Saturday, December 15, 2007

The Big C

I've put off writing this entry because I know I need to discuss the biggest health issue facing our family: my husband's cancer. It's prostate cancer, discovered a year ago. A bit scary to write about - I feel best when not thinking about it. But let me give you a summary.

A high PSA score indicated that a biopsy was warranted, at least in the opinion of his doctors. The biopsy revealed prostate cancer that appeared to be confined to the prostate. The urologist gave us a book about prostate cancer and suggested that we consider the options carefully. He personally felt that surgery was a suitable treatment.

Other tests indicated that the cancer had probably not spread yet. For several months, we studied the options, worried, and procrastinated. My husband (I'll call him Knute) consulted another urologist, followed by a surgeon at UVA Hospital and finally a surgeon at GWU Hospital. The latter had done hundreds of robot-assisted surgeries. So eventually Knute had robotic surgery to remove the prostate at GWU Hospital.

The surgery went smoothly and he came home the next day. Three months later we returned to the surgeon's office for a follow-up visit. Unfortunately, Knute's PSA level turned out to be .85, and it is supposed to be lower than than .2 after prostatectomy. This indicated that not all the cancer had been removed. The surgeon said that eventually Knute would want additional treatment, probably hormone therapy, to slow the progress of the cancer.

My husband does not want hormone treatment because (a) it has unpleasant side effects and (b) it does not cure the cancer anyway, just slows it down for a few years. Fortunately he does not have to decide yet because the doctors feel that he should wait until his PSA doubles before starting it.

We did visit a radiologist for another opinion. She recommend radiation treatment of the area where the prostate was removed because it might help. The other doctors, however, did not feel that the slight chance that it would work was worth the risks of radiation.

Meanwhile, my husband is still struggling to overcome the side-effects of the prostatectomy. They are the common problems result from this surgery: incontinence and impotence. He has made tremendous progress with continence, probably because he does Kegel exercises. However, he is still impotent and it has been six months since the operation. He has read that it can take a year to overcome this so we are not alarmed, although he feels less manly and sometimes gets depressed with the situation.

He is 62. If the cancer grows slowly, it could take a decade or more before it debilitates him. But it is too soon to know how much time ...

Still, we never know how much time we have left on this earth. At 62, he would only have a few decades left of good health even without cancer. And since he also has diabetes, he faces the other health risks that are known to face diabetics.

One thing that we have been forced to face is that we are aging and that vigorous years ahead are limited for us. Even if we are both alive 15 years from now, we will probably be less able to do active things than we are now. So we need to enjoy what we can.