Search Box

Tuesday, January 19, 2016

Cancer

I had a physical in August in which I got a PSA score of 5.5, a little outside the safe range. The second test in November came back at 5.6, so I scheduled a prostate biopsy on January 5th.

I had planned to write a funny post about the nature of the biopsy. Beforehand, I did ask the physician's assistant I made the appointment with, "There's nothing undignified about this procedure, is there?" (She didn't realize I was kidding.)

I had intended to ask the doctor, once the ultrasonic/needle-injecting wand was up my butt, "Say, I hope you don't think me self-indulgent, but does this thing have a vibrate function?" Once actually in that situation, though, I somehow forgot to ask.

On January 8th, I was told I have prostate cancer. Since then, I seem to have lost my sense of humor about it.

The odds are on my side, however. If it's caught early, as mine seems to have been, the survival rates are 99% five years out. It's a slow-growing and relatively easily treatable form of cancer. (Mine is intermediate in terms of aggression.)

My cancer doesn't seem to have spread yet, though I shouldn't waste any more time in dealing with it. I'm getting a second opinion Thursday at Sloan Kettering, and after that I have to make a decision about the course of treatment. At the moment I'm leaning towards radiation, which may have fewer side effects.

It's those potential side effects I'm mostly worried about: impotence, and even incontinence.

(My sex life has always been a tawdry, sporadic thing. But, it was the only one I had, and I would miss it.)

All of this has taken me by surprise. I feel fine physically, and am otherwise healthy. And, I'm in good shape --

(Boasting alert….)

-- The last week of December was a sort of high water mark athletically. On December 24th, an abnormally warm day in the Northeast, I did a 200 meter run in 27.9. On December 26th I did a one arm clean and jerk with a 75 pound dumbbell. And on December 30th I swam a 100 yard butterfly from a pushoff in 1:01.

I challenge any younger guy to hit all three of those marks in the space of one week. (The clean and jerk should be weight-adjusted; I weigh 160.)

I'm lucky to have people who are helping. My brother will have accompanied me to both consultations. My son has made a heroic -- though losing -- effort to cheer me up.

There are a few people who hate read this blog, and I hate to give them the satisfaction of knowing I have cancer. But, I owe the rest of you an explanation for why I won't be blogging as much while I deal with this. I'll continue to post your comments, but won't be as assiduous in responding to them. Don't take it personally.

Speaking of "personally," that is the direction the cancer seems to have taken my thoughts. So far, I'm thinking all the usual cliched thoughts. But if I come up with anything original, I'll let you know. In any case, be forewarned, this blog may be about to get embarrassing.

Then again, some people would say it's always been embarrassing.

64 comments:

Anonymous said...

You will be in my thoughts and prayers.

- birdie

John Craig said...

Thank you Birdie.

Lady Bug said...

Oh dude, this is tough but I am POSITIVE* that you will get thru it.

John Craig said...

Lady Bug --
Thank you. Not really that worried about getting through it, more just the side effects.

Steven said...

Shit. Bad news.

My grandad was diagnosed with prostate cancer about 8 or 9 years ago and he's still okay. He had some kind of surgery and has never had chemo or radiation. That's a big decision because it makes you sick and you might want to enjoy the years you have without sickness, as my grandad has, travelling the world and hiking regularly (both of which he still does at 79). After his initial treatment, his numbers were 0.something for years. It hasn't affected his health and fitness.

I just looked up the survival rates. My source also says 99% for 5 years (almost 100% if localised). 91% for 10 years and 76% for 15 years (for the ones who don't die of other causes). 76% is pretty encouraging. You've got to fancy your chances of being in that 76%, as fit as you are and with the medical care available to you.

You're going to just be fine for a long time. I wouldn't be surprised if you make 80. Hell, you'll probably outlive me. So don't be getting soppy on us now.

John Craig said...

Steven --
I'd actually heard 98% after 10 years, so I guess we're looking at different studies. I'm sure I won't outlive you, but thank you. (And if I get soppy, I get soppy, there'll be nothing I can do about it.)

BTW, are you going to take that athletic challenge? THAT I might beat you on. (Just try the first two.)

Steven said...

yeah you can get as soppy as you like. I think the take home point is my grandad had some op and his numbers were below 1 for like 8 years with no chemo. He just lived a totally normal life. I'll ask him what it was.

I can't even do the butterfly so I can't try the third one. Not sure where I can get timed for precisely 200m...I reckon I could do the first 100 in 13 seconds, then don't you do the second faster?

Got no idea about the dumbbell but I'll definitely try that. Given your pull up ability, and my total lack of callisthenics for the past 4 months (cough virus that really dragged on & still got dodgy lungs), I'll bet I can't beat it. But I'll try. I have some dumbbells at my dad's house.


John Craig said...

Steven --
Just make sure you are careful of your back and arch it the right way when you're lifting the weight from the floor, otherwise you'll hurt it. And the only rule is you can't let your other hand touch the weight; and it's not a strict military press, it's a clean and jerk, so you can use your legs as much as you want. And 75 pounds is 34 kilos, since I think you guys are on the metric system.

As far as 200 meters, I think most tracks have that fairly clearly marked out.

Steven said...

lol yeah but I don't really know any tracks, except one and I'm not sure if its open to the general public. Its where serious athletes train. I used to go as a kid but that was just because my cousin was a British athlete and he got me in & I used to see an Olympic high jumper there. I've never heard of non-athletes going to a track recreationally.

We kind of use both but I don't understand kilograms...75 pounds is over 6 stone..yikes, doubt very much I can do it.






John Craig said...

Steven --
I figured there'd be tracks all over England, given what a popular sport athletics is over there.

mark said...

Good luck. I do enjoy visiting your blog because your smart and I mostly agree with you. That is why I know your smart! Your blog was giving something to the world but now you may need that time for yourself. Thank you for all your posts.

John Craig said...

Mark --
Thank you very much.

Anonymous said...

John, sorry about the diagnosis. It hasn't slowed down any number of guys I know.

I assume you know this: that 27.9 would have placed 6th among your age group at last year's Masters Nationals. Pretty good for a swimmer.

John Craig said...

Anon --
Thank you.

Actually, I didn't know that, thanks. I did look up the world rankings and saw that it took a 26.8 to be ranked 25th in the world in my age group for 2015. I've been meaning to train for it and enter a meet and see what I can do, but somehow I never do.

High Arka said...

Good luck, buddy. Whatever decisions you make, remember that it was the great Jewish physician, Dr. Sidney Farber, who invented chemotherapy during the Great War, when he and so many other international humanitarians were looking at ways to strengthen European-derived communities. The contributions that Farber made to American medicine--promoting "cancer screening" and "early treatment"--are on par with the wonderful blessings of Kinsey and Freud.

All modern cancer treatments since then, from invasive cuttings to punishing radiation, have built upon this great man's legacy. See, e.g., my Cooking with Oncology.

<3

Samuel Nock said...

John,

You will certainly be in my thoughts and prayers. You have a great attitude and are thinking clearly and objectively about things. It sounds like you are taking the right approach. I'm sure you are surrounded by IRL friends and families to support you, and that is key. Your virtual friends here are this site are also no doubt fully behind you, so don't disappear entirely if you need support.

Your level of fitness is amazing, and it is certainly food for thought that nothing makes one totally immune to disease. I'm sure you will come out of this fit and strong.

Best wishes.

Anonymous said...

Spartan said…

Thought and prayers are with you. This is the information age. I'd do conventional medicine, but I would also look into herbs, vitamins, and diets that help fight cancer. Good luck.

Anonymous said...

Sorry to hear this - good luck.

John Craig said...

High Arka --
Thank you. Right now chemotherapy is not on the table (and I hope it stays that way). I read your post, and agree that all of the x-rays etc promote cancer, and that Kinsey and Freud were charlatans. But as far as the modern treatments go, surgery and radiation, they seem to be our (my) only options at the moment.

John Craig said...

Samuel --
Thank you very much….Yeah, I'd figured that fitness as a sign of health, but evidently they are not quite the same. Cancer doesn't seem to respect how fast one can get around a track, or up and down a pool. In fact I read recently that long time exposure to bromine and chlorine can lead to prostate cancer. Al those years I thought I was doing the healthy thing….

John Craig said...

Spartan --
Thank you very much. Assuming I get through this, I do plan to change my diet somewhat after.

John Craig said...

Anon --
Thank you.

Arvind said...

watch the diet as well. more healthy stuff, more good meat, more weights and cardio. maybe less swimming.

also suggest "juicing" to you. it's helped many people.

i will pray for you.
good luck.

Lucian Lafayette said...

John,
I'm sorry to hear about the diagnosis and understand just how uncomfortable that biopsy can be. I guess the good news is that the cure rate for early detection is high. Keep training as much as you can. We'll understand any delays in the writing.

Luke

John Craig said...

Arvind --
Thank you very much.

John Craig said...

Luke --
Thank you very much. The biopsy was actually not that uncomfortable, mostly just embarrassing in an almost funny way.

Mark Caplan said...

I'm sorry to hear about your diagnosis. I hope you tolerate the treatments well.

John Craig said...

Thank you Mark.

Anonymous said...

all the best, john. focus on the things you're grateful for. it can be a time where your family becomes even closer to each other.

B

John Craig said...

B --
Thank you very much. It's funny you would say that, I was so low on Friday I actually woke up on Saturday thinking about how much I have to be grateful for. (You don't think those thoughts unless you're really low.) Then, while it was on my mind, I wrote a blogpost about it, but have held off posting it so far because it's too corny.

PeƱaflor said...

I am sorry to hear that you will be undergoing cancer treatment. It's always a delight to read your blog, and your wit and humor will be sorely missed in the coming months.

I wish you a speedy recovery, and much laughter to help you get through the treatment period.

John Craig said...

Penaflor --
Thank you very much. Shouldn't be months, by the way.

whorefinder said...

God's help and good luck to you!

John Craig said...

Whorefinder --
Thank you very much.

Quartermain said...

What Birdie said in the first comment...

Bob Wallace said...

My father had prostate cancer and the doctors zapped it with targeted radiation and it went away completely. He survived five years until 81.

Runner Katy said...

Oh no, John,

I'm so sorry to read this, and I will pray for a speedy recovery and 100% bill of health. I know you will be just fine and with your current stellar health, you'll experience less symptoms than most do. Don't worry about this, fight it like you do for time on the track or in the water. Make it your b%^&$. (You know I never write like this, but when it comes to cancer, there is no other way.)

Please let us know if we can help in any way, and I hope you feel strong throughout the treatment. Positive thoughts produce positive results.

Anonymous said...

Hi John--If my misery leads to any comfort to you allow me to say that about 6 months ago (I'm slightly older than you, 62) I had such BPH symptoms (frequency, difficulty urination, etc) that I went in and had my prostate lazer ablated--basically burnt out, removed. It was done "transrectally" (up the ass) meaning no cutting of veins or nerves or radiation and it was MRI guided. It's called FLA, focal laser ablation, and is relatively new. Biopsy's were done at the same time and were negative. Anyway, this procedure is mainly for prostate cancer as it gets in and out without the common side effects of incontinence or sexual ED which so many men get, but I just had enough of this vestige of evolution. I just thought I'd mention it as it's so common and I'm certain that you'll overcome this and live a long and healthy life. PS--it has not affected my erectile function one bit--not that it matters, but for what it's worth. Brian

John Craig said...

Allan --
Thank you very much.

John Craig said...

Bob --
Thanks, I'm debating whether to go with zapping or an operation right now.

John Craig said...

Katy --
Thank you very much. Not sure, I can manage the positive thoughts, but...

John Craig said...

Brian --
Thank you very much, I'll ask the doc about that procedure. Sorry you had to go through that, but glad it had a good outcome.

Anonymous said...

I am sorry to read this, JC. I hope treatment goes well and is not too much of a nightmare.

Being in such good shape will undoubtedly help you. Don't feel bad about the occasional bout of self-pity. Soon enough you'll be i the ranks of other "brave cancer survivors," I am quite sure of it.

You may not feel like posting, but keep us updated and stay in touch.

Even if you never found out if you could get them from the ultrasonic/needle-injecting wand, I'm sending good vibrations your way.

- Gardner

John Craig said...

Gardner --
Ha! Thank you very much.

(I think I can feel them.)

Samuel Nock said...

John,

I do not purport to have any expertise in this area, but I have previously read accounts of how prostate cancer is waaaaay over-treated and that there is a good deal of ignorance even in the medical community about risk factors, necessity of treatment, etc.

I would never _discourage you_ from seeking medical advice and treatment, but DO get all the facts and info. I think about something like the concerns over dietary fat, cholesterol, eggs, etc. and the belief in chronic cardio exercise: the medical and health communities have been wrong about SOOOOO much, it shocks to consider it.

That is a prelude to saying maybe you should look into the following book. I have _not_ read it but it will go into much more detail about the issues I alluded to above.

http://www.amazon.com/Great-Prostate-Hoax-Medicine-Hijacked-ebook/dp/B00HBQ6NY8/ref=sr_1_1?s=books&ie=UTF8&qid=1453432315&sr=1-1&keywords=the+great+prostate+hoax

On a related note, there have been Op-Eds and articles in recent years by doctors (not specifically about prostate cancer) but detailing how many many doctors do not follow their own advice or give their relatives the same advice that they do to their patients. For malpractice reasons they HAVE TO advise certain courses of action even if they would not subject themselves to it in the same circumstances.

Again, I am definitely not saying don't get treatment. Just get educated and make an informed decision. Your PSA score is low enough, I would think, that you don't need to take any precipitate action on an urgent basis.

John Craig said...

Samuel --
Thank you very much for all that. From what I've seen so far, from the book reviews, it comes out mostly against the PSA test as a reliable measure of the possibility of cancer. I'm sort of past that stage: I had the biopsy, and I do have cancer. Also, doctors do seem to vary their advice with a patient's age. My father "probably" has it, according to his doctor, but his doctor's advice is to just ignore it at his age. With me, at 61, the likelihood of it spreading and being my cause of death is higher, so I have to deal with it, especially since I don't have the slow-growing variety (I have an intermediate type).

I agree with you about how the medical establishment gets a lot of stuff wrong, though.

In the meantime, I've been doing a fair amount of reading on the pros and cons of each type of treatment. (It's all pretty ugly.)

Anyway, thanks again for doing that research.

Spychiatrist said...

Sorry to hear this news John, but I'm not worried. You'll be fine, you're a strong man with a strong will.

A friend of mine had those radioactive seeds implanted and he's doing great some ten years later now.

John Craig said...

Spike --
Thank you very much for the encouragement. I'm debating which way to go right now, at the moment seem to be changing my mind every day.

europeasant said...

Wishing you well.
Thanks for the challenge(swim, run and weights). I needed that. I'm pretty close to your weight at 165lbs but a little shorter and maybe older(66).
I don't have solid dumbells up to that weight(75). My set only goes to a pair of 25 pounders. I used my adjustable set and worked up to what I thought was 75 lbs. I was able to lift that overhead but it was hard. However when I weighed it on my digital scale it only weighed at 73.7 lbs. I was going to put an extra 2 and a half pounders on each end but they would not fit and I was too tired or worn to do another try.
The run and swim will have to wait. Okay it will not wait as I am 100% sure I will never outdo your results. The lift challenge will have to wait till some other day as I have already started on my evening pain alleviation and health beverage.
Hope everything turns out well. I love reading you common sense stuff.

John Craig said...

Europeasant --
Thank you very much.

Hey, 73.7 is basically the same as 75, so that counts. And if you adjust for the five extra years, you outdid me. So, I'm impressed. The 200 meter dash is a fair challenge, everybody runs, but I have to admit, I knew I was being unfair by throwing in the swim, you'd have to have been a swimmer to do that.

Anyway, thanks for giving the one hand clean and jerk a try, and also for the good wishes. Enjoy your beverage.

Anonymous said...

John,
I'm a long term lurker to your blog and really appreciate your way of thinking. Best wishes for a speedy recovery. I think the side effect thing would bother me more than the actual problem.

John Craig said...

Long time lurker --
Thank you very much…..yes, that's pretty much how I feel.

Annie Oakley said...

John, long time lurker here. When I saw your email about cancer I had to comment. God bless you. You're going to be OK. I'm going to pray for you and keep good positive thoughts your way.

OTOH, I had a co-worker many years ago who had prostate cancer. They did have to remove one testicle. He's still alive and thriving. He has a g/f and his sex life is just fine. The girlfriend wasn't bothered by it.

With all the new advances in medicine and healthcare, your type of cancer is easily cured.

John Craig said...

Annie Oakley --
Thank you very much. I'm supposed to be too old for testicular cancer, but I can see how it could travel from the prostate to the testicles.

I'm reading up on and debating treatments right now.

Anonymous said...

You made me LOL in this post (until the last bit). I hope you don't lose you sense of humour.

Andrew

John Craig said...

Andrew --
Thanks….I guess we'll find out.

Samuel Nock said...

John,

I see you made that clear (the biopsy) in the original post. For that second comment I made, I guess I forgot that from the original post since I went off and brainstormed and posted the comment without reviewing your post again.

Anyway, if there is cancer, you might consider the following as well, although obviously one's ability to do certain things will be hampered by dealing with the treatment itself, time, interest, etc.

-- Get your iron (serum ferratin) levels tested. It is becoming increasingly clear that high iron levels are detrimental to health for a very wide range of things: CVD, cancer, diabetes, among others. Unlike women, who menstruate for a good portion of their lives, men do not lose iron, and it builds up to dangeour levels. I would think that reducing those levels could increase your body's ability to fight the cancer. See E.D. Weirg's book "Iron: Exposing the Hidden Dangers of Iron." Also read P.D. Mangan's blog Rogue Health and Fitness, where he has posted a lot on this issue. Again, this isn't about prostate cancer in particular, but immune health generally.

-- For someone in as good shape as you, consider trying to use methods that activate the body's own immune system. I am thinking in particular of certain breathing techniques that have been shown to achieve this. Wim Hof's breathing exercises are one way into this. Another is through John Alton's Unified Fitness, which is based on Qigong. For Wim Hof, you can search it out online. Again, I do not consider this stuff hokey because both of these guys are coming at this from a scientific perspective: the stuff works, it is not "magic", the fact that we don't fully understand the mechanism doesn't mean it isn't explainable in scientific terms eventually. Whether this interests you will depend on the time committment you can make, particularly in the middle of your treatment. I mainly mention it because I think you are at a level of fitness were it could actually reach a level of effectiveness for you that would take others much longer.

John Craig said...

Samuel --
Once again, thank you very much for putting all that thought into this. I appreciate it. I've had my blood tested several times before, most recently last week, and nobody has ever mentioned the iron thing, but I'll ask about it.

Coincidentally, I just read about Hof's ice baths and breathing exercises last week. Pretty amazing. I've heard about the stomach breathing/diaphragm-expanding method before in terms of controlling anxiety. But I don't have time to look into that stuff right now, at the moment I have to just get this prostate thing taken care of one way or the other, then if I have the time later on maybe I will.

But I appreciate you putting all this thought into my health, it's kind of you.

Samuel Nock said...

Your doctor most likely will not be knowledgeable about the iron issue. As long as you are within the "normal" range (which is from about 40 - 300), he/she will say you are fine. It is much better to be at the lower end of that range.

In any case, I fear my suggestions here are probably all a distraction for you since you are focused (rightly) on the evaluation of the immediately relevant treatments for your condition.

Go ahead and focus on the main thing, and only pay attention to ancillary stuff such as I am mentioning, if you have the mental energy, inclination and time.

Best of luck to you again, and I'm sure you will come out of this strong.

John Craig said...

Samuel -
Thank you again. Your suggestions are not at all a distraction, but I do have to figure out which treatment to go with first. You've been very helpful.

Sally said...

Hey John - I still have you in my favorites ... actually the blog is in my favorites, but I associate you with a favorite past time,swimming of course. Thanks for sharing your struggles with prostate cancer.
My husband was treated at Sloan Kettering over 8+ years ago for 3 different tumors and we can not say enough about their care, not only for patients but families as well.
Good luck & I'll be thinking of you. Hope to do a set in the pool with you soon!
Best,
Sally

John Craig said...

Sally --
Thank you very much. I thought you were going to make a comeback when I saw you at the pool about ten months ago, but then you disappeared again. Hope to see you there soon.

bluffcreek1967 said...

I'm sorry to hear about the news John. Chances are, as you pointed out, you'll survive it and be right back banging out interesting and humorous posts!

John Craig said...

Ambrose --
Thank you very much….I hope so.