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Seidman Cancer Center
University Hospitals
Beachwood, OH

I got a scare last week. On Wednesday I had my quarterly blood test to check the level of my PSA (Prostate Specific Antigen), a number which should be undetectable because of  the surgery to remove my cancerous prostate gland almost exactly ten years ago (June 9, 2005) at the Cleveland Clinic.

But that surgery, which we all hoped would terminate the cancer—remove it!—instead commenced a decade of procedures and tests and trips to clinics and worries and diminishments of the life I'd known.

As followers of these posts know, the cancer returned to such a level that I underwent seven weeks of daily radiation treatments down at the Clinic in 2009.

And things calmed for a bit.

Then, about two and half years ago, my PSA started rising again, and by July 2013 my oncologist at University Hospitals (I'd switched from the Clinic) told me it was time for hormone-deprivation therapy. Quarterly injections of Lupron, a drug that zaps testosterone, the “food” of prostate cancer.

With the usual consequences. Significant loss of energy. Emotional fragility. Depression. Weight gain and redistribution. Hourly sweating—sometimes in drenching fashion. Loss of libido.

But it worked. In just three months my PSA dropped from 22.9 to nearly zero, where it has stayed for two full years, a situation that has surprised my oncologist because the intensity of my cancer was a Gleason 9 (there ain't a number much worse on this scale that runs from 2 to 10).

In any case, Lupron is not a cure. It temporarily blocks the cancer cells, but inevitably they figure out a workaround; then other therapies and drugs commence. But nothing will cure me. I'm hoping to hang on until researchers make that great breakthrough.

Anyway … last Wednesday was my quarterly PSA test. I was a tiny bit hopeful. Although I know that at some point my score will begin to rise again, I was grasping at a flimsy straw my oncologist had offered me back in March: If I stay “undetectable,” well, maybe we can go off Lupron for some months. Maybe—one last time—I'll get to be Who I Was.

I waited a day after the test, then emailed my oncologist about the result. It came back almost immediately (he's wonderful about that—and about so many other things).

And I was shocked. Here's what it said: <.10.  I was detectable.

 I had a weekend full of worry.

Then yesterday morning at our appointment at Seidman Cancer Center he reminded me that <.10 is undetectable. The number is just the cutoff line. At .10 I have a reading; at less than .10 I do not.

My relief was more than palpable; it was alpine. 

And then my oncologist reminded me of my choice--off Lupron for a while?

Joyce and I were both torn. Lupron has been working--though, of course, it will not work much longer. Two years out--especially for someone with a Gleason 9--is a long, long time. (He'd originally told me it might be effective for only six months or so.)

But what if ...? What if there's a chance I could be Me again? Even if just for a while?

Before I left the office, I told him: "Let's go off it."

He agreed--though I will be getting PSA tests every month now instead of quarterly. Which, of course, heightens the anxiety by making it more frequent.

But on the way home--and throughout the rest of the day and evening--Joyce and I have continued to discuss the pros and cons. I vacillate like a politician uncertain of his audience. Yes. No. Yes. No.

Fear struggles with Hope.