The cancer prognosis was indeed not good. All twelve cores from the biopsy showed cancer. All cores showed Gleason scores of 8 or 9. Gleason ten is the most aggressive. Based on the timeline of my symptoms leading up to the biopsy, the cancer had probably developed in a relatively short period of time. Prostate cancer is usually slow growing and is usually found in older men. For younger men it tends to be more aggressive and I was age 45 at the time. From the beginning the decision was made to be just as aggressive with treatment. I was started on hormone therapy immediately to try to shrink the cancer before surgery. On All Saints Day, November 1, 2006, a non-nerve sparing (no more erections) radical prostatectomy was performed to remove my prostate and the surrounding lymph nodes. Pathology showed a final Gleason score of 9, the cancer had escaped the prostate gland, spreading to the seminal vesicles but not the lymph nodes. I would stay on hormone therapy for two years and then we would take a break and check results.
A brief education on hormone therapy. Hormone therapy involves the use of a drug that tells your body not to produce testosterone - it's chemical castration. Testosterone is the fuel for prostate cancer. So by cutting off the fuel, the goal is to stop the growth of and even shrink prostate cancer. Some cancer cells will remain, hormone therapy is currently not a cure. Side affects include loss of libedo, loss of muscle mass, loss of energy, among other things. The hot flashes that come with treatment have actually become an opportunity for humor most of the time. Eventually the cancer cells adapt and learn how to grow with small amounts of testosterone and may even learn to produce its own. When this happens, the cancer is said to be castration resistant and begins to spread again.
Despite the side effects, hormone therapy allowed me to live a relatively normal life. After surgery my PSA was zero for the two years. We stopped hormone therapy and my PSA started to rise immediately, meaning cancer was indeed still present. (Since I no longer had a prostate, the only thing that could produce PSA was prostate cancer cells.) Worse, my cancer velocity showed that PSA was doubling every three months. Prostate cancer is considered aggressive when the doubling rate is twelve months or less. Hormone therapy resumed and fortunately PSA went back to zero. This lasted until 2014 when the cancer became castration resistant.
Historically the only real treatment option left was chemotherapy. In September of 2014, I attended a prostate cancer conference in Los Angeles. One of the speakers/doctors was from the Mayo Clinic. His presentation was on new imaging that allowed pinpointing metastatic cancer spots much earlier and therefore provided the opportunity to go after the individual cancer spots in hopes of eliminating the cancer. A new treatment approach. I had my first imaging done at Mayo that fall and we have been trying to attack the individual spots as they popped up since then. As a result, I have had:
- Radiation treatments to the prostate bed, the L4 lumbar of my spine, my right scapula, and two areas on the left side of my skull.
- Cryoablation (freezing of the cancer spots) to my right clavicle, right #5 rib, left #9 rib, and my left hip.
- Heat ablation to the C7 vertebrae on my neck.
I have also had six rounds of chemotherapy and been on two new cancer drugs at different times which are designed to fight castration resistant cancer. Up until now we have been able to eliminate the spots we find but new spots continue to pop up and we are running out of treatment options.
Despite the challenges, the blessings of this cancer journey have driven home just what a great life I have overall. I don't have the biggest/fanciest house, the best clothes, the newest and fanciest cars, neither did I have jobs that paid me at the higher levels of the pay scale for what I was doing. I do have far more material things than my parents did. I have fulfilled some dreams that they didn't even dare to dream, and I have lived longer than they did. But what really makes my life special is the people I am surrounded with. Without cancer, I am sure some amazing and wonderful things related to the people in my life would never have happened. And the way events and relationships have woven together in this remarkable tapestry leaves no doubt for me that God indeed loves me and has a plan for all of us. We are all surrounded in His love!
Can't talk about this journey without mentioning God's greatest blessing of all to me, my wife Mary. I am not the easiest person to live with. I do a lot of crazy things and my sense of humor is generally of the smart ass variety. I am a very open person, to a fault many times. (Like writing a blog?) More is the wonder that Mary's head isn't in a perpetual state of shaking from side to side in disbelief. And then there is what she has had to put up with related to the cancer. Yet through it all she stands by me and is always there to support me. She is my best friend, the person I love and love having by my side. Our marriage and love for each other continues to grow, despite the challenges, or maybe because of them in some ways. Together we have raised a beautiful daughter, someone who will soon begin her own journey of marriage.
How do you live with cancer? By celebrating life with the people you love! The true moments that take your breath away!!!
How do you live with cancer? By celebrating life with the people you love! The true moments that take your breath away!!!
No comments:
Post a Comment