A Medical Update

Some of you have been reading along with me as I trek across the latest terrain of my prostate cancer.  If you're a newcomer, I was diagnosed late in 2004, had surgery (removal of gland--prostatectomy) in June 2005, had radiation in January and February 2009 when the cancer reappeared, then, not long ago, commenced hormone therapy when the cancer once again decided to make a return appearance.

Before I began this latest therapy, my imagination, boon companion in other times, became an enemy.  I had checked various medical websites to read about the drugs involved in the therapy--Bicaludamide and Lupron--and was not happy about what I read there.  The potential side effects were odious (hot flashes, digestive issues, loss of libido, weight gain, a general feeling of yuckiness--and more!), and I have been spoiled throughout my life by good health.

I was nearly sixty before I had my first real whiff of the fetid breath of mortality, of corporeal frailty (Bell's palsy).  Sure, I'd had the usual complement of injuries and illnesses that go along with being alive (from whopping cough to lacerations requiring stitches to injured joints and limbs), but--and this is the major difference--all were temporary.  All were things I knew I would recover from.  All I needed to do was rest or take it easy or take the antibiotic or whatever, and soon I would be back doing all the things I'd always been able to do.  And so it was ...

Cancer changed that.  Just the word itself, of course, is enough to immobilize you.  Cancer.  The killer of my family members, loved ones, friends, colleagues, the high and mighty, the low and humble.  Even my beloved boyhood family dog, Sooner, was dying of it when a careless driver ended poor Sooner's journey.  Suddenly, you're facing the firing squad; the soldiers are inspecting their weapons, awaiting their officer's command.  And you, blindfold off, face them.  Waiting.  And time becomes your enemy.

As I've written before, my prostate cancer has, so far, been a minor physical inconvenience but a daunting psychological presence.  You're safe, standing in your own front yard, admiring your flowers.  Perhaps your lover is nearby.  You're happy about that, too.  Warm sun.  Gentle breeze.  Perfect.  Then ... you hear a noise; you turn, look beside you.  Cujo.  He's not really doing anything but staring at you.  But his gaze does not waver.  And you know that it could be anytime--anytime--when he makes his decision.

The surgery left me sore and slow for a couple of weeks (and I also got to learn the joys of a catheter).  But I recovered.  The radiation didn't really do anything but wear me out.  By the end of the thirty-five treatments I was sleeping hours during daylight.  But I recovered.

The recoveries, though, were partial--not quite everything.  Because of the surgery and radiation, I'm up several times a night to visit that special little room (my valve situation is not as stable as of yore); my sexual capabilities are less reliable.  Things down there just don't work the way they used to.  But I was getting by, adjusting.  Feeling pretty good.  Then the cancer came back.

It didn't happen all at once.  I was taking PSA tests (blood samples) every three months.  Post-surgery I should have had no PSA (prostate specific antigen) because I had no prostate gland.  Pretty simple.  And for a while, my PSA was zero.  And I was hopeful.

And then it wasn't.  It slowly began rising.  When it reached 0.31, the oncologists at the Cleveland Clinic said it was time for radiation.  My first post-radiation reading (late August 2009) showed that it had fallen to .07.  Looking good!  Six months later, though, it was .17. And the rise continued, accelerating alarmingly, so that by June of this year, it had reached 22.9.  The doctors had seen enough.  Time, they said, for hormones--a treatment that stalls, delays, but does not cure.

I went to University Hospitals for a second opinion (they concurred with the Clinic), and liked the people there so much that I switched all my care to them.  Some of the reasons are personal, but convenience was also a major factor.  There's a UH family practice place a mile from our house; there's a larger ER and lab in Twinsburg, just five miles away; the Seidman Cancer Center is only twenty-five minutes from home--no more long trips to downtown Cleveland to the Clinic.

On July 16 I began taking the Bicaludamide--a thirty-day prescription intended to prevent my testosterone cells from feeding the cancer.  I have about a dozen pills left, and--so far--I have not really noticed anything.  On July 26 I received the first of my quarterly Lupron injections in my quivering rear.  And--again, so far, so far--I have not really noticed anything untoward.  Things could (probably will) happen in the ensuing weeks and months.  After all, these drugs are altering my fundamental body chemistry--blocking testosterone, thereby denying the cancer the "food" it needs to survive and prosper and conquer.

I'm still getting up at the same time (6:30ish), doing all my work each day, exercising out at the health club six days a week (thirty hard minutes on a stationary bike), doing all the things I did before, enjoying every second of the day ... well, except for things that annoy all of us (depressing national news, bad episodes of shows I like, disappointing movies, sucky books, normal Ohio weather, etc.).

But the pattern, for me, has continued: The worst of it is in my mind, my imagination, which, I fear, I can no more shut down than I can my lungs, my heart.