So What's The Plan Man?

So that was how most of my summer went. Like I said earlier, I had a decision to make as to which treatment option to choose. The options were: do nothing and wait it out, radical surgery, seed implant, freezing the prostate, hormone therapy or radiation therapy. I also looked at chemotherapy and biological therapy. Since I was told that my cancer was in its early stage and considering my age, the seed implant or radiation therapy seemed to be the two best options for me.

If I was to do nothing and wait out the cancer I would live 10-15 years because prostate cancer moves slowly. In watchful waiting you get no treatment but see your doctor often. If the tumor starts to grow hormone therapy can be started. That would have been considered if I was older.

My urologist talked to me about surgically removing the prostate. But more than the prostate would be removed. The prostate, the seminal vesicles, and a portion of the urethra are removed. The urethra is then attached to the bladder and you have to urinate through a catheter until you heal. (And do I have a catheter story to tell you) I wasn’t keen on any of the invasive options, radical surgery or seed implant. Call me a wimp but I just can’t stand the pain. (Probably because of my experience with the biopsy or my general hatred of pain). During the biopsy, the urologist used a thin needle to remove tiny tissue samples from several areas of the prostate. That was not comfortable at all and it affected my urine and bowls for two weeks. I had that done after learning about my PSA (prostate specific antigen) numbers. There are also some risks associated with surgery that concerned me. Loss of bladder control, infection, bleeding, difficulty urinating and bowel perforation. But in spite of all the risks, surgery is the most effective option if the cancer is confined to the prostate.

The seed implant is where actual radiation seeds, a lot of them, are planted directly into the prostate. Now remember my experience I just told you I had with the biopsy. I thought about the implants for a hot minute. The thought of having more needles stuck there makes me grimace and send shivers up my spine.

Then there is freezing the prostate. Now I don’t know about you but the thought of having your stuff frozen also didn’t bring any pleasant thoughts to my mind either. So, that option was quickly dismissed. (I probably should be open minded)

Hormone therapy is an attempt to lower the level of the male hormones, called androgens, which are produced in the testicles. Androgens, such as testosterone, help the prostate cancer grow. You get monthly shots. I learned that hormone treatment is used mostly when the cancer has spread outside the prostate gland.

On July 18, I met with a radiation oncologist and two interns at the Cancer Center of UW Hospital and Clinics to discuss radiotherapy or radiation. The UW Cancer Center is the only comprehensive cancer center in Wisconsin meeting the high standard for designation as “comprehensive” by the National Cancer Institute. They focus on the best care for patients with cancer; on research, education and prevention. (See, I told you I did my homework and research on the second trip to Tallulah) I wanted to learn all I could about prostate cancer and my treatment choices. The Radiation Oncology Department is frequently rated among the nation’s best.

Here is the scoop on radiation therapy. Radiation therapy is done using a machine that sends beams of radiation or x-rays from outside the body to the cancer. The risks that I considered were: mild to moderate diarrhea, frequent urination, fatigue and/or gas. (I experience most of that right now) Also with radiation some normal prostate cells may be damaged or the cancer could come back years later.

The big factors for me are that after each treatment I would most likely be able to follow my normal routine and at ten years after treatment, the cure rates are about the same for radiation therapy and radical surgery. There are no surgical risks with radiation therapy. There’s no risk of bleeding. You don’t have to stay in the hospital. You recover faster.

My intent in sharing the treatment plans with you is not to show you how smart I am (although I am) but rather to reveal the process I went through to arrive at a decision and only that.

Now that you are “up to speed” on all of the treatment options, (there will be a test later) and you still don’t know what option I chose. We have a little ways to go before I get to that point.