The journey begins

“You’ve got prostate cancer.”  Exactly what I expected my urologist to say recently as he explained the results of my biopsy which was performed in March.  My PSA had gone from less than 4 to 6.6 between my November annual physicals.  A second blood test also came back in the same range.  I knew about this before my hip replacement last December.  I had asked each of the doctors involved to consult and decide what the best course of action was and the consensus was to do the hip first, let it heal for 3 months and then figure out what was going on with the prostate.  I had a biopsy done of the prostate about a month ago after chances of infection following the hip surgery had subsided.  The coronavirus pandemic meant that I received the news via a teleconference on my laptop.  My urologist removed a kidney stone for me a couple of years ago and we’ve got a great relationship.  He commands my utmost confidence and I’m blessed that he’s a straight shooter.  He explained that the biopsy showed that “active monitoring” was not a good option.  I don’t have a real aggressive cancer, but it does need treatment.  The most probable treatments appeared to be radiation or surgery.  Rather than decide on next steps right then and there, my doctor suggested I read a 500 plus page book called Guide to Surviving Prostate Cancer by Dr. Patrick Walsh, just updated in 2018.  I’d highly recommend it to anyone that wants to know everything there is to know about prostate conditions, their treatments, side effects and the chances for successful outcomes.  Each chapter has a “Reader’s Digest” summary of the pertinent facts, giving you the opportunity to skip over sections that don’t apply to your situation.  It’s only about $15 for a Kindle version, I carry it around on my phone as a reference.  It has helped me to be a much more informed patient, which I am sure was the whole idea of pointing it out to me.  I can’t emphasize enough how important it is to be an educated medical consumer, understanding the pluses and minuses of each option that is considered for your own individual treatment.  That way, when a course of treatment is decided upon, you are going into it with eyes wide open and many of the fears that might have manifested themselves due to ignorance will be put to rest with knowledge, facts and the interpretation of them by your doctors

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After receiving my biopsy results, the next step was to consult with the radiation oncologist.  He had sent me a comprehensive packet of information about the various forms of radiation and hormone treatments that are often used in combination.  His materials and what I learned from the book allowed us to have an educated conversation about what his recommended approach could do for me.  I’m very grateful for the transparency that both he and my urologist have had when it came to my questions.

I learned that in general, most patients in my position could flip a coin and decide to cure the cancer with either surgery or instead with a combination of hormone therapy and radiation that has almost identical results.  There are several factors unique to my personal situation that make surgery riskier in terms of permanent side effects, so after one more telemedicine consultation with my urologist last week, we have decided to pursue the radiation/hormone treatment option.  Thankfully, Medicare and my supplemental insurance will cover most everything.

The first step in the process will be this Thursday afternoon when I get a Lupron shot that will drop my testosterone levels to nothing for the next 6 months.  This will help shrink the prostate some and will slow the cancer, since this type of cancer is fueled by testosterone.  Radiation treatments, probably 5 days a week for 9 weeks, will begin in late June.  In preparation for that, I will need an office procedure in which 2 gold seeds the size of a grain of rice will be implanted in my prostate to aid in pinpoint targeting of the radiation to minimize damage to surrounding tissues and organs.  A gel spacer will also be placed between the prostate and the rectal area, this recent innovation has been shown to minimize damage and side effects that previous radiation treatments caused.  

I am expecting some side effects, particularly towards the last 3 weeks or so of radiation.  I call some of them the 3 “I’s” for incontinence, impotency and the possible need for Immodium.  Many patients don’t get all of these and their severity can vary quite a bit.  In most cases, things are back to normal a few months after the radiation ends and hormone levels return to normal.  Other problems, mostly associated with the hormone side of the treatment include fatigue, weight gain, bone and muscle loss, hot flashes, depression, irritability and more.  Sounds a lot like menopause to me!  I’ve always looked at the fine print on TV ads for various drugs and thought to myself, “I’d rather just stick with the condition I already have!”  There are ways to fight back against these side effects, the most effective ones being diet and exercise.  Being a stubborn German Lutheran, I will fight through the fatigue and force myself to obey doctor’s orders.  My plan is to continue hiking at least 2 to 3 miles per day as I do my nature photography and work on upper body conditioning as well.  Carrying 15 to 20 pounds of photo gear through the woods for at least 2 hours a day is not a bad workout.  Being out in God’s incredible creation is a powerful counterbalance to depression.  The antics of the animals, birds and whatever else I see never fails to bring a smile to my face and this time of year, new life in the form of ducklings, owlets, baby squirrels and many others is precious.

There will be more posts here at this blog as my journey continues and as time allows.  I want to be an encouragement to others who find themselves facing the same thing, so please feel free to share the address to this blog.  I’ll leave you for now with one more thought.  Early detection of cancer is a huge advantage.  It gives you more choices for treatment plans with a much greater chance of being cured. And treatments are light years ahead of where they were even 20 years ago.  So please spread the word that annual screenings for prostate cancer, particularly if there has been a history of it in the family, are not optional but very, very necessary.  Ladies, encourage the men you love to take annual physicals seriously and men, you need to man up and just do it, even though checks for prostate and colon cancer are not usually our happy places!

Please keep an eye on my Facebook page which is devoted mostly to my passion for nature photography.  I’ll announce updates to the blog there.  

God's blessings everybody!  Live long and prosper...