February 2012, Cancer is back

Well, that title seems scary, so let me explain. There is good news and bad news. The bad—I still have cancer. The good—it is controllable with no imminent danger.

There, that said, let me explain. First, the cancer. Ever since I ended my radiation treatments, my PSA has been slowly rising. The most recent number (in January 2012) was .29; the time before it was .19. In PSA terms, for people with my cancer history, .20 is the magic number. Below it and no one does anything, above it and they do. Because the number is now above .20 all my doctors (urologist and radiologist and gp) have concluded that radiation did not kill all the cancer cells and that some small amount of cancer cells are still present. And because of the characteristics of my cancer that small amount will have to be controlled or it could metastasize. By characteristics I mean that my cancer was graded as Gleason 9 (out of 10). That number puts my type of cancer in the aggressive category and explains why I have had PSA tests performed every three months. My doctors have been watching closely.

Second, the treatment. Eventually, probably later this year, I will begin a two-year course of treatment called “Intermittent Hormone Therapy.” In that therapy I am injected with Lupron, an estrogen, three times a year for two years. Then there is a year with no injections and then the cycle repeats. Lupron dramatically suppresses testosterone which is one of the “feeders” of prostate cancer. The less T, the less C. The potential side effects are hot flashes, loss of strength and sexual drive, and a dramatic increase in the desire to watch chick flicks.

My urologist is a man I trust completely. He is blunt (one of his quotes at opur recent meeting was ‘that sucks’), clear, and ethical. He walked into our session having obviously closely reviewed my case. He had numbers and dates on the tip of his tongue. He is very clear that I am in no imminent danger and his prognosis was that I would be around a long time. However, all individual cases of cancer are unpredictable and thus something could happen that would cause him to revise his optimism. I’ll cross that bridge when I get to it.

I am happy to have the explanation that I received this morning. Knowledge is a source of strength and of courage against the fear that always accompanies the word cancer. As I have said many times before I am not worried and I am not afraid (I was both quite a few years ago when there was a diagnosis that said I had a good chance of going blind—which I don’t.) Thank you, once again for your support. Hug people you love, and tell them that too.