Serious Business

Before I get into the real news of the day, my test results, I need to update you on the subject of most of my last post, the missing cross pendant that I was so sick about losing. It's embarrassing, though. Feel free to laugh. I did. I found it hanging on a hook in my closet yesterday. It's a hook that I rarely use or even look at, which is why I never looked for it there. I happened to see it when I was changing clothes yesterday. I don't know what possessed me to hang it there, instead of where I usually hang it when I'm not wearing it.

I feel like such an idiot. And after I made such a big deal about it in this blog! It was hanging in my closet the whole time. I thought I had looked everywhere it could possibly be, but apparently not. My wife was tempted to ask me if I'd checked the freezer. That's a running joke at our house. I've put some strange things in the freezer over the years. I actually accused my dog of eating it, because I've caught her chewing on its leather strap before. But it was just me, being my usual absent-minded self.

So, I'm embarrassed, but I had to tell you. If you want to make fun of me, go ahead. I'm laughing at myself about it. But I'm very glad I had it for today. I was able to wear it to the doctor's office. Its weight around my neck was comforting. It's the reason I was "feeling hopeful" instead of "feeling nervous" in my Facebook check-in this morning from the doctor's office. I'm wearing it right now. Thanks to everyone who prayed that I would find it! Now if you could pray that the Lord would increase my I.Q., that would be great.

I was a bit embarrassed about my last post even before I found the pendant. I have so many brothers out there suffering so much because of this stupid disease, and here I was feeling like the sky was falling because I couldn't find a piece of jewelry. One day, I'm sure I'll wish very much that a missing pendant was the worst of my troubles.

OK, enough of that. We actually have serious business to attend to. Very serious.

My PSA is 2.7, up about seven tenths of a point in the last six weeks. Not good. At this point, it's not so much about the number itself, but the trend. And the trend is in the wrong direction. My last increase, from 1.42 to 1.97, was five tenths in five months, so rate is increasing. But that doesn't necessarily mean the Lupron is losing effectiveness. It still is starving a certain percentage of the cancer cells, just not all of them. Some of the cells are resistant, and the resistant ones are multiplying faster all the time. The question is, how to we approach it?

My oncologist thinks it's possible that the six month Lupron shot I've been getting may not be effective for that long of a period. So he wants to try the four month version of the shot and get another PSA in two months. If my number is down at that point, maybe we just get the shot more often.

But what my oncologist really wants me to do is go for radiation. I've set up a consultation with the radiation oncologist I've seen twice to discuss treatment. But first, my oncologist has ordered a new bone scan and a CT scan of my pelvis area. Those tests should show if my cancer is still confined to the prostate. If these scans show no evidence of metastasis, I'm still a candidate for the radiation treatment they recommend. In that case, I will need to decide quickly whether to go ahead with it.

If, on the other hand, the scans show that my cancer has metastasized, we'll pass on radiation. All that will be left is "systemic" treatments and alternative treatments. To the dismay of some of my loved ones, I've already ruled out chemo. That's my choice. Hormone treatment alone is not likely to sustain my life for more than a few years, maybe less. But that's assuming that alternative treatments won't make a difference, and that's not an assumption that I'm willing to make.

The aggressiveness of my cancer robs me of the luxury of time. One thing you often hear said about prostate cancer is that it's a slow-growing cancer. That's true in most cases, but not in mine. So I can't afford to wait and see. I don't have appointments set for the scans yet, but they will happen within the next week or so.

My thought going into today was that if my PSA had risen, it would mean that I've had my last Lupron shot. In that case, I'd seek some naturopathic treatments for the next year to 18 months, so I could get some things done that are important to my wife and me. Things that could help us in our retirement, and/or help her after I'm gone. I don't feel like I can take months off for harsh conventional treatment right now. But my oncologist doesn't think I have time for that.

He says if I take a year off from treatment, by this time next year my cancer could spread like wildfire. I could have terrible bone pain, which would prevent me from doing everything I want to do anyway. If I refuse the conventional treatments he recommends, I could have a very short remaining time indeed. Maybe a year or two.

Of course, I wouldn't be doing nothing. I'd pursue other treatment options. My hope is that they would keep my cancer under control, if not cure it. I'd be hoping those treatments would help me "hold serve" while still feeling good enough to get these tasks done that are so important to me. But it's a big risk. If they do nothing, I'd be in big trouble fast.

The questions that I have to answer for myself are these: How much time am I likely to get from the treatments my oncologist recommends? If I do everything the doctors want, will cancer come back and get me anyway in a short period of time? And what will my quality of life be in the meantime? And, oh yes, what will all of this cost?

I was talking with some friends a few weeks ago, updating them on my treatment, and one of them said, "You just have to do what they say, right?" I looked at him and said, "No. It's my choice, not theirs." He was surprised by my answer. But it is my choice. I have to decide how much I'm willing to put myself through given my odds.

I've stated many times that I'm more interested in quality of life than quantity. If an ugly ending is in my future regardless, how much hell am I willing to put myself through to put that day off?

The good thing is, I'll have plenty to write about in the next few weeks! Since I started this blog, for long stretches, it has been light on medical information and heavy on navel gazing. That won't be the case for most of September.

So, to summarize, I get a four month Lupron shot on Tuesday, September 6th. Sometime that week, I expect to get a bone scan and CT scan. If they don't detect metastasis, we'll consider radiation treatment. Either way, I will seek alternative treatments in addition to whatever standard treatment I'm getting. And I'll be as transparent about this as I can be, every step of the way.

Thank you for braving this roller coaster ride with me. Your response to my last post made me feel very loved. God is good, and so are his people. I can still feel your love and prayers. They sustain me. I need them more than ever now, and so does my wife. Thank you for being there for us.

I'll close with a quote from my friend Robert Cannady, a dear cancer brother who has become a friend over the last few months. You may have heard or seen me quote it before, but I haven't shared it in this blog yet, and it bears repeating. He said, "Cancer hit me over the head and cracked my heart wide open." Yup. That's what happened to me too.

So please keep it up. Keep praying. Keep loving on us. We need it. And the next time I lose something, ask me if I've checked the freezer. #waroncancer