When Prostate Cancer Returns – Researching Treatments for a Rising PSA – Part 3

October 19, 2013

Well one thing is for sure I don’t want same ole same ole as my treatment for a recurrence of prostate cancer.  Truth be know I don’t want to have prostate cancer rear its ugly head again.  To me once is enough, but apparently there is something more to be learned.

I guess for those that know me, I tend to look beyond the obvious to see what, at a deeper level, there is to what is happening in my life.  So, there must be a reason or a lesson.  After all everything happens for a reason, it’s just up to me and God to help bring the unknown to light.

Mayo Clinic LogoMany would say that there is an emotional issue first that manifests in physical disease.  If that is true, then I apparently have not dealt with the emotional since I am now facing prostate cancer’s return.  Whatever the greater picture the one thing I will deal with is the here and now.  So where from here?

WHAT’S NORMAL?

When prostate cancer returns apparently, as I seem to be told now by a few docs, I am a candidate for “salvage” treatment.  What is normal is radiation in the prostate bed area.  Beyond that, I could take hormone therapy, effectively chemically castrating me (depriving my body of testosterone – a hormone that feeds prostate cancer).  Hum…neither of those appeal to me.  Surely there is a more scientific approach.

Radiation to the prostate bed creates all sorts of potential complications or side effects including erectile dysfunction and urinary symptoms such as frequency, bleeding, or, rarely, incontinence.  Having experienced both as side effects from surgery, I don’t particularly want to experience them again.  In fact, both (especially erectile dysfunction) scare me.

If a man first concludes that prostate cancer is not going to take his life (at least anytime soon) then the issue of quality of life arises.  For a man quality of life is made up (at least a good part of it) in his sexual function.  If a man were to tell you the truth, they would say that they think of sex often and the inability to have sex or be functionally sexual is one of their greatest fears.  Not only is this true for me, but having interviewed over 125 men who have had different types of prostate cancer treatments, most all have said that sexual function was one of their foremost concerns when dealing with treatment options.

Here’s my most popular blog by far on that very subject: https://chuckgallagher.wordpress.com/2008/02/23/sex-after-prostate-cancer-surgery-what-can-you-expect-comments-by-motivational-speaker-and-cancer-survivor-chuck-gallagher/

IS THERE A BETTER WAY?

With the advent of highly specialized ways to do most anything, surely there is a way to find the source of the prostate cancer and deal with it once and for all?  Seems a logical question and one that I was focused on finding an answer to.  It just didn’t seem right that the best that could be done was a massive blast of radiation in a general area.  That’s like going deer hunting with a shotgun and hoping that you’ll be successful (by the way I don’t hunt).

After several google searches I came across something that seemed promising.  Here’s a reprint from the Mayo Clinic website that just might be an answer for me.  The link is here:  https://www.mayoclinic.org/choline-c-11-pet-scan/

Choline C-11 PET scan is an imaging test used to help detect sites of prostate cancer that have returned despite treatment (recurrent prostate cancer). It may be used when other imaging has not been helpful. Choline C-11 PET scan is a positron emission tomography (PET) scan that uses a special chemical tracer called Choline C-11 Injection. At Mayo Clinic, a low-dose computerized tomography (CT) scan is done at the same time to help further show internal anatomy.

Choline C-11 PET scan may help doctors detect possible sites of recurrent prostate cancer that more conventional imaging tests can’t identify. Locating recurrent prostate cancer sooner may allow your doctor to identify small, isolated deposits of cancer — both inside and outside your prostate — that can be targeted for more-effective treatment.

Choline C-11 PET scan uses a radioactive form of the vitamin choline. A small amount of the tracer is injected into a vein in your arm just before the scan is done. Prostate cancer cells in your body readily absorb the tracer. This can help doctors detect areas of prostate cancer cells throughout your body. A biopsy to remove some cells for lab testing is then done to confirm the presence of recurrent prostate cancer.

Accepting that I’m no doctor…I may be missing something, but it would appear that I am finding something here that (at a minimum) could help identify where specifically the cancer is and therefore make a more effective target for treatment (likely some form of radiation).  Now some hope.  Perhaps I am a candidate and for sure I will be certain to ask for this test.  Focus.  That’s what I need to feel that I am at least taking some control over this new phase of my life’s health.

More from the Mayo web site: 

Helps detect recurrent prostate cancer sooner. Choline C-11 PET scan can help doctors detect recurrent prostate cancer before it may be detected by more conventional imaging tests. In men with rising prostate-specific antigen (PSA) levels, this test may help detect sites of possible recurrent prostate cancer at PSA levels as low as 2 nanograms per milliliter (ng/mL). Conventional tests may not detect a recurrence until PSA levels are between 20 and 30 ng/mL.

You can bet I’ll be calling to schedule an appointment!

https://chuckgallagher.wordpress.com/2013/10/18/when-prostate-cancer-returns-one-mans-chronicle-psa-rising-part-1/

https://chuckgallagher.wordpress.com/2013/10/19/when-prostate-cancer-returns-one-mans-chronicle-where-from-here-part-2/


When Prostate Cancer Returns – One Man’s Chronicle – Where from Here? Part 2

October 19, 2013

When you’ve lived for eight years seemingly cancer free and then have the rude awakening that – it’s back – I admit it does cause some serious questions to arise.  It seems that we all (well that’s not fair cause I don’t know what others think or feel – so I’ll speak for myself) live daily as if we’ll live forever.  We can look toward the future and plan for eventualities, but do we really ever normally think that life is far too short and precious not to be taking full Chuck Gallagheradvantage of the most of today?  Having my awareness changed by the recognition that I am not cancer free is creating an on going inner dialogue – a dialogue that I will share as this chronicle continues.

BUT WHERE FROM HERE?

Men are from Mars and Women are from Venus – the title of a popular book.  Guess I’ve first focused on the martian route – a solution.

Wonder if my original doctor from Johns Hopkins would be willing to talk to me?

Turns out he was – now at the University of Florida heading up their robotic surgery program, I flew to Jacksonville and drove to the University so we could meet and talk about two things: (1) a book that I am writing on Prostate Cancer (from the layman’s perspective) and (2) thoughts about my current situation.  One thing I’ve learned is to gather information and explore before making a hasty decision.  Your health, my health, is important and not to be taken lightly.  Honestly, in most prostate cancers, the progression is slow…so there is no need for a rushed treatment decision.

MEETING WITH MY SURGEON

Nervous?  Yea a little bit.  Dealing with the unknown isn’t easy – that’s why before the meeting with Dr. Li Ming-Su I did my homework.  Amazing the depth of information that is available on the internet.

Great seeing Dr. Su and after some initial catch up he asked, “So, how are you these days?”

I would  loved to have said great…but I had to be honest.  “I feel great, but my PSA is rising and that concerns me!”

From that simple beginning I shared with my friend the progression – ever so slowly – of my rising PSA.  While he talked openly about probabilities the bottom line came down to this.  I had recurrent prostate cancer and that was nothing to be taken lightly.  The growth had been slow, which to him, was a positive sign.  Yet any growth in something that there should be no growth in was enough to set off alarms.

“Do I need to rush to deal with this?”

“No, but do you have a urologist?”

“No.”

“Allow me to recommend one.”

As you can imagine I was delighted to get a recommendation from someone I trusted with my life when prostate cancer was first detected.

I can’t quote him as this part is shared more in general terms rather than specific comments, but when prostate cancer returns after surgery then one becomes a candidate for salvage treatment when, for the most part, is radiation and/or hormone therapy.  Neither of which I wanted – especially hormone therapy.  But it was now time to come to grips with the harsh reality of being told yet once again that I had prostate cancer.

NEXT STEPS

Occupying my mind with next steps was far easier than dealing with the emotions that kept creeping into my being.  Optimistic?  Yes!  Yet at 56 it doesn’t yet seem to make sense to connect with one’s mortality.  It seems far more normal to believe that life will go on for 30 more years and that I have “plenty” of time to do what I came here to do.  Yet, with a second diagnosis of a disease that can prove to be fatal it is clear to me that I need to re-evaluate my priorities and choices.

I guess when we are young we think that we will live forever.  As we age we know that is not true.  But, damn it, it seems that we shouldn’t be spending too much time thinking of life or the lack thereof till we are 70 or older.  Now I am wondering if I’ll make it to the age when I can draw social security.  Not that that is important, but I’ve paid into it so it seems that getting back is an entitlement.  (And I can’t even believe I used that word!)

For now…the question is what am I willing to do to preserve life in a manner that I wish to live it?  As I write those words it strikes me that “in a manner I wish to live it” is important for me – at least at this point.  Perhaps faced with no life I’d consider making different choices, but at this moment the NEXT STEPS will be a journey of discovery – both inward and outward.

https://chuckgallagher.wordpress.com/2013/10/18/when-prostate-cancer-returns-one-mans-chronicle-psa-rising-part-1/

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