A plan of attack

So... we're getting close to coming up to date... finally!

I returned from my bike trip on September 20th with my mind made up.  I called my radiation oncologist the morning of the 21st and he had a cancellation that afternoon, so I nabbed it.  I wanted to see what he had to say about Dr. Stone's comments, and also wanted to set things in motion.

It turned out that my RO had been trained by Dr. Stone on the seed implantation methods, so that was good. We made a small change in approach that seemed good to me (we didn't go for a biopsy of the seminal vesicles because my doctor planned to place some seeds in those areas as well).

The plan of attack I decided to go with is three-pronged:

• Hormone therapy
• Radioactive seed implants (in the prostate and seminal vesicles)
• External beam radiation therapy

Step away from that analysis... oh sure.

So... where was I now?  I was in a fog, to tell the truth. And at the same time I had more information than ever.  My pathology numbers looked like this:

• PSA = 13.7 ("normal" range is 0-4)
• Clinical stage = T2b (meaning at least half the prostate is involved)
• Biopsy results = 7 out of 12 samples showed significant cancer
• Gleason score = 7 (at least 2 samples were 4+3, the rest were 3+4)
• No PSA rate indicated (due to lack of data points)
• Bone scan and CT scan were both negative
  

I went off for a week of bicycling around the Willamette Valley in Oregon, a wonderful Pinot Noir region.  But as I said, I took my laptop to be able to continue some research in the evenings.

The second opinion

We (my sister Ellin, Ginny, and I) went to see the radiation oncologist on September 9th.  And after a very thorough discussion and examination we all went into his office to talk.  And he was much more specific about where I was right then, clinically, and he provided a boatload of information and data.

But his first question to me was this: "What is your biggest frustration right now?"  Amazing question, right?  At least I thought so.  My response...
"There's too much general information on the web and not enough specific to my case. I can't correlate all of the pieces clearly enough to make a decision."  And he understood.  And he began to provide real data.  But first, he listed what he called my pathology.  Here it is:

Frustration... and initial leanings on treatment options

At first, I was so new to the whole prostate cancer issue that I soaked up almost all the information I could find.  And I thought I might be missing some critical information, but wasn't quite sure.

But I used all the web sites I could find.  And there are a lot of websites.  And a lot of opinions.  And a lot of treatment options.  I began getting frustrated with almost all of them, because while I could find out about surgical techniques, for example, I couldn't find a lot of data to help choose surgery over radiation.  I hope that makes sense.  Neither could I find information to help choose radiation over surgery. Or seed implants over the other two. Or even if choosing one meant being locked out of the other.

The Diagnosis and more tests...

August 6th, 2009: My urologist called me at work to tell me that the biopsy showed "fairly aggressive" cancer in a significant number of samples taken (7 of 12). He set up a time that afternoon for me to come in to discuss the next steps.  At that point, I learned some new words, "Gleason score" being one.  I recall being numb... and somehow not surprised, but I don't know why I felt unsurprised. The doctor said we'd need to run a couple of other scans before going any further, and we didn't need to take any more steps until we did those - a CT scan of the pelvic area, and a full-body bone scan.  Once we had the results of those, we'd set up a consult appointment and talk about next steps.

On the way out I talked to someone who helped get the scan appointments set up.  We got a slot the following day for the CT scan (amazing!) and on August 15th for the bone scan.

The wonderful prostate biopsy experience

The biopsy procedure happened on August 4th, and the diagnosis of cancer came back on August 6th.
This post was my attempt at some humor about the whole procedure, and I wrote it about 2 weeks after the procedure.  Warning... this is a long post.  Most of it (but not all) is true... so, keep that in mind.
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Last week I had to go in to get a biopsy done on a part of the male anatomy we don't tend to discuss in public.  No, not that part. The prostate gland. Anyway, it was an interesting experience from all sorts of directions.  Let me see if I can describe it...

The first indications...

I'm a total waste when it comes to doctors and doing check-ups and all the preventative maintenance things I'm supposed to do. And I had some weird idea that because my father hadn't been diagnosed with prostate cancer until relatively late in his life, I somehow was working with the same time line.

WRONG!

So, what got me on the path of prostate cancer? My shoulder. 

An Introduction: The Prostate Chronicles

I intend to chronicle my experiences and thoughts as a prostate cancer patient... from discovery to where I am now, and throughout the course of treatment I chose to follow.

Some of this will be lighthearted... because that's one of the ways I deal with hard information. Please forgive me if they offend. I don't mean any harm to anyone. Cancer, any kind of cancer, may not be a thing to joke about. But some things that surround it are funny, or at least they seem easier for me to handle if I can laugh at them one way or another.  Some humor, after all, comes from pain.

For example, several of the medical procedures have some bizarre aspects to them that make sense and have a purpose to the medical professional, I'm sure, but to the patient they might seem, well, funny. Or at least odd, which ended up making me laugh a bit.

Other aspects are incredibly serious or frustrating, or both, and I'll try to come up with a method of identifying the humorous ones from the serious stuff. My hope is that this will be useful to someone else, besides just being a random ramble on the web, adding to the noise. And hopefully it won't be the proverbial tale told by an idiot. <grin>

So... with that introduction, let's begin...