With Jane’s encouragement, I thought I would write this blog entry. I want to keep my friends and family up to date, and for the most part they are the only ones reading this blog anyway.
The short version is that I was diagnosed with a small but clinically significant prostate cancer in September, and will have RP surgery (Radical Prostatectomy) using robotics on January 19. I’ll be at Kaiser’s West L.A. Medical Center for one night, then recovering at home for about three weeks. Within a few months, the expectation is that I’ll be pretty much back to normal for the duration.
For those of you who really want all the details, how this came about, and what decisions were involved, I’ll go into it all below. For lots of people this comes under the category of “too much information,” and you are certainly excused without prejudice.
It all started with a routine physical back in June. A blood test then revealed an elevated PSA (Prostate Specific Antigen) level. 3.5 is considered significant, and mine was 3.6. My previous test 18 months earlier was around 1.something.
One positive test is not a result, so my doctor ordered a retest, which had a count of 4.1. That called for a referral to the urologist.
The urologist meeting came in September. Prostate cancer is so slow-growing that one has the luxury of dealing with it deliberately. After reviewing my chart, he scheduled a biopsy, which we did the following week or so.
(In discussing the process with other men who’ve been through it, the biopsy seems to be the most unpleasant part. I called Jane after mine and said, “I need a drink.” We met at Traxx Union Station shortly after.)
The biopsy took fourteen “cores” (yes think of core samples) which were examined visually under a microscope. One sample was 30% cancer cells, and one was 10%.
Interestingly there are absolutely no symptoms at this stage of the cancer. I feel great, have no urinary troubles, and no other symptoms of any kind.
In this instance, I must recommend my experience with Kaiser Permanente. They take advantage of having a vast and closely-tied medical staff, combined with the best Electronic Medical Record system in the business. The efficiency and accuracy is very confidence inspiring.
The question after diagnosis becomes the choice of treatment. Interestingly, because prostate cancer grows so slowly, new treatment studies can’t know their effectiveness for 15-20 years. The accepted treatment these days is either RP (surgical removal of the prostate) or radiation treatment.
My urologist scheduled me for a type of seminar session in which Jane and I would meet with specialists from each of the different treatment options to discuss the matter. In one morning we discussed the options with surgeons and radiation oncologists.
(For men closer to 70 than 50, another possibility is “no treatment.” Prostate cancer is really slow growing. Indeed most men will have prostate cancer when they die, but it will be something else that killed them.)
Which treatment to pursue was really a no-brainer. Surgery and radiation treatment are about equally effective. The big advantage of the surgery is that they get to actually examine and analyze the cancer in vivo. They get to take it out and send it to a lab for analysis or research. The surgeon can see without any doubt if it has spread beyond the prostate and if any follow-up treatment is required. All of those advantages disappear with the somewhat blind radiation treatment.
The modern robotic surgery technique is fascinating. The doctor sits in a corner watching high-def video and manipulating the tiny robotic instruments. I’ll spend one night in the hospital and head home the next day.
I get to spend ten days at home with a catheter, and another couple of weeks recuperating. They taught me an exercise regimen to restore tone to the pelvic floor muscle, so I’ll be doing those.
I decided to do one other bit of preparation before going in. I had already joined Weight Watchers, and have been sticking with it to drop another five pounds of weight or so. I also hired a personal trainer to try and be in decent physical shape. I managed to make progress in both areas over the past three months. These are not part of the official protocol for surgery prep, but to me they just made a lot of sense.
This Friday, Jane and I are going to celebrate our 10th wedding anniversary in Las Vegas at the Venetian. We’re going to have a splendid vacation weekend. I’ll turn 53 on my birthday on Monday, January 18, but won’t get to eat any solid food that day. It’s okay, we’ll celebrate plenty the day before.
A lot of men are going through this now, or will be in the future. Prostate cancer is the most common cancer, but not the most common killer. Don’t put off the routine physicals; this thing has no symptoms until it starts to become a serious problem.
At my stage of the game, I can treat it as an inconvenience. Throughout everything leading up to this, I’ve lost no sleep, had no serious worries. Bridge players learn to do the best they can with the cards they hold, and it doesn’t hurt to have a top-notch partner across the table from you.
Update: This lolcat went by today on ICanHasCheezburger:
Hello Mr Jones,
I am a 48 yo male Marine Corp veteran who has been through the prostate cancer journey, and survived but without worry since they caught it early but if I did not have the rectal exam which most men scoff at and unfortunately the thought of that keeps them from going for the examination. If it was not for that exam I would not of known that I had a palpable abnormality on my prostate gland that caused them to recommend a biopsy. And you are right it is very unpleasant to say the least. I would think in the future it would of saved my life, My PSA show no detection of anything wrong with my prostate function. I went for the radiation treatment and it went well I am due to return to my oncologist on the 21st of this month for a checkup . I am confident that it will be fine
It nice to hear some of these stories to relate to and be thankful that I am blessed in many ways
Congrats on your upcoming 10th Wedding Anniversary , Best to you and God Speed.
KIrk
Sorry to hear this, Mojo. But here’s to your speedy and thorough recovery. …doug
Mojo,
Thank you for the “too much information” section! I’ve seen several friends though prostate cancer and all have had excellent outcomes. I can safely assume it’s a matter of time for me (a year+ older than you), so hearing the experience soberly presented is good preparation. I was also recruited for the Kaiser Mens Health Study on prostate cancer and get asked to send in a sample every now and then… but those prospective studies are careful (too careful?) to keep study results off your chart. I did get a digital exam last month, painless and hearing the word “normal” always sounds wonderful.
Best of luck and we’ll be in touch!
Pete
My family and I wish you a speedy recovery Morris.
Thanks for sharing and for the routine check-up advice.
Happy early birthday, 10-year anniversary, and a fun, safe trip to Vegas this weekend.
Be strong and fight hard.
Josh
Thank you all for the great comments!
Yes clearly the PSA test needs backup from a digital exam and vice versa. My digital exams have always been negative — but gee aren’t they fun.
Mojo,
I hope that you will have a rapid recovery. I applaud you for being so candid about a very personal issue.
-S
Thanks for the update, Mojo. I’m confident that you will come through OK, and, like all your friends, I’m rootin’ for you.
Mojo
Thanks for telling your story. No thanks for reminding me of how nasty the biopsy can be – I had one several years ago. My story was just like yours, except that the biopsy was negative. Since then, I get the PSA and free-PSA test twice a year, and see a urologist whenever my PCP thinks I need to – which has not been very often. The difficult thing about this prostate cancer phenomenon is that the PSA number doesn’t really tell them anything – even though, sometimes, they act as if it does. They have to look at a few years of repeat tests to see if there is a trend. The free-PSA test gives them a bit more information, but they still don’t know anything for sure. So then they might suggest a biopsy – and I’m sure by now billions have been spent on biopsies that came up negative. (I don’t know any idle urologists.) But we pay for them so that, when someone really does have cancer cells, we find them. And the robotic surgery sounds like a great advance. It should make for a speedy and relatively painless recovery.
So…are those exercises the same as kegels?
Jane and I are grateful that you shared your story here – we expect a full report in a couple of weeks. We’ll be thinking about you. Happy Birthday! Happy Anniversary! Here’s to your health!
You’re right, I had been reading about the loose correlation between PSA and a positive biopsy. In my case of course it was the only indication.
And yep, they’re kegels. I don’t think that makes me a kegler.
Hi Mojo,
Happy birthday, happy anniversary (as I remember what a beautiful, warm, FUN wedding you two had) and we are sending good thoughts as you have robotic surgery. Will you look the same except for bionic eyes?
Karen
Mojo,
I remember when I received my first digital exam a few decades ago from a not very pleasant GP. As he began the exam, and greased up the rubber glove, I think I heard him mumble “take THAT!”.
Have fun this weekend in Vegas. As my dear sister Mary Lou used to say when a family member or friend might need a little extra warmth, “I’ll tenderly hold you in my heart and mind these next few days”. Know that, for many of us, Mojo, you are being “tenderly held”.
Our love,
Alan and Barbara
Ed just told me. Recover quickly and completely. My prayers are with you.
— Art Z.
We wish we had known you were down here sooner. Hope you are doing better.
Pim & Lu
(Doug & Mary Lu)
Mojo, i just learned of your diagnosis and operation through Jane’s “Moondance” email. I was, of course, shocked at the news but relieved to know all is well and you are on the mend. Best Wishes to your speedy and full recovery! We’ll see you at a future OTSA event in Monorovia. And, lest I forget, happy birthday!
Rick R. (JPL) and Michal A.
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