Another decision required ...

When I walked into the Cancer Clinic at the Dixon Center (VG Hospital Complex) yesterday, I was hoping I would walk out a "free man". But it was not meant to be. The monster is not letting go so easily!

The meeting with the Radiologist Oncologist went very well. He indicated he would like to give me the "full meal deal" when it comes to "slaying the monster". Although my overall results are very positive, he indicated I could increase my 5 year survivor odds if I agreed to two additional types of therapy; (1) short term hormone therapy and (2) radiation therapy in the area were my former prostate resided.

The good Dr. H. indicated that the overall key monitoring signs are good; my PSA was non-detectable, my surgery margins were negative (no cancer detected at the outer limits of surgery), the biopsy of the removed lymph nodes were normal (no cancer cells were found) and the Gleason Score was downgraded to an eight (8) from a nine (9). Given these positive results, Dr. H. indicated my 5 year survival probability is 70%.

This shocked me a little as I thought it would be higher. He pointed out that his concern was the fact the monster did breach the prostate capsule (albeit microscopically). He was concerned that a stray cancer cell could have dislodged from the tumor and could still be present in the prostate area and/or moved to distant location. The problem is that he could not tell me with certainty if of or where the cancer may be. It would too small to detect with current technology.

Here is my dilemma; I have been given a probability of a 70% cure rate. If I choose radiation of the prostate area, I would increase my 5 year (plus) survival probability by an additional 15%. If I also do hormone treatment (chemical castration), my survival odds may increase by another 5% (although Dr. H said there is controversy on the benefit of hormone treatment at this time).

As with any medical treatment, there are pros and cons. The pros are obvious. The cons could be substantial. Radiation treatment can damage good tissue in the prostate area and may cause me more problems with the urinary system. Radiation can also damage the colon. There is a potential that I would have to use a "poop bag"; this certainly does NOT excite me. Radiation would consist of 33 individual treatments and would last between 6 to 8 weeks. Radiation will cause diarrhea and result in general fatigue. Hormone treatment can also cause unwanted side effects that I am not to crazy about.

My major concern is that I would be treating a possible non-existent problem. Since there is no measurable PSA, this means that there should technically be no cancerous prostate cells in my body. The Oncologist and Urologist both confirmed that only prostate cells can produce PSA. So why not wait? Well Dr. H. indicated if the PSA starts to rise in the future and if the cancer cells have moved to my bones or other locations, it will be more difficult (but not impossible) to treat.

The good news for now is that I don't have to make a decision right now. I need to completely recover from my surgery which should be done towards the end of August and I have more meetings with my Urologists. I have more homework to do; more reading and more questions. I will also be asking other prostate cancer survivors what they did and this should help me make a decision in 3-4 weeks time. My "A" and God will be a big part of the decision making process. Another Serenity Prayer request being issued!

More tomorrow. I was given some interesting facts and stats by Dr. H.