Deliberations

In August I had my prostate removed after being diagnosed with cancer. The good news is that disease was not detected in my pelvic lymph nodes, which were removed anyway. The bad news is that the cancer had well and truly spread outside of my prostate and had fully invaded my seminal vesicles, which were also removed.

Two months before my operation, my serum PSA had already reached 43 ng/mL, so in the end it was probably ultra-high. I also had a confirmed Gleason score of 7 (4+3), indicating that the cancer is quite aggressive. Putting all that together, nomograms that indicate the statistical probability of even medium term survivability look bleak. My disease was classified as Stage III, which affords a poor prognosis.

Now ten weeks after the laparoscopic surgery I am fully mobile, have regained full urinary continence and am feeling quite well. I have chosen to live, let me repeat that, to LIVE, with erectile dysfunction, it’s a no-brainer. (Thirty years ago I wouldn’t have admitted that to friends, let alone in a publicly-read blog. I’m thankful that masculinity has grown up.)

As predicted by all the medicos, I still have prostate cancer, with a current PSA reading of about 0.1 ng/mL. Even though it has been falling since surgery and is very low, it cannot be ignored.

Due to the advanced disease, there is a significant probability that freed prostate cancer cells have already travelled via the bloodstream or central cavities to other parts of my body and attached microscopically to bone, which is typically the metastatic stage of disease that manifests next. There is nothing medically I can have done about that now. However, for many weeks I have already taken dietary supplements and chosen diet options based on anecdotal evidence that metastatic prostate cancer can be managed through lifestyle.

I am proceeding on the small chance that a cure is still possible. The hope for cure is that the free cancer cells that are registering the PSA are present only in the fatty tissue in pelvic region after surgery, even though the surgeon cut a lot of that away.

So, on Thursday I begin a course of radiotherapy aimed broadly in the pelvic region. Five days per week, for the next seven weeks I’ll lie on a table and be zapped for a few minutes. Luckily, the treatment centre is only a 20 minute walk away.

I have been warned to expect to feel very fatigued, which will escalate a few weeks into the treatment. I can also expect considerable discomfort and even permanent scarring to my urinary tract and bowel. That’s because the spread of my disease demands the broadest feasible application of radiation. These difficulties will last several weeks after the treatment is completed.

I have a challenging time ahead of me. Today is as good as I’ll feel for quite a while, and probably as optimistic too. I thank everyone who has kept following up on me to see that I’m okay. My positive outlook today is entirely a result of that encouragement.

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Posted by Ron Lubensky on 26 October 2010 at 09:33 AM | Link