COCHRANE PCa SURVIVOR
A SHORT DESCRIPTION.
For those of you who don't want to read a lengthy story, here is a condensed version about why I chose cryo.
If what you read here interests you, then I strongly suggest you read the LONGER, much more detailed version that follows the SHORT version.
THE SHORT VERSION
This bio is being written in Nov. 2006 and I'm now 80 years old and an 11 year survivor. I'm a Chemical Engineer from Purdue (1950) and I have an engineer's outlook at things...I'm analytical, questioning, innovative, methodical and curious. "Why is something done this way? Could we do it another way and perhaps make it work better and save some money, etc.?"
Back in the late 80s or early 90's my regular doctor began taking my PSA and putting his finger up my fanny as part of my annual physical. I understood it had something to do with the prostate. As I recall, my PSA was somewhere down around 4.0! All my plumbing worked as expected.
Around 1993 the PSA was up to about 6 and I had a Color Doppler Ultrasound (called TRUS). This is a technique allowing the doctor to actually look inside your prostate and get a "virtual computer picture" of what are suspect prostate tumors. It was also a turning point in my life.
By 1995 my PSA had risen to 8.5 and I had 6 biopsies taken. Two of the 6 biopsies were positive. They were 2 mm in size and a Gleason 9 (5 + 4) and were located right down in the apex (the base) of the gland very close to something called the "external sphincter." It is probably the most critical part of your plumbing that keeps you from wetting your pants. A Gleason 9 is very bad news...it only goes to 10. It is very aggressive. Generally speaking, prostate cancers are slow growing, but they can be aggressive and move pretty fast and that was my situation.
For starters, I didn't know diddly squat about prostate cancer or the seriousness of my particular Gleason score situation, much less what I was going to do about it.
And contrary to what I now know about most men's reaction to the news when they learn they have CANCER, I didn't have any frightening reactions. I kinda figured, "...well, things happen! I have cancer. I guess I better learn what it's all about and figure out what is the best thing to do to stop it." And so I began. It didn't think of it as a "fight against the beast", it was just something I had to do.
Most doctors recommend their own specialty. The options are usually the radical prostatectomy (surgery) or some sort of radiation. I had distinct reservations about both. I was too old for surgery and I don't feel radiation would get all the bad guys.
CRYO
I kept looking and heard about cryo and it seem to make a lot of sense to me. They actually freeze the entire prostate (except for the urethra) into a solid ice cube. A cube from your Fridge is all ice - nothing else. There is no way the cancer cells in that frozen cube are golng anwhere.
The actual freezing does not kill the cancer cells. That occurs when the entire frozen gland is RAPIDLY THAWED. The thawing ruptures all the frozen cell membranes and they are ALL dead meat. Right now! Not tomorrow! Not like radiation where cells continue to die for months. This was the thoroughness I was looking fore.
It is only a minimally invasive procedure requiring 24 hours in the hospital and you can go back to work is a day or so.
The cure rate is every bit as good as surgery and the radiation techniques, and in some case it is significantly better.
The down side is that your pecker may not rise to the occasion as well as before, but that's also a big problem for surgery or radiation.
So I had the procedure done on Jan. 15, 1996. Today my PSA remains 0.1, I don't have any full erections and I'm completely dry. My quality of life is excellent!
Jack Cochrane
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NOW THE MORE DETAILED STORY
INTRODUCTION
This bio is written in Nov. 2006 and I'm now 80 years old. I'm a Chemical Engineer from Purdue (1950) and I have an engineer's mentality...I'm analytical, questioning, innovative, methodical and curious. "Why is something done this way? Could we do it another way and perhaps make it work better and save some money, etc.?"
Back in the late 80s or early 90's my regular doctor began taking my PSA and putting his finger up my fanny as part of my annual physical. I understood it had something to do with the prostate. As I recall, my PSA was somewhere down around 4.0! All my plumbing worked as expected.
After a physical early in 1993 my PSA was up around 6.0 and my doctor seemed somewhat concerned. He suggested I go to St. Jos Mercy Hospital and have them run a new test called "TRUS." This stands for Trans Rectal Ultra Sound.
Instead of the finger up the fanny, the test uses a probe about 8" long and 3/4" in diameter. When inserted through your anus into your rectum and then pressed against the outside of your prostate gland, it allows the doctor to see "virtually" what is going on inside your prostate by looking at a TV screen. This was a relatively new concept at that time.
Little did I expect that examination would be a turning point in my life. Not only have I have become an aggressive advocate against prostate cancer, but I have become quite knowledgeable about the resulting matter of urinary incontinence. To that end, my partner and I have invented and patented an external penile incontinence control device called the Squeezer Klip to control this problem. Most of the patients have had the radical prostatectomy.
The purpose of the examination was to check my prostate with this new machine and at the same time use my clinical examination as a classroom "show and tell" for about 12 interns in white hospital coats.
When the doctor walked in, I recognized him. It was Dr. Fred Lee, a man I had been playing tennis with here in Ann Arbor since 1966. MI. I knew he was a doctor and he "foot faulted" every time he served, but I didn't know he was a Prostate Cancer survivor. As this bio is written in Nov. 2006, Dr. Lee is now 76 and is probably the longest living survivors in the country. He is also generally accepted as one of the world's premier practitioners of using Color Doppler Ultrasound for detecting and staging prostate cancer and also for performing the cryo surgery procedure. He has become a very close, personal friend.
He recently flattered me by suggesting I was probably one of the more learned laymen he knows (I am not a doctor) when it comes to understanding and discussing the concepts and limitations of Color Doppler, the biopsy sampling of PC tumors and the Cryo Surgery procedure. I'm pleased to accept his gracious words and if you believe these credentials are valid and you would like to talk with me for some insight as you plan your trip through this new part of your life fighting prostate cancer, don't be bashful. Call:
Jack Cochrane 734-971-7399 Eastern Time Zone. From mid-December until the end of March I'm down in Florida at 904-273-0657. I talk with lots of men from all over the country.
OK! SO WHY DID I CHOOSE CRYO instead of surgery or one of the many radiation techniques?
That ultrasound exam was in 1993. When I had my 1995 physical, apparently you know what hit the fan inside my prostate. My PSA had now risen to 8.5 and the doctor told me they were going to take some biopsies.
Two of the 6 biopsies were positive. They were 2 mm in size and a Gleason 9 (5 + 4) and they were located right down in the apex (the base) of the gland very close to something called the "external sphincter." It is probably the most critical part of your plumbing that keeps you from wetting your pants. A Gleason 9 is very bad news …it only goes to 10. It is very aggressive. Generally speaking, prostate cancers are slow growing, but they can be aggressive and move pretty fast and that was my situation.
For starters, I didn't know diddly squat about prostate cancer or the seriousness of my particular situation, much less what I was going to do about it.
And contrary to what I now read about most men's reaction to the news when they learn they have CANCER, I didn't have any frightening reactions. I kinda figured, "…well, things happen! I have cancer. I guess I better learn what it's all about and figure out what is the best thing to do to stop it." And so I began. It didn't think of it as a "fight against the beast or deamon", it was just something I had to do.
My urologist's specialty was the radical and he does good work. Initially, he suggested the following:
1. Because I was almost 70 and there was a good possibility the cancer might be out of the gland, he did not feel the radical would be appropriate.
2. His recommendation was radiation.
3. And because my gland was somewhat enlarged, he placed me on a combined hormone medication (Lupron and Flutamide) for 3 months. This would shrink the size of the gland and make it easier to work on no matter what procedure I eventually chose. It would also reduce my PSA down to essentially 0.0 because the medication stops the production of testosterone that is the "food" for the cancer tumors. It also eliminates your urge for sex and some men have "hot flashes" but I had very few.
This gave me some time to research and decide what I was going to do. I read, checked websites and talked with others who had prostate cancer. I was amazed at how many had already gone through my present dilemma.
It didn't take too long for me to begin forming a negative opinion about the radiation options. I could not bring myself to believe that any of the radiation procedures could guarantee that they could generate a uniform tumor killing radiation field. I just felt there was a great likelihood there would be "dead" spaces or "cold spots" that would not kill all the cancer cells.
Sure, they made accurate measurements to aim the various radiation beams so they would be right on target every day when you went for your treatment but then I found out a disturbing piece of information. Your prostate gland is not in exactly the same place from day to day. It moves a bit and that would put their measured focus points "out of focus."
The seeds implants were just beginning to get a lot of play about that time out in Seattle. It was a short procedure and they were putting the radioactive seeds directly into the capsule, but I still wasn't convinced.
I BEGAN TO LOOK AT CRYO
The more I learned about the procedure from the literature and benefiting from conversations with Dr. Lee, cryo began to make a lot of sense to me. The data was every bit at good as for the radical and all of the various radiation techniques. In some instances cryo makes much better sense than the others.
I believe the basic concept of making the prostate gland into a solid block of ice at a very low tumor freezing temperature (-41 F), temperature was very logical. The urethral warming tube was relatively new, and from an engineering point of view it would keep it from freezing.
The specific features of cryo as I understood them at that time were:
1. Drs. Lee and Bahn had performed about 425 cryo procedure since about 1990 (not positive about the date). They were getting very good results.
2. It seemed obvious that there would be little chance that there would be "unfrozen" areas. After all, an ice cube is solid all the way through.
3. It was a lot less invasive than a radical. You were in and out of the hospital in 24 hours and back to work in a couple of days. The radical took a lot longer than that.
4. I still had misgivings about the effectiveness of radiation's ability to apply a uniform killing area. The procedures were five days in a row with Sat. and Sun. off and it went on for several months. I learned you began to feel pretty punky on toward the end of the treatments.
I was pretty certain I was going to try the cryo. After about a month into my combined hormone treatment, Dr. Solomon (my urologist who practices at St. Jos. Mercy in Ann Arbor) asked me when we were going to schedule the radiation procedure because there was beginning of a backup at the hospital.
My response was that I was giving serious consideration to cryo. Dr. Solomon's expertise is the radical. He also does the various radiation procedures plus an occasional cryo with Dr. Lee.
I give Dr. Solomon credit …he remained steadfast and consistent that a radical was inappropriate. He said he still felt radiation would be best but he also agreed that my conclusions about cryo being a good choice were very valid. He booked the operating room at Crittenton Hospital and was officially the "doctor of record" and he assisted(?) Dr. Lee.
I had the procedure done on Jan. 15, 1996. Drs. Fred Lee and Hugh Solomon both participated.
I checked into the hospital about 7 AM and was in the operating room by 9 AM. Procedure completed and back into intensive care around noon. Ate a quite good hospital dinner and 5:30 PM and was walking around the hospital corridor at 7 PM.
I checked out of the hospital at 8:30 AM on the following day, the 16th, wearing a urine collection bag on my thigh. I could have driven the car home myself, but my wife insisted on doing the honors. Just for fun, When I got home, I rode my bicycle up and down the street - slowly! No problem!
Probably the most difficult part of the entire procedure was wearing the Foley urethral catheter for 3 weeks. That can get a little uncomfortable but I understand that it is now only worn for about a week.
WHAT'S NEW?
The cryo procedure has changed significantly since I had the procedure.
1. The equipment has been much refined.
2. Much better temperature control including more thermal couples.
3. Improved urethral warmer.
4. Use of Argon gas for freezing instead of Nitrogen gas.
5. Helium gas is now used as the "quick thaw" warming mechanism
6. They now are doing a cryo version of the radical prostatectomy's' "nerve sparring" procedure to save your erections.
7. Cryo is the procedure of choice for men who have a failed radiation procedure. You can also do another cryo procedure if YOUR original cryo fails.
There are a lot of doctors now doing cryo. The fact is, the entire field of cryo treatment for many cancers is rapidly growing. This would include skin cancers, liver and kidney cancer and breast cancer just to name a few. Why? They are getting better results than are possible with a knife!
I've had no second thoughts. I'd do it again. Call me if you want to talk about it.
Jack Cochrane
11 years after cryo with PSA 0.1
Dry but Willy doesn't work!
734-971-7399 in Ann Arbor, MI
904-273-0657 in Florida from mid- Dec. to the end of March