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NOTE: This accompanies "The Silent Disease"


Early December, 1995:
Fitness aficionado Craig Asmundson, 48, happily sweats his way through a vigorous daily exercise regime, jogging, riding a stationary bike or lifting weights. Wanting more, he doubles his time on the stationary bike.

Dec. 22
Intermittent, minor pains in the area between scrotum and anus prompt Asmundson to get his first physical in more than two years. A digital rectal exam discovers a small lump on his prostate. A PSA (prostate specific antigen) blood test is ordered; he is referred to a urologist.

Jan. 3, 1996
The urologist reports Asmundson's PSA result is 6.1 when it should be under two for a man his age.

Jan. 16
Asmundson goes to Vancouver General Hospital for a biopsy. An ultrasound anal probe draws a "bead" on his prostate and a spring-loaded mechanism drives six needles through the rectal wall into his prostate where they extract minute tissue samples for analysis.

Jan. 31
At Burnaby General Hospital, a tube-scope is directed down Asmundson's penis, allowing the urologist to see inside the urethra as far up as the prostate gland and into the bladder. After the procedure, it is confirmed from the biopsy report that Asmundson has prostate cancer. It appears to be confined to the gland.

Feb. 6
Asmundson has a bone scan at Burnaby General Hospital to determine if any prostate cancer cells have spread to his pelvic bones and vertebral column. The results are negative.

Feb. 7
After intensive research on his own in medical libraries, on the Internet and through other sources, Asmundson tells his urologist/surgeon that he wants eight months of hormonal blockade drug therapy and then surgery to remove his prostate. He decides, given his grade and stage of cancer and his age, that this approach offers the best odds of survival.

Feb. 14 - Oct. 8
Hormonal therapy eliminates all testosterone and adrenal androgens. Asmundson escapes potential side effects such as hot flushes, depression, liver problems and severe diarrhea. But suffers fatigue, loss of libido, anemia, increased body fat and a 10 to 15 per cent loss in strength. He forces himself to continue an active strength-training program to counteract muscle-wasting.

Oct. 9
At Royal Columbian Hospital, a surgeon cuts Asmundson from his bellybutton to the top of his pubic bone and, during two hours of delicate nerve-sparing surgery, removes his prostate gland. In the process, his urethra is severed and then reconnected to the bladder. A catheter is inserted for three weeks to remove urine and allow the urethra to heal.

Oct. 14
Five days after surgery, Asmundson returns home and with daily visits from home care nurses makes swift progress. His pathology report shows no evidence that cancer had escaped his prostate gland.

Nov. 12
Asmundson returns to SFU and resumes full teaching duties in kinesiology.

Nov. 20
Six weeks after surgery, Asmundson begins, carefully and gradually, to resume a daily exercise program.

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