Post 602: At University Hospitals ...

I just realized I forgot to mention blog post #600 when I uploaded it a couple of days ago.  It was, appropriately, the one about my mom's 94th birthday, which the family celebrated with her over the weekend--though her actual birthday was just yesterday, the 9th.  So ... this is #602, and on and on and on we go.  Who would have thought so many words were hiding in me, seeking escape?

Yesterday (Mom's birthday), I had a session with my oncologist up at the Seidman Cancer Center at University Hospitals in Chagrin.  But first ... a quick summary of my history with prostate cancer--for anyone new to the site.  If you know about my situation, you can skip the next paragraph--italicized for sake of convenience.

Late in 2004, I was diagnosed with prostate cancer.  The biopsy indicated a mid-range cancer, so no one was too worried.  I elected surgical removal (prostatectomy), which a Cleveland Clinic surgeon performed in June 2005.  The post-op pathology indicated a cancer far more serious than the biopsy had indicated--and also revealed that some of the cells had escaped the gland and were on the loose.  I waited until my PSA became evident again (it was undetectable for a while after the surgery) and then underwent 35 daily radiation treatments--again, at the Cleveland Clinic, early in 2009.  But my PSA, which fell dramatically after the radiation, began climbing again, and when it reached 22.9, my Clinic oncologist recommended I commence hormone therapy--a treatment, not a cure.  At that time, I switched to University Hospitals (for a variety of reasons--convenience a major one), where I began oral meds (Bicaludamide) on July 16, 2013 (ironically, our son's birthday) and received my first injection of Lupron (I'll do so every three months until it stops working) on 26 August.  My most recent blood work showed that my PSA had fallen to 0.59  And my other numbers on other tests were also good.  Yesterday, I met with my oncologist at UH ...

My oncologist had already phoned with my test results--so I was not worried about them.  The numbers were good--encouraging even.  But I knew, too, that my pathology placed me outside the norm, so I was both eager and worried about the discussion that would ensue.  I also has several Lupron side-effects to report:

• Declining libido.  Not a surprise--not when the entire intent of Lupron is to kill testosterone, the food of prostate cancer cells.  Still ... discouraging, depressing.
• Digestive issues.  Rather than venture into TMI Territory, let's just say that I have found that some sugar-free butterscotch hard candy often resolves the issues.
• Sleep habits.  This is actually a good one: I find that although I still wake up several times a night for my customary nocturnal inspections of the restroom (you never know what's been going on in there), during the periods I am asleep I am deep asleep--more so than I've been in years.  On Sunday night I was so fast asleep that I woke up in an odd position with no memory of having assumed it.  I mean, I was lying across that bed in a weird configuration, so weird that Joyce (startled?) had fled to the back bedroom for the remainder of the night.
• Body heat.  I had read that one of the most common side effects of Lupron is the hot flash.  I don't know what I expected--a microwavy effect?  But what I'm experiencing--oh, a dozen times a day (including the night)--is not so much a flash as a suffusion.  I gradually become aware that I am hotter that I ought to be, given the ambient temperature, the activity.  I perspire--sometimes heavily.  These periods do not last long; they are not debilitating.  They're just, as I said, a suffusion of heat--a filling of a sponge--somewhat like the arrival of shame.

Dr. H. (let's call him that--since oncologist gets a bit tiresome to type) is a warm, supportive man (as well as being highly knowledgeable); he listens, asks questions whose answers seem genuinely to interest him.  He has a heart.  No question.  He told me that he was glad to see the big drop in my PSA (for some men the drug does not work at all) and reminded me that Lupron's average period of effectiveness is 18-24 months.  That's the average.  And we all know what that means: Some men go much longer, some much shorter, before the cancer returns.  With my pathology, it's likely that it will be a shorter time.

And when that happens?

He told us there are some new clinical trials available--including a drug that attempts to target the cancer cells themselves.  That's hopeful.

I made some subsequent appointments for tests, for consultations, for injections.  It's all kind of complicated, seeing everyone I need to see at the times I need to see them.

I confess I've felt sort of "down" since I got home Monday noon.  It's sobering to hear "18 to 24 months" directed to you.  Dr. H. was not discouraging: He was happy with my numbers, happy to hear about my strict diet (I eat the way you're supposed to), my general lifestyle (no smoking or drinking or drugs), my daily exercise. He emphasized that I've done well since 2005--a sign that my body has been doing an effective job fighting off the cancer.  So we'll see ... the damn stuff does keep coming back ...

Meanwhile, I will navigate my way through this fog, looking for lighter sky, for signs of the sun.  I will throw myself, as always, into my reading, my writing--and, best of all, into the arms of that gorgeous soul who holds my hand in the darkness, squeezes tightly, always, just when I feel I can no longer see my way.