One Day At A Time
Eating the elephant
January marks the first anniversary of my prostate cancer diagnosis. On January 11, 2023, I learned about my cancer through a phone call. Two days later, one year ago today, I sat down with my urologist and my wife to discuss the options.
Things moved pretty quickly and I had my surgery in February. Time marches on and I had a follow-up appointment with my doctor this week to decide where to go from here.
I was expecting a difficult road for 2024. At past appointments, the doctors had hinted that radiation treatments would be likely since the pathology report after surgery had indicated that cancer cells were found in one of the 10 lymph nodes that were removed. From my previous research, I also knew that hormone treatments with testosterone-suppressing drugs usually went along with radiation treatments. As I said, I was expecting a difficult year.
Things did not go as I expected.
My wife and I drove to Atlanta to meet my urologist at Emory University. Dr. Martin Sanda is a top-notch physician, and Emory is one of the best-ranked cancer hospitals in the country. I feel very fortunate to have connected with him and gotten on his surgery schedule so quickly. I recommend Dr. Sanda and his team wholeheartedly to anyone in a similar situation.
I had months to prepare for this appointment, unlike the shock and numbness that I felt when I first met Dr. Sanda almost a year ago. Nevertheless, I could feel my heart rate accelerate when the hospital came into view.
After we checked in and were brought back, my wife, Debi, and a nurse joked about my pulse and blood pressure being high. Debi attributed it to the facts that she had just been talking about how I had reached a point in the healing process where “little David” was returning to normal, a boon to our sex life, and that I was in a room with two attractive women. (I still haven’t done an installment about sex and prostate surgery. Maybe one day. That story is still being written.)
“Sorry to disappoint, y’all,” I said, “But my blood pressure went up as soon as I saw the building.”
Hashtag that one as “WhiteCoatSyndrome.”
Dr. Sanda came in with a radiologist and promptly dropped a bomb. He said they had planned to recommend preemptive radiology treatments but that new studies since we made the appointment six months ago indicated that such treatments had no real benefits. About that time, I felt as if a huge weight had been lifted.
I was prepared for radiation, but it wasn’t something that I was looking forward to. Hormone therapy was an even bigger problem. That would require another round of FAA approvals for my medical and I might not be able to fly until the treatment was over. That could be a year or two.
Knowing the possibility of a work interruption was coming, I was trying to both save money and get as much costly honey-do stuff done in advance as I could. To hear that it wasn’t going to happen (at least right now) was a massive relief. It might come later, the delay is a blessing.
The gist of the new information was that we weren’t sure if cancer cells were still present and we weren’t sure where they would pop up if they did exist. Preemptive treatments were not effective because the cells could turn up in different parts of the body once they were in the lymphatic system.
The doctors said the better strategy was to wait to see if my PSA level rises again. If it does, I’ll get a PET scan to see where the problem is and then they’ll focus the radiation on that spot.
So far, I’ve been getting PSA checks done every three months and the level has been “undetectable,” indicating no significant presence of cancer cells. That’s a good thing. The plan is to keep to that schedule.
So there is good news and bad news. The good news is that there is no detectable cancer in my body and I don’t have to be out of work for the next year. The bad news is that there’s a decent chance that the cancer may be there even though it’s undetectable and may flare up again at some point, requiring treatment. The good news is that such a flareup could be 10 or 15 years down the road when treatment options are improved. The better news is that maybe it will never come back.
I think I’ve prayed harder in the past year than I’ve ever prayed. It seems to be working. And I’m going to keep up the prayers for healing and God’s comfort and support, as well as thanking him for allowing my life to return to normal.
I think that for most people who have experienced cancer, the anxiety probably never completely goes away. The fear has subsided from a year ago, but the awareness that “I have cancer” is still never far from my mind even though it’s still hard to believe. To say that the thought haunts me would be accurate. I’m certain that every time I open the results of a PSA check, my heart will pound. I expect that phenomenon to last for the rest of my life.
I want to commend Debi. She has been strong throughout the entire ordeal. She was adamant that I didn’t need radiation and that I wouldn’t have to get the treatments. She also believes that the cancer is entirely gone. I hope that she is as correct on the second count as she was on the first.
When left the doctor’s office, I collapsed in her arms, and yes, I did tell her that she was right. I even told her in front of other people.
But I don’t want to be blindsided by bad news again the way I was in 2023. A year ago, the diagnosis sent me into shock and then the news about the pathology report sent me into weeks of depression. Being a little bit pessimistic is a kind of defense mechanism under the circumstances.
I think Debi is also correct that part of my purpose may be to help other men navigate their own prostate cancer issues. She was one of the people who encouraged me to start this blog. Reception for it has been good.
Beyond the blog, I’ve talked to a lot of men in the past year who either had cancer or thought they might. Some I knew already and some I didn’t. The night of my appointment alone, I talked to two men who were about to face prostate surgery. It’s a common problem, and I’ve found that talking and writing about it has helped me deal with my own issues and fears while I help to comfort other men about what they face.
I hear people say that their illness doesn’t define them. I agree that it doesn’t define me either, but it has changed me. Even if the cancer never returns, it has become part of my experience and altered the course of my life and my outlook. It’s not so easy to take life and health for granted anymore.
If you’re going through cancer or some other life crisis right now, one important piece of advice that I can give you is to take things one day at a time. Don’t get so caught up in the problem that it seems insurmountable. Break it down into manageable chunks. That may mean focusing on getting through the next day, the next hour, or even the next minute.
As I tell my kids, “Remember how you eat an elephant: One bite at a time.”
RECOMMENDATION: A while back, a fellow prostate cancer warrior commented on one of my articles. Chemofreak is undergoing chemotherapy and has a Substack where he posts his cartoons. Show him some love with a like, a follow, and a prayer.
“Don't worry about tomorrow. It will take care of itself. You have enough to worry about today.”
-Matthew 6:34
Please keep in mind that I am not a medical professional and this blog does not provide individualized medical advice. If you think you are sick, you should seek treatment from a real doctor.
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Previous Installments:
1 - The Diagnosis
3- Easter Special - An Apology to Apostle Thomas
4- My Treatment
6-Night is the Darkest Time - The Mental Battle of Cancer
7-How To Be Prepared For A Health Crisis