Grounded - damned prostate

U

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Gents, check your PSAs.

A raised PSA from a routine physical brought me to a urologist. 1 week later I had a prostate biopsy (Un-fun. Plus, since I'm at a teaching hospital, I had an audience.) Four days later, on March 22, I got the call: prostate cancer. That's the bad news. Now the relatively good news: it's non-aggressive, and very low on the Gleason score scale. And I'm young (51).

I met the urologist yesterday, along with a resident, a nursing team, and a designated nurse coordinator in a large, state of the art teaching hospital cancer center. I looked at other patients and realized I am really one of the fortunate ones. We spoke about the disease, all of the treatment options, and the risks involved. I will be going the surgery route. I will get a 2nd opinion, but for those who know about such things, the key is to have someone who has done a LOT of these surgeries. My urologist is a professor and urology department chair. He has been doing these for 25 years, and does over 2 of them a week himself, and his total is around 1,300. He was also up front with statistics on all of his patients in terms of risks and side effects of this very complex surgery. I haven't found the "Consumer Reports" on prostate surgeons, but I feel like I'm in good hands.

One catch: I need to shed 25 pounds before he'll do the surgery. As my wife said in the meeting: "DONE!" I have never - ever - had such motivation to lose weight, which will have long-term benefits well beyond getting my prostate removed. At a minimum I'll be able to carry 4 more gallons of fuel when I get back in the air!

So, I have a weight check in 6 weeks, and if I'm showing appropriate progress, we'll schedule surgery for July. I am grounded for now, and may miss AirVenture this year, but I know these things are temporary.

My wife and daughter are taking this journey with me. I've got a friend who has gone though this 2 years ago, who told me that treatment is like fraternity hazing for a pretty large fraternity that you want to be in for a long time. I've reached out to the very kind Dr. Bruce, who told me that this is a bump in the road, not structural damage. And I've reached out to a couple other pilots who have been through this or are going though this. I've never met them, but they have both treated me like a brother. Thank you to all.

I'm a regular on PoA. I ever thought this could happen to me, but brothers, it did, and it can happen to you. Get your PSA tested.
 
PSA tests don't always tell the truth, but if they're done annually it'll show up soon enough, I think. Prostate cancer kills as many men as breast cancer kills women but gets a tenth of the attention and concern. The lack of concern (by men themselves) is probably the major cause of the death rate. Catching it early would make a big difference.

Dan
 
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Unregistered said:
I am grounded for now, and may miss AirVenture this year, but I know these things are temporary.
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You are not grounded, my friend. Get a buddy or CFI (preferably one person who's both) and go flying. You just need someone to act as PIC.

Hang in there! :)
 
Think of this a a warning bump in the road. Just a bump. But ahead, I mean many miles ahead the road turns to GRAVEL and after that......sigh.

You WILL fly again.
 
Our thoughts are with you OP. Good news from Bruce and we will all be happy that it is nothing more than a pain in the crotch for you!
 
As one who has BTDT, get your prostate cancer taken care of. Then ask Bruce for the process for getting the SI and follow it to the letter. I did, plus called the folks at the PNW Regional medical office to see exactly what they wanted. Sent them the paperwork and had my SI in 8 days. You'll be seeing the AME annually until you've been cancer free for 5 years. I've got a couple years to go on that.

#1 - beat the cancer
#2 - work the system and get the SI. This isn't difficult once your PSA is undetectable.

If you need encouragement, come on back. Remember, there are a lot of us who've already dealt with this and we're still kicking the tires and lighting the fires.
 
I too was diagnosed with prostate cancer, mine was also very low on the Gleason scale. Our plan (urologist and myself) was to do a prostate biopsy once/year and a PSA once/year. We have since gone to PSAs twice/year and no biopsy unless the PSA (including free PSA) indicates otherwise. It has not, so far. I already had an SI due to Type 1 diabetes (insulin dependent) for which I initially was grounded for about a year until control was proven. The prostate discovery later grounded me for another eight months, but I am back with my SI. The FAA medicos approved our treatment regimen!! So, DON'T GIVE UP. If it's in control, you'll be a PIC again! BTW - I am not overweight and I am have good physical fitness. I don't know how that affects the prostate, but my blood glucose is in good control.
 
Unregistered said:
One catch: I need to shed 25 pounds before he'll do the surgery. As my wife said in the meeting: "DONE!" I have never - ever - had such motivation to lose weight, which will have long-term benefits well beyond getting my prostate removed. At a minimum I'll be able to carry 4 more gallons of fuel when I get back in the air!

So, I have a weight check in 6 weeks, and if I'm showing appropriate progress, we'll schedule surgery for July. I am grounded for now, and may miss AirVenture this year, but I know these things are temporary.
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I'm the OP. After reading my daughter's notes from our family meeting with the urologist, it was actually "25 to 30 lbs", not just 25. Anyway, today, 16 days after meeting with the urologist, I've shed 10 lbs - I'm on my way. I've been working out daily, usually on a treadmill or rowing machine, all of which leave me sweating. My daughter had me do the P90X "Ab Blaster" workout with her this morning - OMG.

After meeting with the nutrionist at the cancer center, my wife has had me on an 1,800 calorie/day diet, which has been great. By eating good stuff throughout the day, I haven't felt "denied" at all. And, as mentioned above, I've never been so motivated. 270 lbs down to 260 lbs today, with say 20 more to go. I'm confident it will come off, so I can have this surgery.
 
Keep up the good work, discipline is the key. I should go see a doc myself, though some days I'd rather sicken and die before talking to an MD.
 
Unregistered said:
I'm the OP. After reading my daughter's notes from our family meeting with the urologist, it was actually "25 to 30 lbs", not just 25. Anyway, today, 16 days after meeting with the urologist, I've shed 10 lbs - I'm on my way. I've been working out daily, usually on a treadmill or rowing machine, all of which leave me sweating. My daughter had me do the P90X "Ab Blaster" workout with her this morning - OMG.

After meeting with the nutrionist at the cancer center, my wife has had me on an 1,800 calorie/day diet, which has been great. By eating good stuff throughout the day, I haven't felt "denied" at all. And, as mentioned above, I've never been so motivated. 270 lbs down to 260 lbs today, with say 20 more to go. I'm confident it will come off, so I can have this surgery.
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Hmmm.... Whyvsurgery? Some die, some are incontinent, some suffer ED. PROTON BEAM HAS AS GOOD A CURE RATE, BUT NO DEATH, INCONTINENCE OR ED. Oops, sorry about the caps lock.

You owe it to yourself to check it out.

Paul
 
steingar said:
I should go see a doc myself, though some days I'd rather sicken and die before talking to an MD.
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That worked well for my dad. Right up to the point where they found him lying on the floor of an FBO men's room.

The cancer was well developed at that time.

Oh, and the surgery didn't go well either. Nicked his bladder, cancer wasn't contained. Complications.

Chemotherapy, radiation, hormones, etc. No joy. Long slow decline.

I suspect that if it had been caught 10 years earlier, it may have been different.
 
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Capt. Geoffrey Thorpe said:
That worked well for my dad. Right up to the point where they found him lying on the floor of an FBO men's room.

The cancer was well developed at that time.

Oh, and the surgery didn't go well either. Nicked his bladder, cancer wasn't contained. Complications.

Chemotherapy, radiation, hormones, etc. No joy. Long slow decline.

I suspect that if it had been caught 10 years earlier, it may have been different.
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Gotta die of something.
 
PaulMillner said:
Hmmm.... Whyvsurgery? Some die, some are incontinent, some suffer ED. PROTON BEAM HAS AS GOOD A CURE RATE, BUT NO DEATH, INCONTINENCE OR ED. Oops, sorry about the caps lock.

You owe it to yourself to check it out.

Paul
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I think that it is a good idea to get an unbiased opinion from an expert before deciding on one of multiple treatment options. If you go to a surgeon there may be a bias for surgery, a radiation oncologist will probably favor radiation. When you are a hammer, everything looks like a nail. Primary physicians are not always the best judge of what specialist to refer to. Sometimes one approach is clearly better while in other cases not as clear cut. The trick is finding the right expert to help a patient decide on the best treatment option for them. I have sent patients to tertiary medical centers like the Mayo Clinic or the University of Michigan for second opinions.
 
Capt. Geoffrey Thorpe said:
That worked well for my dad. Right up to the point where they found him lying on the floor of an FBO men's room.

The cancer was well developed at that time.

Oh, and the surgery didn't go well either. Nicked his bladder, cancer wasn't contained. Complications.

Chemotherapy, radiation, hormones, etc. No joy. Long slow decline.

I suspect that if it had been caught 10 years earlier, it may have been different.
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At least they caught it though. My father went to the hospital 09 August after Flomax didnt help him go. Biopsy found small cell prostate cancer, further tests found it virtually everywhere. He died October 15. This is somewhat of an exception to the norm tho; we were told this is a more rare, harder-to-find and much more aggressive cancer, and it had been there no less than a year. The sooner you find it, the sooner you fight it, the sooner you beat it, the sooner you're back in the air.
 
PaulMillner said:
Hmmm.... Whyvsurgery? Some die, some are incontinent, some suffer ED. PROTON BEAM HAS AS GOOD A CURE RATE, BUT NO DEATH, INCONTINENCE OR ED. Oops, sorry about the caps lock.

You owe it to yourself to check it out.

Paul
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OP here. This hospital (and medical college) handles all the different kinds of treatment. My understanding is that the protocol for someone so young (I'm 51 - first time I've been "young" for anything in a long time) is for removal of the prostate. You have the typical surgery risks, but after it's removed, your risks level off quickly and approach zero (never get there, but that's the trend) over time. Assuming they get it before it spreads anywhere, there's usually no chemo, no radiation, and you are cancer free. The key is to get a surgeon who has done a LOT of these surgeries, and is cutting edge. They are very good at saving the nerves around the prostate necessary to avoid incontinence and ED.

Conversely, the radation risks are low up front. However, the prostate is not removed, and if cancer returns, I understand that it can no longer be removed as by that time it is "mush" (not a technical medical term). So on the risk over time graph, the risks are low up front, but ramp up after 10 years. I didn't want to play that game.

The book "Surviving Prostate Cancer" by Dr. Patrick Walsh (Johns Hopkins professor who perfected the nerve-saving surgery technique) is a must read for all affected by this.
 
Gary F said:
I think that it is a good idea to get an unbiased opinion from an expert before deciding on one of multiple treatment options. If you go to a surgeon there may be a bias for surgery, a radiation oncologist will probably favor radiation. When you are a hammer, everything looks like a nail. Primary physicians are not always the best judge of what specialist to refer to. Sometimes one approach is clearly better while in other cases not as clear cut. The trick is finding the right expert to help a patient decide on the best treatment option for them. I have sent patients to tertiary medical centers like the Mayo Clinic or the University of Michigan for second opinions.
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OP again. Good advice. I met with the chair of Urology at Froedtert Hospital and the Medical College of Wisconsin. We went through all of the options, the risks, the patient history of side effects, etc. and he let me make the decision. He personally does two "open" prostate cancer surgeries per week, and has been doing these for 25 years; another doc does two "robotic" prostate cancer surgeries per week; and they have a number of patients in radiation therapy at any point in time.
 
Radiation causes DNA damage, which makes the cancer cells undergo a process called apoptosis, or programmed suicide. Chemotherapy works similarly. But if the cancer cells are not completely destroyed, they can become resistant to DNA damage through deletion or disruption of the apoptosis control system.
 
OP here. Well, surgery is scheduled for noon tomorrow (8/3). I'm nervous, but confident. I'm down 36 lbs since 3/28/11 (goal was 25-30 lbs), lost about 3" off my waist, and feel great. Working and walking at AirVenture sure helped put me over the goal. See - aviation is healthy! Plus, I can carry 6 more gallons of 100LL.

Recovery will suck. Catheter will be out in 12 days. I'll be off work for perhaps 3 weeks. I hope to be back on PoA by the weekend, but we'll see.

Fly safe everyone.
 
Hey we will be thinking about you OP. All the best. Hopefully, couple days of discomfort and you will be back at it. Check in soon!
 
Best of luck with your surgery.

I am involved with a company that designs / manufactures brachytherapy products and radiation therapy is an excellent choice for prostate cancer. Of course I'm biased but the success rate of radiation therapy for this application speaks for itself.

Of course, if the doc's recommend it comes out, best that you do it that way! Wish you a quick recovery.
 
Good luck and good luck in getting back into the air soon. Going to Osh was probably a mistake since it usually gives one a bad case of "the fever."
 
I had mine taken out a few years ago. I believe I'm probably as close to 100% recoverd as you can get. They used the robotic method. There is much less cutting involved.

Despite the fact I am overweight, I really work at fitness. I'm swimming about 3 miles a week with calisthenics, jogs and light lifting in between swim days.

It's all about hanging on to the medical. I also believe personal fitness is very important from a human factors standpoint.
 
Been there - done that.
Hope your surgeon told you the WHOLE story. Mine didn't. I'd advise a lot more time to research this given that you say it's not aggressive. But it sounds like it's too late now. Not a good approach. There are some serious ramifications to this and it doesn't sound like you've had the time to fully appreciate them. But since you are in a rush I sure wish you the very best.

Believe me, the catheter is very least of your worries. I really ****ed off my buddies drinking beer all 9 innings of ball games with a smile while they ran to the can every 1/2 hour. And the same on the links.......
And, by the way, if later on it plugs up and you WILL know as it will wake you up, go to an emergency room and they will suck it clear with a huge syringe. Can't tell you how good that feels! :yikes:
Then be ready for it to do it again. Best then to pull it out. Have them call the Doc, he'll approve it.

Just a few comments from unfortunate experience. Don't buy any one guy's experience from any book or any email like this one. The odds are never down to close to zero as you suggest. Actually they stay relatively scary for 5 years, then get a little better and eventually get down some more. But contrary to the common theory these days of sticking one's head in the sand and hoping for the best, like the nation and the economy, the odds never go to zero and the microscopic cells seriously disturbed by the violence of the biopsy and possibly by the surgery may well escape any removal or radiation and come back to haunt you. It shows up in the bones so watch for it. Any Doc that tells you differently is pulling your leg.
Hope you read this before you go in so you'll stop and think about it some more. If not, I wish you the very best.
 
flyingiki,

I may not be reading your post right.

I had a catheter in for about 7 days after the surgery. I did cautiously walk outside with it sometime during the first week, but it felt like knife wounds in my gut.

Catheter was removed after about calendar 7 days, and I went back to work after week 3.

It never once occurred to me during that three week period to go to a ball game and drink beer for the day.

You are much tougher than I am.

Note: I edited this after posting to correct for my poor date recollection. My motivation for posting is to share some fact based reasons for optimisim. Things can go well.
 
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BTDT. 3 years ago. PSA undetectable since and may it stay that way.

The catheter is no big deal. At least it wasn't for me. Got it out about about 10 days. Went back to the office after 3 weeks, but I worked from home most of that time. An Ethernet connection and a phone and I'm good to go.

Good luck with the recovery. As noted earlier in the thread, follow Bruce's instructions and you'll have your SI and medical back in no time.
 
OP again. Surgery went very well Wednesday afternoon. Surgeon said it could not have gone better. I was back home Thursday late afternoon. Not much pain though which is weird. Except when i move around. I had open vs robotic so some ab muscles were cut. I feel like i did the P90x ab blaster about 50 times in a row. Then catheter is a pain but doable for 12 days.

More later.

Flyingriki, what a depressing post. I'm sorry it didn't work out that well for you. But I had over 4 months to read and research, and I think I took the right approach.
 
Unregistered Guest,

I hope and wish the very best for you! Check back in a year and let us know what's going on with you. This isn't a short term situation.

More folks need to know how these situations work out so they can make their decisions with the best and latest data available. Yours will be important!

For those interested enough to follow this thread, mine was discovered in my mid 40's, so don't think you're too young to have an issue....

Had I waited for a normal, age specific test, I'd be dead.
 
Hi OP,

I'm also 3 years out, my experience started exactly like yours open surgery, one night in the hospital with not much pain and never had much problems at all. The next big deal is the path results where they will tell you if it was contained or not, if it was, Yeah!. Then the cathater, which is more annoying than anything else. Walk as much as you can... As soon as you get a PSA with "0", which with with negative margins is very soon, you can apply for the SI and you'll be cleared to fly. The SI is a Joke as long as the papaerwork is straight. Exactly straight. It's all about the paperwork.

Good luck.
 
Well, I'm the OP. The path report came out about as good as it gets - fully contained! Recovery is much easier than expected, especially after the catheter came out. 6 week PSA in a week and a half.

Docs are enroute to Dr. Bruce. I hope to have my SI toward the end of September. And, judging by the Wx I observed sitting on my porch for the last 4 weeks, I've missed some of the best flying Wx in the upper midwest, and am anxious to get back up!

Safe flying to those of you bound for the U.P. this weekend!




Edit: Oh, and I'm still down the equivalent of 6 gallons of 100LL, and I'm going to keep that weight off for good. I've never felt better, and in a way, I think my doc saved my life in two ways.
 
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Man. Once the catheter is out, the rest is much much better..... (necessary but medieval instrument of torture....)....
 
bbchien said:
Think of this a a warning bump in the road. Just a bump. But ahead, I mean many miles ahead the road turns to GRAVEL and after that......sigh.

You WILL fly again.
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You were right, Dr. Bruce. It was just a bump in the road - a big, scary bump, but a bump nontheless.

It was great meeting you today, and I sincerely appreciate your handshake and "congratulations, PIC" as I walked out of your office with my fresh third class medical and SI. You are a true gentleman.

I have a friend who is a CFI candidate and had breast cancer. Her AME submitted her paperwork for her SI in June, and she received it the last week of September. I got my paperwork to you last week, and walked out of your office today a pilot again. Thank you!

Now to a checkout with my CFI, and then fly somewhere by myself - something I never thought I'd miss until I couldn't do it anymore.
 
May I ask what the PSA reading was that caused the concern? Is any reading above zero serious?
 
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