To Page II of My Husbands Prostate Cancer Story

Sept 11.1997

This is our first appointment for a consultation with Dr. Frank Critz of Radiology Clinics of Georgia (RCOG). Dr. Critz developed this treatment, and has used it on over 2,000 patients over the past 20 years. We are armed with a large folder containing PSA blood test results, biopsy results, CAT scan films, and a letter from my husband's urologist at home. Dr. Critz examined all of the information, then examined my husband. Then he spoke with us, and gave us the news. He told us that the chance for a cure was 95%. He did caution us, though, that we were dealing with two diseases, and not just one. Yes, we were dealing with the cancer, but we were also dealing with Benign Prostatic Hypertrophy (BPH), and that it could take as long as 18 months for the prostate to shrink to its smallest size. We decided to have the seed implants done, and Dr. Critz immediately made an appointment for us with the urologist who would be working with the radiologist to do the seed implants. We went to the urologist's office that very afternoon, and the procedure was set up for October 15th.

September 12,1997

Today we went to DeKalb County Hospital for pre admission labwork, and Physical exam. They asked Joe if he wanted general or spinal anesthesia, and he chose a general. The staff was professional, yet friendly. The nurse did pre-operative teaching, and gave Joe directions for his bowel prep and diet. We had to arrive at the hospital early in the morning of October 15th. They even validated our parking ticket. That afternoon we spent our time driving around Atlanta looking for affordable housing for the week of the procedure, and for the six weeks of radiation that would follow. We ended up staying at a nice quiet apartment complex called Tanglewood, that rented corporate apartments by the week. (It was quite pleasant, and we came to refer to it as our home away from home). RCOG had also provided us with a housing list, and we did check out several of those as well.

October 7,1997

On this day, we went to Biloxi, and spent the night at the Grand Hotel since Joe had a coupon for a free night's lodging. I, as usual, just paid rent on the machines, but Joe won quite a bit. He had a wonderful time. (Biloxi, MS is loaded with gambling casinos and we usually go every three months).

October 13,1997

This is the day we drove to Atlanta, and settled in our apartment. On Tuesday, Oct 14 th Joe was on a liquid diet, and also had to drink a gallon of golytely to completely clean out the bowel in preparation for the procedure. The big day was fast approaching. I don't believe either of us got much sleep that night.

October 15,1997

We arrived at the hospital while it was still dark outside, and the admitting procedure went without a hitch. We met both of our Doctors, and again the procedure was explained. Joe remembers very little after getting his preop medication. He just remembers waking up in the recovery room, and then being transferred to his room on the second floor. His biggest complaint was that he had to have a catheter in. It takes two Doctors to do this procedure. It is described in detail through the link on page one, but essentially what they did was place radioactive iodine seeds (118 in Joe's case) directly into the prostate gland. The urologist then performed a cystoscopy (using an instument called a cystoscope, he actually viewed inside the bladder to make sure no seeds had escaped, and to make sure there were no other problems). That afternoon Joe was taken to Radiology for another CAT scan. We took those films to RCOG the next day. Those films would then be used to properly determine where the radiation would be aimed. That evening, a nuclear technician stopped by to explain about the half life of radiactive iodine, and the precautions it would be necessary to take with children, and that contact with pregnant women should be avoided. He came back the next day with a geiger counter, and determined that Joe was pretty hot stuff and no seeds had escaped into the urine.

October 16,1997

This is the day I was able to bring Joe home. When I arrived at the hospital, they had already taken out the catheter. Joe was having a serious problem urinating, and before we left Joe was taught how to do self catheterization by the hospital ET nurse. Upon return to our apartment, Joe became totally blocked,and could not urinate at all so self catheterization was not feasible, and since I am an ET nurse, and after calling the Doctor, I did put a catheter back in. Joe was to remain in a catheter for about three months. We tried every three to four weeks to take it out but he would always become totally blocked. Finally, on March 3rd, 1998, we were able to remove the catheter for good. We left Atlanta on the the 18th of Oct. and spent three weeks at home. Joe bought me another computer which I took back to Atlanta with me for the six weeks of radiation. I was really glad to have it, and it was so nice to be able to stay in touch with all my friends.

November 5,1997

We returned to Atlanta for the six weeks of radiation. On this day Joe had tattoos placed on both hips. These tattoos were the landmarks for where the radiation would be beamed. X-rays were taken weekly so that adjustments could be made as needed. We also saw a Doctor weekly to handle any other problems, and to determine if any side effects were developing. There were actually two types of radiation given. One type radiated the whole area and the other was with lead blocks that was given only specifically to the prostate. The people at RCOG were wonderful. They used to do out of towners early on Fridays, and late on Mondays so you could spend the long weekends at home. They had fresh coffee brewing all the time, and even had a jigsaw puzzle in the waiting room for people to work on. Plenty of reading materials were also available. Every other Tuesday they had a support group which we enjoyed attending. As many as 180 patients were treated on a given day, sometimes more. Generally, it took all of 15 minutes to get the treatment, that is from walking in the door, waiting your turn, and leaving. Side effects were minimal, but we did have to make some dietary changes limiting roughage to combat some bowel problems. Only one time did the machine break down, but they made things as pleasant as possible until they got it fixed, and resumed treatments for the day. One side effect I noticed was that Joe was tired, and he used to doze off for a couple of hours at least twice a day, and he seemed to require more sleep at night. On the two occasions that I needed to call a physician due to problems, I was completely surprised that I got return phone calls within 15 minutes, and both times the problems were handled over the phone.

Prior to the beginning of this treatment Joe's PSA was 8.9. Two weeks after radiation his PSA was down to 2.2, and three months after radiation it was down to 1.3. We just returned from Joe's three month checkup with Dr. Critz, and with Dr. Remigailo (the urologist who performed the procedure), and they were both delighted with the progress he has made. Of course, we always knew Joe was special, and he will return to Atlanta in six months secondary to the urinary problems he encountered. Only 2 % of patients experience these problems. At one point in time we were anticipating further surgery to open the blocked urinary passage but the problem has resolved by itself.

Page III will be devoted to upgrades of Joe's condition, and we found some humor related to his experience, and treatment. I will get that page up as soon as I can. We are happy with our decision; RCOG made things as easy as they possibly could, and at this time the results from Radical Prostatectomy, and Brachytherapy are running just about the same. We understand the cost is comparable as well. However, the big difference is in the pain, and in the recovery process. In some cases the patient misses as little as one day of work with Brachytherapy, and incontinence and impotence are generally not a problem. If we had it to do over again, we wouldn't change a thing.

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