Graham was diagnosed with prostate cancer in March 2006 at age 59. He visited his doctor for a general check-up, but also reported increased frequency of the need to urinate.
“It had been two and a half years since my previous DRE, when the gland felt ‘nice and smooth’ – that’s what she said”!
A blood test showed Graham had a PSA reading of 6.1, and the DRE indicated involvement of a seminal vesicle.
Graham was referred to a urologist, who undertook a biopsy; this produced a Gleason score of 9 (4+5). Bone and CT scans were performed, and these were negative.
“The urologist who did the biopsy wasn’t really able to tell me anything that sounded positive. He explained how serious it was and sent me off to decide what treatment I wanted, after saying there was no established way to handle such a case”.
Graham’s wife Karin accompanied him on the next visit to the urologist, “… as I was struggling to take it all in”.
“After hearing that if I was 75 I would be put on watchful waiting; the exact words were ‘sent away and told not to start reading War and Peace’, we decided to seek a second opinion”.
Graham saw a second urologist, who referred him to radiation and medical oncologists. They all recommended surgery, to be followed by additional treatment, based on the surgery results.
While waiting for the surgery he was given hormone treatment – Zoladex with daily Casodex for a month, the aim being to put the brakes on the tumour. The last PSA result before surgery was 0.16.
The urologist also sent Graham for an endo-rectal MRI, to assist him in his preparation for the operation.
Graham had open radical prostatectomy surgery at the end of May 2006. Pathology results confirmed Gleason 9, with no lymph nodes involved and all surgical margins clear.
Six weeks after surgery Graham’s PSA was <0.01.
The recommendation from the team was that radiotherapy should be held in reserve, but that he should proceed with chemotherapy and hormone therapy given the high Gleason score.
He was given 4 cycles of chemo with 3 weeks apart. At the end of this the PSA was 0.05.
Immediately on completion of the chemotherapy, Graham was started on three-monthly Zoladex implants, and his PSA dropped straight away to <0.01. He was kept on Zoladex for 2 years (8 implants), up to late 2008.
Graham had been working for IBM as an IT consultant. He retired from work about a year after surgery and says that his prostate cancer situation impacted on his decision to retire.
Graham and Karin moved from NSW to Victoria, and so moved on to a new urologist and contact with a new support group. An internet search soon put him in touch with the Geelong Prostate Support Group, and Graham has regularly attended Group meetings since.
His PSA was monitored every 3 months, and in the autumn of 2010 it had started to rise, and was doubling about every 8 weeks.
He had bone and CT scans, which were negative, and discussions with radiation and medical oncologists. Graham also had an FDG PET scan which was negative – although he had been warned that these scans often don’t show anything for prostate cancer, especially when there is a relatively low PSA.
He went back on Zoladex late in 2010 and responded immediately, with the PSA falling to <0.04. He had 2 implants, followed by further 3-monthly PSA monitoring.
Late in 2012 Graham went through the same cycle of rising PSA followed by 2 Zoladex implants, although the hormone therapy didn’t get the PSA down quite as low this time.
The second half of 2014 saw same thing – a rising PSA and more Zoladex. But this time after the second implant the PSA rose from about 0.6 in September to 1.2 in December.
Graham was booked in for a PSMA PET scan at Peter Mac, in February 2015. That scan showed one spot in the prostate bed and one on a single lymph node; there was with no bone involvement detected. “I felt very fortunate that this scan became available pretty much at just the right time for me”.
Graham was then referred to a radiation oncologist at Epworth and by May 2015 he had completed stereotactic treatment of the lymph node, and 7 weeks of radiotherapy to the prostate area. His PSA immediately prior to the start of radiotherapy was 1.84, and he continued on Zoladex. Graham’s PSA had fallen to 0.68 in mid June, then to 0.29 in late September. Given these results, his urologist wanted to stop the Zoladex. The PSA then started rising again.
In June 2016 Graham had another PSMA PET scan. This showed that the two spots previously detected were gone, but it also detected two spots on the bones, and in the lungs. He is now back on Zoladex to stabilise or lower the PSA.
When he was first diagnosed, Graham chose to empower himself with information, especially in relation to diet and supplements. Graham has chosen to eliminate red meat and almost all dairy from his diet. In particular, his decisions have been influenced by the writings of ‘Snuffy’ Myers and British breast cancer survivor, dairy-free advocate and author Jane Plant. In more recent years, American author and professor of preventative and alternative medicine Mark Moyad has been a guide for supplements. He has also found the advice of GPSG member Steve Radojevic a great help.
Graham enjoys his retirement living at Torquay. He is a member of The Sands Golf Club, plays golf competitively. He is very conscious of his health and the impact of hormone therapy, and regularly works out in the gym. With his wife Karin, he also enjoys walking and photography. Their three children live in Sydney, near Adelaide, and Port Townsend (Washington, USA).