Tuesday, February 22, 2011

Saturday, February 19, 2011

Things I Can Control

Entry 38
February 19


Now that we know my prostate cancer is persistent in spite of the prostatectomy in December, we'll try to learn more about managing the disease with the aim of getting back to wellness. The prescribed hormone therapy will help.  I've been thinking more about some of the things I can control like staying fit, enjoying a little laughter and maintaining a proper diet. 


Nutrition and Wellness
The quotes below are from a fascinating TED video presentation at http://www.ted.com/talks/william_li.html about when angiogenesis becomes pathologic. Thanks to Toni for pointing to it.
"When angiogenesis is out of balance it leads to a myriad of diseases. 70 major diseases all share abnormal angiogenesis as the common denominator." 
"Angiogenesis is a hallmark of every type of cancer."  
"We need to start asking, 'What can we do for ourselves?' " "There is a new future in the value of what we eat." "Can we eat to starve cancer? " 

"While biotech companies are beginning to rally around this idea, a growing body of research is showing that fruit and vegetables contain an arsenal of naturally occurring angiogenesis inhibitors. These include substances like ellagic acid (berries), resveratrol (grapes), curcumin (turmeric), ECGC (green tea), procyanidin (cocoa) and genistein (soybeans). Increasing the intake of these substances may prove to have antiangiogenic benefits, such as cancer prevention and weight reduction. Antiangiogenesis may be yet another reason why fruits and vegetables are so beneficial."






There is also a related interactive explanation of  tumor angiogenesis in 3D or HD  that we highlighted earlier in December.

Food
Delicious TV (Vegetarian Episodes)
Foodily (Search Tool)

Humor 

Fitness 
RehFit - My gym

Email contact: hdstimson @ shaw.ca

Tuesday, February 15, 2011

The Cancer "Genie" Is Out Of The Bottle

Entry 37
February 14


As we explained in Entry 36 of this blog, the cancer "genie" is out of the bottle. Clearly there is more cancer hiding out in my body perhaps by way of the lymph nodes or in the area where the prostate was before its removal. 

Now that we know the cancer still exists within me, it kicks the urgency level up a notch. In the first postoperative meeting, Dr.Saranchuk was pretty sure I was going to require further treatment including radiation and/or hormonal therapy. He based this judgment on the pathology report plus what he encountered during surgery. He requisitioned a blood test on the 1st of February, almost two months after the prostatectomy.  That revealed my PSA level was .26 ng/ml. We were hoping for an almost undetectable PSA amount of .02 ng/ml or less. Once the prostate gland is physically removed there should no longer be any prostate specific antigen (PSA) produced hence the requirement for a low to non existent score. If the PSA number had come in  <.02 ng/ml we would have had the luxury of taking our time with the next treatment phase, perhaps preferring radiation over hormone therapy. The higher than acceptable PSA number however forces the issue. 

It would appear that the next logical step in my case would now be hormone therapy. Testosterone is what feeds the cancer. By tackling the testosterone with hormone therapy, you dramatically limit the cancer's ability to grow and consequently spread. Again it does not kill the cancer but it buys you time to consider other treatments such as the radiation used to eliminate any cancerous cells lurking in the pelvic region.

Today I had a second post-surgery blood test. If the amount of PSA trends downward, that would be good news. If it rises that indicates the cancer is advancing. The speed (or velocity as they call it) with which the PSA number increases tells us how active the cancer is. I will know that in a week or so. Irrespective of what that number indicates I will be obliged to start hormone treatments as soon as possible. 

We were informed of an additional treatment option. Cancer Care Manitoba is conducting a clinical trial that involves using a combination of hormone therapy and chemotherapy simultaneously. Chemo is usually introduced at a later treatment stage. They are looking at the efficacy of introducing it earlier on in the treatment process. The most obvious drawback to my participation in the trial is that my PSA is presently four times lower than required so I would have to wait.

February 15th - The blog is updated and I'm heading out to the Forks for a skate with friend, Dan Williams. I'm feeling good.

Hormone Therapy Explained

Email contact: hdstimson @ shaw.ca

Saturday, February 5, 2011

More PSA Tests in My Future

Entry 36
February 5, 2011


The first postoperative visit to the the surgeon occurred last Tuesday, nearly eight weeks after the prostatectomy. The purpose of the visit was to gauge how well the healing process is going, assess the side effects, and finally discuss what the pathologist and surgeon found as a result of the surgery itself. 


The surgeon, Dr Jeff Saranchuk, seemed pleased with my recovery, as well as with my efforts to aid the recovery by being physically active.  With regards the side effects, he remarked on how quickly the incontinence is resolving itself. Except for a couple of small setbacks early on, I have had very little need for protection.


Apart from incontinence the other major side effect is ED, commonly known as Erectile Dysfunction. This is determined by the impact of the surgery on the nerve bundles at the base of the prostate gland. If the surgeon is able to do ' nerve bundle sparing' during the surgery this is less of an issue. In my case the cancer was lined up along the nerve bundles and Dr. Saranchuk was very clear with me prior to the operation that these may take a hit. Well, they did. As that old cliche from the 80s goes, ' the lights are on but no one's home'. There are still options available here which we will consider but I must admit to being less than enthusiastic at this time. Dr Anne Katz of The Prostate Center at Cancer Care Manitoba has been unfailingly helpful, knowing and sensitive in putting up with what are no doubt my typically male attitude to this issue. If worse comes to worst, it's been a good run. Enough said.


I must admit that I was disappointed by the pathology report that was based on closer microscopic examination of the pelvic lymph nodes, seminal vesicles and prostate gland all of which were removed in the surgery. The unfortunate thing is that the cancer managed to escape the prostate capsule and has been detected in two of the seven removed pelvic lymph nodes and in one of the seminal vesicles.  Not  good.


I was not so much surprised by the potential for more cancer in the area adjacent to the prostate itself. During our October consultation with Dr. Aldrich Ong, the radiation oncologist at The Prostate Center, he noted that while I was a good candidate for either surgery or radiation, the volume (amount) of cancer I had in my prostate gland (35%) was such that there was a 6 in 10 chance he would see me for follow up radiation therapy after a prostatectomy. I suspect he is going to be right. 


Harry shovelling snow off the roof today. Click to enlarge.


When my wife convinced me that it would be a good idea to start this blog we did so with its primary purpose being a means to allow friends and family to have access to a quick way of checking in on how things were proceeding with my treatment. Much to our surprise (and delight) it has turned into something much larger. It has now become obvious that this blog is being read not only by friends and family but also by people who are going through, or have friends that are going through the same mental and physical gymnastics as I am. It  gives me pause for thought on how to word the updates. 


I don't know anybody in Moscow, Tehran, or Marseilles, or for that matter any number of communities all over North America, but they have somehow found this.  Through the magic of the internet the site has been found, stumbled upon, referred, or otherwise wound up on the computer screens of people from all over the world. This amazes me!  


Postoperative Radiotherapy
Postoperative Treatment After Radical Prostatectomy
Male Sexual Dysfunction
Sexual Function After Prostate Cancer Treatment


E-mail contact info: hdstimson @ shaw.ca