GREG'S LEGACY

Specialising in the human experience of Living with prostate cancer – warts and all

Posts Tagged ‘Prostate-specific antigen

Latest Advances In Treatment Of Prostate Cancer And The Butterfly Effect

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The Blue Tiger

The Blue Tiger

The first blast of winter has reached my little tropical hideaway part of the world. There is a massive high pressure system south of the Great Australian Bight directing Antarctic winds right up the east coast of Australia. Night time temperatures have dropped below 10 degrees celsius with day time temps below 25 deg. It may not sound like a big deal to my southern neighbours but living in temperatures that average minimums of 25 deg to maximums of 35 degrees for nine months of the year it becomes a shock with the first winter blast in this part of the country.

At least the butterfly swarms are still passing by my verandah but I am guessing that this cold dry change will knock them back a bit for this year. Between March and May every year I can sit daily on my verandah and watch the procession of these beautiful creatures as they travel from the south in a northerly direction. I have even seen these swarms over the ocean 100 kilometers from land. Where they come from and where they are going I have no idea. They just happen here every year with the main type being the “blue tiger” but also many other species of all colours and sizes can be mixed with them.

Watching them the other day reminded me of an old metaphor called “The Butterfly Effect.” This was a theory exploring the concept of a small thing happening on one side of the planet (such as the flapping of a butterfly wing) can cause an immense reaction in one form or another on the other side of the world. It was part of a theory called the “Chaos Theory” and was generally attributed to calamities, however I believe in “Yin and Yan,” so the theory in my opinion should apply equally between good and bad.

One thing cancer has taught me, is to look at life more deeply and appreciate things in a more meaningful way, hence my fixation of my butterflies, their life cycle and the theory. Such a beautiful creature that evolves by unfolding itself from a lowly caterpillar after pupation. I like to believe the whole story offers hope that small actions can create massive changes for the good in this world. Mankind is still at the beginnings of meaningful good changes as witnessed by lifestyle differences. opportunities and other madness going on in the world; We are seriously out of balance. However the more developed countries involve themselves in the opportunity to continue to make advances in areas such as medical practices the more likely these advances will eventually filter throughout all the world. This then takes me to the subject I wish to offer readers in this article, regarding the advances made recently and where we are headed in the treatment of prostate cancer.

So how has treatment for prostate cancer advanced over the past number of years? Before I begin I should quote the following statistic for my readers. The prostate cancer 5-year survival rate has improved from 59% in 1986 to above 92% today, and likewise for most types of cancer the 5-year survival rate has increased. This increased survival rate is due to improved medical practices, the introduction of new drugs and/or the treatment methods and successful research outcomes.

In the case of prostate cancer, over 3300 men will die of this disease this year, even though it is still thought of as a slow-growing old mans disease. The truth is, that early low-grade prostate cancer is indeed slow to promulgate but there are high-grade aggressive varieties that are lethal, and indeed more younger men are now being diagnosed with this disease in their thirties and forties.

While PSA monitoring and DRE procedure have been the main indicators for biopsy; Research is searching for other prostate cancer markers to use, and several exciting pathological trials are underway. Medical imaging has also expanded, with much advances in imaging from MRI, CT and PET scans, along with ultrasound technologies. Much of this future researching and improvements should bring huge benefits in assisting doctors to discern at diagnosis, between the non lethal and lethal types of prostate cancers. This then, should have a great impact in decisions regarding primary treatment for the patient. Improved imaging should enhance the ability to locate and direct biopsies and also to better detect metastasis to bone and other tissues.

In the past few years there has been the introduction of new drugs such as Abiraterone Acetate (Zytiga) and Enzulutamide (Xtandi) which are advances in hormonal drugs offering greater survival rates, with less side effects. Sipuleucel T (Provenge) is an Immunotherapy drug and treatment, which stimulates the individual patients own immune system to attack cancer cells. Radium 233 (Xofigo) which is a radioactive type drug, used in the treatment of bone metastasis with prostate cancer.

Much research continues to search for and identify the different individual characteristics of prostate tumours. This may lead to drugs being available for specific types of tumours, and could lead to individual tailored drugs being used on a patient circumventing the need for current primary treatments of surgery and radiation. This could  have profound effects in preventing major life changing side effects.

AMEN

AMEN

There is much excitement and discoveries still to come in the medical world over the next decade, and I hope I am still alive to see much of it. Meanwhile I will keep admiring my butterflies for the hope they offer for a better world to come. Is it Possible?????? Perhaps.

 

Lee aka Popeye

 

 

The Spicks and Specks of a Cancer Patient

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Now Showing

Now Showing

I know it seems a while since I have published anything for readers on this site and I do have a couple of excuses to offer for my lack of effort. I Thought my last two articles could stay up front for a little extra time due to their content, and the possible benefit a person might receive who might also be doing it tough. My other excuse is that my health over the past four weeks has not been good at all, and as a result I have undergone a series of tests and scans to try and resolve some health issues.

I decided to put this article together and call it Spicks and Specks. It contains a bunch of stuff that has been happening to me over the past couple of months, plus a personal comment from me regarding cancer in general. Spicks and Specks was the title of a BeeGees song released in the mid 1960’s and I loved it. The title just seemed appropriate for this bits and pieces article.

Touching on the BeeGees has just reminded me to let my readers know that since September 22nd I have been the proud owner of a Ukulele given to me by my family as a birthday present. Prior to this and for many years I played the guitar poorly and sang even worse, however my family knew I harboured a desire to get hold of one of these little fun instruments and give it a go ( they most likely had, had enough of my guitar playing) . So here I sit looking across at my happy little hippy friend all decorated with stickers, and yes I do play Spicks and Specks on occasion. Everybody should have a Uke.

My latest blood test results were excellent and the PSA result was 0.02 almost undetectable. However I have been experiencing quite a bit of pain in the hips, groin, leg and lower back area. I also had a problem with weakness in the legs and huge fatigue issues. So after presenting to the doctors, they decided I should undergo some scans and tests which I completed and the results were all clear of progression, with one small area needing further investigation. It seems I have blood in the urine and this will involve the insertion of a camera to inspect the urethra and bladder and I will report back when the procedure has been completed.

While all this doctor visits,scans and blood tests was going on, it occurred to me how having a cancer diagnosis is all about management. My current view of cancer is that I see it as a chronic illness, just like any of the dozens of other chronic illnesses that abound. Cancer may be more prevalent than other chronic illnesses but it seems to me that having cancer of any type is still, all about the management of treatment designed to cure, or lessen the impacts and maintain and extend a patients quality of life.

Research for a cure for cancer goes on and over time humans have made many discoveries and strides forward in cancer management and treatment. When looking at some of the statistics it is interesting to see just how far we have come with testing and treatment. Consider the following:

  • One man in two will receive a cancer diagnosis by the age of eighty-five years and for women it is one in three.
  • Over 120,000 Australians will be newly diagnosed with cancer this year.
  • The good news is that the survival rate from cancer has increased by 30% in the past two decades.

I might expand on this subject of living with and managing cancer in future articles from my own personal experience and from other information freely available. It is an interesting way of life, this living with cancer stuff and it has many different facets to explore.

In my small rural community and amongst the residents I personally know, there has been one other man diagnosed with prostate cancer and three ladies diagnosed with breast cancer. All of us have been diagnosed within the past eighteen months and this has been a bit of a shock to me regarding the prevalence of cancer among us. I now have to admit that when I was healthy and cancer free I never previously noticed those less fortunate at the time. It is interesting how blind some people can be at times, myself included.

Even with pain and fatigue issues I am still able to get about and contribute to the workings of our household. I still try to do my daily walks and exercises but most days I need a pensioner nap in the afternoon. I have been able to put my recent mental melt down behind me with the help of counselling from the Queensland Cancer Council. That event was a bit scary for me but I have learned a great deal about myself and the human response to moments of despair from the experience.

And that my dear readers is my spicks and specks for the moment.

Everyone should have a Ukulele

Everyone should have a Ukulele

“All of my life…I call yesterday…..The spicks and the specks of my life gone away. Everybody…. spicks and specks…..spicks and specks now…..spicks and specks.”

Lee aka Popeye

Those Old Post Treatment Blues

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Also 23 types of PC

Also 23 types of PC

Well the songs are banging around in my brain like a bunch of old blues numbers creating an earworm. “Won’t you cry me a river,…….. cry me a river,……I cried a river over you” or “You must remember this, a kiss is still a kiss, a sigh is just a sigh,….The fundamental things apply,……….As time….. goes….. by.” Ah Play it again Sam.”

I had read about the mental anguish that can accompany a patient when nearly all primary treatment for prostate cancer is completed and life goes on. Seemingly, the only thing treatment wise, happening for the patient is a three monthly PSA test and more than likely a periodic injection for continuing ADT. However the lack of any major future medical goals provokes these blues attacks and for very understandable reasons.

It has taken me 12 months down the track to arrive at this point in my little journey. Now here I am all treated out, apart from continuing ADT and wondering where the hell I go from here. I have not seen my GP or Urologist for several months, I am in need of my next eligard injection which I fortunately have a script for (The last injection was given at the radiology clinic) and I am now back home released from the radiologists care. Where do I go from here ??

I have issues with my Urologist that I am not happy about and I was constantly thinking up excuses not to phone and make the appointment that I knew deep down I really should make. I feel like giving him a miss completely, but he is all my country town really has to offer a prostate cancer patient like me, as unfortunately the only other Urologist in town may have some issues with me. My last GP had fled from the area some 9 months ago but I do have a good option to see the doctor who owns the family practice. So into the GP I go and after a little chat he advises me to do the thing I really knew I had to do.

So there I was, three weeks later in the urologist waiting room clutching my 4week overdue eligard package. I had spent the previous couple of weeks worrying about the results of my PSA test and wondering if the numbers may have risen slightly. The question is always in the back of a prostate cancer patients mind, has the PSA gone up?? Has the cancer become castrate resistant and is on its merry way ??? There are no guarantees for any of the treatments in this game because given enough time all prostate cancer will progress despite ADT.

To a prostate cancer patient, life can seem to revolve around waiting outside a doctors door for the bad news you do not want to hear. You already know the cancer will get you in the end if you don’t die from something else first. However, onward you go, wishing for the good news every time the door opens and then back to managing your disease until the next time. Prior to this visit of mine to the Urologist I did consider shutting up shop completely, meaning no more ADT, no more Urologist, no more pathology and just get on with my life for as long as I could. To my mind this would be like walking away from the door and throwing off the chains of the side effects of the ADT drugs.

The flow chart

The flow chart

However, here I am and into his office I go…. Before I even sit down, he is reading the riot act to me about “I have a rule with all my cancer patients that they see me regularly and at least every three months in the worse case.” So I bent down, picked up my bag, turned and took a step toward the door. “What are you doing???” He asked. “…….I am leaving” I replied and then my wife and carer sprung into action to diffuse the situation . Nette let fly with news of our past 4 month stint and that we had kept his office up to date with progress, he on the other hand had sent us nothing. She then asked me to sit back down.

The rest of the session did not improve when I informed him that my wife and I were considering leaving private health insurance for financial reasons. This news was not received well from his side of the fence as he failed to conceive that a pensioner could not easily find $5000 per year for private health cover. His last word on the private health dilemma was to offer me the advice that I might consider having a subcapsular orchidectomy ( surgical castration ) to help out with future costs. I received my eligard injection and the good news that my PSA was still 0.04, he asked me to have a bone density test and PSA test and to make an appointment with his secretary for June.

I shook my head as I closed the door trying to work out how surgical castration may help or save me money in the long run. I am sitting here writing this post a week later and I am still pondering his suggestion and wondering what I will do with myself. Oh and by the way, I haven’t made the next appointment yet.

What goes around

What goes around

Lee aka Popeye

Prostate Cancer Screening My Two Bobs Worth (20 cents worth for those born after 1966)

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The Quandry

The Quandry

The past two posts published on this site, discussed issues surrounding prostate cancer screening and treatment. Debate is still raging throughout the world with study results quoted and decisions made creating mayhem among patients, medical practitioners and supporting associations. It seemed timely for me to add my thoughts on these issues and offer my opinions for discussion to anyone interested.

In my mind I think the actual term of prostate cancer screening is misleading for Australians as it implies that the male population is under some national program to regulate screening for this cancer. Eg mammograms, breast screening etc. There is no national program, you will not receive a written invitation from the government.

Screening for prostate cancer as I see it applies to the use of the PSA blood test and DRE examination. Both of these procedures are available to all men at the invitation of the GP or the request of the patient to the GP and would be better termed  prostate function testing.

For better or worse the PSA and DRE procedures are the only common simplest testing available to men at this time. The PSA test comes in for heavy criticism on many fronts but is still the initial test that rings the alarm bell. So until research is able to find an improved substitute for these tests we should continue to use and improve the tools we have.

There are many forms of prostate cancer and each mans cancer is different. Some low and medium risk prostate cancers (Gleason grade 6 or 7) may never cause any health issues while some will turn aggressive and will be terminal. When low and medium risk prostate cancer has been diagnosed we have no way of determining if the cancer will remain indolent or will become aggressive. Improved research needs to be done in this area to find a way to better define the cancer that has been diagnosed.

Initial primary treatment for prostate cancer includes surgery, radiation, ADT drugs and/or a combination of these. Primary treatment can save your life or help manage the illness for those with aggressive prostate cancer. The price of this treatment can include either temporary or permanent side effects with urinary and bowel issues, including incontinence, erectile dysfunction, fatigue and a whole range of effects from the ADT treatment.

The considerable side effects of primary treatment for prostate cancer and the difficulty in determining between the prostate cancer that will kill you and the one that won’t is at the heart of the conundrum. Many men with low to medium risk cancer will elect to be treated who may not have needed primary treatment in the first instance.

There is another option for men diagnosed with low or medium risk cancer and that is with active surveillance over a period of time. In this case the patient and doctor will continue to monitor the PSA levels, conduct a DRE with follow up biopsies if needed on a regular basis. Further action could then be taken if and when indicated by a change in monitored results.

There are conflicting study results available that state there is no mortality benefit in screening (testing) and other study results that state there is a mortality benefit of 20%  with regular screening (testing). Regardless of the arguments from all sides, the fact remains that one Australian man will die every three hours from this disease! So with proper education and information every man should have the right to make his own decision regarding to get tested or not.

Capt Sparrow is befuddled

Capt Sparrow is befuddled

Memorial Sloan-Kettering Cancer Clinic operate a set of guidelines for prostate cancer screening that seems sensible to me and I re- produce it here as follows:

Our doctors recommend the following screening guidelines for men expected to live at least 10 years:

  1. Men aged 45 – 49 should have a baseline PSA test. If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate. If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every 2 – 4 years. If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test at age 51 – 55.
  2. Men aged 50 – 59 should have their PSA level checked. If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate. If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every 2 – 4 years. If the PSA level is less than 1 ng / mL, men should see their doctor for another PSA test at age 60.
  3. Men aged 60 – 70 should have their PSA checked. If the PSA level is 3 ng / mL or higher, men should talk with their doctor about having a biopsy of the prostate. If the PSA level is between 1 and 3 ng / mL, men should see their doctor for another PSA test every 2 – 4 years. If the PSA level is less than 1 ng / mL, no further screening is recommended.
  4. Men aged 71 – 75 should talk with their doctor about whether to have a PSA test. The decision whether to have a PSA test should be based on past PSA levels and health of the man.
  5. Prostate cancer screening is not recommended for men aged 76 or older.

A high PSA level does not generally mean that a man should have a prostate biopsy. A doctor will often repeat the PSA test after a few months to determine if it is still high and investigate whether there is a reason other than cancer that could explain why the PSA level is elevated.

This is one solution

This is one solution

In summary it will still be an enigma for a man diagnosed with low-risk Gleason 6 or medium risk Gleason 7 to choose his path. Does he run the gauntlet of risking possible side effects and choose a primary treatment. Or does he accept to play mind games for a while and choose to sit on the fence with active surveillance. That is the Question????? However it should be each mans right to supply his own answer and provide his own actions.

Here endeth my post

Regards

Lee aka Popeye

Further reading and reference

http://www.dailymail.co.uk/health/article-2163640/Dont-rush-prostate-operation–worst-thing-do.html#ixzz1yfps3qP4

http://www.bedfordresearch.org/images/blog/SH-Prostate-Cancer-PSA-Test-2012.pdf

http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm

http://ses.library.usyd.edu.au/handle/2123/6835

http://www.mskcc.org/cancer-care/screening-guidelines/screening-guidelines-prostate

Would PCa Screening Have Helped Me

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Prostate Testing and Screening

I have been a contributer to Greg’s Legacy for a short period of time. I was diagnosed in March 2012 with advanced prostate cancer, Gleason 9 graded T3/T4 with 18 out of 18 core samples positive at between 80% and 100% PCA cancerous tissue also involving the lymph system.

Scans taken in March indicated that there was no spread of the cancer to the bones, lungs or liver at that time.

I had been suffering urinary symptoms since August 2011 which increasingly worsened until finally in late January 2012 I sought help which finally led to my diagnosis in March. After diagnosis I was immediately put on ADT ( Hormone therapy) to stabilise the spread of the cancer. My urologist believes that he has a chance to cure this cancer for me using ADT , HDR Brachytherapy and External Beam Radiation.

Due to my urinary issues I had to undergo a TURP procedure in May 2012 to correct my urinary symptoms before I could undergo the radiation treatments. I am almost ready to proceed with the brachytherapy hopefully sometime in September 2012 and am awaiting word from the specialists in Brisbane to confirm the dates.

At diagnosis my urologist made a statement to me after some interrogation of my immediate past 15 years including the fact that I had not been tested for prostate cancer for the past 14 years. He stated the following:  ” You have most likely had this cancer for at least the past 10 years when you have been symptom free”. As I was 64 years old at diagnosis that meant that this cancer may have been picked up when I was 54 years old if screening was the practice.

After receiving this news I was at first upset that perhaps if it had been picked up early I would not be going through this advance stage and its implications that I am now dealing with. However more investigation and wider reading by me on the effects of prostate cancer, treatment, side effects and statistics have slowly changed my mind to be more open on this subject and I offer the following to any readers who may be interested.

There is much debate in the prostate cancer world at the present time as to the relevance of screening men over the age of fifty or forty if there is a family history of prostate cancer. Having now read fairly widely on this matter it appears most of the controversy centres around two main issues. The first issue is the aggressiveness of the cancer that may be diagnosed and the second issue is the debilitation of the side effects of any treatment given to these men.

It is a well known cliche that most men if they live long enough will test positive for prostate cancer. Prostate cancer is in most cases a slow growing cancer and many men who have this type of cancer will never experience any symptoms and may die with the disease rather than because of it. It is interesting to read a quote from the discoverer of PSA Dr Richard Ablin who made the following comment. ” The PSA reading as a test is hardly better than a coin toss. It cannot distinguish between the two types of prostate cancer. The one that will kill you and the one that won’t.

Another piece of information I came across which I found interesting is the yearly prostate cancer death statistics in Australia. Approx 2900-3000 men will die from prostate cancer in Australia each year. Of these 58%  are men aged 80 or over, 82% are aged 70  or over and just 2.8% are aged under 60.

The main debilitating side effects from treatment of prostate cancer is incontinence, erectile dysfunction and ejaculation reversal. If you go in search of statistical data related to these side effects you will be hard pressed to find results from different studies that correlate with each other. Rather you will see wide variance of results such as between 15% and 60% of men experience incontinence one year after treatment or between 20% and 70% of men experience sexual problems one year after treatment. All forms of treatment from surgery to radiology, brachytherapy and other forms have the same widely ranging data figures.

Since I became symptomatic back in August 2011 and following my TURP procedure I now have a small taste of what it can be like to have incontinence problems and erectile issues. I have been unable to have sexual relations for nearly a year now and since the TURP I am still wearing pads and experiencing pain on urination.  I still have nocturnal urination issues  sometimes several times throughout the evening. I now know quite a few prostate cancer survivors personally who have advised me of their issues after treatment. A quick read through any prostate forum will reveal that incontinence and sexual issues are very common indeed and debilitating for these men.

So here I am looking at my situation at the present moment. The question for me to answer is, do I regret not being tested earlier so my cancer may have been found and treated easier? If I had written this article two months ago you would have found that I was bitter toward the medical industry for not advising or carrying out any testing during my 50’s. I was bitter that I had to become symptomatic for the cancer to be diagnosed and when it was diagnosed it is advanced. My thinking then was that,  “Man if only I knew back then I could have had it fixed easily”

Education and information is a wonderful thing as it has the power to change opinions and actions. I have since given a lot of thought to the question of “would I have been better off fixing this cancer back when I was say 54 yrs old”? My answer is really my acceptance to myself that things have worked out as they have and cannot be changed. Throughout my fifties I enjoyed a satisfying sexual life, I had no urinary issues and led a good life. At 64 yrs this all changed but I now understand more and I think to myself that perhaps, the past 10 years could have been a lot more miserable for me if I had treatment for the cancer back then due to these side effects.

So would screening for prostate cancer have helped me. I don’t think so and in fact may have led to a loss of quality of life that I enjoyed throughout my 50’s.  I am now satisfied that things have worked out for the best given this cancer is a reality for me to deal with right here and now, for better or worse. If in the next five years I do not die from something else, chances are that this cancer will run its course. In five years and a bit I will be seventy years old which puts me nicely into the statistics for prostate cancer deaths in Australian men.

Further Reference Reading

http://ses.library.usyd.edu.au/bitstream/2123/6835/3/Let-sleeping-dogs-lie.pdf

Lee aka Popeye

Four Monthly Prostate Cancer Review Negatives and Positives

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Christmases past

Negativity takes over

I have just attended my urologists practice last friday afternoon on a scheduled review appointment and I was in a foul negative mood. My mood must have affected both my doctor and my wife as it was as if a dark cloud had descended on the meeting and I suddenly became a target for both of them.

It has been almost four months since my diagnosis and I am due for my next hormone implant injection come the 17th July. So with nothing better to offer as a post I decided to allow these two themes to guide me through and weigh up the negatives and the positives as they have happened to me over these past four months and throw them out there and see what comments I might stir up.

To be fair to my wife and urologist and to explain to everyone up front, I felt so bad after fridays meeting with my doctor that I emailed him an extended apology that evening and spent the next couple of days trying to make it up to my wife. To my urologists credit the apology was accepted without any problems and my dark mood on the day was mellowed by the doctors explanations to my problems and the ghost of Andy Ripley looking over my shoulder and whispering in my ear “Read my poem again you idiot.”

As a lead up into my dark mood on the friday I had spent the last eight weeks since my TURP procedure with  typical symptoms that had not fully resolved since the procedure. In fact I was collecting more symptoms along the way. The bleeding and purging of prostate material had continued and I was still experiencing pain on urination particularly throughout the daylight hours. I had developed stiffness and pain within the pelvic region and thighs. I had developed off and on chills and fever and an inability to stabilise my body temperature from time to time. My main ADT side affects of tiredness and heavy breathing were still with me. So I was getting a little worried. I had dark thoughts that these symptoms were possibly a result of the cancer extending itself subtly throughout.

As I began to unveil my diagnosis of my fears my doctor told me to drop anchor for a minute and presented me with the medical facts of my rotten position and the deepening symptoms I was experiencing. He explained with diagrams what he had done to the prostate during the TURP procedure and the fact that most of the tumour had been removed leaving behind an empty prostate sac that has two saggy edges near the bladder. My problem with pain and shut off while urinating throughout the day was because the bladder was not filling to acceptable levels and when trying to urinate the two edges of the prostate sac would flap together causing a shut down with associated pain. During the hours of darkness the bladder would fill sufficiently for the pressure to be such that this would not occur hence no pain throughout the evening. In time the remains of the prostate sac will shrivel and will not cause any problems. My other worsening symptoms are being caused by bacterial prostatitis which is being treated by ongoing antibiotics. He showed me in my pathology results with my urine samples that my leukocytes had risen from less than 10 to over 1000. This indicates a massive lot of crud still to be expelled from my urinary system.

My doctor then went on to advise that my latest PSA test was 0.01 so my prostate cancer at the moment wherever it happens to be within or without the remains of my prostate gland was not going anywhere for the moment. He reminded me that we have one shot at stopping this thing and it is with ADT combined with HDR Brachytherapy and External Beam Radiology. But I have to become symptom free before I start further treatment. At this stage it could be late August/September before we continue.

My other negative views which I have expressed in the past and did again at this meeting upset my doctor and my wife to the point where they were challenging my logic. I will explain these here as I said at the begining I would look at both the negatives and the positives according to my understanding.

Balancing the prospects

Proper Balance Needed

In the case for the negatives. I have almost reached the age of 65 years and have led a great life. No one lives for ever, we all have to head off this planet sometime. I don’t fear death but I do fear a long prolonged down hill slide to death. I do not wish to prolong this type of degredation for my family. So for me 65 is a pretty good innings, a lot of my friends and family were not so fortunate. So in good faith I am ready to declare my innings but not so my urologist and my good wife and I might add  bloody Andy Ripley.

For the positives and to be fair here it could be said (and was actually stated by the urologist) that from my initial diagnosis and cancer grading of gleason 9 that this prostate cancer had most likely started within me some 10 years or more before it became symptomatic. That would mean that with proper screening I could have been diagnosed with prostate cancer at the age of 54. Now if that had of happened through early screening I may not have been writing this post as this thing may have been nipped in the bud way back then when it was less agressive and easily cured. There was no way I would have been happy to leave this planet then. I was still a young and vibrant man of 54 with the world at my feet at the time.

The next positive I confronted was the ghost I uncovered in my last post and was really the reason I apologised to my urologist. I couldnt get the spirit of the poem written by Andy Ripley out of my head and it is worth repeating here.

Dare We Hope? We Dare

Can We Hope? We Can

Should We Hope? We Must.

We must, because to do otherwise is to waste the most

precious of gifts, given so freely by God to all of us.

So when we do die,it will be with hope and it will be

easy and our hearts will not be broken.

Andy Ripley 2007

So here I am feeling pretty ordinary. My life since late January this year has gone down the drain. My expectations of any real future are on hold. I now need a pad in my jocks to contain small accidents. It looks like any hope for a continuation of a satisfying sex life has long since gone out the window. How my wife really feels about this is really unknown to me although she has stated that it is not a real issue for her ( I am not sure how to really take that). My best mate and spouse for forty years now has to share, care and continue to love this poor old sod for better or for worse. A real positive for us is the fact that at the moment and for the past four months our relationship has expanded considerably. Being straight up with each other and being satisfied with a hug and holding hands is sustaining us through this time. I pray this will continue. My mental and physical abilities seem to have flown out the window in the case of ever being able to return to any previous work positions and responsibilities that I once took pride in. These abilities are now gone from my reach.

So here I am stuck with a bloody great spiritual poem, an inspirational story about a man who wrote it. A urologist who will not let go and refuses to concede defeat. This man is almost spiritually revered in my home town of Mackay and whose reputation is beyond repute. I am also stuck with a family including my wife who I know loves me and wants our life to continue together. My son does not want to lose me nor does my daughter. The grandkids mostly the young ones are not really sure what is going on. My special grandson Jesse who is seventeen is a different matter. His medical condition and history is a complete unknown story on its own to the world and a modern miracle that he has survived. He and I have a special bond and I am priviliged to have been his friend and mentor throughout a huge part of our lives together.

So, as from this day I have committed to a positive attitude for the next few months. I will turn up with a smile and a shes right mate attitude for the next few months. I will commit to the HDR Brachytherapy and External beam radiology when it is deemed that I am fit enough to endure the treatment. However I reserve the right to make new decisions after these events depending on how it all turns out.

Positives and negatives

Positives and Negatives

Regards

Lee aka Popeye

I must submit some popeye photos of me taken some years ago. Please remind me sometime?

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