Dealing with Metastasized Prostate Cancer

My cancer has metastasized. It is now at least in my hip bone, my iliac crest, and it could be two other places, tumors in my stomach and near my rectum.  So I have new realities to live with.  I think that that issue (new realities to live with) is the one that needs comment and certainly keeps me aware of my emotional state.

The deal is this. My PSA in the past year has elevated from below .2 (where you are considered cancer free) to 22. So far doctors have declared that lupron therapy has failed, though I still keep taking it, or rather getting the shot every four months because it is actually suppressing testosterone, one of the feeders of growth of prostate cancer.  In addition my oncologist--I now do not regularly see a urologist; the oncologist focuses on treating tumors. He tried casodex a new drug to manage and slow the spread of the cancer. It failed. So now I am on dexamethasone, a steroid that is supposed to shrink tumors or at least negate their growth. I have a preliminary check up on Feb 17 and he will make a final decision in March. Apparently if it fails, I will go on another drug and if that fails I will start chemo. Lord.

For me all that drug taking and trips to the doctor are not the issue. They are what has to be done.  I have to have facts so I can worry about them, rather than things I make up. For instance I can feel a very hard spot right next to my belly button. I decided that this was one of the tumors. It isn't. It is scar tissue from my operation 7 years ago. Dr. Sershon, the urologist, confirmed that recently.

What is the issue is the "downs." I suppose you could call them the blues, but that seems too beautiful for what I am talking about. At this point I don't feel anything, any pain, that indicates that I have cancer. But I know I have it. And periodically that knowledge not only forces its ways into my awareness but takes out after any attempt to plan. I want to go to Europe in June-July. But the dexamethasone is tested in March. If it fails, and I have to go immediately to chemo (I might not have to, there is yet another new drug out to fight this cancer), then going to Europe is out. I will be here getting IVs every couple weeks. If I dwell on that possibility, the logical answer is Don't make those plans. If you have to cancel a trip to Europe it is a real pain, not too mention a money-loser. So my 'down' self says, "forget all that; get through today."  THAT is what I have to fight. That is basically giving up and I refuse to do it.  It takes a will effort to do that. I have had to learn to roll with that punch and come back.  I am delighted to report that I can do that. I am not always sure why I flip from the downs to some kind of upper. I have come to trust that I will, yet when the down is in, it is difficult.

The second issue here is What is the reality that I have to accept?  When my friends and family heard the word 'tumor' it set off reverberations in them.  I get concerned looks and quiet questions--how ARE you feeling? When I told one good friend that I felt fine, he asked if I was lying. I get questions about why not remove the tumors. Actually I asked the urologist about that wondering if someone could freeze those tumors. He felt that the risk was way too high. If they tried to freeze the one near my rectum they actually could open a hole in the intestinal wall which as you can imagine, would be bad.  I am not sure, though, what I have to accept. There must be a point where the kind of lightness with which I treat the disease is foolish. I just don't know where that point is.  And when I hear plans for things 2 or 3 years out, I admit I think 'Will I be there?'  Not fun.

Mary and I have discussed the end and what she would do after, and those have been rather emotional discussions, and I am glad to have had them, but they don't change the fact that I have to work my way through tomorrow and I have to keep up my ability to plan.

Enough for now. I will add to this train of thought in later posts. For now my advice continues to be Find out the facts of your case and focus on/worry about them. I like my urologist for this because he is so candid. And I like my oncologist because he is so matter of fact. He is in the game to manage this stuff in my body. What I have determined is that I need to create my own team of doctors. They don't appear to realize the need for a team, but now that I have advanced cancer, I do.  More on this in a later post too.