A brief history of my prostate cancer

Feb 18, 2010

I guess the first thing is to clear my personal space so I can write in the present about what is happening to me and how I am dealing with it. I’m going to do a brief history of what got me to this point where I am going to radiation treatment at Sunnybrook Monday through Friday for 6 and half weeks. I was diagnosed with prostate cancer in October 2002 at a routine annual check up. My friend and doctor diagnosed it tentatively with a finger up my ass. A few days later it was confirmed with an over the top PSA and a biopsy 3 days later. A month after diagnosis I had my prostate removed surgically. Cherie, my wife says when I got the news from Dr Singal the urosurgeon from TEGH I said, I’m fucked, I’m fucked.” I can’t remember that but I know I was terrified and then I nearly passed out. I had to lie down on his examining table.

The timing was terrible because I was about to compete for the top job at my agency and I felt the ground slipping out from under me. I managed the surgery and I managed the recovery with lots of help from friends and family. I went back to work about six weeks later as the interim ED and did that for 7 months. I didn’t get the permanent job which may have been a blessing. I go back and fourth on that. I know I impressed myself with how after that initial panic I took it all in stride. For the last seven years I like to tell people that I have used the mail capacity for denial well. I have been living life fully and feeling okay. I surfaced from denial for appointments with Dr Singal where my latest PSA was reviewed and then largely forgot about it in between. I didn't really see msyself as having cancer. My plumbing hasn't been up to the presurgical standard but I have been able to live with that.

There was more to deal with. My PSA didn’t go back to 0 meaning in some ways that the surgery didn’t work. Cancer has leaked out of the prostate into the surrounding tissue and surgery apparently didn’t clear it all out. I lost my seminal vesicles and some lymph nodes which in all fairness may be a part of why I have been healthy for the last seven years. I did go on hormone suppressants for about a year and a half and I adopted a special diet for which Cherie gets all the credit. My PSA went back to 0 on the suppressants and stayed there for several years.

Sometime in the last couple of years it reappeared and it has gradually been creeping up at a rather slow rate. Eventually Dr. Singal began to talk about the possible use of radiation and talked me into a consultation with a radiation oncologist. I was not keen and didn’t bite immediately and given that my PSA change rate was slow he let it ride for awhile. At 0.48 , having seen Dr. Szumacher from Sunnybrook and with recommendations from rounds and something with the awful name of tumor boards I said yes.

Actually I sent the email below and he replied as below
Hi,
Do you have anything from the tumor boards?
Peter

Peter
Yes the feeling was that it probably is a good idea, probably hard to quantitate (sic) the benefit but everyone agreed that you have never followed an expected course. The best explanation is that maybe the 2 years of hormones destroyed any micro metastatic disease and that we now only have local disease. I think I would encourage you to do it but you have to be comfortable with the potential toxicities.
RS

Well this was not exactly do this and you’re cured but his honesty has always impressed me. The truth is I’m risking the toxicity based on a number of assumptions, any or all of which could be wrong but when I think of sitting around and waiting for metastasis it seems like a better alternative. For the record I think the diet Cherie researched for me and which I have stuck to like glue may well have played an important role in keeping cancer down in my body. High soy, lots of fresh fruits and vegetables, no red meat, occasional skinless and boneless chicken, no egg yolks, no dairy products, no nuts and not oil but olive oil. No restrictions on carbohydrates. Essentially we are talking high soy, high anti-oxidant and low fat. I couldn’t stick to the green tea and I eat dark chocolate.

As for the toxicity lots of things could happen and I should know more about the probabilities that I do. On the up side this can be short term pain for long term gain or it could be long term pain and no gain. I won’t bore you with the details just now.

I’m committed to 33 sessions of focused x-rays Monday through Friday for six and a half weeks. To get it I have to go to Sunnybrook which is not bad going from work but, unless I drive, a pain from home. This brings us up to session 1.