Good News, Bad News: Seidman Cancer Center

Seidman Cancer Center
University Hospitals
Beachwood, OH

On little cat feet my cancer has come creeping back. As it has always seemed determined to do. Last week I had my quarterly blood test (PSA--Prostate Specific Antigen), and for the first time in about two years my PSA is "detectable." Not a good sign. I should have no PSA because a Cleveland Clinic surgeon removed my prostate gland in June 2005.

But the intensity of my cancer was surprising. The post-op pathology showed it was much more so than the pre-surgery biopsy had indicated. That biopsy had given me a Gleason score of 5 (middling); post op, Gleason 9, near the top of the scale that runs from 2-10. (Here's a link to a little more info about the Gleason.)

Anyway, there was even worse post-op news in 2005: Some of the cancer cells had already escaped the prostate and were somewhere waiting to do some damage.

At first, though, they lay quiet. But then my PSA, which had been undetectable, began to rise once again, so I went through daily radiation treatments for six weeks at the Clinic (downtown) early in 2009. And, once again, my PSA plummeted.

And then--a little over two years ago--it once again began to rise. And quickly so. In July 2013 I got my first quarterly injection of Lupron, a testosterone-killing drug that works by denying the cancer cells the food they crave (testosterone).

But we all knew that Lupron was not a cure--just a stop-gap. A delaying tactic. The cancer would return--and eventually move elsewhere. Some scans showed early evidence that it had moved into my bones.

But the Lupron stopped--well, delayed--it all well beyond the time frame my UH oncologist had given me (he'd said maybe 6 mos to a year).

But now it's back. Once again "detectable." It's at a low level but, still, not the happiest of news.

Yesterday (Monday) I went up to Seidman to meet with my oncologist and talk about how we'll proceed.

Things were moving slowly yesterday. My appointment was for 1:00 p.m., but by the time I actually saw him, it was about 2:30. As I've said here before (I think), I don't really have a problem with that. When he apologized profusely, I said, Hey, this is a cancer center, not a car wash. You can't predict to the moment what folks are going to need--or how long it's going to take.

Anyway, he was happy with me for a number of reasons, among them--I've lost ten pounds since I last saw him, a difficult thing to do: Lupron usually results in a weight gain, as it initially did for me. But I've been trying. He told me that fat cells aid the ability of the cancer to find a "workaround" to their testosterone diet. Anyway, I've been exercising more and adhering to a diet I know will work for me--though slowly: healthful food--no seconds, no desserts, no snacks. I'm now in my fourteenth week of it, so the loss is slow. But steady. I hope I can continue.

He said that he will watch me more closely (PSA every six weeks now for a while), just to see how things progress. He will especially watch the "doubling time" of the PSA rise--how quickly does the score double? The answer is an indication of the cancer's aggressiveness.

He also told me what will be next--once my PSA has reached the benchmark level of about 10.0 (as it surely will): "pill therapy," a daily pill that will mirror the Lupron symptoms I've been experiencing for more than two years now: weariness, depression, weight gain, frequent infusions of heat (with mucho sweating), complete loss of libido. A nice combination.

But I remain grateful--and hopeful. I'm not really "sick"; I can still do most things I want to do, although I must rest far more than I did pre-Lupron. And, of course, Joyce is here.

In the Seidman waiting room I saw--as usual--folks of all ages and races, both genders. Many were in difficult shape--both medically and emotionally. It's profoundly humbling. And moving.