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Sticky Note #1

Throughout my cancer journey, I’ve made mental and physical notes to myself about cancer, about people with cancer, about my cancer. They’re random, casual and brief — almost all would fit on a sticky note. This is my first sticky note.

Early on after my cancer diagnosis, Kristina, a friend then in a courageous contest with breast cancer, advised, “Don’t get caught in the Calendar Game” — that bell curve of statistics that seeks to bracket the X and Y of years of probable longevity. “Those numbers include all kinds of people,” Kristina said. “Focus on your disease, your treatment and your health.” I’ve always thought that was sound advice: There are people in those numbers with multiple health problems, people who never took care of themselves, people who don’t follow their doc’s advice, and on and on. They become part of the odds, and probabilities, and chances. It’s about all, not about you. Or me.

Focus on your disease, your treatment and your health.

The HAY Question

It happened again.

A very close friend asked, “How are you?”

“I’m fine.”

“No,” he said. “How are you.” Oh, my cancer.

And a cousin wrote, “I signed up for your blog, and it’s very informative, but sometimes I can’t get a real sense of how you are doing.” They’re certainly not the first to ask, and I doubt they’ll be the last. So here goes.

I’ve been open (blatantly so) that I’m Stage 4, and that there is no Stage 5. But within my staging, there’s a cancer continuum that arcs from where I am all the way out and beyond the horizon to hospice. I’m classified Stage 4 because of lymph node involvement, a tiny tumor in each of two lymph nodes (out of 13) sampled at surgery. Regional metastasis, I believe it’s called. It’s that serious, and it’s that simple.

Physically, I’m fine. I’m active, and I feel great — no aches, no pains, no masses burgeoning within me to make life uncomfortable. When my calendar’s not full, it’s busy. On any given day, I feel like a healthy 67-year-old who goes to the gym for a vigorous workout. I take no meds related to cancer, and I live a ‘normal’ life, traveling hither and yon, unimpeded by my cancer. I’m soon off to Peru and then Sri Lanka.

Life goes on even as more hormone therapy and radiation await. They’re in queue not because I’m in dire straits but because I’m being aggressive — early and often — in kicking cancer’s ass. Prostate cancer has an affinity for bone when it metastasizes, and my April 27 bone scan came back clean. But, like about 99.9 per cent of cancer fighters, I get fatigued — not so bad now as when I was on hormone therapy. Back then, somewhere around 4 each afternoon, I’d fall off a cliff. Fatigue just comes with the territory, whether the territory is cancer or cancer treatment.

Bottom line: To be with me day in, day out, you’d never react, OMG, Bill’s ill! I make plans, sometimes quite far out, and I buy green bananas, sometimes quite green.

Mentally, I think my head’s screwed on straight. I accept the fact I have cancer — I’d rather not have it, but I accept that it’s my new normal, and I don’t waste time/energy/life being angry about it or wishing it weren’t so. It is so. I had two best buddies, Al and Bill, both killed in their 20s, and I’ve often thought they’d love to be my age and have a good case of prostate cancer. That gives me perspective on life and puts my cancer in its place.

I try to focus on enjoying life, enjoying my family and friends and doing all I can to counter the cancer within me. Oh, and getting as much good out of my cancer experience as I can (and there is good to be had, make no mistake).

I confess to three really bad head days — all of which occurred while I was on hormone therapy: From out of the blue came black. I just fell into a black hole, and that’s the only way I can describe it. A black hole. How, why — who knows? Each time, I spent about a day in the black hole. Twice I climbed out by watching the movie “Rocky” (see the Yo, Adrian post below), and once, I just had to have a little talk with Bill.

Bottom line: It is what it is, and I’m dealing with it as best I can, given who I am. There’s no training or preparation for cancer. One day, someone just hands it to you, and you begin the process of figuring out how you’re going to handle it — the where and how it fits into your life and into your mind. Stoically, I’ve never even been tempted to ask, Why me?

Although I have mused, Why not me?

My Cancer Hobby

Days after my prostate cancer diagnosis on March 26, 2007, my wife presented me with a copy of Newsweek dated April 9, the one with the cover story, “My Life with Cancer,” by Jonathan Alter. I didn’t read it then, and I haven’t read it now. I remember the exact words that ricocheted through my mind the moment she handed me the magazine: “Cancer is not my new hobby.”

This was, of course, back in the days when I lived under the presumption that  a prostatectomy would “cure” my cancer, and I had an 80 per cent chance of it. So, no, cancer was not going to be my new hobby: I’d have surgery, be done with it, and get on with my real life enjoyments — travel, photography and cooking.

But my first cancer did not go away, as was my plan, and this blog exists not because I had cancer back then; it exists because I have cancer right now.

And cancer has become my new hobby.

How did this happen, I ask? My treatments certainly have not taken up that much of a retiree’s time. So…?

It started with annual prostate cancer symposiums and then general cancer gatherings, where researchers, survivors and families would share the latest. (A woman in a wheelchair at one of these conferences talked about being sent to hospice to die — three times! She just refuses to.) Next I added informal monthly presentations on cancer and nutrition, and my kitchen hobby morphed into a cancer-fighting cooking interest.

And all along the way, there became this increasing need to get current on the latest developments in treatments of my advanced (or Stage IV) prostate cancer. (I had skipped that chapter in the book I read in March 2007.) Ever so gradually, gathering by gathering, article by article, test result by test result, cancer was expanding its place in my life, just as it was expanding its presence in my body.

Then this blog. I started it to keep family and friends in the loop on something that’s become more than a fleeting wisp of a health matter. It’s fun, I enjoy it, and it helps me work through how I feel about cancer things.

But — and how did I not foresee this? — the blog, and similar postings on my high school class website, have prompted extraordinary conversations with others about their cancers. Long-time veterans with courageous war stories. Serial survivors on their second and third diagnoses. Super people who challenge me and, in the process, help me distill my thoughts and decisions. Some long email exchanges, and often. You’ve seen some of their names here; you’ll see others in the future. It’s no longer about me; it’s a bit about us, the cancer community, and each other, and those who care about us.

And now, on May 25, I’m to give a presentation at the Seattle Cancer Care Alliance on Blogging about Cancer. So I’ve been somewhat in overdrive to get ready to stand and deliver next week. I even found research saying that people who have meaningful conversations and who blog about their cancers “better cope” with their health conditions.

It’s been so mind-expanding — and the notion that I might be able to give back just a little, just a teeny bit, to others dealing with their cancers — well,  we’ll see how it goes.

I am, after all, early on in my cancer hobby.

It’s a go.

Three doctors, three opinions — and unanimity: I’m going to proceed with radiation, combined with more hormone therapy, in yet another effort to manage my first cancer. I’m not kidding myself that this will “cure” me,  that this will be the silver bullet, that all will be jim-dandy after a go of radiation.

The likelihood is that we’ll only be putting out microscopic brushfires, and that, down the road, some further treatment will be needed. Fair enough. And the docs all agree — and I understand — that there’s no way of knowing for sure that my recalcitrant prostate cancer is in my pelvis and/or abdomen. But there’s a likelihood that at least some of it’s there, and that’s enough for me: To re-quote Lora, let’s kick its ass. (Just writing that makes me feel like I got a kick in.)

I’ve some travels and important life experiences on the calendar, like my 50th high school class reunion, but the docs say, OK. So under current planning, I’ll re-start hormone therapy in late July, be on it for the requisite minimum of two months, and begin radiation the end of  September or soon after. It feels good just to get this stuff on the calendar, like I’ve already pushed back once more.

Most important is doing everything I can. I’ve been aggressive in pushing back at cancer at each stage — an experimental drug before surgery; surgery; hormone therapy after surgery; and diet, exercise and nutrition from the get-go. Ever since my diagnosis, I’ve wielded every weapon extended to me.

And I’m not quitting now.

Eighth Day of the Week

Scan my bones, Jones! (Official T-shirt of the Prostate Cancer Foundation)

Today was Scanday, the day between Wednesday and Thursday, of two CT scans and one bone scan at Seattle Cancer Care Alliance. The scans are in preparation for my almost-certain radiation treatment…depending still on a third medical opinion a week off. An uneventful, information-free Scanday.

Except for the young man, the very young man, sitting opposite me in the waiting room. In his 20s, there with his mom, drinking the same contrast solution I was, and wearing a patient i.d. wristlet like mine. One of the mind games I play in the waiting room of the cancer ward is to try to guess what kind of cancer someone has — an impossible game of no consequence whatsoever, but one that does put my senses on alert for clues and ambient conversations.

Across the aisle, May 5, 2008: Man #1: “Are you a bone-marrow transplant, too?”

Man #2, tapping his right abdomen: “Pancreatic.”

Fast forward to the young man today. I couldn’t glean enough to learn what his cancer is or what stage it’s in. I merely drank in his wristband, his mom, his presence in the cancer ward — and his raw youth: so much life ahead. Maybe. And I recalled what my dad would say when he’d hear of someone else’s straits:

“I got no problems today.”

Hooked on a Feelin’

I’m now on the calendar for three scans in anticipation of radiation to deal with my just-won’t-go-away prostate cancer. Two CT scans, one bone scan. We’re nearing a decision, but — pending new information — the contours in favor of radiation already draw themselves.

My prostate-cancer friend, Tom, wisely observed in an email, “My approach in dealing with my cancer was that there was no room for second-guessing. Whatever feels right is right…and then deal with whatever comes next.”

Whatever feels right.

Indeed. All my attitudes and values about how I deal with my first cancer, how I counter it, and what I do at each step — they all interlace themselves into one, single, solitary feeling: It just doesn’t feel right to walk away from radiation.

Just doesn’t feel right to kick the can down the road and hope for something better after things get worse.

Or as Lora, an ovarian cancer survivor and one of my heroes, told me: “You need to kick ass every chance you get.”

Decisions, decisions…

April 4, 2011, Blood Draw

Spent this afternoon at Seattle Cancer Care Alliance — quarterly blood draw and Radiation 101, my very first consultation on the possibility of rad therapy to my pelvis. There’s a lot to chew on:

There’s good reason to believe the offending cancer is in my pelvis, but no certainty. There’s good reason to believe my cancer is microscopic, given my minuscule level of PSA (0.11). There’s some chance this could be a cure, but a greater chance that it’ll resurface somewhere else later. There’s some chance of long-term side effects Down There, but many of them can be treated.

Bottom line: The rad oncologist says he’d do it. So does my oncologist, knowing me as he does.

I’ve talked with cancer buddies who’ve confronted the radiation option. The decision to go ahead with it (or not) seems to turn on the hinge of values and attitudes, not on the  chance of success or the possibility of nasty side effects. Kristina put it this way: “I told myself that at each stage of my cancer, I’d do whatever I could.” And she wanted to send a message to her cancer: “You give me any trouble, I’ll come after you.”

While percentages and probabilities are derived from really large groups of people, for any one of us — you or me — the results are either 100 per cent or 0 per cent: It works or it doesn’t.

The flip of a coin.

Breakin’ Bad

I’ve made much to-do about the Holy Trinity of diet, exercise and nutrition and how they’re central to my dealing with cancer. But there comes a time, every now and again, when you just have to say, “Screw it! I’m going to enjoy the food.” And I couldn’t think of a better place to do it than Emeril’s original NOLA restaurant — both touristy and authentic, all at once. So here’s the general drift of the luncheon special the day we were there: grilled mahi-mahi on top of a mound of Southern cole slaw, topped with some watermelon preserves and something else I forget. Blueberries?

Q: “So what’s the sin?” you may ask.

A: The base, the foundation, the footings from which all these good, kinda healthy things arose: Southern-fried green tomatoes! Fried, fried, fried as they come. Oh, but so tasty!

Emeril, when you read this, I want you to know it was great. As you can see from the photo below, your team did well, very well, indeed. Hard to send a dish back for a re-do when your plate looks like this.

What can I say?