After I had taken casodex for a month, I suddenly had blood and blood clots in my urine. Well, the first time you see that it is unsettling, though like everything else about managing this disease, you toughen up. . It is not as bad as it looks. Probably it is cystitis, an inflammation of the bladder wall caused by radiation. Another test looms.
I once spent time in the Arctic with a fellow who had spent winters there. He told me that up there a person has to learn to fight the cold. It can depress you and make you lethargic, potentially putting you at some risk. I recall the conversation frequently. I am not worried and I am not afraid and I am willing to be candid about my condition, but I fight every day.
Here is the email I sent to my family and support group detailing this new turn:
OCTOBER 14, 2014
Hi, this email contains a bit of graphic detail about my condition but I tried to keep it vague. To bring some people up to date, I started taking casodex in early September. This drug is an androgen receptor blocker. Basically that means that it hampers the ability of cancer cells to connect with the testosterone that they need to expand their presence into various parts of the body. After about a month —hear comes the graphic part—i began to have blood and clots in my urine. This happened three times and does not happen with each urination. The clots are like little black pieces of fiber. No pain associated with their passing. The oncologist suggested I stop taking casodex until we could talk. I did. After our conversation he said that my description of these passings did not sound (or look, I took a picture of one) like the side effect of casodex. He recommended that I begin taking casodex again, which I will do in the morning. I offer these emails with the candor I do because I believe that this disease must be discussed openly so that the fear level it creates is dramatically reduced.
Here is what I sent out earlier to my children:
Hi, today I met with Dr. Basu. My PSA went up slightly in the past month. From 7.3 to 8.2 He is not concerned. He says that if the PSA is going to go down, that will not happen until December or January. He had suggested that I stop using casodex until he could talk to me about the blood in my urine. As it happened, I have a picture of one of the clots in the toilet. After he looked at that and listened to my explanation of the way the bleeding occurred, he told me to go back on the casodex. What he saw and I described is not what casodex does. He then ordered a cystoscopy next week in order to determine whether the blood is coming from the bladder. Some years ago, when I had first had blood, Dr. Sershon investigated, found lesions from the radiation in the bladder, and cauterized them. Dr. Basu wonders whether what I am currently experiencing is a recurrence of lesions, a long range side effect of radiation. I will find out on Wednesday, Oct. 22.
We also discussed whether change of diet will help my immune system enough to impede the progress of the cancer. He was skeptical. He felt that the change could have various positive benefits but for the new diet to make an immune system change, it would need more time, maybe several years.
I also have an ongoing “deal” in my right groin up the side to just below the ribs. It moves around. He wants first to have the urologist determine that nothing in the bladder or kidney is causing it. He is pretty certain that the tumor in the iliac crest is not causing it.
After I meet with the urologist next week, I will write again.
Love,
D
PS. I told the doctor that I have previously taken photos of piles of shit, but this was my first one of a pot of piss. He did me the courtesy of laughing.
Wednesday, October 15, 2014
Cancer in my bone. The heavy hitters come out.
These two emails continue my reports to my family as my situation changed.
AUGUST 12, 2014
Hi, the biopsy shows that the tumor in my right hip is prostate cancer. Who told me that is my GP. He will set up a consultation with an oncologist in Eau Claire in September after we return from Seattle.
At this point there is very little more to say. The result is basically what I expected. It is too early to discuss treatment. Most likely it will be chemo, probably spread over the fall, but apparently there are other possibilities. As I say, too soon to discuss. After I talk with my urologist, if there is more to report, I will let you know.
I am not afraid and not worried. This is a management problem. And yesterday I almost reached the top of the route that has befuddled me all summer. Tomorrow I expect to top it. I will bring my climbing shoes to Seattle. We have taken biking back up and I can’t wait to get going on skiing this winter.
Thanks again for your support.
Love,
Dan
SEPTEMBER 4, 2014
Hi all, today we visited the second of two oncologists. He is PJ Flynn of Minnesota Oncology. Yesterday we visited Dr. Sandeep Basu of Luther Mayo Health in Eau Claire. They both recommended the same thing. For convenience we will go with Dr. Basu. Actually Dr. Flynn thought that was what made the most sense.
I will begin tomorrow taking the drug Casodex, once a day. My PSA will be regularly monitored. If the drug works, my PSA will eventually level off and remain more or less at the same level. I should know whether that occurs by December or January. If it works, I will continue to use it. If not, I will move to another drug. Right now chemo is not in my near future.
We were impressed with both doctors. They were thorough and clear. We got basically the same information from both, in all details of treatment prostate cancer of the type that I currently have.
And so, off we go. Another phase. I continue to be neither worried nor afraid. Thanks for your support. Hug those you love. If you have things you want done, do them now. If you have questions, please ask. I think about this stuff enough to have been over all the ground from deep concern to elation. And Dr. Basu told me that rock climbing was an extreme sport. Maybe I can get into the septuagenarian olympics.
Love, Dan
AUGUST 12, 2014
Hi, the biopsy shows that the tumor in my right hip is prostate cancer. Who told me that is my GP. He will set up a consultation with an oncologist in Eau Claire in September after we return from Seattle.
At this point there is very little more to say. The result is basically what I expected. It is too early to discuss treatment. Most likely it will be chemo, probably spread over the fall, but apparently there are other possibilities. As I say, too soon to discuss. After I talk with my urologist, if there is more to report, I will let you know.
I am not afraid and not worried. This is a management problem. And yesterday I almost reached the top of the route that has befuddled me all summer. Tomorrow I expect to top it. I will bring my climbing shoes to Seattle. We have taken biking back up and I can’t wait to get going on skiing this winter.
Thanks again for your support.
Love,
Dan
SEPTEMBER 4, 2014
Hi all, today we visited the second of two oncologists. He is PJ Flynn of Minnesota Oncology. Yesterday we visited Dr. Sandeep Basu of Luther Mayo Health in Eau Claire. They both recommended the same thing. For convenience we will go with Dr. Basu. Actually Dr. Flynn thought that was what made the most sense.
I will begin tomorrow taking the drug Casodex, once a day. My PSA will be regularly monitored. If the drug works, my PSA will eventually level off and remain more or less at the same level. I should know whether that occurs by December or January. If it works, I will continue to use it. If not, I will move to another drug. Right now chemo is not in my near future.
We were impressed with both doctors. They were thorough and clear. We got basically the same information from both, in all details of treatment prostate cancer of the type that I currently have.
And so, off we go. Another phase. I continue to be neither worried nor afraid. Thanks for your support. Hug those you love. If you have things you want done, do them now. If you have questions, please ask. I think about this stuff enough to have been over all the ground from deep concern to elation. And Dr. Basu told me that rock climbing was an extreme sport. Maybe I can get into the septuagenarian olympics.
Love, Dan
July 2014 Things take yet another turn
I sent this series of emails to my family and support system in July
JULY 16, 2014
Hi, here is the report. My PSA went up to 3.5. It had been doubling but this is quintupling (it was .7 before). So what does this mean? First, the doctor said we are not talking months but years in terms of mortality. His concern is what he calls “morbidity” by which he means the cancer gets into my bones and makes my quality of life less stellar. He used the helpful term “rot” my bones (He also told us that he needed to check a few numbers on my screen to make sure he was not talking out his ass. I like this guy and trust him). Based on our visit, I feel really good. I am not worried nor afraid.
This rise does mean that I will have more activity about my numbers.
1. They took a testosterone level blood draw. He expects it will reveal that my testosterone is low. If it is high, he will simply change the medication to see if the change affects the PSA.
2. He ordered a bone scan. I will have that tomorrow morning at Red Cedar. The goal of that scan is to determine whether any cancer is in my bones. He expects that scan to be negative.
So 3. If both tests are negative, I will see a doctor, his partner, who specializes in cases like mine, which are, it turns out, a bit rare. That doctor could order another test that tries to exactly locate the cancer in the body and as a result of that knowledge propose a customized treatment. Dr. Sershon says that there have been remarkable advances in treating prostate cancer and that advances are happening rapidly.
So I guess I will eventually get to try some of that advanced remark ability.
I thank you for your support. This fall it is 7 years since I was diagnosed. I love you. If you have questions, or if your kids or others have questions, please ask. This stuff is on my mind and I don’t mind discussing it. I think that everyone should hear as much as possible about this disease in order to be better prepared to handle it. So, back at it.
I look forward with delight to our reunions in the next 10 days. I have rock climbing to do, and gym workouts, and biking, and traveling, and german to study. And I feel so good knowing you are there and you care. Dan
JULY 29, 2014
Hi, I had the bone scan I mentioned awhile back. The drs were unwilling to draw a conclusion from it. They thought there was a problem with one area of my pelvis. So I had an X-ray. It showed that there is an irregularity in the pelvis at the spot being investigated. So now, sometime in the future, the next several days or weeks or after we return from Seattle, I will have a biopsy of that area. After that there should be some decision about what direction to take for managing the cancer. Lots of hurry up and go slow. Dan
JULY 31, 2014 Hi, I want to bring you up to date on the latest with my condition. I had the tests that I mentioned earlier, testosterone and bone scan. Nothing is resolved yet.
First I had a testosterone suppression test. The results were fine. The lupron is doing that part of its job, suppressing the testosterone.
Then I had a bone scan. Well, there was an area on my pelvis that looked suspicious. So to resolve that I had an X-ray. That X-ray told the drs that something was going on in that area. It has a name like scorosis (sorry, I have not looked it up).
So now on August 5 I will have a biopsy of the area. The results of that biopsy should be back several days later. Depending on what the biopsy reveals, some more action will occur. Whatever that action is, it will not happen, as near as I can tell, until September after we return from Seattle. Actually the urologist suggested I wait until we return to have the biopsy but since I could get in right away, I decided to do the scan now. After that, who knows?
I am amazed at the slowness of this process. I suppose that is a good sign but it has taught me to not expect a clear answer at any particular point. The dr continues to say "years" plural, so that is nice. When I know more, I will let you know. I am still whacking away at German and my rock climbing has hit a plateau that is annoying. So it goes. In the meantime, thanks for your support. It means a lot to me. Tell people you love them.
Dan
JULY 16, 2014
Hi, here is the report. My PSA went up to 3.5. It had been doubling but this is quintupling (it was .7 before). So what does this mean? First, the doctor said we are not talking months but years in terms of mortality. His concern is what he calls “morbidity” by which he means the cancer gets into my bones and makes my quality of life less stellar. He used the helpful term “rot” my bones (He also told us that he needed to check a few numbers on my screen to make sure he was not talking out his ass. I like this guy and trust him). Based on our visit, I feel really good. I am not worried nor afraid.
This rise does mean that I will have more activity about my numbers.
1. They took a testosterone level blood draw. He expects it will reveal that my testosterone is low. If it is high, he will simply change the medication to see if the change affects the PSA.
2. He ordered a bone scan. I will have that tomorrow morning at Red Cedar. The goal of that scan is to determine whether any cancer is in my bones. He expects that scan to be negative.
So 3. If both tests are negative, I will see a doctor, his partner, who specializes in cases like mine, which are, it turns out, a bit rare. That doctor could order another test that tries to exactly locate the cancer in the body and as a result of that knowledge propose a customized treatment. Dr. Sershon says that there have been remarkable advances in treating prostate cancer and that advances are happening rapidly.
So I guess I will eventually get to try some of that advanced remark ability.
I thank you for your support. This fall it is 7 years since I was diagnosed. I love you. If you have questions, or if your kids or others have questions, please ask. This stuff is on my mind and I don’t mind discussing it. I think that everyone should hear as much as possible about this disease in order to be better prepared to handle it. So, back at it.
I look forward with delight to our reunions in the next 10 days. I have rock climbing to do, and gym workouts, and biking, and traveling, and german to study. And I feel so good knowing you are there and you care. Dan
JULY 29, 2014
Hi, I had the bone scan I mentioned awhile back. The drs were unwilling to draw a conclusion from it. They thought there was a problem with one area of my pelvis. So I had an X-ray. It showed that there is an irregularity in the pelvis at the spot being investigated. So now, sometime in the future, the next several days or weeks or after we return from Seattle, I will have a biopsy of that area. After that there should be some decision about what direction to take for managing the cancer. Lots of hurry up and go slow. Dan
JULY 31, 2014 Hi, I want to bring you up to date on the latest with my condition. I had the tests that I mentioned earlier, testosterone and bone scan. Nothing is resolved yet.
First I had a testosterone suppression test. The results were fine. The lupron is doing that part of its job, suppressing the testosterone.
Then I had a bone scan. Well, there was an area on my pelvis that looked suspicious. So to resolve that I had an X-ray. That X-ray told the drs that something was going on in that area. It has a name like scorosis (sorry, I have not looked it up).
So now on August 5 I will have a biopsy of the area. The results of that biopsy should be back several days later. Depending on what the biopsy reveals, some more action will occur. Whatever that action is, it will not happen, as near as I can tell, until September after we return from Seattle. Actually the urologist suggested I wait until we return to have the biopsy but since I could get in right away, I decided to do the scan now. After that, who knows?
I am amazed at the slowness of this process. I suppose that is a good sign but it has taught me to not expect a clear answer at any particular point. The dr continues to say "years" plural, so that is nice. When I know more, I will let you know. I am still whacking away at German and my rock climbing has hit a plateau that is annoying. So it goes. In the meantime, thanks for your support. It means a lot to me. Tell people you love them.
Dan
Tuesday, February 25, 2014
The situation in late February 2014
Addendum, written on Feb 25.
I never published the November 4 piece of writing until now. It was a shock. You can see what I finally published in the email to family and friends. I waited until I knew more and then spoke from facts not fantasies. I publish the my November writing so that you have some idea that this affliction cannot be ignored.
As it turned out it took a loooong week until I finally heard from the doctor. He told me that the PSA had gone up, that what he was doing was giving me a heads up that if it stayed up, I would probably need a different treatment. We did not talk about end of life issues. I have thought about them, though, as you can imagine. The only thing I know to keep your sanity as this thing dwells in you is to look at it clearly. Don't flinch. Don't look away. It is not going away.
November 4, 2013
Well, what a hell of a day. First, I take off for my CVLR photo class. It goes well. I have the pace correct for the audience. I take them through steps that I am astounded they can’t do, like find macro. During the class, my phone rings. I make a joke about never calling me at this number and go on. The class is a blast. I love it. The technology worked well. The students appeared to get the processes. I leave feeling great, even though it has rained all morning. At home Mary has had a fine workout. I check the phone to see who called me. I don’t recognize the 651 number. But there is a voice mail. A man. My urologist. His message is ridiculously brief. “Is there a better number to call me at? “ I call back, go through a zillion pick-this-number items.
All I end up with is his voice mail. I leave a message to call me back. And then I wait, and have waited all day. I had my psa taken on Friday. This is Monday morning. Urologists don’t call to tell you “My that was a fine test.” The nurse does that. Urologists call because there is an issue, and in this case the issue surely is not good. On Sunday I had odd shooting pains down the left side of my penis. Today I have had ones on the right side and a bit in that right testicle. During the summer and fall I often felt really tired when I woke up, even if I had slept for 8-9 hours. What is the deal?
I spent the afternoon sending a few emails, playing solitaire, working on some camera and Photoshop Elements 12 processes. It is amazing how slow the time can pass. I avoid Mary. She tries to act like she has lots of jobs to do, and, well, she does them, working on her letters. Good. I am trying to think what might need to be arranged. A funeral service. Money items. What to do with the house. What to do with all the junk I have collected—tools, furniture, books, photos. I want someone to publish a book of my photos. In the end my goal is to show others how to die. But, to be honest, I would rather do that in several years. I feel great about 2013 and tell Mary. She agrees. I am in a position right now where I am not regretting what I have done with my life and my years. I like where I am. Here it is, 8:47. He will call tomorrow I am sure, not tonight. Happy 3 a.m. February 25, 2014 Time passed. I am at ease with the many possibilities that lie ahead. What you find out when you have this disease is that you can’t live with fear and you can’t stop living. God, is that neat.
But in December I had a physical from my GP. He suggested that I eliminate all dairy from my diet, so I have. Dairy products contain casein, a protein that prostate cancer “feeds on” (not sure exactly what that means other than if there is more casein in your body, the cancer finds it easier to grow and metastasize). I have eliminated dairy. I drink soy milk, eat (very little) fake cheese and ice cream. Milk was easy to give up. Cheese was harder. I have learned to read the ingredients lists on food products. I am amazed at how many products contain dairy. My family and friends have been very supportive in adjusting their food selection when I am present. My neighbor has had prostate cancer for about 15 years. He works hard at his diet. Diet, it turns out, can have an impact on how quickly the cancer grows. I decided to take the doctor’s advice.
I am having and have had a good winter. We thought of a month in Italy, especially in the south in Puglia, the heel of the Italian boot. I decided against it. It felt like running away to me. So we have stayed here. I have rather enjoyed the harsh winter. I have started to teach myself German, I have spent lots of time tracking my ggggrandfather Jacob Weber, I will give a talk on that process on March 15. I started a photographers’ group—we meet once a month to critique photos. The owner of the restaurant we meet at has invited us to put up an exhibit of our works; that happens in mid-April. My own show of photos will be up throughout March at the Menomonie Coop. I have written another article about genealogy, and I have a series of drafts exploring the nature of questioning in teaching. We have snow shoed. We have had many dinner guests. We had a spectacular Christmas get together. The grandkids have stayed here. Jane spent a great weekend here. I have gone back to regular rock climbing.
We try to work out three times a week. Those workouts have been wonderful for things like balance and confidence lifting. Just past week I slipped on some ice, but caught myself so I did not fall. I suspect I would have done a header two years ago. I helped Mary put on a very successful Martin Luther King event based on his idea of community and the work of her students from her creative writing class in the Dunn County Jail. We have been to a number of cultural events here in Menomonie and in the Twin Cities, including not only “The Ballad of Emmet Till” but also a small event featuring the playwright, several of the actors and the director of Penumbra theater. What we have done the past few months feels so right, so good. Many years ago a friend wondered if we had been smart enough to immerse ourselves in the joys of the moment. I am not sure about then, but I know I do now. What a great gift.
And so, that brings you up to date. I go to the urologist on Thursday, March 6. My new PSA will be posted probably the next day or else by the following Monday. I decided not to wait for a phone call. They are willing to just post the numbers and you deal with what you see. I am fine with that. Rather that than the voice on the line being the doctor and me knowing we are not having a ‘hey-how-ya-doin’-call.’
I never published the November 4 piece of writing until now. It was a shock. You can see what I finally published in the email to family and friends. I waited until I knew more and then spoke from facts not fantasies. I publish the my November writing so that you have some idea that this affliction cannot be ignored.
As it turned out it took a loooong week until I finally heard from the doctor. He told me that the PSA had gone up, that what he was doing was giving me a heads up that if it stayed up, I would probably need a different treatment. We did not talk about end of life issues. I have thought about them, though, as you can imagine. The only thing I know to keep your sanity as this thing dwells in you is to look at it clearly. Don't flinch. Don't look away. It is not going away.
November 4, 2013
Well, what a hell of a day. First, I take off for my CVLR photo class. It goes well. I have the pace correct for the audience. I take them through steps that I am astounded they can’t do, like find macro. During the class, my phone rings. I make a joke about never calling me at this number and go on. The class is a blast. I love it. The technology worked well. The students appeared to get the processes. I leave feeling great, even though it has rained all morning. At home Mary has had a fine workout. I check the phone to see who called me. I don’t recognize the 651 number. But there is a voice mail. A man. My urologist. His message is ridiculously brief. “Is there a better number to call me at? “ I call back, go through a zillion pick-this-number items.
All I end up with is his voice mail. I leave a message to call me back. And then I wait, and have waited all day. I had my psa taken on Friday. This is Monday morning. Urologists don’t call to tell you “My that was a fine test.” The nurse does that. Urologists call because there is an issue, and in this case the issue surely is not good. On Sunday I had odd shooting pains down the left side of my penis. Today I have had ones on the right side and a bit in that right testicle. During the summer and fall I often felt really tired when I woke up, even if I had slept for 8-9 hours. What is the deal?
I spent the afternoon sending a few emails, playing solitaire, working on some camera and Photoshop Elements 12 processes. It is amazing how slow the time can pass. I avoid Mary. She tries to act like she has lots of jobs to do, and, well, she does them, working on her letters. Good. I am trying to think what might need to be arranged. A funeral service. Money items. What to do with the house. What to do with all the junk I have collected—tools, furniture, books, photos. I want someone to publish a book of my photos. In the end my goal is to show others how to die. But, to be honest, I would rather do that in several years. I feel great about 2013 and tell Mary. She agrees. I am in a position right now where I am not regretting what I have done with my life and my years. I like where I am. Here it is, 8:47. He will call tomorrow I am sure, not tonight. Happy 3 a.m. February 25, 2014 Time passed. I am at ease with the many possibilities that lie ahead. What you find out when you have this disease is that you can’t live with fear and you can’t stop living. God, is that neat.
But in December I had a physical from my GP. He suggested that I eliminate all dairy from my diet, so I have. Dairy products contain casein, a protein that prostate cancer “feeds on” (not sure exactly what that means other than if there is more casein in your body, the cancer finds it easier to grow and metastasize). I have eliminated dairy. I drink soy milk, eat (very little) fake cheese and ice cream. Milk was easy to give up. Cheese was harder. I have learned to read the ingredients lists on food products. I am amazed at how many products contain dairy. My family and friends have been very supportive in adjusting their food selection when I am present. My neighbor has had prostate cancer for about 15 years. He works hard at his diet. Diet, it turns out, can have an impact on how quickly the cancer grows. I decided to take the doctor’s advice.
I am having and have had a good winter. We thought of a month in Italy, especially in the south in Puglia, the heel of the Italian boot. I decided against it. It felt like running away to me. So we have stayed here. I have rather enjoyed the harsh winter. I have started to teach myself German, I have spent lots of time tracking my ggggrandfather Jacob Weber, I will give a talk on that process on March 15. I started a photographers’ group—we meet once a month to critique photos. The owner of the restaurant we meet at has invited us to put up an exhibit of our works; that happens in mid-April. My own show of photos will be up throughout March at the Menomonie Coop. I have written another article about genealogy, and I have a series of drafts exploring the nature of questioning in teaching. We have snow shoed. We have had many dinner guests. We had a spectacular Christmas get together. The grandkids have stayed here. Jane spent a great weekend here. I have gone back to regular rock climbing.
We try to work out three times a week. Those workouts have been wonderful for things like balance and confidence lifting. Just past week I slipped on some ice, but caught myself so I did not fall. I suspect I would have done a header two years ago. I helped Mary put on a very successful Martin Luther King event based on his idea of community and the work of her students from her creative writing class in the Dunn County Jail. We have been to a number of cultural events here in Menomonie and in the Twin Cities, including not only “The Ballad of Emmet Till” but also a small event featuring the playwright, several of the actors and the director of Penumbra theater. What we have done the past few months feels so right, so good. Many years ago a friend wondered if we had been smart enough to immerse ourselves in the joys of the moment. I am not sure about then, but I know I do now. What a great gift.
And so, that brings you up to date. I go to the urologist on Thursday, March 6. My new PSA will be posted probably the next day or else by the following Monday. I decided not to wait for a phone call. They are willing to just post the numbers and you deal with what you see. I am fine with that. Rather that than the voice on the line being the doctor and me knowing we are not having a ‘hey-how-ya-doin’-call.’
A turn of events in the cancer fight
In November 2013 I received a bit of sobering news, though not entirely unexpected. My cancer is acting up.
Here is the email I sent to family and friends: Hi, I sent this email to my kids earlier today. Here is your copy. What can I say? What is, is. Share with your kids. Thanks for all your support. If you want to talk about it, please ask. You are great, Love, Dan Hi, I had my PSA drawn on November 1. On November 11, Dr. Sershon called me to tell me that the number had jumped. He did not tell me the new number. I can get it in the next few days. It was my choice. The old numbers had always been below.2, or "undetectable". Well. He said he will watch the number at my next PSA draw in March. If it stays up, I will be referred to his associate for further treatment because it probably means there is a clump of cancer in there somewhere. Which of course I already know: The cancer has never gone away completely; that's why the PSA never went to 0. Sershon also explained that the number could go back down, that PSA related to lupron treatments sometimes jumps and goes back. So there is nothing to do but wait to see.
Just to be clear, Sershon is a pretty blunt guy. No mention of "affairs in order" or "bucket list." And I have no such intentions, though a month in Europe sounds good. The last thing he said to me was "Have a good winter," which is exactly what I plan to do.
Please know that I am not afraid nor am I worried. Look at these things head on and don't flinch. I refuse to allow these facts to affect the way I live in the now. And living now means that I am deeply in love with you all and your children, and that I know what that means at a very deep level, and that it is a lot of fun, making for a very fine way to get up in the morning. So, a bit sobering, but having cancer is a bit sobering. Hug, laugh, dance, call me, try new things (I am working, after years of ignoring it, to learn flash photography. I just bought a nice external flash. Tomorrow I can get back to rock climbing. Today I checked out cork flooring for the kitchen.) God it is great to be on the same team as you guys.
Love, Dan, Dad, Doc
Here is the email I sent to family and friends: Hi, I sent this email to my kids earlier today. Here is your copy. What can I say? What is, is. Share with your kids. Thanks for all your support. If you want to talk about it, please ask. You are great, Love, Dan Hi, I had my PSA drawn on November 1. On November 11, Dr. Sershon called me to tell me that the number had jumped. He did not tell me the new number. I can get it in the next few days. It was my choice. The old numbers had always been below.2, or "undetectable". Well. He said he will watch the number at my next PSA draw in March. If it stays up, I will be referred to his associate for further treatment because it probably means there is a clump of cancer in there somewhere. Which of course I already know: The cancer has never gone away completely; that's why the PSA never went to 0. Sershon also explained that the number could go back down, that PSA related to lupron treatments sometimes jumps and goes back. So there is nothing to do but wait to see.
Just to be clear, Sershon is a pretty blunt guy. No mention of "affairs in order" or "bucket list." And I have no such intentions, though a month in Europe sounds good. The last thing he said to me was "Have a good winter," which is exactly what I plan to do.
Please know that I am not afraid nor am I worried. Look at these things head on and don't flinch. I refuse to allow these facts to affect the way I live in the now. And living now means that I am deeply in love with you all and your children, and that I know what that means at a very deep level, and that it is a lot of fun, making for a very fine way to get up in the morning. So, a bit sobering, but having cancer is a bit sobering. Hug, laugh, dance, call me, try new things (I am working, after years of ignoring it, to learn flash photography. I just bought a nice external flash. Tomorrow I can get back to rock climbing. Today I checked out cork flooring for the kitchen.) God it is great to be on the same team as you guys.
Love, Dan, Dad, Doc
Saturday, February 11, 2012
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.
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.
Friday, April 29, 2011
April 2011 A change
I just this week met with my radiologist. He suggested that I see him again in January. I will see my urologist in July and, the radiologist suggested, I should arrange to see him in July 2012. I was amazed. And, somehow, a lid was lifted off me. I feel better than I have in years. I am not afraid, but, still, there is that awful, well-you-are-good-for-three-months feeling. I have had it the entire time. Each time I go for a psa I fill with concern. What if it really spikes? Then what? Propelled by that, well, fear, or awareness, I have crammed a lot into this past year. We have travelled, I have delved deep into family genealogy, spent as much time as I can with family and especially grandkids, and learned to love each moment.
Here is the deal. My psa has slowly, very incrementally risen over the past year. I am now at .1. The cut off is .2. At that point they can no longer say, Well it is random. At that point it is Well it is back. So each time I go to the psa and hope it will be lower and it has not been. Each time I fantasize about the consequences. And now the radiologist, who strikes me as conservative in his evaluations, has said, Let's go to 6 month intervals instead of three month. I floated out of the office.
I have had the stance throughout this ordeal that I keep having a three-month reprieve. Nothing notable this time, so off you go for another three months. My urologist has used the phrase 'cancer free' with me, but, to be honest, I could only interpret that as 'cancer free for 3 months.' This last encounter has left me basically very uplifted. I am surprised at how all of a sudden I am thinking far in advance--which means what we might do next year--and not focusing on what today and the next few days.
I find, as I have said before, that I am not worried or afraid. What is, is. I know fear and I know its relative anger. I don't have them. I can face this. But I have to tell you that it is ok to face it later, rather than sooner. I want, I find, so desperately to have my grandchildren remember me. And this disease has pushed me into a way of relating to those kids unlike the way either my father or father-in-law related to my kids. I try to be more involved and personal.
And so, off I go into the summer. I still have July's psa to deal with, but whatever it is, will be fine. Over and over I learn the gift of cancer--I love better and I enjoy more. Love you. D
Here is the deal. My psa has slowly, very incrementally risen over the past year. I am now at .1. The cut off is .2. At that point they can no longer say, Well it is random. At that point it is Well it is back. So each time I go to the psa and hope it will be lower and it has not been. Each time I fantasize about the consequences. And now the radiologist, who strikes me as conservative in his evaluations, has said, Let's go to 6 month intervals instead of three month. I floated out of the office.
I have had the stance throughout this ordeal that I keep having a three-month reprieve. Nothing notable this time, so off you go for another three months. My urologist has used the phrase 'cancer free' with me, but, to be honest, I could only interpret that as 'cancer free for 3 months.' This last encounter has left me basically very uplifted. I am surprised at how all of a sudden I am thinking far in advance--which means what we might do next year--and not focusing on what today and the next few days.
I find, as I have said before, that I am not worried or afraid. What is, is. I know fear and I know its relative anger. I don't have them. I can face this. But I have to tell you that it is ok to face it later, rather than sooner. I want, I find, so desperately to have my grandchildren remember me. And this disease has pushed me into a way of relating to those kids unlike the way either my father or father-in-law related to my kids. I try to be more involved and personal.
And so, off I go into the summer. I still have July's psa to deal with, but whatever it is, will be fine. Over and over I learn the gift of cancer--I love better and I enjoy more. Love you. D
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