Friday, February 1, 2008

JANUARY 26 - FEBRUARY 23

JAN 26 Learned today what I suspected. Prostate cancer. Wasn't surprised. Listened eagerly as the urologist spelled out the options. Conservative management (Watchful Waiting) wasn't one of them. Surgery or radiation the only way. Immediately said, NO SURGERY! Would opt for radiation. Would have signed on then and there, but he said I should think about it and talk to others and access the Internet for more information. Urologist mentioned that chemical castration might be wise for 3 months preceding radiation. I winced and more or less said no way. Was relatively upbeat for the rest of the day . Called Dad and emailed the kids and Warren. Also told Barb and Ellen via e-­mail.

JAN 27 Went to the spa as usual and talked to a friend who has had prostate cancer for eight years. His tumor, however, is not as aggressive as mine, yet I did find comfort in talking with him. Emotions still OK. Still upbeat and positive. Still leaning towards radiation.

JAN 28-31 Mixed bag! Began intensive search on the Internet for information and guidance. Much that I saw was depressing. My mood began to change. Flipped-flopped between optimism and pessimism. Anxiety was VERY strong. Began thinking that NO TREATMENT might be desirable. Don't want the easy way out! Want the RIGHT way out. So many conflicting opinions. Becoming consumed by all of this! Literallly spent the past three days on the Net... .researching and emailing people. SINCE DIAGNOSED, NOTHING MUCH ELSE ON MY MIND BUT MY CANCER. Freida extremely supportive and understanding. Would really be out of it if that wasn't the case. Interestingly, we've become closer than usual. More touching, etc., not to mention great sex on Saturday and Sunday, perhaps because I fear that our sexual future, because of the disease, might not be optimal! I haven't cried yet and that surprises me! Though I remember not crying for Mom till the third day after she died. Thought I was numb and insensitive. Guess some crying will come for this too. Scared? I guess a bit. Uncertainty is the main thing. Still don't know WHAT to do. Aggressively treat it or sit on it?

FEB 1 Slept in this morning till 10:30AM!!! Must have been the physical work I did yesterday. Spent a couple of hours in the cold trying to repair the overflow pipe in the pond. Not as anxious today as I was yesterday. Mildly depressed. For someone who is clinically depressed (hard to believe that I've been carrying that with me some twenty years or so), I'm surprised that I haven't sunk into a really deep funk over this. More time on the internet and e-mail with cancer related topics. Still trying to get a grip of the proper course of action. Still confused. Still bewildered. Haven't ever ignored the stock market like this. Somehow money doesn't seem all that important right now. Positive note: walked a mile over at the spa this PM. Haven't done that in years! Got to say occupied, but that notwithstanding the cancer is never NOT on my mind. Haven't yet started feeling sorry for myself. Life is a crap shoot. I'm fortunate to have had the outstanding life that I've had. A wonderful wife and two adult kids who hopefully will survive me. I think about Manny Zuckerman and his loss and feel glad about my own circumstance. My kids have no idea how much I love them. Neither does Freida. I've always been so damn standoffish to them and everyone else in my life. Hard to express my feelings. At that, I've been a failure. Have decided to ask for a second opinion from a nationally prominent pathology lab of my biopsy results. Will see Dr. Cook tomorrow for his input. Just have to talk to someone!! Core question is whether throat or lung cancer gets me before prostate cancer! What's the point of treating something that's NOT going to kill me? Intellectually, as I read somewhere tonight, we all know that death is inevitable. It's not till your faced with something like cancer that it sinks in emotionally. It becomes reality. Questions involving quality of life and longevity whip you around tornado-like. My primary concern, and I mean PRIMARY, is the possible hormone treatments before radiation, if that's the route I take. From all that I've read, there is a chance of permanent loss of testosterone and, hence, sex drive. PERMANENT! I can handle incontinence and impotence, but to be sexless for the rest of my life is NOT an option. I've already decided that if I cannot have radiation without "chemical castration," I will simply watch and wait. The point is to shrink the prostate and tumor, making an easier target for the radiation oncologist. But my tumor is small as is my prostate. I will fight this one! Enough of this ... it's all too consuming! Thank God for booze! I can sleep nights at least!

FEB 2 I am physically and emotionally drained. This past week has been an emotional rollercoaster. Up, downs, and everything inbetween. I feel so very tired. But today may have been resolution as to what I will do. Larry Cook, my doctor, was very supportive and understanding. Spent a half hour with him. Made me realize that Watchful Waiting IS NOT one of my options. Prostate tumors grow much more rapidly in younger men, like me. This confirms the many messages I've received over the Internet from those that have gone through this same crap. Larry was gracious enough to give me copies of all of the reports from my urologist, Dr. Naylor. I will continue this tomorrow. Too much booze to be coherent tonight.


FEB 3 Much better day today. After I read Dr. Naylor's last report which said that my desire to forego chemical castration WAS ACCEPTABLE, I felt a great deal of relief for the reasons mentioned above. What irritates me is that when Taylor and I talked about this last week, he was absolutely non-commital about this issue, allowing me to squirm for a week! At my request, Dr. Cook has sent my biopsy slides to Johns Hopkins for expert analysis. The original pathology was done at Mercy Hospital. Everyone that I have talked to or corresponded with (including many doctors on the Net), feels that this should be standard operating procedure. There are a dozen or so "centers of excellence" in the country for pathology. I chose Johns Hopkins for no particular reason. Why didn't Naylor suggest this? Next appointment (to discuss my decision) with Naylor is next Friday, Feb. 9. Freida is taking off work to come along. At this point, I feel pretty comfortable with my decision to choose 3D Conformal Radiation Therapy. I don't want that cancer in me, so let's go for it despite the ultimate side-effects. I 've been much LESS preoccupied with the disease all day. Encouraging!


FEB 4 Today was another good day. Spent little time on the computer regarding the disease. Feel that I've come to accept the reality of it all and, compared to many of the horror stories I've read on the Net, I even feel kind of lucky to have the low level cancer that I have! Some guys are just going through living hell and I feel for them. We spent part of the day forward-looking . . .to our future fantastic trip to the Yukon and Alaska. Still blood in the semen and a drop or two after straining at the stool Freida thinks she's menstruating again! LOL. I am concerned about whether the cancer has already spread outside of the prostate. This is a major question for Naylor on Friday. Saw a distant herd of about 13 deer over on campus at twilight.


FEB 5 Another good day. Freida expressed surprise that, given my chemical depression, I haven't sunk into a deep funk about all of this. I have come to some kind of understanding about my mortality and death, at least in general terms. It's all a little vague right now. Think I'm a lot more worried about the inevitable lung cancer than I am about the prostate variety. Not as well treatable and death follows quickly upon diagnosis in most cases. I don't have a clue as to why I'm keeping this "journal." Maybe it is a form of therapy. I do know that I want the 3D Conformal Radiation Therapy to start as soon as possible! The good thing is that I'm no longer dwelling on this, and that's healthy in of itself! Life goes on and one must make the most of each and every single day.


FEB 6 Lethargic and mildly depressed today. Not specifically cancer-driven. Just life in general and my clinical depression kicking in. Nothing unusual. Surprised it hasn't happened earlier. Still not dwelling on the prostate thing. Still think, as I told Dr. Cook, that either throat or lung cancer will get me before prostate cancer. My previous argument was that because of this, WHY do ANY treatment. I've since concluded that such a decision would be shortsighted. Some people smoke all of their lives and die at 85 in a car wreck. Maybe I'll be one of those! Sure!


FEB 7 Carryover from yesterday, but not as bad. Having MINOR second thoughts about my decision. Worried about peeing in my pants the rest of my life. Not so worried about impotence, since I'm somewhat there already and Freida and I have always been able to deal with it. There is SO MUCH negative sentiment out there about the prostate cancer treatments. But I've decided, and that's that. There will ALWAYS be second guessing now and down the road, but one has to make up his mind and stick to it.


FEB 9 Freida and I met with my urologist this morning to discuss treatment. Told him at the outset that we have opted for 3D-CRT. Had many questions, which he answered to our satisfaction. Chose to do the radiation at St. Luke's, mainly because it is closer to home, not to mention the fact that it is ranked in with the top 100 hospitals in the USA! Somewhat depressed for the rest of the day. Not sure why, but cripe for 25 years I've never known what triggers the depression. The weather changed today, so that might be it. Uncertainty and fear regarding the cancer might have done it. Second guessing my choices - treatment and hospital - might have triggered it. Who knows! E-mailed Gregg, Jane and Warren, supplying them with details about the 3D-CRT treatment. The thought of being permanently impotent is grating at me more than I thought it would. Even broached the topic of penile implants with Freida . She's been extremely supportive. Not too many that would settle for someone to cuddle as opposed
to a hunk! Love is grand and so is life! I've got so much to be thankful for. To be sure, I've done my share of suffering. Only a fellow stutterer knows what that means! From Day One, it has been Hell! But I was able to overcome it (or at least fake it) for the sake of my family and career. And I beat overwhelming odds! First professor at the University to be awarded the Great Teacher award! Wow! I would love to dig up the bodies of those people at California State Teachers College who told me that I would NEVER teach and show them that award. I'm off topic, so I'll close for tonight.

FEB 10 Depression has lifted for the most part. Had a good day. Have got to maintain and upbeat attitude and avoid stress. Radiation alone isn't going to whip this. A positive attitude is a MUST and for me that is not always easy to do, but I'm trying.

FEB 16 I'm back. Been a pretty good week, but today was bad. Heavy depression. St. Ritas finally called and my initial appointment is on Feb. 23. I'm not sure I'm doing the right thing! So many negative posts on the Internet about ANY medical treatment. Many stress alternative stuff- Chinese herbal cure, etc. Very confusing and disturbing. DAMN IT! Like I told Freida about an hour ago, Hiroshima victims never asked for their radiation, but I'm volunteering!! Gotta wonder. I also said to Freida that it is not a matter of being scared, BUT not knowing if what your about to do is RIGHT!!! I mean, they are going to blast my prostate with radioactive beams! Whoa! About being scared . . . you bet! Shaking in my boots!
FEB 22 Just e-mailed Dr. Cook. Asked if he could expedite the second opinion on the pathology from Johns Hopkins. I WILL NOT have my prostate burned until that second opinion is in! Damn it, it might be a Gleason score of 3, 4, or 5 and if so, I will "watchfully wait," rather than submit to a life-altering treatment! The one thing I've learned about prostate cancer is that it is VERY CONTROVERSIAL . What to do, when to do, how to do, etc. It's really mind boggling. Been doing some serious reading about penile injections should that ever become necessary. I've stayed up later than usual these past two days, probably in anticipation of my Friday appointment.

FEB 23 Spent two and a half hours at the Radiation Oncology Center (St. Luke's) this morning. It was more or less just an introductory session. The regular radiation nurses were busy elsewhere, so I had a substitute nurse named Kelly, who had mountains of paperwork to do. Saw a short videotape on what to expect in my treatment. Discovered little which I didn't already know. The radiation oncologist finally showed up about an hour or so into the session. Her name is Dr. Timmerman and we hit it off very well. One surprise was she said that I will have 42 sessions of radiation . . . that's 8 1/2 weeks, longer than what the literature normally suggests (6-7 weeks). For some reason, I didn't follow up with a "Why?" question. I will next time. A couple of comical moments: When I started to lower my sweatpants for a DRE, Dr. Timmerman told me to wait a minute until she could arrange for a screen. The pull-around ceiling mounted screen was missing (laundry?), so Kelly was called into the room and told to make a screen with a bed sheet. So here I am with one woman sticking her finger up my ass, while another woman is standing in front of the door holding an outstretched bed sheet under her chin (guess she wanted a view!) Guess that's about as close to a menage-a-trois as I'm ever going to get!!! The screen was necessary to ensure my privacy in the event someone accidentally came into the room, something they said was a common thing. Well, Kelly peering over that sheet was hardly one of my more private moments in life! LOL. I REALLY wanted to say something "cute," but I held back. Dr. Timmerman said that the tumor was basically what my urologist had reported and she was impressed with the smallness of my prostate .... makes an easier target. She also said that because of the tumor's location, surgery would be somewhat difficult and that 3D-CRT is definitely the best choice of treatment. My next appointment is next Wednesday (Feb.28) at 1PM, having explained to them that I am definitely not a morning person! The cat-scan and various other procedures (lower-body cast and body markings) are scheduled for that time. When I thought I was about done, Kelly announced: "Oops, we forgot to draw blood." So she went out to get the appropriate materials. Upon returning, and after she had cleaned the vein with alcohol, she said: "Now where did I put that tourniquet." So off she goes again to find a tourniquet. Upon return, we get down to business. Found a nice vein (unusual for me) and proceeded. Normally I don't look when my blood is drawn, but after I heard her talking to the syringe, trying to coax the blood out, I looked! She was wiggling the needle back and forth, trying to fill the tube. Then blood started coming out along the sides of the needle, so she pulled it out and cotton swabbed it. She only had about 1/3 of the tube and went to see someone else to see if it was enough. Thankfully it was! Then, because she had oversized rubber gloves on, I had to help her put on a bandage!! Wonder how the regular radiation nurses are?

1 comment:

joec said...

Visit my web page at
http://prostate-cancer-log.blogspot.com
I am battling small cell prostate cancer (am 57 years old) and had surgery, plenty of chemo and then IMRT radition.