Wednesday, May 25, 2011

The Test Results

May 25, 2011

Today (5/24/2011) I had the results of all of my screening tests reviewed and to quote Ginny; "we couldn't have asked for better results.  All of the test results indicate that my prostate cancer has not spread to other parts of my body.  This means that my cancer can be treated by focusing only on the prostate.  I should point out as I have painfully learned that there are no "guarantees" in this business of dealing with cancer.  It is possible that some renegade cells are hiding inside of my body and only waiting for the opportunity to wreck havoc at some future date. 

Given these results the task now is to decide on the best option to fight the cancer.  My options are as follows:

1. Radical Prostatectomy:  This is an operation that essentially removes the entire prostate gland, both seminal vesticles (small glands behind the bladder that produce most of the semen) and a portion of both vas deferens (tubes that transport the sperm from the testicles to the urethra).  This is a major surgery and will require 2 to 3 nights in the hospital and full recovery will take anywhere from 4 to 8 weeks.

2. Radiation Therapy:  There are essentially two types of radiation treatment.  The first is external beam radiation where a machine delivers radiation in brief sessions to the cancer cells.  The treatment usually takes 40 sessions.  This means that you have to make a trip to the hospital for 5 days a week for about 8 weeks.  The second type is radioactive seed therapy.  With this procedure radioactive seeds are inserted into the cancerous area of the prostate and over a period of days or weeks the radiation is emitted from the seeds and attacks the cancer cells.

3.  Cryotherapy:  With this procedure a probe is inserted into the prostate and something like liquid nitrogen is used to freeze, thaw, refreeze and thaw the cancerous cells to kill them. This is one of the newer treatments for prostate cancer and the results have been promising with some patients but the long term effects of this procedure are still being developed.

4. Watchful Waiting:  This is exactly what the name implies.  I would essentially do nothing but watch my PSA scores and have periodic biopsies taken of the prostate to see if anything changes.   This may be an option if  I were 80 years old but at 65 it isn't an option that I am considering.

5. There are other options such as hormonal therapy, chemotherapy and investigational therapy (clinical trials)  that probably are not appropriate for me.

During the month of June I will have consultations with doctors who are experts in the first three options.  My intent at this time is to make a decision either in late June or early July and have the procedure as soon as possible after I have made my decision.

I should point out that none of these options are to be taken lightly.  They all have potentially serious side effects and as I stated earlier there are no guarantees that any of the procedures will kill all of the cancer cells.  Also, some of the options preclude the use of other options should the cancer flare up again.  For instance if I elect external beam radiation I probably will not be able to have surgery to remove my prostate at some future date.  No simple solutions and no guarantees.  This is serious business.

At this point I feel it is appropriate to mention a few people who have been very important in helping me deal with my prostate cancer and  giving me guidance and comfort through this challenging journey.  The first is my urologist Dr Michael Del Terzo.  He has been very open, informative and supportive since the beginning.  I couldn't have asked for more.  I am very lucky to have him on my team.
Second is our neighbor and good friend Liz (Korman) Bond.  Liz is a dietitian with Lancaster General Hospital who works with cancer patients.  Liz knows a lot about my cancer and she is well connected with the key specialists who work with prostate cancer.  Liz was able to get me signed up with a couple of doctors who are among the best in treating prostate cancer in their specialities.

Finally of course there is my wife Ginny.  Always by my side and always looking out for my best interests.  Sometimes I ask myself; "how was I so lucky to find a mate like this?"  As you can imagine, I am not always the best of patients but Ginny is always there.  I hope I can give her the same kind of care should she ever need me.

Now its off to China and a wonderful trip with my wife!

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