Prostate Surgery and Beyond

In my last post, I had mentioned that after considering our options, we decided that surgery was the best choice for us. We researched and read in order to prepare ourselves for the big day. Sure, we both had some deep concerns regarding what the pathology report would read and what the next steps would be. But we prayed and left all those anxieties and worries at the foot of the cross.

On a partly cloudy day on September 20th, as sat as a family in the waiting room, I almost forgot why we were at the hospital. However, I was quickly reminded when my name was called and a nice lady applied a bracelet to my wrist. Things were starting to get more real. But I was ready! I was also hungry… I mean, I’m a breakfast man so… I’m just saying… When my name was called again, it was for real. It was time for me to take the long road to the pre operative area.

I was given a gown to change into. The anesthesiologist then came to the room. He was a rather quiet, stoic man. He asked me if I needed anything, to which I responded, “how about two shots of Jack Daniels?” Unimpressed by my response, he said, “well, we’ve got some medications that…blah blah.” “Could you just humor me,” I thought to myself. But the anesthesiologist went about his business. The nurse who was completing my pre-op papers kind of chucked at the exchange. Much to my surprise, I got a visit from my pastor and one of our elders who said a quick prayer and wished me well.

After an IV was started in my arm, I was wheeled to the cold operating room. The only thing I remember was seeing a large piece of equipment in the center of the room. This was the robotic machine used for the prostatectomy. After that, all I remember was waking up in the recovery room with a catheter. I was then transferred to a hospital room where I stayed two nights.

It was nice to come home to my own bed. I’m not the greatest of patients but the recovery was not too bad. I had a lot of help and mother-in-law even came down, and she was great!

Fast forward to eight months after surgery and I’m doing great! My latest PSA was still undetectable and I’m officially cancer free. I will still have my three month checks for two years. I continue to thank God for the medical team that treated me, for all the prayers and support from friends and of course for my family. I especially thank my one, my only, my forever partner, my love, mon cherie, my ride or die. My wife of 23 years has a been my rock, my unwavering support, my nurse and my best friend! I couldn’t have gotten this far without her.

I can officially say that I’m a survivor!

Staying Close During Social Distancing

People who know us well, know that I’m an extrovert and my wife is an introvert. I require longer periods of socializing whereas my dear wife, contrary to popular belief, does like social interaction, but has to have it in spurts and needs time to decompress after long periods of socializing.
So how do we, as polar opposites on the socializing scale, make our marriage work during this time of quarantine? This also applies to couples who don’t normally spend a great part of their day together. I offer a few suggestions:

Love our walks together!
  1. Respect Each Other’s Differences

Respecting one another’s differences is important at any time but when you’re in lockdown mode it’s extremely important. I have to be aware of not “suffocating” my spouse and she in turn connects with me after she’s had her alone times. 

  1. Be Willing To Communicate 

In times of a quarantine when social interaction is limited, it’s important not to isolate yourselves further.  It’s vitally important for us to communicate with one another if we need hugs, space, kisses or conversation.   

  1. Be Attentive To Your Spouse

No matter how much “alone time” a person enjoys, we all need some amount of socializing. When this is not possible, feelings of isolation, anxiety and fear can squeeze like a vice grip.  So it’s up to each spouse to be attentive to each other’s needs.

  1. Be Patient With Each Other 

Being around each other more can feel like your spouse is in front of you every turn you take.  This can feel a little like deja vu.  It’s important to be patient with one another and try to somehow have fun with these situations.

  1. Say I Love You

The most important way to survive a time of social distancing is to tell each other “I love you” often. These three words can never be said enough and are the foundation to Twobecomingwon!

What are other ways for a marriage to survive an increased time together?

CONFUSION ABOUNDED

So we thought we were ready to embark on the radiation pathway. Yep, I thought a one time procedure of pellet implantation was very desirable over 40 external beam treatments. This would be much less disruptive to my schedule.

Furthermore, I had a conversation with at least two people who either had external beam or pellets with external beam. But before I committed to any type of treatment, I was still confused about what I had heard at one of my urologist appointments regarding my Gleason 7 score. This was confusing to me. But after doing some research, it seems that even if most of the core specimens are 3+3 and only one is staged at 3+4=7, the person is staged according to the higher number.

So the Gleason system is based on the assumption that the higher number is representative of what’s actually occurring. Here I am thinking that sine most of the core biopsies were a Gleason 6, that’s what was representative of the cancer. Oops, I guess NOT!

Oh well. I had to stay on track. I had to keep moving forward. So next stop on this train was an appointment with the oncologist at the cancer center. I was ready. My wife and I had discussed this and made up our minds on the treatment plan and was ready to go and get this radiation thing scheduled and started. But I could not have been less prepared for what came next.

Continued….

THE RECONNAISSANCE MISSION

After having heard about my treatment options, I was determined to speak to someone who had been through radiation. However, my quest was more specific than just anyone. I was on a mission to hear from someone around my own age who had been through radiation treatment.

So through a friend, I was able to speak to a gentleman who had a history a higher Gleason score and went through both brachytherapy and external beam treatment. And he was doing well with minor side effects. So after this conversation I was encouraged and ready to go forward. So I thought.

After this conversation, my wife and I met a couple who were nutritional vendors promoting a vegan lifestyle. The gentleman had a significant history of prostate cancer, however, his had metastasized. He underwent both surgery, testosterone suppression therapy and radiation. He shared research information about how a diet free of animal products and low in saturated fats, was known to protect against prostate cancer and actually reverse the process.

The name that stuck out the most during our conversation was Dr. Dean Ornish. He authored a study in the Journal of Urology, which detailed the effects of an “intensive lifestyle change” on men with early, low grade prostate cancer. The study showed that the PSA revealed a 4% decrease on the experimental group versus a 6% increase in the control group. Furthermore, there was an decrease in the growth of cancer cells of up to 8 times as much in the control group.

This sounded groundbreaking! But was it truly real science? This may not be mainstream, I thought, but certainly worth some attention. Furthermore, Dr. Ornish may not be a cardiologist or nutritionist, but even the American Cancer Society recommends a reduction of saturated fats and reducing red meats.

Although this gentleman had some side effects, his claim was that they were improved with a vegan diet. Although I was not totally ready to bet the farm on these claims, it was clear that there were at least anecdotal evidence. So we did research on a vegan diet and decided to adopt this practice. I had nothing to lose. And my wife, in a demonstration of love and support, decided to adopt this lifestyle with me. (Mostly because she’d be doing the cooking anyway. LOL)

Our hope and prayer was that God would use this change in diet in conjunction with the upcoming radiation treatments to give me good outcomes. But wasn’t totally sure if this was my treatment option for sure. I still had a consult with the Cancer Center.

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.

The Start Of A Journey

About two months ago we embarked on a new journey. Although, I got ticket for this ride when I was by myself, it became apparent rather quickly that this would be a trip for two. A journey or a trip usually implies something new and exciting. Although we are experiencing something new, it’s not necessarily exciting.

There’s no better place to start other than the beginning. So here it goes:

I just recently had my first physical in at least 13 years! Yeah, yeah I know. This in spite of the fact that there’s a strong history of prostate cancer in my family. Well, the same evening of my physical and blood work, I received a call from the doctor’s office advising me that I would need to call to schedule an appointment “to go over the blood work.” That’s never a good sign.

Well, I called the next day, which happened to be a Saturday, and was told I could walk in. I was told that my PSA was elevated. For those of you that don’t know, the PSA stands for “prostate- specific antigen.” which is a protein produced by both cancerous and non cancerous cells in the prostate. There is normally a small amount of this protein in the blood, so the PSA blood test is a screening tool for possible prostate cancer.

Back to my PSA. It was 16 ng/mL. To put this in perspective, a range of 0-2.5 ng/mL is considered a safe zone. This however, can vary a little by age. Anything over 4-5 ng/mL will most likely be followed by a discussion with a medical provider. So obviously there was cause for concern. Was my father’s history of prostate cancer making its fateful appointment with me? I was told that an appointment would be made for me with a urologist. After an initial visit and a repeat PSA blood test, my value was still high, 14 ng/mL. Now came the moment of truth: “We’ll have to do a biopsy.” Each stop on this ride became a little more serious and a little more surreal.

If you’re a man between the ages of 40-50, please get a physical and a simple PSA blood test.

To be continued…

Why I Love My Wife

She’s beautiful. The kind of beauty that radiates from the inside.

She loves life and loves speaking life to others!

She’s analytical. She’s often deep in thought about a lot of things.

She’s an introvert but she loves that even though I’m an extrovert, I respect her need to withdraw at times.

She loves family and would do anything for her family.

She’s a motivator and deeply enjoys helping others reach their personal and fitness goals one on one.

She has the loudest, cutest laugh in any room! But it’s a joy to see her enjoying herself.

She always has a sacrificial kind of love.

She always believes in me and makes me feel strong.

In short, I love her because she means everything to me!

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.

Thursday Marriage Tip

Gentleness, kindness, and self-control will produce more fruit in a marriage as a post to sarcasm.