As Time Goes By

So far, for me, post prostate cancer treatment  has been uneventful. This is a good thing. However, I still do not go a day without thinking about my journey on the path with prostate cancer. Hopefully as time goes by, I will think less about it. But for now it is a constant reminder of my mortality. A New Testament writer once wrote "Yet you do not know what your life will be like tomorrow. You are just a vapor that appears for a little while and then vanishes away." A recent example of this for me was that my high school class celebrated our 40th reunion in August of 2010. I was unable to attend, but through FaceBook and email I was able to join in vicariously through my fellow classmates who were there. It has been fun reconnecting with many of them. But that four year period of my high school days is just a blip on the radar. Yet I wonder how many from our class are on a similar journey with cancer as part of their timeline.

Just this month I had my annual physical which, thankfully, was also uneventful. Again, this is a good thing. As time has been going by since my treatment, more proton treatment centers have opened with more still on the way. Yet it surprises me how many people are still not aware of this cancer attacker. I'm sure in some people's mind it conjures up visions of the crew of the Enterprise firing photon torpedoes at the Klingons. In some ways this is good analogy.  After all protons are a powerful weapon in fighting cancer efficiently. They are very effective at delivering the payload at the intended target whether it be the prostate gland or some other menacing tumor dwelling within our own earthly vessel.

Star Trek's opening line "to boldly go to where no man has gone before" can also apply to the future not just space travel. So far human travel into the future is fictional and no one I am aware of has been there. I did not see "tomorrow" as one of the options on the sundial. However, even though I do not know what tomorrow holds, I do know who holds tomorrow.

Anniversaries

Most anniversaries are intentional. You plan a wedding, you get married and, voila, a year later you have yourself an anniversary. This past year as I reflected back on the events that led to my treatment for prostate cancer I found myself re-tracking each milestone: the day of my diagnosis, the day I left the comforts of my home and headed to Southern California to begin my treatment, and today which marks the anniversary of when my treatment actually began. This, however, falls into the camp of unintentional. Significant events in your life leave a lasting impression. Some you would rather not remember while there are others that are worthy of achieving anniversary status. Without a doubt, proton treatment for my prostate cancer at Loma Linda University Medical Center falls into the latter.

There are many others I have met along the way who have similar stories. We are blessed to live in an era where this type of treatment is available with such favorable results. Not only physically, but emotionally and spiritually as well. So without further fanfare I wish myself a happy proton anniversary.

Was I Really Sick?

One of the surprises for me with my prostate cancer was finding out how many people envisioned me gaunt and stuck in a hospital for 11 weeks. And now, “How are you feeling?” is a common recurring question since I am on this side of treatment. With early stage prostate cancer, there are no symptoms. You don’t feel or look sick, and until the doctor tells you “you have cancer” you think you are healthy. I could have gone for another 10 years (statistically speaking) and been unaware of my cancer. In fact when my urologist told me I had prostate cancer, he said it had more than likely been there for a few years.

So what does this mean? First of all, ignorance can lead to bliss but it is not bliss. Last April the wellbeing of my prostate gland was not part of my health concerns. I have to confess that I wasn’t sure “exactly” where the prostate gland resided in my body or what its purpose was. I had a general idea where it was as my doctors had this uncomfortable procedure to “point out” exactly where it was. This is not something you actually see; it is something you take by faith through the “experience.” In hindsight (no pun intended), I wish I had known more. But, like most men, we go through life living the mantras “if it isn’t broken, don’t fix it” and “out of sight and out of mind.”

Secondly, do not take your health for granted. I really felt I was living a healthy lifestyle. But as I have discovered, the Western diet is far from healthy. There have been improvements, but we have a long way to go in this area. Diabetes, heart disease and cancer have been shown to have definite links to diet. Heredity also plays a role but diet and lifestyle are key factors to increasing the risks of developing any of these life-threatening maladies.

Yes, there was definitely something wrong with me internally (medically speaking that is), but without the early diagnostic tools of today’s medical community, I would never have known it. As I look back, it is more of a “take it by faith” type of situation since my experience did not have a hint of forewarning that cancer was on my horizon for 2009. Part of that was due to my ignorance about prostate cancer and its early warning signs. Now with proton treatment behind me, I take it by faith that the protons are having their intended results. This is not a blind faith. It is a faith based on a 20-year history of successful proton treatment from the James M. Slater, M.D. Proton Treatment and Research Center at the Loma Linda University Medical Center. In fact, this October marks the 20th anniversary of the opening of the LLUMC proton treatment center.

So “How am I feeling?” … I feel great!

“It’s All About the Numbers”

With the US Census upon us we are faced with the fact that a lot of what we have or do not have is based upon how many of us there are and where we are. The following statement is taken directly from the US Census website” “When you do the math, it's easy to see what an accurate count of residents can do for your community. Better infrastructure. More services. A brighter tomorrow for everyone. In fact, the information the census collects helps to determine how more than $400 billion dollars of federal funding each year is spent on infrastructure and services….”

Likewise, with men who face their annual check ups, it’s all about your numbers. You can go down the list: height and weight, body temperature, blood pressure, PSA, cholesterol, glucose and on an on. With each of these there is an ideal level or number and then there is a level that draws the attention of your health care practitioner. That is what happened to me about a year ago with my PSA and cholesterol levels. The number associated with my PSA test raised a flag that started a series of events that I had not anticipated. A “4.02” waved a red flag during an application process for life insurance. However, 3.99 would have been acceptable. Three one hundredths determined the course of action that impacted me over the last 11 months. A cholesterol level of 233 was a little unnerving as well

With all of this now in the rearview mirror I have a new set of numbers with which to work. As of April 5th, 2010 my PSA level is down to 1.42 (thanks to Protons) and my cholesterol is down to 165 (thanks to diet and exercise). If all goes according “to the numbers’ my PSA level should continue this downward trend in the following years to where it will eventually level off. I am aiming for similar results with my cholesterol.

Patience Test

Who wants to know what it is like to wait for results? Someone smarter than I at NBC came up with this “patience test.” The idea was to broadcast a major US West Coast event live to the East Coast and on a three-hour delay to the West Coast. In this way they could see how many people out West do not watch NBC’s delayed coverage versus the East Coast people who do watch it live. That made perfect sense to someone.

One of the potentially unsettling aspects of proton beam therapy for prostate cancer is waiting for the results. In my case I am 74 days post treatment and I do not know if it worked. I imagine that is why some people choose against PBT. I admit I am one to look at the Olympic Games results live and online rather than wait for the 3-hour tape delay outcomes.

My first scheduled post treatment check up is on April 5th where I will hopefully find out if my PSA level is going in the right direction. I have been told that at the four month check point my PSA level should be about half of what it was prior to treatment. That downward trend should continue over the following 20 months. At that point my PSA level should arrive at what is called my “nadir” or the lowest point where it will level off.

If you have been following along you have been exposed with me to a whole new lexical world with words like “nadir” mentioned above. PSA used to be an airline company. Not any longer. The prostate gland was a mythical part of the anatomy that only manifested itself when the airline company ran into trouble. When I find myself in a group of people who have walked this same path it is funny how you throw around terms like “Gleason Scores” and you know what each other is talking about.

A year ago I was oblivious to this new language. Like any other foreign language, personal exposure is the best teacher. In order to survive in the hostile world of cancer you learn the language and forge ahead. Part of that forging involves waiting. Had I chosen surgery for my treatment path, I would know now whether or not I am cancer free. But then again I would be dealing with other issues.

For now I am content to wait. After all, is not patience a virtue (unless, of course you live on the West Coast)?

Post Treatment

“Post Treatment” is not a new cold cereal packed with protons (even though it could easily be confused with Post Toasties). In reality it is learning how to land after 9 weeks of radiation treatment and 11 weeks from being away from home. Looking back it is almost surreal. I know for patients that live near the medical center and carry on their normal daily routines during treatment this may not be the case. But for me, there was this emotional withdrawal I did not anticipate. I was definitely ready to be done with the “balloons” but not the relationships. In our final “exit meeting” Lynette prepared us for the medical side of post treatment, but what about the sudden arrival of this emotional wrinkle?

This week I have been going through a number of photographs I took during this adventure for the purpose of sending them off to some of my proton pals. I was reminded what a special time this was in my life. Chances are I will not see very many of them again in my lifetime, but there will be this permanent memory of a shared journey. Being treated for prostate cancer almost took a backseat to the rest of the experience.

I remember when I first arrived at the Loma Linda Medical Center I had the opportunity to attend my first Wednesday night support group meeting the day of my first balloon. The facilitator, Lynn Martell, made the statement that “we” were not to worry about our cancer while we were here because “they” were taking care of that angle. Our focus was to be on the rest of the healing process and the many opportunities that surrounded us. What was interesting was that without really thinking about that statement, it naturally happened. Probably not so much so with the “locals,” but for many of us “pilgrim patients” a unique bonding takes place.

This did not take place on its own. A choice was made to make the most of what could be otherwise construed as a negative situation. I am sure there are those who go through this by “holing up and waiting it out.” Having my bride of 36 years with me through this whole voyage guaranteed that would not be the case for us. We wanted to take advantage of each day and the opportunities that awaited us … and that we did.

In reflection this all revolved around relationships. Interaction with the staff at the medical center stands out as a significant part of the healing process. From the reception rooms to the treatment rooms these people became more than a name tag. They are your allies, your friends. At the Drayson Center you are made to feel like family. We have become “Friends” on Facebook with a number of the staff. At the Wednesday night support group you are part of the “community.” Lynn, Patti and Clyde make sure of that. All along the way you touch other people’s lives and they yours.

What now? Do we let this all get stored on a shelf in our memories or do we plug it in and use it? My vote is to keep these relationships active for as long as possible. Fortunately with modern technology it is easier today to stay in touch than ten years ago. But it is not automatic … it has to be intentional. Be the one to take the initiative. You will be glad you did. If you are at the beginning of your journey with prostate cancer, remember you are not alone. Get plugged in.

Who in the World Do You Think You Are?

On an outing to Disneyland this past November we found ourselves surrounded by an abundance of heads donning Mickey and Goofy ears, wannabe Jedi Warriors and an assortment of Disney princesses. And those were just the parents. As for me, I just settled in to being plain old John from Vancouver. No fanfare, no autograph seekers and no special treatment at any of the attractions. The fire truck driver did let me sit at the wheel on Main Street while he snapped a picture. Wow … I sat where Walt Disney sat!

Along with the fictional characters of our youth, sports teams and athletes, beer companies, and colleges across the land all strive to imprint themselves into our personalities. What does your favorite t-shirt say? I know I have my fair share of logo-laden garments. Your sports teams wax and wane, the t-shirts fade and tear, and your college teams still have a hard time graduating their star players. What is it that drives us to identify ourselves with other people or other things? Are we trying to feed our alter ego or live vicariously in another galaxy far away?

With prostate cancer another defining dimension is added to your life. However, this dimension chooses you rather than you choosing it. No one can really answer the question, “Why did I get prostate cancer?” But we can wrestle with this next question, “What can I do now that I have or have had prostate cancer?” Do I wear it like a hat or a T-shirt? Truth be told, there is not a market for “Prostate Power” t-shirts. There is an enigma associated with this cancer. It strikes at the core of a man’s “maleness.” This is a cancer that most men would rather not talk about.

One of the benefits from the offerings for the prostate cancer patients at Loma Linda is attending the Wednesday, men only, clinical support group. In this format we can bare it all in a manly sort of way. No fancy paintings on the wall and no soft music or water features attending our souls. Just a bunch of guys sitting around a table with a center piece of chocolate chip cookies and fruit juice discussing and sharing questions and concerns about our personal journey with prostate cancer. We all had something to add because we all had been impacted by this cancer.

With more men being diagnosed earlier, the opportunities to draw on the experiences of others are also increasing. Not all of us are going to start a prostate cancer foundation, but opportunities to involve ourselves in others’ lives are all around us. At work, in the neighborhood, at the gym or at the barbershop we can find men who are or will be faced with this disease. This is not a challenge to wear your story but an invitation to share your story. After all this is who we are.