It's That Time Again ...

Seidman Cancer Center
Beachwood, Ohio

Last Wednesday I had my quarterly PSA test--Prostate Specific Antigen. Such tests, for me, should return "undetectable" because my prostate was removed nearly ten years ago (June 2005) when I commenced this ongoing struggle with prostate cancer. But some balky cancer cells survived the surgery and began to multiply, so a few years later (2009) I underwent thirty daily radiation treatments down at the Cleveland Clinic. The growth slowed. Then rebooted. An increasing PSA number--for me (and men in my situation)--means that the cancer cells are growing, feeding on their favorite snack, testosterone.

I switched to University Hospitals a couple of years ago (give someone else a chance, eh?) where I began Lupron therapy (quarterly injections). Lupron switches off testosterone (with side effects you can imagine: Hmmm, what would a man without testosterone be like?). Lupron is not a cure. It's a therapy. And, for me anyway, it continues to work. And it's been working beyond the time frame he thought it would. Because my cancer scored a 9 on the Gleason scale (rankings range from 2-10, so a 9 is very severe), he had originally thought that Lupron would work perhaps only a year.

But my latest test ... undetectable.

That's nearly two years, as I said, and today my oncologist had some options for me. When he came in the examination room, by the way, he was wearing a face mask. A cold, he explained. I told him I was just relieved he wasn't wielding a machete. (That lightened the mood.)

He told me my other data were good, too--metabolic function, BP, and the two scans I'd had last time--bone density and another bone scan to see what's been happening to the area in my ribs where the cancer had set up shop after moving into my bones. Earlier (pre-Lupron) scans had showed one of my ribs lit up like a Star Wars light saber. No more. (And the dull pain there is gone, too.)

He reminded me that Lupron is a temporary fix, but he's so pleased with my response to the drug that if my PSA remains undetectable next time (late June), he's going to recommend that I go on hiatus from it. The benefits of testosterone will slowly return (energy, weight control, libido, etc.), and when (not if) the PSA rises beyond the threshold, I'll go back on Lupron until it no longer is effective. Then it will be time to start yet another drug.

So ... we're happy about these most recent results--but we're also aware that these past two years have been a gift, a gift of time (among the most priceless gifts of all). The ticking of the clock has been fainter the past two years. Today, it's a bit louder.

Addendum: The nurse who administered my injection today is the mother of Ashley Quintin, a student I taught in eighth grade at Harmon Middle School many, many moons ago. Ashley's mom has been great to me. Whenever I'm at Seidman, she makes sure she finds me to say hello and to update me on her wonderful daughter, who now teaches at Ohio Wesleyan University.