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My Unexpected Diagnosis

Unexpected-Diagnosis
By Jerry Friedman #83844

According to the American Cancer Society, prostate cancer is the second most common cancer in American men, after skin cancer. It is also the second leading cause of cancer deaths in American men, after lung cancer. One man in six will be diagnosed with prostate cancer during his lifetime, about two-thirds of whom are over age 65. Yet, fewer than three percent of American men will die from prostate cancer.

You can hardly be alive without being aware of the number of things that can befall you just because you exist. For me, prostate cancer was not high on the list. I was a healthy 64-year-old male with no history of chronic illnesses or pain, and I was not on any regular medication. I maintained a good weight, ate a healthy diet and exercised regularly. I have been getting annual physicals for as long as I can remember, and all my blood tests revealed normal values.

One of the blood tests is the PSA test, which measures the level of PSA in a man’s blood. The prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. The blood level of PSA is often elevated in men with prostate cancer. (There has been a controversy recently as to whether the PSA test is worthwhile, as statistics show that an elevated PSA does not always indicate prostate cancer, nor does a low PSA confirm the absence of prostate cancer.)

In my many years of annual physicals, my PSA has always been between 2 and 3. During my last physical, it was 5.5, above the range that is considered “safe.” Normally, another blood test would be done to verify the results since there are events that could skew the number, or, lacking other indications, the PSA would be tracked over time. Prostate cancer is very slow-growing, so delaying action for a short period of time is not a problem. However, a digital exam revealed a firm spot on the prostate, and it was recommended that I have a biopsy performed.

A biopsy of the prostate is a painless procedure that is done in a doctor’s office. About a dozen thin cylindrical “cores” of prostate tissue are removed from various points in the prostate gland and are then sent to a pathologist for microscopic examination. My biopsy revealed cancer cells in four of the 12 samples. The Gleason grading system assigns a grade to each of the two largest areas of cancer in the tissue samples. Grades range from 1 to 5, with 1 being the least aggressive and 5 the most aggressive. My Gleason score initially was 6 (a combined total based on the two largest samples), indicating a medium grade cancer. It was later upgraded to a 7.

Now came decision time. My wife, Shirley, and I are full-time RVers, and we were in Austin, Texas, when I got the diagnosis. The decision was easy. With our familiarity with the exemplary reputation of the MD Anderson Cancer Center in Houston, and the positive experiences some of our acquaintances had there, we immediately contacted MD Anderson and set up an appointment to determine a course of action.

There are basically three options when dealing with prostate cancer—radiation, surgery and active surveillance. At MD Anderson, they set up sessions for us with specialists in the areas of surgery and radiation and explained in detail the pros and cons of each option. They emphasized that there was no wrong option and no one right option.

There are several options within the category of radiation—external beam radiation therapy, proton therapy and brachytherapy, where tiny radioactive implants are placed directly into the prostate. One of the drawbacks, in my mind, is that, if the radiation is not successful, subsequent surgery is not a viable option.

Surgical options include open surgery and robotic surgery. The advantages of robot-assisted surgery with the da Vinci Surgical System are significantly less pain, less blood loss, fewer complications, less scarring, shorter hospital stay and a faster return to normal activities. An acquaintance of mine preferred the open surgery because “I want the surgeon to see what he’s doing!”

Active surveillance is just that—don’t do anything but track the progress of the cancer. This is often a choice of older men because this cancer is so slow growing, older males will most likely die of something other than the prostate cancer.

Having done a lot of research prior to the meetings at MD Anderson, I was pretty sure I wanted to opt for the robotic prostatectomy. My interviews confirmed that this was a good option for me, and the appropriate arrangements were made.

 One advantage of being a full time RVer is that your home is truly “where you park it.” So, no matter where you choose to have treatment, you can move your home close by. There were several RV parks near MD Anderson, and we found one we were very happy with. The owners of the park were aware that many of their renters were there for medical treatment and were sensitive to their needs. Also, we met several people in the park who were undergoing various surgical procedures, so there was a good forum for sharing experiences. And, if the spouse of someone who was recovering at home from the surgery needed assistance, there are many folks around who are more than willing to help.

My surgery went well and, although I was cleared to go home from the hospital the next day, I felt better about staying an extra day and getting more information about my recovery and what I needed to do during my recovery at home. My second day in the hospital, they already had me up walking 20 minutes, three times a day. After I got home, I continued my walking, and, although I was on a catheter for two weeks, it was much easier to deal with than I ever would have imagined. I had restrictions on the amount of weight I could lift, and I wasn’t to drive while I was on the catheter, but each day I could feel myself getting stronger and my appetite returning. Shirley was thrilled when I could be the one to dump the tanks again.
We stayed at the RV park until my six-week checkup, which revealed that there was no residual cancer, and a PSA test four months after that still showed the PSA as undetectable.

There are adjustments to be made in everyday living but nothing that causes a major change in lifestyle. The most important thing is that the cancer is gone and life goes on pretty much like normal. The projection is that it takes two to three years for all bodily functions to return to their original working order. I can handle it.

The one thing that surprised me was the impact the prostate surgery had on my wife. It took her a while to approach me with her concerns, but we now have good, open communications about her feelings. She was having trouble dealing with the ramifications of the surgery, but she found some good forums on the Internet specifically aimed at the wives of prostate cancer survivors, and that has been of great value to her.

The demographics of the RV community are such that there are a large number of males that will be subjected to prostate issues. It is important for all males over the age of 50 to have regular prostate exams. Plus, it is almost an advantage to be an RVer when dealing with prostate issues, as it provides more flexibility with regard to scheduling and location.

Jerry Friedman, his wife, Shirley, and their two dogs have been full-time RVing since 2004. Jerry was diagnosed with prostate cancer in December 2011, and he had his radical prostatectomy in March 2012. He has been cancer-free since then.

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