on the right of my prostate came back positive for cancer and I had a Gleason score of 6 (See link below for information on Gleason Score). A Gleason score of 6 was better news for me as it wasn't in aggressive category, it was in the intermediate category. Also, my staging score was between a T2 and T2a according to my doctor (See link to below for information on stage/staging system). I asked my doctor what he recommended at this point with the clinical data and my age and in his opinion he said based on my age that the best option was to have the robotic prostatectomy because he felt like we have caught the cancer in an early stage and he wanted to see me around for another 40 years. He did say that he may be a little bias toward surgery because he is a very experienced surgeon, but said that based on the clinical's and my age that he really felt that it would be the best long term result. At this stage I asked about pros and cons of surgery and when he told me of the bladder control issues and male erection issues for a period of time, I began to fell very sick to my stomach. By the time the appointment was over the doctor spent over an hour and a half with me and my wife which meant a lot. I told him I needed time to think about everything and talk with my family and prayer and we scheduled another appointment for the following Tuesday. This gave me 5 days to absorb, talk to my family, do my homework and pray about my options, and if I wasn't comfortable at that point I could delay. This is a day I will never forget in my life, the day that changed it forever. Its off to do my homework which we will discuss in my next blog.

A Primer on Prostate Cancer:

Information on Gleason Score:

Information on Stages/Staging of Prostate Cancer:

American Cancer Society

The Biopsy

My prostate biopsy was scheduled for May 15th and I am a wimp when it comes to pain so I chose to be put under (asleep in dream land) and went to the outpatient surgery center in Gainesville,FL for the biopsy. My beautiful wife (who has been so awesome through all of this) of almost 17 years went with me and my sister-in-law from Ocala met us there for support. I was very nervous about the actual biopsy procedure and it it made me feel better to have my family with me. It was also comforting to know that people were praying for me as well, as I am a person of faith, which has helped me through this experience (I credit my parents for this, I was raised in church and really appreciate them). I went into the pre-op area and was prepared for my adventure. I have to say that everyone I have met in this healthcare community at UF/Shands has been very nice and gracious. Well, I fell asleep in the OR and woke up in the post op area. When I woke up I had a big problem, I could not go to the bathroom (#1) and was in pain. Dr.Parekattil did my biopsy and came to see me afterwards and said they needed to put in a catheter to help me. Well, remember I said I was a wimp, the doctor had to put in the catheter while I was awake! This was the most painful thing I have ever experienced, I could tell the doctor felt bad about having to do this, but it still hurt. Afterwards the doctor told me he felt good about my biopsy and was optimistic that everything would be okay. I had to go back into his office the next day to have the catheter removed and that was much easier. We made my follow-up appointment to get my biopsy results on May 29th. My next blog will discuss what happened at this appointment.

Saturday, June 7, 2008

In the beginning, a diagnostic timeline

I will attempt to capture the timeline of events that lead us to my current diagnosis. About 3 years ago, I noticed that I had to go to the bathroom many times during the day including waking up a few times in the middle of the night and running to the bathroom. This was very disruptive in my life. I wasn't sure what to do with this and thought it was normal so I didn't do anything for a while.

Late in 2006 I made an appointment with a local Urologist to discuss getting a vasectomy and I then told him about my "going problem". He did an in office test and said that I possibly had an enlarged prostate and he prescribed me "Flomax". At this time he did not do any screening of my prostate. I took the medication for about 1 year and it did help a little in the beginning but I did notice that it was going back to the same pattern. My wife was concerned and asked me to ask the doctor at my six month follow-up about taking a PSA blood test just for peace of mind and my doctor said I was too young for this test. He also did not do a digital rectal exam. Almost a year and a half later I discussed it with my local PA (Physicians Assistant) and she suggested we try a different medication for 30 days to see if it would improve and said if it didn't improve that she would send me to a specialist. Well, after taking the new medication the symptoms did not improve and she referred me the Urology Center at Shands Hospital at the University of Florida in Gainesville, FL. Since I am a UF Football Booster and season ticket holder and was happy to be going to the Urology center at UF. My first appointment was on April 22, 2008 and first saw a PA and Nurse Practioner which spent about 30 minutes with me going over my history. The PA did a digital rectal prostate exam and found 2 nodules on my prostate. He seemed concerned which concerned me. When the doctor came in he rechecked me again with the same result. The doctors name is Sijo J. Parekattil, M.D and he is the co-Director of Robotic Surgery for Prostate Cancer, Kidney Cancer & Director of Male Infertility and Microsurgery/Vasectomy Reversals at Shands hospital at the University of Florida. I really liked him,becuase of his awesome bed side manner and the bow tie he wore. He made me feel really comfortable and was very thorough. He explained to me that there are two screenings for prostate cancer, the digital rectal exam and a PSA test. (Prostate-specific antigen (PSA) is a substance released into a man's blood by his prostate gland. A PSA test measures the amount of prostate-specific antigen in the blood). He said if either of the test come back abnormal then its recommended to do a prostate biopsy to confirm the evidence of cancer. So in my case he recommended a biopsy becuase my digital rectal exam was abnormal. He did go ahead and order a PSA test and my PSA level was a 1.4 which was good news to me becuase anything over 4 is cause for concern. He felt that the biopsy would be routine and felt that my chances were very good for not having cancer becuase I was 41, and had no family history of prostate cancer along with a PSA result well in the normal range. My next step was to get the biopsy and will discuss in my next blog...

Thursday, June 5, 2008

It can't happen to me I am too young!

I have recently learned that at age 41 that I have Prostate Cancer. Yes, you read that right. I can't believe it myself. After a series of test I learned about it on Thursday May 29th, 2008. That day will be forever entrenched into my mind. Since then I have done a lot of research, talked to a lot of people and have learned way more than I ever thought I would know about the prostate and prostate cancer. This is my first post on my blog. It seems that my age in an anamoly and there isn't much data on the Internet for people in their early forties diagnosed with prostate cancer. I want to create this blog so I can share my experience from beginning to end with the hope it will help someone else that may be my age going through this or someone who may have suspicions at this early age but haven't done anything about it and should be screened. In my next post I will go back to the beginning and talk about my symptoms and blog through until I reach the current time period. From there I will blog my experiences moving forward. Until the next blog...