They can't do a DRE because it would involve tremendous pain and a PSA blood analysis would be meaningless at this point. The last three zaps were directed at a narrower field (similar to the narrowing at treatment #30). I see my urologist next Friday, probably just for chit-chat and to see how I'm doing. I'll have my first PSA analysis on August 9 and a meeting with the oncologist on August 16 (results of PSA analysis and DRE). As I understand it, the PSA reading should be less than one (1) if the "cure" was effective. Let's hope!! Of course, even if it is, that doesn't mean I will be prostate cancer-free forever. One of my spa friends, for example, had 3D-EBRT eight years ago and was proclaimed "cured." Well, he's got it again! But, he did buy himself at least eight years! Can't close without a little humor!!! Last Thursday, I apparently undressed and got into my gown quicker than usual, showing up at the radiation control booth and taking a seat right outside. One woman technician says: "Who's up?" Another says "Doc." Another woman technician comments "Oh, that young stud." The first technician looked up and saw me sitting there and said: "Oh, Doc, how much of that did you hear." I, of course, just broke up and said "All of it." The radiation session that followed was hilarious, with the "young stud" nurse taking much "abuse" from her colleagues and me. What a hoot!
May 11 Not a good day. Very depressed, almost suicidal. Don't feel good physically. The news of the cancer "smart pill" just came out. Should I have waited? Moot question. Spent 9 weeks destroying one of my organs and don't know yet about all of the consequences and ramifications. Have no interest in sex and that's bothering me a lot. Starting to feel like my Dad . . . pissed off at the world and all of the unfairness out there. DAMN!
May 18 A week has passed since my last radiation treatment. My spirits are higher than last week, but I've been really fatigued, much more sothan during treatment itself. Saw my urologist this morning for a routine follow-up. Will establish a pattern where he and my oncologist will alternate DRE's and PSA analyses every six months. I'll see the oncologist in August, then the urologist in February, etc. The hope is that the PSA will be considerably lower and, over a period of two years, become stable. If the PSA begins to climb over this two year period, it will suggest that the cancer has not been fully contained and that it has spread to other places, the bones in particular. At that point, hormonal therapy and chemotherapy come into play. The urologist likes his statistics. He gives me a 90% chance of the PSA stabilizing and being prostate cancer free for the rest of my life, but there aren't any guarantees! It is obvious that in one way or another, cancer has become and will remain a part of our lives. It certainly has become a regular part of our thinking, though not in a debilitating manner. In answer to my question "How do we know that the cancer hasn't already spread," the answer is "We don't." Only after a careful monitoring of the PSA readings will we know for sure. One way of looking at it is that the nine weeks of radiation therapy represent the opening chapter of a story whose ending is not especially clear at this point. We can live with that, at least for the time being.
Aug 7 Had blood drawn yesterday at St. Luke's for my first post-radiation PSA. Will see Dr. Timmerman on the 16th for the PSA numbers and a DRE. Somewhat uneasy. Uneasy? "Worried" might be the operative word! What will be, will be. It has been a Summer of on-again, off-again depression and "feeling-sorry-for myself." Sex drive is zero and non-sexual erections few and far between. Very frustrating. I have so many physical and mental problems that two hands with ten fingers can't count them, making me irritable and hard to live with. Sometimes I wonder if life likethis is worth it! Gut pain is driving me crazy. Hard to function, let alone want to have sex, with it! Not suicidal, just pissed-off! Again, thank God for booze. Enough of it kills the pain and allows me a good night's sleep. I think Freida thinks that I'm rejecting her, but that's not the case at all. It's the pain and discomfort, damn it!
AUGUST 16 - FEBRUARY 6
Aug 16 Saw my oncologist this morning. My PSA has dropped to 0.97 from 5.3 before the radiation. The doctor was extremely happy with that number and said that she would have been happy with any reading below 2 . 65 (half the previous high) . She anticipates that my next reading will be even lower.
The PSA number is an indicator of cancer growth or non-growth. If it remains low and stable, cancer probably isn't present; if it begins to climb, it is an indication that the cancer has returned and/or spread to other areas of the body. So I will have several PSA tests (blood drawn) annually for the rest of my life. The rectal exam (DRE) went well too. The doctor's exact words were: ""Not much left of the prostate. It's flat and there are no nodules." Sweetest words I've heard in a long time!! So, officially, my cancer is in "remission," at least for now. The radiation apparently did the job, but as I've noted previously, a cancer-free future is not an ironclad guarantee. But we're upbeat and positive about these recent developments, to say the least.
This morning's session with Dr. Timmerman was my last (unless, as we joked, another part of me needs zapped in the future) . I earlier thought that she would be seeing me on-and-off for a couple of years, but such will not be. I'll be totally in the hands of my urologist from this point on. Next appointment with him is in February. I will miss Dr. Timmerman, an outstanding person. Of course, a great hug concluded our session!
Sept 6 Been depressed for the past month. Cancer-related? Who knows? All other "problems" are intensified, especially the IBS. Saw Dr. Cook and he prescribed a new anti-depressant, which I will be taking whenever it arrives from our mail-order pharmacy.
Oct 26 The anti-depressant didn't make any difference, so I'm off of it. Have stopped taking all prescriptions except my high blood pressure pill and an aspirin a day, coupled with zinc, Vitamins C, E and A. Even stopped the over-the-counter joint medicine. Hate pills with a passion. Anxiety levels were VERY bad after the 9/11 attacks, but since stopping the anti-depressant (which had as a side effect heightened anxiety) I've calmed down. The good news is that the last of the insurance stuff has been settled, I think. I haven't really added up the total cost, but it certainly was in excess of $50,000. The insurances, both mine and Freida's, covered at least 99% of that, and for that we are grateful, recalling my earlier worry that we might get stung bad. Still have burning pee and a general feeling of being tired. Recently, some "burning" with bowel movements.
Feb 6 Just returned from my urologist's office. Had blood drawn a couple of weeks ago for the PSA, and the results are very good: down to 0.65 from the previous reading of 0.97. The doctor was very encouraged. Don't have to do another PSA for a year!! Now, if I could just get rid of this bad cold I've had for over three weeks. We're both tired of me smelling like Vicks and seeing the steam-vaporizer sitting on the dining room table! Ready to move South!!!
FOLLOW-UP
This journal covered my prostate journey from January 26, 2001 until February 6, 2002. My annual PSA readings since that time have remained positive - all below 1.0 (last tested in June 2007: 0.82). My urologist declared me prostate cancer free in 2005.
So, would have I pursued the same course of action described above if I could turn back the hands of time? No easy answer here. For all intents and purposes, my sex-drive is non-existent, one of my worst fears at the outset of this journey. Even if I had some libido left, the problem of erectile dysfunction would still exist. Additionally, I've developed other serious health problems (not related to the prostate cancer) which will probably take me out before I reach 70. Being only 66 now, that is a grim prospect. Whether the prostate cancer would have "got me" first (which I tend to doubt) is anyone's guess. My initial decision to treat the cancer, rather than "watchful waiting," was a crap-shoot or a coin-toss. Right? Wrong? Who knows?
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