But, this morning, I will submit to another PSMA PET Scan machine, a very expensive, noisy, technological donut that politely judges my cells. After two surgeries (including a radical prostatectomy), 36 radiation sessions, and 19 months of pharmaceutical castration to take my testosterone down to nearly zero, my monthly PSA score has been stable for nearly a year, around 0.11, based upon my monthly blood tests. Doesn’t sound bad, right, especially when what’s worrisome (with a prostate) is 4.0 or higher. But, when you don’t have a prostate and you have prostate cancer markers in your blood, it means the cancer escaped the walnut-sized prostate and has been resting in my lymph system.
But, now it’s active again and has been nearly doubling in score every month so that I’m up to 0.66 as of a couple weeks ago. Not a death sentence, but a confirmation that Andy Anxious has something to worry about. When I read about baseball legend Ryne Sandberg or Dilbert creator Scott Adams dying of metastatic prostate cancer in the past year, I wince. Prostate cancer is supposed to be a “good cancer” since it tends to move slowly in many men, but it is also the second leading cause of cancer death in men after lung cancer. And, for me, it’s radically resilient against my best wishes. I’m ready for this squatter to be evicted.
Some of my disappointment comes from the fact that my doc at MD Anderson (which is providing a second opinion to my UCSF doc) thought I was in remission. I’m experiencing what’s typical for lots of us with a chronic cancer condition: a fear of recurrence, uncertainty, anxiety about scans, questioning life priorities, dealing with body image issues, sexual changes, relationship dynamics, energy limitations, hypochondria about that new ache in my body, and deciding how to fit this inconvenient medical treatment regime into my busy schedule. And, then there’s the dizzying array of advice from everyone about which new path I should take. There are days when I just want to pull the covers over my head and take a very long nap.
I’ll keep you updated on my condition and whether (likely) and when (soonish) I’ll be doing new treatment, but you can also listen to my recent Midlife Chrysalis podcast episode with Dr. Caryn Lerman, the head of the USC Norris Comprehensive Cancer Center, who I’ll be teaching a workshop with at our Santa Fe campus April 5-9: From Survive to Thrive: Cancer as a Catalyst for Deeper Meaning & Purpose. If you or someone in your life is dealing with cancer, I hope you’ll join us.
-Chip