Prostate Cancer – One Year Later

This past week I passed my one year anniversary as a cancer survivor.  It was last Valentine’s Day that I had a Radical Prostatectomy, having my prostate removed.  At that point everything looked very positive that the cancer had been completely contained within the prostate and should be gone.  But there is always the chance that the cancer had spread and might have migrated into my bones.  As a result my PSA, a blood test looking for a prostate antigen, become very important.  With the prostate gone it should be essentially 0.  But if the prostate cancer is growing in my bones that value will start to grow.  Well, the good news is that as of last week it is still at that 0 threshold; there is no sign that the cancer had spread.  This will continue to be an annual test just to be sure, but it was good to see.

Physically I seem to have fully recovered from the surgery, being able to do just about anything I could a year ago, other than become a new father; something I am not interested in anyway.  I am left with a 4 inch scar on my lower belly that is slowly fading, but no other signs.  And having the prostate gone  now saves me from one of the more unpleasant aspects of the annual physical; you older guys will know what I am talking about.

I am thankful that we have the technology now to discover this cancer at an early stage and to be able to deal with it, even though that process was less than pleasant.  Prostate cancer is generally a fairly slow growing cancer and easily treated when detected early, but very challenging to treat when not discovered in time.  I would encourage all of you men, especially once you are over 50, to keep an eye out for this.  Statistically, most men will get prostate cancer if they live long enough, so thinking it just happens to someone else is not really realistic.  Keep an eye on your PSA and learn about this disease.  Don’t let it sneak up on you.

And my thanks again to Sue and her wonderful support through all this.  To the medical staff who took such good care of me.  And to all those who uplifted me in prayer during that time and still periodically check up on me.  And thanks to God who has used this event in my life to draw me closer to him.

And Life Goes On

Well it’s been four weeks now since surgery; and not a four weeks I would hope to repeat.  I have never spent so much time laying around doing little or nothing.  And if I never see a catheter again, it will be too soon.
There is a projected healing process that most guys go through during recovery from a radical prostatectomy.  And according to that, I should have been out of the hospital after two nights, had the catheter out in 2 weeks and quickly been about getting back into the swing of things.  Unfortunately there are those outliers that fall outside the standard curve, and while I was not totally surprised that I was one of those, I was surprised that I fell on the slow side.  I was in excellent health and in good physical condition so to have healed quicker than normal would not be too surprising.  But no, I had to struggle through every step of the way.  Troubles with the catheter started in the recovery room, continued during my hospital stay leading to an extra day there, and on into my home recovery period.  The silly thing kept plugging up, leading to leakage through the anastomosis (the reconnected urethra and bladder) and out the cavity drain.
The catheter problems hit a crisis point on the Saturday after coming home and resulted in a trip back to Tacoma and a replacement catheter, quite a fun process – NOT!  The only highlights of this was Sue being called in to assist the doctor, and that it fixed the problem.  Unfortunately it appears that by this time one of the sutures in the anastomosis had blown out, requiring an extension of the time for the catheter from 2 weeks to nearly 3 1/2.  At that point the doctor removed the catheter, not because the leak was gone (it wasn’t) but because I was going crazy.
Life post-catheter is much improved.  I am able to move around much easier and life is almost back to normal (whatever that is).  Today, four weeks to the day after my surgery, I was finally able to lace up the running shoes and get back on the road.  Just a short easy run, but it is a start.  And I was finally able to make it back to work.  While there is still some discomfort, it is wonderful to be able to re-engage with the world outside of the house.
So what does the future hold?  The cancer should be gone, although I will be tested periodically over the next few years.  The healing process continues and I should be able to gradually increase the duration and intensity of the runs.  In another couple of weeks I should be able to get back on the bike and into the pool.  The major issues facing me in the future are incontinence and impotence.  Both of these should slowly resolve but there is no assurance of that.  The next 6 to 18 months will tell the story here.  Whatever it is like at the end of that period will likely be permanent.
Still a long road ahead, but I am thankful to have the past few weeks behind me.  Also extremely thankful for my loving wife who has been willing to wait on me hand and foot, and to the others who have prayed for and supported me during this process.

Surgery: A Big Adventure

I must admit that surgery was quite an adventure, but one that I do not look forward to ever having to experience again.  I have heard from lots of people who have had surgery, and read about it some, but nothing quite prepares one for the actual experience.  Monday started at 2AM with a mandated shower and double wipe down with a MRSA disinfectant, along with no food or fluid.  Report in time was at 5:30 but, being who I am, I got there at 4:50 and got to wait around for someone to show up and check me in.  Highlights of the pre-op experience included the poofy robe and winning the blood pressure contest.  Because of the length of the surgery I got to wear a warming robe.  It has a hose that connects to it and circulates warm or cold air through the body of the robe.  Made me look kind of chunky but it was warm.  Blood pressure was a bit of a problem throughout this whole process.  It started off low (somewhere in the neighborhood of 110/55) and never got higher.  That was impressive to the folks checking me in but in the hours and days after surgery when it was dropping to 95/39 it got me a little extra attention.

I remember pretty well everything through the pre-op, getting wheeled into the OR and shifting from the bed to the operating table and meeting the OR staff.  The next thing I remember though was being woke up in recovery, about 3 hours later.  Apart from not getting a room until after nearly 8 hours in the recovery room, and a short drop in blood pressure and pulse as well as some intense pain, the recovery room was pleasant.  I got to know my recovery room nurse and had visits from Sue, the Dr. and the Anesthesiologist and got to listen to folks talk about me.  I was supposed to be a really easy case but the one incident I had seemed to have changed that.  According to my anesthesiologist it was because I was ‘too’ healthy.  With my blood pressure and pulse normally pretty low, it didn’t take much of a drop to push me into the danger zone.

The original plan was for me to stay in the hospital through mid-day on Wednesday.  And up though most of Tuesday everything seemed to be OK.  But the catheter seemed to have other plans.  We noticed mid day on Tuesday that it was not draining correctly and the drain line from the incision site was draining way too much.  Tuesday night was long and painful and had the Dr’s and nurses puzzled.  Finally, midday Wednesday it just started working on its own and so far has continued to do so.  I have it for two weeks so have to keep a pretty close eye on it.

Throughout this process my swing and graveyard nurses were great, especially the angel who cared for me from midnight to 8; I’ll never forget Nina.  My day shift nurse was nice enough but she seemed a bit distracted.  I would have guessed that she was new on the job but apparently was not.  I found it both funny and scary that I had to help her with her duties and give advice on my care, including having to remind her to take out my IV line after she had discharged me.

In the back of my mind I knew that modesty was not a high priority for a hospital.  But I never fully appreciated just what it would be like.  The experience of having a seemingly endless succession of doctors, nurses and CNA’s poking around in places that are generally off limits to other people was very interesting.  I am very thankful indeed that they were able to do what they needed to, but am also thankful that I do not have any kind of social relationship with any of them.  Not sure how I would handle that.

Now, other than taking it easy at home for a while and letting everything heal up, the next step is a trip back to the doctor to check up on how things are and to get a pathology report.  That is currently scheduled for next Tuesday afternoon, my 10th appointment in this whole process.

God is good.  And I am thankful to all the friends and family who have prayed for me through this whole process.  I am especially thankful for Jon and Bonnie spending the surgery day with Sue in the waiting room.

Surgery Pre-Op

Surgery is now six days away and today was the day scheduled to get all of the pre-op stuff done.  Spent time with my surgeon as well as the admitting process at St. Joseph’s.  My surgeon gave me a rundown on all of the things that would be taking place on the day of surgery as well as the following couple of weeks.  The admitting nurse also walked me through the preparations I will need to make to get ready for the surgery.  Since this is my first time for anything like this I have found it to be very interesting.

I need to rest on Sunday and eat lightly, but nothing that will cause gas or bloating.  That probably eliminates the chili feed at the church that night.  And no food or drink after midnight.  The surgery is on Monday and the Dr. told me they would likely starting giving me fluids to drink on Tuesday with solid food on Wednesday.  Think maybe Monday will be a good day to schedule a time of fasting. 🙂

I have to check in at St. Joseph’s in Tacoma at 5:30 AM, which means I need to leave home around 4.  But prior to that I have to take a shower, shampooing my hair, followed by two complete wipe downs with a special wet wipe that will kill germs for 6 hours.  Apparently all of this is to cut down on the chances of a MRSA infection.

Surgery is scheduled for 7:30 AM and should last for for 2 to 2 1/2 hours.  Because I am skinny they will only have to cut a 3 inch hole in my tummy, carve out the prostate and related stuff, re-route some plumbing, install a catheter and then sew me back up.  Should be a piece of cake; or so he says.  Will be in recover for an hour or so and then into a room for a couple of days with an expected release on Wednesday.

They want to have me up and walking sometime Monday after the surgery and I am encouraged to walk as much as I like.  But no running for at least 3 weeks, and then only a light jog.  It’ll be another week or two after that before I can really start running again.  I’m guessing that a marathon in March is probably out of the question.

Once I get home I will have three jobs.  The first is to not hurt, which I am all in favor of.  Take more drugs when the pain hits a 5 on the scale of 0 to 10.  The second task will be to avoid phenumonia.  This is done by sucking on a breathing thingy a few times an hour, at least until I am up and walking around a lot.  And finally I am supposed to avoid blood clots.  I can accomplish this by wiggling my feet around a lot, again, until I am up and walking.  Seems like a pretty rough routine but I suppose I will be able to manage it for a week or two.

As a side note, most of the medical folks I have seen in the past couple of months, and it has been a lot, say that I am about as healthy as anyone they get the opportunity to examine.  Blood pressure is running around 110/60 with a pulse rate in the upper 50’s to low 60’s, all the blood work right in the middle of the chart, never smoked, no alcohol consumption, answering no to all of the ‘have you ever had this…’ type questions.  And the shocker for most of them is when they find out I go on 20 mile runs.  The gal today’s mouth fell open.  That’s been the fun part of this routine.

It’s Surgery

It’s been an interesting few weeks trying to find out as much as I can about prostate cancer and how to treat it.  I’ve read books and looked on the web.  Also spent over an hour talking with my doctor about it.  I have found that there are three basic options for treatment with sub-options for two of them.  One treatment option is to do nothing and hope the cancer does not kill you before you die naturally; not a bad option for someone either much older or much poorer shape than I am in.

There are several forms of radiation that are used to treat the cancer.  This option is much easier than surgery but can take a long time and has no guarantee of actually eliminating the cancer.  More generally it is thought of as a control mechanism.  The primary potential long term complication of this treatment is impotence.

Surgery also has several different options but they all include removal of the prostate along with a hospital stay and recovery period.  The biggest plus for the surgery is that the prostate is gone and, so long as the cancer has not spread, there is little chance of having a second bout.  The potential complications of surgery include impotence and incontinence.  If the cancer has spread beyond the prostate, determined by biopsy, then other treatment may be required, otherwise it should be the end of the cancer.

The biopsies I had earlier, plus my PSA reading, indicate that the cancer is in an early stage and should be contained within the prostate.  Based on that, my age, general health, and desire to ‘know’ where I stand when it’s all done, I have opted for surgery.  It seems to offer the best long term outlook for me.  Surgery has been scheduled for Feb 14th with several pre-op activities leading up to that date.  This will be my first over night stay at a hospital as a patient since I was born.  Should be interesting.

In the meantime Sue is reading up on dietary treatment for prostate cancer.  Looks like I am going to have to learn to like tofu 🙁

Prostate Cancer

Cancer.  Such a simple word; but with such ominous overtones.  One day all is well in my little world, then the bi-annual physical, a high PSA reading in the blood work, a trip to a Urologist, a 1 in 8 chance of cancer, a biopsy, and then the results; prostate cancer.  It is still in the early stages and is very treatable.  But still, it is cancer.  Both of my parents died with cancer, as have many others in my circle; and now its my turn to do battle.  I must admit that the first couple of hours were a bit difficult.  But now, two days later, the shock has pretty much worn off and it becomes just something else to plan for and deal with.  Doing a lot of reading and digesting material about prostate cancer now.  Next week it’s back to the doctor to discuss treatment options and then following through with whichever one we decide on.

The journey ahead is full of unknowns.  I am so thankful to have a wife, a God and friends who will be walking with me through it.