The Beginning

2007: My First Cancer

My annual physical in February 2007 revealed evidence (digital rectal exam, PSA) that I should have a prostate biopsy. Indeed, I had cancer, with a prognosis of an 80% chance of being cured once and for all (no recurrence). Cancer thus entered my life as a manageable interruption — a mote to be smitten — not something so game-changing or visibly obvious that it warranted telling everyone. So I kept my diagnosis rather closely held.

On Sept. 11, 2007, I had surgery¹. (Want more medical info? Follow the footnotes.) Surgery was successful, but the pathologist found — quite unexpectedly — two tiny tumors in nearby lymph nodes². Alas, the prognosis of a cure was not to be realized.

Hormone therapy³ immediately ensued, an injection every three months for a total of nine injections⁴. My oncologist was gratifyingly blunt: “We’re not trying to cure your cancer; we’re trying to manage it.”⁵

Hormone therapy ended in October 2009, but in July 2010, PSA (prostate-specific antigen) was detected during my quarterly blood test at the Seattle Cancer Care Alliance⁶. After prostate removal, PSA should be zero; thus, detectable PSA meant that prostate cancer was still somewhere within me. This news was virtually inevitable at some point, given the lymph node tumors, but the return of PSA so early after hormone therapy was disappointing.

So how’s Bill doing? Bill and family have continued to live a normal life, doing pretty much as we always have. Our lives move on. I feel great, and I’m doing all the things I’ve been advised to do: Vigorous, regular exercise. Proper diet. Aggressive pursuit of cancer-fighting nutrition⁷. These efforts are within my control, and gaining control is a found treasure when your body is out of control⁸.

I also hobnob with other cancer survivors. We commiserate over the indignities and inconveniences of our treatments. We learn from each other. And we celebrate the joy, the wisdom, the courage — and, yes, the humor — we discover in our cancer journey⁹. It’s a journey none of us chose to make, but one we choose to make the most of.

Looking ahead, at some point I’ll be back on hormone therapy, and maybe there’ll be radiation, and, farther down the road, perhaps immunotherapy or possibly some chemotherapy, or maybe even one of the new drugs now in clinical trials. It’s just way too early to ponder what may be in store during the years to come. I’ve a l-o-n-g  future full of hope.

May 19, 2013 Update: Since writing these words (“maybe there’ll be radiation…”) I’ve since undergone radiation, 36 daily treatments of Intensity Modulated Radiation Therapy at Seattle Cancer Care Alliance. This “salvage radiation” was accompanied by six more months of hormone therapy, which ended in January 2012. Since then, I’ve been “no evidence of disease” (undetectable PSA). It seems then that, so far, I’m right on schedule with the previous paragraph, written more than two years ago.

Footnotes for the medically curious:

¹Open radical retropubic prostatectomy and two nights of hospitalization at the University of Washington Medical Center. Before surgery, I participated in a clinical trial of the effects of Nexavar (sorafenib), a liver and kidney chemotherapy drug, on prostate cancer. This study continues.

²Prior to surgery, there were zero indications that cancer had spread beyond the prostate. Metastasis to the lymph nodes qualified me as having “advanced,” or Stage 4, cancer. There is no Stage 5.

³Androgen deprivation therapy (ADT). Testosterone fuels the growth of prostate cancer; ADT suppresses testosterone. Among the side effects of ADT is osteoporosis, which for me required a quarterly infusion of Zometa (zoledronic acid). The osteoporosis has abated to osteopenia, and the yearly Zometa infusions ended in July 2012. I’ll next have a bone density scan in July 2016.

⁴Lupron Depot (leuprolide acetate), 22.5 mg, intra-muscularly

⁵Technically, I’m receiving palliative care for advanced prostate cancer, but that sounds like I’m on morphine at the hospice. You’ll actually find me on the floor at the gym, doing 100 push-ups.

Seattle Cancer Care Alliance, where I’ve been treated since 2007

⁷See study on exercise and prostate cancer survivorship; also, The Cancer-Fighting Kitchen: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery, Rebecca Katz with Mat Edelson; Celestial Arts, 2009, available at Amazon.com.

⁸Cancer has been called “one big metaphor for loss of control.”

⁹Treat yourself! See the one-woman play “Jonna’s Body, please hold,” if it ever plays near you. Or buy the DVD of the movie.

One Response to “The Beginning”

  1. Bill;

    Congratulations on getting across the finish line!

    For what it is worth, I suspect patients with ‘distributed’ cancer rarely are given the thumbs up/all clear sign. Frankly it is probably irresponsible for an Oncologist to suggest this in most cases. Continued positive news over time may be the best we can hope for, and you now have a timetable to follow going forward.

    As you likely know, most lymphoma patients (including me) are told up front that ‘your disease is treatable, but not curable’ and that it will recur sometime down the road. I long as you do for a silver bullet, but the best we can do is to keep going with the knowledge that better treatments are continually being created. We just need to stick around long enough for the next therapy to be developed.

    For now, be proud of your achievement, and live it up!!!

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