AND NOW - THE REST OF MY LIFE! (Written Feb. 1998)
It is now a little over a month since I completed my treatment at Loma
Linda University Medical Center, and I have returned to my job and family. The
effects of the radiation are gradually fading away, and my life has to a great extent
returned to normal. But things are not really the same. This is what I have discovered
about going through this experience.
In February I went back up to UCSF and saw Dr. Eric Small, who is considered one of the world's top urologic oncologists. My goal in seeing him was to understand what, if anything, I should do now that I have completed my chosen course of radiation therapy. He felt that I should continue on the Combined Hormone Blockade for a total (including the time before treatment) of 12 to 18 months. Then I would stop and wait to see what happens.
If I am lucky, my PSA readings will be stable at some low value, and after five years or so, I will be pronounced "cured" at least to the extent that our current medical science can tell. If I am unlucky, my PSA readings will start to go up, indicating the presence of cancer cells still in my body. This is what happens quite frequently, even to people who have surgery (radical prostatectomy), and who at first appear to be out of danger. Unfortunately, none of the treatments available today are really a "cure" for prostate cancer in the same sense that penicillin is a cure for an infection. Surgery works well, if none of the malignant cells have wandered away from the prostate, and radiation works well even if some cells have spread to nearby areas. But if cells have entered the blood stream and are carried far from the original site, and if they find a convenient place to settle down, such as bone marrow, lungs, liver or other organs, the outlook is not good.
The best treatment that medical science can provide in this case is the same Hormone Blockade which I have been using for the past few months. Even this often fails after a period of time, usually a couple of years. One possibility for improvement is what is called "Intermittant" Hormone Blockade, in which the treatment is stopped until the PSA reading climbs to one-half of the initial reading, and then it is resumed. Some men have survived on this mode of treatment for 5 to 10 years.
The time I spent in southern California gave me a chance to do some thinking about all of this. I'd like to share some of my thoughts with you. First, I have started to appreciate that life is really a very uncertain thing. I have realized that this is not the way I have been used to thinking! I guess since I have never been seriously ill in my life (even since being diagnosed with prostate cancer) it is hard to appreciate my mortality. But the fact is that even with the best treatment available today, there is at least a 15% chance that I will not be around in 5 to 10 years. Now the question is how do I deal with this new uncertainty? I feel fortunate that I have an excellent oncologist here in the area who I see on a month to month basis. His name is Dr. Tal Pomeroy, and he provided a lot of the inspiration for what I am about to say.
Well, I think there are two sides to this coin. One is that a person can not fall into the trap of becoming a "victim." I noticed that several people I met at various support groups for prostate cancer patients referred to themselves as "prostate cancer survivers." And indeed that is the only way to look at it. Each day that I survive, that I make the most of my life, I am victorious over that cloud of fear and doubt that tries to take away my ability to live my life to its fullest.
To feel sorry for one's self, to be a victim, is to admit defeat. You could say that a person like this has already lost the battle, and even if they don't die of the disease, their life, as it was, is over. On the other hand, who knows how much time anyone has to live? You might as well try to make the most of life, and enjoy it while you can! I now realize that this is the only way a person can "win" the battle with a disease like mine. If you don't let it get to you, and if you live your life to the best of your abilities, then indeed you have won the battle.
That said, I still find myself angry about one thing. Most of us really don't appreciate the importance of medicine until we are on the "receiving end" of it. And what I have discovered is that nowhere near enough of our society's resources have been focused on improving medical science. I am an engineer, and I am used to the idea we can do almost anything we can imagine, given sufficient resources and commitment. Thirty years ago, men walked on the moon. Today the average person can buy a home computer more powerful than any super computer available at that time. But despite all of this amazing progress in technology, we have not cured many of the deadly diseases that then as now seem to strike us at will. Why? Isn't life important enough to make its preservation our top priority? Do all of the giant screen TV's, the cordless phones, the programmable microwave ovens make up for the lack of an answer to multiple sclerosis, emphysema, or cancer? Which would you rather have: another new toy, or a cure for a disease that might just kill you or someone you love?
You decide.