When my brother, Mike, told me he had prostate cancer, I knew he would beat it because of the confidence he expressed, especially after he described in detail how that would be done. After consulting with his doctor and specialists, he talked with his good friend, Ken, who was diagnosed with prostate cancer several years earlier. Ken underwent brachytherapy, a treatment protocol in which radioactive seeds are implanted into the prostate. Mike and his wife, Joan, did their research and, together, decided brachytherapy would work well in his case. It did.
As I watched Mike deal with his disease, I concluded—because I am five years older than he—I was fortunate to have dodged the prostate cancer bullet. Five years later, however, it was a different story. My annual checkup in August 2010 revealed an elevated Prostate Specific Antigen (PSA) number and discovery of a 1mm node on my prostate. Further tests confirmed the elevated PSA. A biopsy was scheduled for October 2010. In discussions with the urologist prior to the biopsy, I told him about Mike’s prostate cancer. He was reasonably certain a biopsy would find cancer as, in his words, “the disease is hereditary.” The biopsy revealed early stage cancer. I hadn’t dodged the prostate cancer bullet after all.
The journey from discovery to cure was a bumpy ride.
To begin, I have antibiotic allergies and was unable to take two of the four antibiotics prescribed for the biopsy procedure. Two days after the biopsy, I was in the hospital with septicemia. It was during my hospital stay that the urologist told me the pathology report confirmed cancer.
On receiving the urologist’s news, I called Mike. He’s solid and dependable. A shelter from the stormy blasts of life, Mike is always there for me. He told me to get a copy of Patrick Walsh’s book, Guide to Surviving Prostate Cancer. Having brought my iPad with me to the hospital, I was able to download Walsh’s book which I began reading immediately.
My first idea was to undergo a radical prostatectomy, the surest way to be certain the cancer is contained. Troubled by the possibility of incontinence as a result of the surgery, I had second thoughts. Talking with Mike and Ken, I decided brachytherapy would work as well for me as it had for them.
In December 2010, I met with an oncologist at the cancer center and felt “okay” with his description of the procedure and the prospects for a cure. Another PSA test was ordered.
I met again with the urologist in January 2011 to discuss various options for treatment. I expressed my need to be certain about the nature of the disease and the potential for a positive outcome. He reassured me that I was right to explore all options; and, he supported my request for a second opinion of the pathology report. Reviewing the PSA test results with him, I discovered the results of the test ordered by the oncologist were missing. The urologist ordered the missing results, telling me we would talk again once he had all of the test results. I arriving at home twenty minutes later to find a voice mail message from the urologist’s office.
“The doctor would like you to have a bone scan,” the message said. “Please call our office to arrange for the scan.”
I called the urologist’s office at once and told the receptionist that the doctor needed to call me with an explanation.
“The test indicates your PSA is 10.7,” the urologist said when he returned my call later that evening. “Standard procedure among U.S. urologists is to order a bone scan any time the PSA is over 10 to rule out the possibility of metastasis.”
“And what is the prognosis if the scan reveals metastasis,” I asked.
“Well,” he said, clearing his throat, “It’s not as good.”
Frantic, I called Mike.
“Look,” Mike said, “you’re okay now, right?”
“Well, yes, I guess so,” I said.
“Get the scan done and then let’s deal with the next step when we have more information.” Dependable, solid, and calm, Mike talked me in off of the ledge. He’s good at that.
Next, I called Randy, a friend from my Navy days. We met in 1965 at a technical school in San Diego where we were sent from our respective ships. In the course of the three months we were there, we became good friends. At the end of our technical school training, we returned to our ships, deployed to Southeast Asia, and lost touch. In February 2010, I reconnected with Randy on FaceBook. We exchanged emails, phone calls, and met in San Francisco in February 2011 where we picked up at the point we left off forty-five years earlier, almost mid-sentence.
Randy has extra-capsular prostate cancer. His wife, Mary Ellen (ME), is a medical physicist who works with CyberKnife, the latest “cutting-edge” technology used in the treatment of prostate and other forms of cancer. When I told Randy about my diagnosis, he suggested I talk with ME who confirmed what I had read about prostate cancer.
“I’ve worked with a radiation oncologist in San Diego,” she said when I called her the next morning. “He’s a leader in treating prostate cancer using the CK technology and has written several of the national standards for treatment. I’d be happy to shoot him an email and ask him to talk with you.”
Two days later, I received a phone call from “Dr. D’s” office asking if I could email copies of my medical records. I scanned the pathology report and all of the test results and emailed them as requested.
A day later, Dr. D phoned. He reviewed my medical records with me, explained the procedure, and told me I was an ideal candidate for treatment as well as for the national study he’s conducting. He asked me to participate in the study and I accepted. Dr. D advised a bone scan was unnecessary. Since I had the scan scheduled, I went ahead with it and heaved a sigh of relief on reading the radiologist’s report stating “No bone scan evidence of osseous metastatic disease.”
Besides the initial consultation and two appointments for preliminary procedures, the actual treatment consists of four visits to the CyberKnife Center on four consecutive days for an hour and a half to two hours each day. The consultation and preliminary procedures were scheduled for March and early April and the treatments for the last week of April.
With everything in place, I called Allan to describe the treatment plan. Our friendship spans more than fifty years. I can tell him everything. He loves me despite my blemishes. Allan is probably the closest I will ever come to having a soul mate. If it’s 7:00 p.m. on Thursday, Allan and I are on the phone, our conversations many times last an hour or longer.
A few days later, Allan phoned me.
“I decided,” he said. “to drive to Bakersfield to take you to San Diego for your treatments. I don’t want you to go through all of that by yourself.”
I was speechless and more than grateful. We spent nearly a week together with plenty of time to talk and to enjoy each others company.
On October 21, 2011, I met with Dr. D. “This is very good news,” he said, showing me initial and follow up images on his computer screen. “There is no evidence of residual or recurrent prostate cancer.”
In the 1989 movie, Field of Dreams, Iowa farmer, Ray Kinsella (Kevin Costner), tracks down the reclusive and irascible 1960s writer, Terrance Mann (James Earl Jones). When asked by Mann the reason for Kinsella’s pursuit of him, Kinsella recalls the impact of the writer’s words on him at a young and impressionable age:
“There comes a time when all the cosmic tumblers have clicked into place and the universe opens itself up a few seconds to show you what’s possible.”
I am grateful for what it is possible to accomplish through the use of technology: CAT Scan and high resolution/high contrast MRI images superimposed to render virtually 3D representations of tumors; microscopically precise delivery of high dose radiation that is non-invasive and, in my case, without side effects.
I am grateful for what is possible through the love and support of true friends.