Friday, February 13, 2015

Almost forgotten in the midst of ski season

A year ago, I was still on the mend from surgery known as RALP - Robot-Assisted Laparoscopic Prostatectomy.  That surgery, on 1/6/2014, was the end of a 5 month period of time where I had a high PSA test result, two more high results, a biopsy of my prostate, and a diagnosis of prostate cancer.  To be honest, my wife has gone through worse issues in the past 6 months, but that diagnosis and surgery really shocked me and changed my life.  Aside from a simple skin cancer, I don't think that anyone ever feels like their life after a cancer diagnosis is ever the same again.  Mine certainly hasn't been the same.

Since the surgery, I've had my PSA tested 5 times.  In some ways, prostate cancer really is one of those "good" cancers.  If it does kill you, it usually takes a long time for it to happen.  And, when it spreads, it doesn't disguise itself.  No matter where it moves in your body, it is still prostate cancer and it still produces PSA.  So, unlike many other cancers, a simple PSA blood test will tell you if the cancer is active or not.  I have had tests in April, July, October and December of last year, and January of this year.  Two of the 5 tests were done using an "ultra sensitive assay", meaning they could detect lower levels of PSA in the bloodstream.

But, in all 5 tests, the machines failed to detect any PSA at all.  According to some calculators online, I have a 98% chance of being free of prostate cancer a year from now, and an 84% chance of being clear in 15 years.  Many doctors will start to use the word "cured" at 5 years.  At 5 years without recurrence, according to the online calculators, I would have a 91% chance of being recurrence free at 15 years.

My life has changed.  I will be anxious for every single PSA test for the rest of my life.  The side effects of the surgery truly suck.  I have done better than the average patient in my recovery, probably due to my fitness regime, or maybe just luck or the skills of the surgeon, but some things will never be the same.  To be honest, some of those permanent changes are frustrating, but I can't undo my treatment decisions.  I can only move forward and hope that future prostate cancer patients have better treatment options than I had.

So, where am I?  I appear to be free of cancer at the moment.  I'm in pretty good physical shape for an old fat guy.  I'm teaching skiing like I have for the past 13 years.  I'm in the gym 3-4 days per week.  I'm getting ready for trout season, which starts 8 weeks from tomorrow.  I have been setting new PRs in the gym for the last 6 months.

Life is pretty good.  My primary focus for the past few months has been helping my wife navigate the healthcare system due to a rare form of melanoma and a troubling uterine fibroid problem.  Her treatments are over and she is on the mend these days.  She even skied last weekend and did a CrossFit workout this week.

Bit by bit, we hope to get back to the less exciting (but certainly fun) way we lived our lives prior to all of this cancer nonsense.

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