Week Fifty-Four….Decisions

Here’s the medical news for the past week….first, the weight bumped up a bit, 134.7 lbs.

We saw the ‘sleep study’ doctor on Tuesday.  He said my sleep pattern showed me waking up 42 times an hour, and that I am an ideal candidate for a CPAP breathing device.  So I’ll be getting fitted for that over the next couple of weeks.

Also on Tuesday we had a ‘consult’ with a surgeon to discuss the pros and cons of the surgical removal of my prostate.  After a thorough discussion of the options, the surgeon said he would lean away from surgery.  He said the surgery could be hard on me, given my age and the fact that I am still recovering from the esophageal surgery.  He was also concerned about the scaring from the radiation and esophageal surgery and how that might impact the prostate operation.  He said that the side effects of the surgery are immediate, with improvement over time, whereas with radiation the side effects take much longer to manifest themselves.  His thought was, it would be a shame for me to struggle through all the surgery side effects only to have the esophageal cancer come back (apparently that cancer is a very aggressive cancer).  He also said the nerves around the prostate should be removed on the side where the cancer tumor was the most concentrated.  If the cancer has gotten out of the prostate, then I would have to go back for radiation treatment.  So surgery might not be the end of it…I might have to do both surgery and radiation! He said that if I decided to do the surgery, he would probably refer me to UCSF.

He dismissed the idea of implanting radioactive seeds as my prostate may be too large for that approach to be effective.  In addition, I would not be able to hold my grandchild for several months until the seeds lost their radioactivity. He thought radiation the best option, with enhanced results if I also followed the hormone protocol.

Thursday we met with the oncology radiologist (the same one who did the radiation for the esophageal cancer).  Again after a very thorough discussion, she recommended the radiation approach, with hormone therapy.  She said they would expand the radiation beyond the margin where the major tumor was, to zap cancer cells that might have gotten out of the prostate gland. After much back and forth on the hormone therapy, we decided to do that as well.  She said that greatly improves the likelihood of success.  I will get started on the hormone pills today.  The doctor said the side effects of the hormone pills are moody swings, hot flashes, weight gain, muscle mass loss….it all sounds, well, not so pleasant.  I believe it’s about a six month protocol….two months before the radiation starts, the two months during radiation (yes, eight straight weeks of radiation), and two months after radiation.  The doctor also said that if I didn’t like the side effects after we started, I could always quit the hormone part of it.  But….if I’m going to go through this, with the best opportunity for success, I may as well go the ‘full monty.’

I will go in for a ‘planning session’ with the radiation oncologist, to map out my prostate and the nearby organs, on August 8th, just before we head to Alaska for two weeks.  Upon our return, the radiation treatment will start on August 23rd.  That will run until mid-October, and hopefully I will feel well enough for our planned trip to Mexico at the end of October.  We’ll go there just to relax, lie on the beach, and read a good book or two.

So, that’s about it on the medical front.  I’ll let you know how this next leg of the journey plays out.

This week’s poem:

Attitude

A finger slightly bent

And crooked at the knuckle

Knees okay on straight-aways

But up the stairs they buckle.

 

A constant minor ache

Comes from the lower back

One shoulder cracks and pops

The other slightly out of whack.

 

There are some other issues

Some other aches and pains

That come with getting older

That are simply life’s refrains.

 

So manage all these complications

And keep your attitude upbeat

Life is bound to treat you better

On the sunny side of the street.