Thursday, February 28, 2013

Prostate Cancer Treatment Update

Bill entering the cancer center

Yesterday I met with my doctor (an oncologist) at the local cancer and radiation oncology center.  I had just about made up my mind as to what kind of treatment I wanted for my prostate cancer.  After meeting with him yesterday, and hearing him explain my options for treatment, I have decided to have radiation seed implant therapy.


Me checking in

Yesterday's meeting took about three hours. The first hour or so was supplying them with all my paperwork (insurance, doctor's, blood tests, medical history, etc).  

The second hour was meeting with my oncologist.  He went over my prostate biopsy result with me.  He explained to me that my cancer was discovered early and I had a 95% chance of survival if I decided on a treatment.  He told me that my cancer ewas "localized" and had not spread beyond my prostate. He said if I decided not to do anything, that maybe I would have another ten years of life.  


Bill waiting with me in the doctor's office

He asked how long my father lived (80) and my mother (86).  He explained to me that I had a "long lived familial history" and that if I got treatment I would probably have another "good" twenty years.  I'll take that!  I'm 71 now, that means I would be blogging until I was 91 years old before I faded out to the big Gay Bar in the sky.

Then he went over my five choices of options.


  1. Do nothing.  Just live with my prostate cancer.  This is the option where I would probably live another ten years assuming my cancer didn't turn aggressive.
  2. Remove my prostate by a radical prostatectomy.  He said at my age (over 70) this probably wasn't my best choice but that I could have it done because he said I "appeared" in good health.  I had long since decided not to go this route because of the incontinence side effects as well as impotence.  I'm not ready to go eunuch yet.  
  3. Hormonal therapy.  This is one I hadn't considered and after hearing the side effects, I decided against this one too.  Basically this therapy turns you into a woman.  They inject female hormones into me to lower my testosterone (as if it isn't low enough already) to slow the growth of the prostate cancer.  Some of the side effects are that I would grow breasts (I already have man boobs which is quite enough thank you), gain weight, lose muscle tone, get hot flashes and basically become a woman going through menopause.  No thank you.  Option out.
  4. Direct radiation therapy.  This is where they pinpoint the cancerous cells in my prostate.  They paint my stomach and make a mold of my hips so I don't move when they radiate me five times a week (weekends off) for nine weeks.  Not only is it inconvenient going to the cancer center for forty-two visits, they also have forty-two times to get it wrong. In other words, radiate a non-cancerous part of my prostate gland. He said I could move or my prostate could move.  A definite possibility that my prostate could move after my experience with the latest video I downloaded from "Clothed Men-Nude Men".
  5. Radiation seed implant therapy.  This is where they pin point (by an very invasive procedure which doesn't thrill me) the cancerous cells in my prostate and  inject 80 to 90 radioactive seeds in my prostate.  Even though the procedure is very invasive (apparently there is no getting out of invasive procedures with prostate cancer) I decided this was the best option for me.  My doctor agreed.  He told me the downsides were that I couldn't hold my grandchildren in my lap.  Bill was sitting with me in the room with him and I explained to him who Bill was and that I didn't have grandchildren nor would I be holding any children (grandchildren or not) in my lap in the foreseeable future.  In fact, I don't think I ever had a child sit in my lap in my lifetime.  He also told me that I shouldn't hug pregnant women.  OH WELL, no worry there either.  Then I told him that I may be near a pregnant women at my upcoming family reunion in October.  He said "As long as you don't hug them for half an hour."  Not likely.  He did say that I could be with a man....close.  Oh well, that's not going to happen either at my age.  The only sexual experience I'm going to have is to be near my iMac watching my latest "Clothed Man-Nude Man" download.  He told me that wouldn't be a problem.  Thank you God.
So my next visit on March 15th, he and my urologist with knock me out with anesthesia, catheterize me (a first, getting catheterized, finally after avoiding it all these years); then they "map out" my prostate prior to inserting the radioactive seed implants at a later day.  Oh joy.  Want to know some of the details?  In addition to "markers" to my prostate though my anus, needles will be inserted through my scrotum.  Good thing I'm out.  

Me waiting for my oncologist

Then when I come too they remove the catheter (not looking forward to THAT) and send me on my way.  He did say that if my prostate swelled up they may have to leave the catheter in so I could pee.  Hopefully that doesn't happen folks.  

Then he said "about a month later we'll do the actual seed implants."  He said they will remain radioactive up to ten months.  I'm not sure if those needles go through my scrotum at this time or while they're doing the "mapping" of my prostate.  I sort of "blurred out" when I head "needles through your scrotum."  

So that's it folks.  I do feel less anxious and more at ease with myself since I made my treatment decision.  Now just to get through it.

Bill checking out the puzzle at the cancer center

One thing I do want to say though, I was very impressed by how they treated me yesterday.  They took their time with me and answered all my question in a patient and respectful way.  I didn't feel rushed at all by anyone, especially the doctor.  That's one of my pet peeves with doctors, some of them never seem to have time to discuss things with you, they're so quick to get to the patient in the next room.  This wasn't my experience yesterday.  


Another thing that impressed me greatly was that they allowed and even encouraged Bill to be in the room with me.  Not only did this save me the trouble to explaining everything to Bill (which I always have to do after visiting a doctor), but it showed me that they respected both me and Bill and our relationship.  I actually got choked up a couple of times, sentimentalist that I am.  

So I'm on my way folks.  I'll still be able to attend the Blog-a-Rama March 22nd and 23rd.  And hopefully my seeds will be implanted in time for Bill and I to take our annual vacation down south.  I'll be radioactive but maybe that's what they need down there to wake them up to the reality of diversity.  Not only will a gay couple who have been together forty-eight years be traveling through red states Virginia, North Carolina, South Carolina, and Georgia; I'll be leaving a radioactive trail behind us.  Oh if they only knew.  

Me at Tallulah Gorge, Georgia last year

Tallulah 

25 comments:

  1. I think you're about the smartest man I know when confronted with such a plethora of information - the good, the bad, and the ugly. I hope and pray everything turns out OK. I think it will, it sounds like it's all going your way despite the invasiveness of it all. . I will bring my Geiger Counter with me to the Spo-a-rama so we can watch it light up and beep (j/k!).

    Peace <3
    Jay

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    1. Jay,

      My crotch won't be radioactive until sometime in April. This procedure on March 15th is to just map out where they're going to implant the seeds. Should be fun.

      Ron

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  2. Ron,

    Thank you for giving us an update. I was reading up on the mapping procedure. Yikes! That IS invasive.

    The geek in me finds the technology behind it to be absolutely amazing.

    I'm glad that they really took their time, and explained everything.

    I hope it was helpful to Bill to be able to hear all of this firsthand. I hope it set his mind at ease too.


    Have a good night!

    Sean

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    1. Sean,

      My mind is much more at ease now after this meeting we had yesterday. Still, I'll be glad when the next two procedures are over and then I can be doctor free for at least a few months. Seems like the past several months have been nothing but a series of doctor's visits.

      Ron

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  3. This sounds great and positive. So do you.

    I've been catheterized twice - both times I was out when it went in but awake when it came out. It really is not a bad experience and the thought of it is much worse then the reality. However, one time it had been in for a few weeks and it's removal was felt but still not bad at all. Just don't look and do some deep breathing to relax. You'll probably still be feeling the affects of the anesthesia so you shouldn't feel anything.

    See ya in a few weeks!

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    1. Sean,

      Are you coming down to the Blog-a-thon? Where are you staying?

      Ron

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    2. Wrong or different "Sean." You're staying with Cubby, right? Thanks for the encouraging words about the catheterization. My brother had a horrible experience with one of his catheterizations, that's why I am so apprehensive about it.

      Ron

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    3. You have too many friends named "Sean". Have you all noticed that they're all spelled the "right" way? (That's my Irish roots showing!)

      Sean R.

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    4. Sean,

      I never had a friend in "real" life named Sean, only in the Blogger World. I have loads of friends named "Bob, Bill, Don, and Ron." So many that it's hard to keep track of them. I even have one "Robert" but he's much younger than my other "Bob" friends. I think the younger generation of gay men prefer the long form of their name. Of course my Bill is Irish all the way: William Daniel Kelly. Black Irish that is, no redhead he nor Papist.

      Ron

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    5. there's sean (jeep guy), sean (idol eyes), and sean (frozen chosen). then there's shawn (from san diego). too many of them; they are taking over the world!

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  4. OMB! yeah, about #3; as a woman, I can tell you that menopause is hell times infinity.

    my nether regions got into a tight clench reading about the procedure. ouchie! :(

    the bright spot? "it showed me that they respected both me and Bill and our relationship." :)

    http://www.youtube.com/watch?v=di3CLFj6_Ag&playnext=1&list=PLCB671309E97B3037&feature=results_video

    the above video is just for fun; but considering your situation and jay's comment above, I could NOT pass this up!

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    1. Anne Marie,

      I have enough problems just being a man, I don't need to take on "woman problems." No thank you.

      Yes, it is refreshing for Bill and I to have our relationship recognized and respected the same as a heterosexual couple.

      Ron

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  5. I'm impressed with the Bill pictures. You keep that calm strong caring person with you through this and you'll do fine. The examination rooms are identical to those of my several cardiologists, except Norma is in that other chair. One finds measureless confidence in that other chair.

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    1. Geo.,

      Bill has always been my rock. I moved in with him when I was 22 years old and he was 35 years old. For many years he was like a father figure to me. Now that he is 84 (to my 71) I take care of just about everything (household, dealing with other people, etc) but Bill is still my "rock." Always there for me which makes a big difference in my life. It is nice that you recognized that just looking at that picture of Bill. I was so glad they allowed him to be in the room with me during my discussion with my doctor.

      Ron

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  6. Randy in NEB.2:23 AM

    Ron, Sounds like you're in competent hands there. Oh my now I know some more of whats to come for me, maybe. Again, sending nothing but good thoughts your way. Do you need to wear a atomic symbol on your belt buckle?Also wish I could be there for your blog-a-thon, sounds cool. Randy.

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  7. I never realized there were so many options. None of them sound pleasant but I definitely think you chose the best one. I applaud your optimistic attitude, which is extremely important and beneficial.

    I liked Tallulah in "The Devil and the Deep" (1932)

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    1. Jon,

      I didn't know about the hormone option, which of course it totally out of the question for me. You're right, none of them are pleasant. I chose the one that was the lessor of all the other unpleasant options. Still, I'm going to have a radioactive crotch for a while. Good thing I"m not sexually active these days.

      I Tallulah in everything she did. I wish she had done more movies, especially "Little Foxes."

      Ron

      Ron

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  8. Years ago Carlos had severe abdominal pain and his appendix nearly burst. We took him to the hospital and we're getting all his paperwork done. The woman asked who was his emergency contact and he said me; she looked at me and asked who i was and I said I was his partner, er, significant other.

    She gave me one of those looks, you know the kind, and I was gonna leap over the table and tell her what she could do with her bigotry when she said, "Oh good, we just got a new admissions program with the words 'partner/significant other' on it and now i get to use it!'

    Plus, the doctor wanted me in the room during all the discussions, and when the surgery was done the doctor came to find me and tell me all about it. Plus, they let me sleep in his room one night after the surgery.

    Small things, for sure, but they make a big difference.

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    1. Bob,

      Your story warmed my heart. The times are a changing, that's for sure. I have a similar story. Three years ago I was sent to the Emergency Room at Beebe Medical Center. I was passing a kidney stone but I didn't know that. The pain was so unbearable and getting worse, I thought I was dying. I was in agony. As they where wheeling me on a gurney into the operating room, one of the people asked "Who is that?" Bill was standing in the corner, devastated. I managed to get out "He's my partner." Then someone said something that totally shocked me and brought tears to my eyes, in spite of agonizing pain I was going through. They motioned with their hand to Bill to follow them and said "Come one!" I really did think I was dying but I felt at peace because I thought at least Bill would be with me when I died. I have never forgotten that act of kindness that that unnamed person did for me and Bill.

      Compare that to the time two years previously when Bill was taken into the Emergency Room at the VA Hospital in Philadelphia. I was housesitting in Delaware at the time and couldn't get to him because of the snow. Bill's gall bladder had to be removed. When I tried to call him after the operation (he was in intensive care for four days), they wouldn't put me through because I wasn't "family." I tried to explain to them that I was his partner of over forty years. The nurse on the other end of the line told me that she was sorry but she could only put "immediate family" through. I explained to her that Bill HAD NO FAMILY. I was his "family." She still wouldn't put me through. I had to call Bill's straight friend who was a medical technician (radiologist I think) that he met while taking my Mother for her cancer treatments. He arranged for me to be put through to talk to Bill. Thank God.

      Thank you for sharing your story Bob. I hope same sex partners are now considered "family" across the country now. But I still have my doubts about the South where we travel every year for spring vacation. I always worry that we will have a medical emergency during our vacation.

      You're right Bob, being recognized as "family" makes a BIG difference.

      Ron

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  9. Ron,

    I haven't uncrossed my legs since you told me the procedure the other day. If you family is long-lived, I guess mine is too. Dad was 94 and mom 92 when they passed.

    Lar

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    1. Lar,

      You haven't uncrossed your legs since I told you of my upcoming procedures? How do you think I feel? Man oh man, I just can't wait to get this over with. It seems all my medical procedures are always below the waist. Yes, I do think you'll be around for a long time and in good mind too.

      Ron

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  10. It sounds worth than it is going to be (I hope). What is very sad is that so many wonderful people died of prostate cancer when they could have been saved. I am so glad you are going into all the details of this cancer, options...
    Prevention and being pro-active about our health is really the best option of all. We are lucky to have better medicine, doctors.... than only 10 years ago.

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    1. Nadege,

      I am a believer in not keeping these things secret. Perhaps by my blog postings on how I deal with my prostate cancer, can help others by alleviating the fear and anxiety. I hope I've done the same thing with the need for everyone to get a colonoscopy once they reach fifty years of age. I know too many people (relatives and friends) who refused to get a colonoscopy and eventually died of colon cancer because of their stubbornness. Many men don't like the finger prostate check, which I can understand. That really isn't necessary but they should get a blood test and pay attention to their rising PSA score. A PSA score isn't always an indicator of prostate cancer but one should have all the facts on hand to make an informed decision.

      Ron

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    2. todd just got his yearly psa blood test this week; don't know the results yet; no worries. kinda like my annual female checkup scenario.

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    3. Anne Marie,

      Here's hoping that Todd's blood tests come out good. Annual blood tests are a good way to keep check on your health.

      Ron

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