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.
Email contact: hdstimson @ shaw.ca
Well Harry, it was difficult to read about your disappointments and not easy to know what to say. There are so many uncertainties, but there is one certainty- no matter what path you will need to follow, we all know you will do it well.
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