Lumps and Bumps in Places They Shouldn't Be

Entry 68

Well Hello!

The previous entry to this blog was 5 months ago in September of 2014 and it did not have much to say about the status of my prostate cancer other than my PSA number was increasing (not good, but not surprising) but it was doing so at a slow rate (good, oddly surprising). Not only is it moving slowly but it is doing so in a manner which is uncharacteristic. By that I mean the 2 terms urologists use to define the recurrence of the cancer in metastatic patients such as myself are 'volume and velocity'. I don't want to repeat myself so if you are interested to know these how 2 terms work please see Entry 66# in this blog from last January (paragraphs 2 thru 6) for a brief non technical explanation.

In my case the volume and velocity are both low and slow (respectively) and the velocity is uncharacteristic in that it is not 'doubling'. Again see above mentioned paragraphs in Entry 66#.

So what does this mean? Not much different than previous entries really. The cancer continues to manifest its presence but at a slow rate.  In March of last year the PSA number was just under 1 ng/ml, in July 1.33, in October 1.96, and 2 weeks ago it was 2.87 ng/ml. - increasing but not doubling.

This slow increase may be interesting but somewhat academic. The PSA reading for a prostate cancer patient post surgery, radiation, etc. is a much more accurate assessment of what the cancer is doing than readings prior to those treatment options. Quite simply if it hadn't already metastasized and/or the doctors managed to get it all the PSA reading should be .01 ng/ml or less and showing no signs of increasing with subsequent blood tests. Mine is, albeit slowly.

In case you are unfamiliar with the term metastasized (metastasis) it is defined as 'the spread or development of secondary malignant growths at a distance from the primary site of the cancer.' In my case it had spread and was found in 2 of the dozen or so lymph nodes that were removed and biopsied at the time of my surgery. Node Positive Prostate Cancer (LN+PCa) as this is termed.

It was with this in mind that I got a scare last October when while showering after a workout I detected a lump on one of my testicles. Yikes! Considering the cancer had already metastasized once and is likely to again, my brain was in catastrophe mode.

A visit to my doctor confirmed the presence of a lump. He immediately ordered a scrotal and abdominal ultrasound. Wouldn't you know it, the date for the ultrasound fell right in the middle of a month long trip to Argentina & Chile Margaret and I had previously committed to. Arrrgh! After consultation with my doctor we decided the 2 weeks difference was not likely to be that pivotal, plus he wasn't convinced it was cancerous. Turns out he was right. The ultrasound detected no 'intratesticular mass lesions' but rather 'small bilateral varicoceles'. A bilateral varicoceles in layman's terms is a swelling in the veins not unlike most of us would think of as a varicose vein. Apparently about 15% of men get them and it tends to be age related. Rarely do they pose a serious threat and if there is discomfiture, which I do not have, it can be surgically repaired.

So much for the scrotal ultrasound - the abdominal ultrasound was equally positive. They found no evidence of 'abdominal aortic aneurysm'.

Harry in Prince Edward Island 2014

So the moral of this story for any guys out there who may read this; don't automatically assume the worst if while washing or playing picket pool you notice a lump or bump that shouldn't be there. Get it checked out immediately. It may well be benign.

In summary, the lumps & bumps in places they shouldn't be are not cancer related and as such, much to my relief, are not evidence of the prostate cancer migrating (metastasizing) to places elsewhere in my body. However, and there is always that hesitation with cancer, my slowly increasing PSA number is indicative of it recurring. As mentioned earlier this is not unexpected. What it does mean is that I will likely return to the ADT (androgen deprivation therapy) sometime this summer or fall. Hopefully the ADT treatments will do what it did last time and knock the cancer and subsequent PSA number back to a negligible 0.01 ng/ml.

The surgery to remove my prostate gland was roughly 4 1/3 years ago. The ADT treatment 3 years ago. I live a relatively normal life and while there are unquestionably side effects from both the surgery and ADT therapy, for me at least, they are tolerable, indeed, so much so that it has allowed me to pursue my passion for yearly multiple week, long distance wilderness canoe trips, as well as travel the world with Margaret in month long intervals to the Maritimes, China, South America and Europe. 

All this travel happened without recourse to medical attention, cancer specific medication, or related paraphernalia such as incontinence pads etc. The incontinence that frequently follows PC surgery has not been an issue for me. In fact, and this is just unconscionable bragging, I can go to a Jets hockey game, drink 2 jumbo beers (17oz/503 ml each) and not have to pee until I get home 3 plus hours later! Hah! Take that you guys & girls stricken with TB (tiny bladder); and I'm doing it missing some of my urethra and the relevant sphincter muscle(s) therein.

All kidding aside, I have seen 3 doctors and had tests done in 2 hospitals since we returned from South America on December 20th. I feel very fortunate to have had that professional care and ongoing monitoring of my health.

hstimson @ shaw.ca
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