Summary of a year

I think it best to summarize the events of the past year and to talk about my mental/emotional reactions.

In November 2013 I discovered that the lupron was no longer holding the PSA steady and low. At the time the urologist only called me to tell me that and that he would watch it. Well, in March, 4 months later, the PSA had doubled, and then again in July the PSA quintupled. At that point the urologist ordered a bone scan, figuring it would reveal nothing, and then he would start me on a course of action with a specialist in dealing with prostate cancer after lupron is no longer effective. However the bone scan revealed an abnormality in my iliac crest, a bone in my pelvis. A subsequent biopsy revealed that the abnormality was a tumor and it was prostate cancer. As a result I began to see an oncologist who put me on casodex, an adrogen receptor blocker. In December or January I will find out whether this course of medication is working.

In the meantime I have also had blood in my urine. I have now had a cystoscopy which revealed that the blood is the result of effects of the radiation I had a number of years ago. The current prognosis is to do nothing and see what happens.

Dealing with all this has kept me emotionally active. I am not afraid, I am delighted to continue to discover. I know what fear is, and when I look into my soul, it is not there. Frankly, lucky me.

I am not particularly worried, though all this activity is periodically unsettling. I find that working out and rock climbing are wonderful ways to keep focused on the challenges of life. I have also spent time learning German, a slow task, but fun. For what it is worth, I have used the Pimsleur course to work on my ability to speak it and I hope to go to Germany in the spring to tour that wonderful country and try out my new found (semi) skill.

Nevertheless, some of these events have been quite upsetting. In November, after I had my PSA analyzed,  the urologist called me on my cell phone while I was teaching a class in photography. I didn't take the call. He left a message informing me that he needed to talk to me. I called back. It took a week for us to connect. The dr never calls. The nurse does. When the dr calls, it is bad news. That week was harrowing. I try to look this stuff in the face and know exactly what it is, but no matter how hard I try, all the bad things leapt to life in my mind. Essentially the concern was, Well, what has to be done to negotiate the end of life? I tried to tell myself that there was no reason to believe that that concern was one I needed to deal with. I had no information. I had to fight those emotions in order to stay calm.

As has happened with everything since, those concerns are not in play and do not need to be. That realization has helped me immensely since.  When I finally talked to the doctor, he said the PSA was up and we would watch it until March. "Have a good winter," was his wish to me. I did. Another doctor, my GP, suggested that I give up dairy because that would reduce the amount of animal protein I was ingesting and would increase the amount of estrogen in my system. I tried that too. It was easier to do than I thought it would be, though giving up cheese is hard to do in Wisconsin. I lost about 10 pounds, but the new diet did not reduce my PSA, though perhaps it kept the PSA from going higher.

As the PSA checking dates of March and July approached, I found myself restless, hoping that the PSA would go down, but expecting nothing. It never went down. I have to say that each time I was amazed by the matter-of-fact way I handled the results. I am not sure where that ability came from. I used to be a pretty excitable guy.  The other thing I got used to, as July moved into the autumn was the whole sense of hurry up and go slow.  I would get a fact, a PSA or a bone scan result, but then while I wanted something done the next day, I had to wait.  I was ready to put off a trip to the west coast of take care of grandchildren while their parents were on vacation. I would have the biopsy instead. The urologist said No, take the time out there, then have the procedure. I did and am happy I did but at the time I also thought Well, how serious is this?

Serious it is. It is clear that there is no cure for this disease, at least not in my body. But where I am is managing the stuff. I have said over and over, Look it in the face. I try to do that. I ask how long do I have? No one has said weeks or months. So I go on with all those wonderful people, places and events that I love. We have fixed up our house quite a bit, started to declutter and get rid of stuff. We have travel plans. We had a wonderful summer and autumn at family reunions and visiting friends and family.

Still, it is hard to make long range plans. I always think, What if the next set of tests means I have to cancel plans? Why make them in the first place? That attitude is a tough one to fight. It is easy to say that we will just deal with the next four months and nothing beyond. But that lets the disease win.  We have plans for Germany in the spring and a Rocky Mountain hiking vacation in the summer and I hope an upper New York state vacation in the fall.

On it goes. If you are reading this, do what I urge my support group to do--hug those you love, talk about what is important. I hope you will find that cancer, oddly, gives gifts of revealing the support you have and count on, and making each day that much clearer as a good moment in your life.