Well, 12 days had elapsed and to be truthful, I had been living in a "fool's paradise". I believed the old saw that no news was good news, and that with almost 2 weeks gone past the prostate biopsy the only reason the urologist hadn't called by now was the result had to be negative. Wrong conclusion! The urologist was actually out of town on an 'emergency' for a week so was incommunicado. But he did call today, actually his nurse, and informed me that 5 of the 12 extracted tissue samples were positive for cancer - with two of the samples displaying high Gleason scores, of 6 and 7. That means the malignant cells are aggressive. The good news is they're contained and relatively localized.
I am scheduled to meet the urologist tomorrow at 10.15 a.m. and he will discuss my options at this point. I do know he is a Da Vinci robotic procedure specialist so will be eager to go that route. However, my reaction will be 'Not so fast'!
After reading the account ('Hello, Prostate Cancer') of Dr. Steven B. Mason in the latest issue of the Region VII Intertel Newsletter, I definitely do not want to go that way. Not with excruciating pain, with 12 weeks of post-op recovery and being basically hobbled to the point of a cripple. Mason noted that one ("not uncommon") complication he had was a "pelvic abscess" and having to go back into the hospital after 8 weeks "with a drainage tube poking out of my belly a second time". At the end of his 12 -week ordeal (which he says he'd never have gotten through without a mate) he states he retained urinary control, but many sources suggest rates of incontinence approaching 50% after Da Vinci robotic surgery. It ain't as neat and straightforward as many have been led to believe.
The options? Well, proton beam therapy (which is VERY expensive, averaging $48,000 a treatment) and HDR brachytherapy - for which my wife was an expert treatment planner before retiring. The HDR stands for "High Dose rate' and it entails a procedure in which radioactive seeds (usually of Iodine) are implanted into the prostate by way of hollow needles through the perineum. The implanted seeds then release specified doses of radiation to the affected region and thereby kill the cancer cells. (This is also the method that Warren Buffet has elected to use in treating his own prostate cancer.)
We just talked on the phone to a guy (who used to work with wifey) and had HDR monotherapy done last year, at the Univ. of California - San Francisco, and he said it entailed just three sessions - each in the hospital - over 5 days total, and there have been no side effects, whether to urinary function, inflamed rectum or other. He said the only incidental discomfort was from a reaction to the local anesthetic but that this was unusual. The great thing is he was up and about in just a week as opposed to being laid up like an invalid on pain killers for 12 weeks.
Of course, negative nabobs note that if the radiotherapy doesn't work then your pelvic area will possibly be too damaged to then have surgery. But hey! Them's the breaks of the game! Nothing is assured, as I am finding out. Even PBT or proton beam therapy can have its nasty side effects including the need for resection of intestines or even needing evacuation (ostomy) bags worn permanently if the treatment goes awry. Surgery meanwhile invites high rates of infection, including from prolonged use of catheters, as well as possible strokes. Not everyone walks away from it unscathed, or clean as a whistle.
You basically take your pick of treatment, go with it, and (hopefully) live with it without regret. But there are no ironclad guarantees. Anyone who wants such guarantees has no business living. Life is a crap shot each time you wake up in the morning. Ask those people still recovering after going to the Batman midnight movie premiere in Aurora, CO ten days ago.
So I will let blog readers know what the upshot is from the meeting tomorrow. In any case, I also have other medical issues to deal with as well including a possible perforated eardrum. (For which I have to see an ENT specialist on Thursday).
When it rains, it pours!
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