After the initial shock of my diagnosis, I read a lot about prostate cancer, and quickly calmed down. (Samuel Nock, who comments on this blog occasionally, was quite helpful in that regard, sending me all sorts of reassuring information about the disease.) Prostate cancer is the slowest-growing, most easily treatable form of cancer. In fact, many believe that the disease is over treated, and many doctors who get it don't even follow their own advice and get treatment, opting for "watchful waiting" instead.
I ended up speaking to two more doctors. The first, at Sloan Kettering, recommended a prostatectomy. But the side effects from that operation (a higher chance of incontinence and impotence) seemed pretty grim. Plus, I didn't like the doctor. I got the strong sense that he was showing off the entire time for the young female Spanish doctor who was accompanying him on his rounds.
The second doctor worked at Procure, which specializes in proton therapy, a type of radiation which has fewer side effects. Protons, as opposed to the photons which are used in traditional radiation, just dissipate after they hit the target, and don't pass through the rest of the body before exiting.
By that point I had pretty much made up my mind to go with proton therapy anyway, and the doctor I met there, Henry Tsai, helped confirm that decision. He was both extremely knowledgeable and down to earth, the combination you want in a physician. And he didn't oversell the treatment. He also didn't give the impression that he was rushing me into anything, even telling me that I could wait a year, two years, even three years before treatment and probably not have to pay a price, though he didn't recommend that.
I didn't want that uncertainty hanging over my head, so I moved the process forward.
The only unpleasant part of the entire treatment was having the markers installed in my prostate. As I drove to the doctor's office that day, I thought mostly about the upcoming humiliation: you lie down on what is basically a gynecological table, your legs in stirrups, and he injects them through your perineum while you have an ultrasound up your rear end. But once the five needles started going in (dunno about you, but that's always been a pretty sensitive area for me), I forgot all about the humiliation.
The nurse offered to hold my hand. I felt a little foolish doing so at age 61, but ended up squeezing her hand so hard I thought I might have hurt her. It actually did seem to help. (Pain trumps embarrassment.)
The next step was the CT scan. By this point, I was pretty much resigned to the lack of dignity, and to the idea that I was nothing more than a blob of protoplasm to be poked and prodded, and wasn't even that embarrassed.
Next was an MRI, which is basically twenty minutes in a coffin, a little foretaste of eternity.
And then, nine weeks of daily radiation sessions. My son suggested I ask for the kind of radiation that gives you superpowers, like Spiderman got. But evidently that wasn't available.
You never feel the radiation. (It's like going to the dentist to get an x-ray.) You lie down on a table (you have to remain still), and a few minutes later the technicians come into the room to tell you it's over. (You only get about 45 seconds of actual radiation in each session.)
People would always ask how my treatment went that day, as if it might be some sort of ordeal. My reply was always the same, that it was uneventful.
I almost felt guilty about the amount of sympathy I was getting from people I knew. I never once felt pain, other than the original biopsy, which as mild, and the implantation of the markers, which was pretty intense. As far as the cancer itself, I never felt a thing; it was just a poisonous little seed that had started to grow in my prostate and that I had to take care of; I've had colds that were more painful.
I opted not to under go chemotherapy, which for prostate cancer consists of taking drugs which lower your androgen levels. (No thanks.)
I had originally said in that post in January that I'd be blogging less, thinking that either the cancer or the treatment might be debilitating. But neither ever were. In fact, after five weeks of radiation, on Memorial Day, I ran 200 meters in 27.2, my best since 2007.
This, of course, didn't stop me from playing the cancer card. ("I'm dying of cancer and you want me to take out the garbage?!!")
There were patients at Procure who had more serious forms of cancer. I saw two without noses. And there were little kids with cancer, a stark reminder of how unfair life is.
The staff was friendly and cheerful. It's a tough thing to put a smiley face on a cancer ward. But the nurses and radiation therapists must be told it's part of their job to act like happy hostesses, and they did a good job.
And the radiation itself can cause cancer down the road (I had 47 x-rays to go along with my 44 proton therapy sessions), so the future seems less certain. I no longer see my life stretching out another 40 years until I'm 100.
In the meantime, I guess I'm supposed to have absorbed some lessons about how precious and fleeting life is, and how I'm supposed to savor every moment of every day. Have I? Nah, not really.
I'm still the same obnoxious guy, as I plan to demonstrate on this blog.