ANOTHER ROLLER COASTER RIDE

I have been quite for a while as I recover. But I wanted to continue my story…

As we met with the oncologist, he thoroughly described my staging and reviewed the NCCN Guidelines.  According to the Gleason score and high percentage volume involvement, of at least two specimens, my prostate cancer staging, according to the American Joint Committee on Cancer was the following:  

pT2b or PT2c with most likely no node involvement (NO). 

If this sounds confusing, it’s really not as long as you have a legend to follow.  For reference, you can follow the attached diagram.  But just as a quick explanation, the “p” along with the “T” refer to the pathologic staging of the primary tumor and how much of the organ is involved.  This is designated with the prefix pT2-4 referring to the extent of the prostate gland involvement (minimal, one lobe, two lobes, whole organ and surrounding tissues). 

The other letters refer to lymph nodes and distant metastasis, N and M, respectively. The N is staged from X-1, ranging from no lymph node sampling to node metastasis. The M is staged from 0-1C, indicating no metastasis to bone involvement.

As we heard about the staging, we felt some optimism.  But then the doctor described percent success rates with and without androgen deprivation therapy. Wait, what?  I had already decided on a course of treatment that I wanted. What was happening?  Furthermore, I was now told that I would first have the radioactive pellets placed in the prostate and then four weeks later I’d have the external beam treatment.  

We were also told about the precautions I would need to take with having the pellets in terms of holding babies.  Mind you, I have a baby grandson (nine months old during this occurrence).  When he told us that the pellets never stop giving off radiation, I was paralyzed.  Although I had read that the pellets would not be a danger in terms of holding a baby, the radiation oncologist said that holding the baby on my lap for a long period would not be advisable for three to six months.  To say I was shocked would be an understatement!

Then came the other bomb.  We were told that because of the enlarged size of my prostate, it would be highly recommended that I have ADT first to decrease the size to allow for safer placement of the pellets.  Now I became numb.  How did I go from having a choice on the ADT to now it almost being required?  Not only that, the percent survival at later years were also improved when adding this therapy.  As with any treatment, there were several possible listed side effects from radiation and ADT. 

My world was absolutely rocked!  I felt like someone had pulled the carpet from underneath me!  What I thought was an appointment to go over the treatment protocol and start scheduling sessions, became a bombardment of information that was overwhelming and surprising! However, given the intermediate, unfavorable category of my prostate cancer, made sense.  It was just unexpected.

Well, the other option, which I had totally ruled out before this visit was surgery. However, we were told that obviously, we would have to make that decision.  And obviously, there were also some side effects discussed with the surgery.  We were told that although no medical professional could force me in any certain direction, given my age, surgery could be a viable option.  I left this appointment with totally dejected.  Needless to say, it was a very long night!

To be continued…

THE TREATMENT PLAN

Now that we are well versed on the Gleason system, I’ll continue my story.

So with all the pieces of the puzzle together, now came time to break out the National Comprehensive Cancer Guidelines (NCCN) to develop a treatment plan. The NCCN is a comprehensive set of guidelines developed through extensive review of clinical trials and existing treatment protocol along with expert medical judgment and recommendations by physician panels made up from Member Institutions. These guidelines cover 97 percent of all cancers affecting patients in the United States and are updated on a continual basis.

According to the NCCN flowchart, interventions or treatment protocols are based on age and life expectancy. This means that the younger the patient, the more aggressive the intervention. Conversely, the older the patient, the more conservative the approach. For example, a 75 year old male diagnosed with a Gleason 7 prostate cancer would more than likely undergo radiation rather than surgery.

Well, from what I remembered, my Gleason score was 6. According to the NCCN Guidelines, the recommendation was prostatectomy (removal of the prostate), brachytherapy (radioactive pellets placed into the prostate gland) or external beam radiation. And with the radiation, I would have to decide if I wanted to have androgen deprivation therapy (ADT), which are basically injections to decrease testosterone, which is known to promote prostate cancer growth.

So, again, my Gleason score was repeated as a 6. And now I had to decide on which type of radiation I wanted as treatment and if I wanted to go through with ADT. Well, nothing sounded extremely attractive about pellets being inserted into my prostate or ADT. So I decided against those and surgery and opted for external beam radiation, which I know from others who had it or were having it, that it was 40 treatments.

Of course, as with any discussion of a surgical procedure or medical treatment, came the discussion or “informed consent.” “Everyone is different and not everyone has these effects, but some of the side effects of radiation are urinary incontinence, blood in the urine, painful urination, diarrhea and erectile dysfunction. These are mostly temporary and medications can be given for erectile problems.” (Sorry, I have to keep it real). Just what I wanted to hear- feasible ways in which I could help keep the prescription drug industry viable! (insert sarcasm face). Well, this was starting to sound less attractive

I left that appointment determined to do more research in terms of pros and cons of radiation therapy. I knew I need to find people who had been through this type of treatment and glean from their experiences. To be continued…

As we continue to raise awareness for prostate cancer, please remember: Although there may not be a hard rule for screening, talk to your doctor about a PSA test if you’re between 45 and 55 years old. Screening should be done at 40-45 years of age for African Americans, Latinos or if there’s a strong family history.

Love Built To Last

Recently I had a situation which left me surprised, speechless and stunned. I may share particulars of this issue at a later date. My natural tendency was to stop, breathe and process what was going on.

To do this, I had to withdraw so that I could gather all my thoughts. However, in the midst of organizing my thoughts, I was slipping into reclusiveness. Unbeknownst to me, I was at the same time pushing away the one person who wanted to be with me, cheer for and support me.

But my bride of 23 years would not allow me to withdraw, be quiet or remain lost in my thoughts. Nope! She took me by the hands and told me, “we are in this together, I want to know your thoughts and feelings. You can’t shut me out!” At that moment I realized that she would not compromise or back down. I was reminded of her deep love for me. I was reminded that because we are “won” my thoughts, feelings, fears and tears are also hers.

Yes, I was reminded of the fact that our “woness” does not work in isolation. I was reminded one more time of what our love means:

Lasting

Not Ordinary

Vital

Empathetic

Thanks honey!!

Understanding Differences Between Men and Women

So this past Mother’s Day, I tried to do more stuff around the house so that that my wife, and mother of our kids, could just relax. While my wife enjoyed her cards, flowers and lunch, she also had arranged her empty Clinique products on the bathroom counter for full display. “I don’t ask much, just for some observation,” she said as she swept her right hand as to uncover a prize.

At that moment, I felt like I was three days late for the prom! So I went into “fix it mode,” because that’s what men do, right? I told her that I would get new products but she told me not to bother, that she would do it.

This incident portrays a stark difference between men and women: women want men to notice things they need whereas men want to be told what women want or need.

A woman’s desire would be for her husband to be observant and proactive in both noticing and fulfilling some wants. This lets the woman know that she is being thought of. Unfortunately, most men aren’t wired this way. Most men would be happy to fill a need once they are asked.

Knowing and understanding these differences is of vital importance in a marriage. It prevents misunderstandings, unrealistic expectations and disappointments. It is also important to be able to discuss these differences with grace, patience and without setting ultimatums. This allows for healthy communication and may also help each person to be more sensitive to each other’s needs.

So how did this play out? Well, she never did go to get her Clinique products. So I assured her that I would take care of it and I did! Now she’s all set…and I’ll try to be more intentional on being observant.

Marriage Tip Thursday

Being the first to apologize after an argument shows more strength as opposed to expecting your spouse to do it first.

Thursday Marriage Tip

Actively looking for ways in which to serve your spouse will strengthen your relationship because it will make your eyes habitually more sensitive for opportunities to serve.

Positivity Bears Positivity

Positivity Bears Positivity

I’m sure we can all point out at least five things about our spouses that are annoying. For instance, I sometimes cringe when I hear the sounds of cabinets being slammed in the kitchen. And my my dear wife really dislikes (to be gentle) the way I clean the kitchen and leave at least two items in the sink.

  • But instead of focusing on that laundry list, we try to focus instead on the things we love about each other. Sometimes this list may seem shorter, especially if it’s not thought about often. However, the more we think about them, the more positive qualities we can come up with!
  • So let me encourage married couples to spend more time looking for the good. Your relationship, intimacy and love will all grow.