Latest Dispatches from the Body

Last Tuesday--July 16, our son's birthday--I began taking Bicaludamide, the first of the drugs my oncologist at University Hospitals had prescribed to try to arrest the progress of my prostate cancer, which, as followers of this blog know, has already defeated surgery (2005) and thirty-five radiation treatments (2009).  Bicaludamide, which I will take in pill form for only three weeks more, is a drug that will shut off the ability of the cancer cells to "hook up" with my testosterone, which, in a simple way, is the "food" for prostate cancer.  Without that "food," the cancer cells begin dying and/or shutting down.  I will go into remission, if things go as planned.

I have not really noticed any side effects since I've begun taking the pills (though it is early--only a little over a week), other than that I'm sleeping more deeply at night--and that, actually, is a good thing for me.  Next, though, starting on Friday (tomorrow, the 26th, less than a week after Joyce's birthday), is Lupron, a more serious drug that basically shuts off my testosterone altogether, denying the cancer any sustenance.  Many--not all--cancer cells will die.  Its side effects are potentially nastier--and one is certain: the death of my libido.  Not something any post-pubescent man--or human being, I would guess--wants to have happen.  I know I don't.  Here's a link to some information about that drug, if you're interested.  Oh, and it's not in pill form.  I get an injection (in the derriere) every three months.

If you know anything about Lupron, you know that it's not a cure.  It works for a while, killing and immobilizing cancer cells, and then some of them evolve to ignore Lupron's effects; those cells survive and reproduce (survival of the fittest--heard of it?), and my PSA begins rising again.  So then it's on to other treatments--probably chemo.  It could be a year--two years?--before that happens.  And during that time I will feel (a) somewhat normal, (b) somewhat shitty, (c) completely shitty.  Nothing to do but take the shot and see.

(In the (a) category: Yesterday, in the coffee shop, I chatted briefly with a man I've known awhile.  He's just had prostate surgery and is on hormones already.  He told me he hasn't really noticed anything yet ... other than ... you know.  Here's hoping I'm in his category.)

Of course, we're all hoping that a cure is imminent.  Few scientists are more motivated, I would think, than the men who are working on prostate cancer research--not to impugn the women (no way!), but the men have an even more urgent, personal motive since most of them, if they live long enough, will develop the disease.

In the days leading up to the commencement of my Bicaludamide treatments last week, I was very nervous and emotional.  Both Joyce and I were in tears at the damnedest times--i.e., just about all the time.  I took my first pill at lunch that day, and as I put it in my mouth, I was weeping--okay, sobbing--but I could still hear the words of Joyce, who was right beside me: I love you.

I wept even more because I know what those words mean--what they could mean for her.  I carry the medical burden right now, sure--but her share of the psychological burden is immense.  She's immersed in worry; she wants me to stay healthy, to continue doing the things I've always loved (exercising, reading, writing, traveling, being with family--with her), but she also knows that if the drug knocks me down, she will become more of a caretaker, and I will become, in ways, a man she has not ever really known.  (At our weddings, we say so easily, even thoughtlessly, in sickness and in health, as if the former were some vague possibility instead of a virtual certainty.)

And so I worry about her, and all of this forms a dark whirlwind that marks the infancy of grief.