Friday, June 12, 2020

I was relieved I had cancer


Synopsis

I was diagnosed with prostate cancer the first week of 2020 and my prostate was removed on April 21st.  I shared the news only with my immediate family and a couple of compatriots who coincidentally had had the same diagnosis.

That time between my diagnosis and surgery was filled with many memorable moments that made me forget about those rogue cells dividing within me.  It was not an intentional effort to look for diversions, I was just busy doing the things that I enjoy.   We visited our grandchildren for fun outings and hung out with friends;  A couple of my PhD students defended their PhDs; I did some of my own work in the lab with my own hands, interacted with my students on research projects, and developed new ideas for future research.  In addition, I wrote several papers and spent almost one day per week working on my cabin in the wilderness.  I enjoyed playing floor hockey and ice hockey -- ending the season as the highest-scoring player in the league.  I even squeezed in a ski trip with friends.

So, in heart and mind, I did not feel like someone with cancer.  I did not give myself that label.  The impending procedure was in the future akin to an upcoming tooth extraction – an unpleasant event, but because of the good prognosis, a relatively short period of recuperation and a wonderful life to return to afterwards.  I was not in denial; I just did not want to spend time discussing it as you might not care to talk about your upcoming dental visit or physical.  That would have been a distraction from all the fun I was having, especially in my work, pondering the beauty of physics.

I was tense over the wait, not at the dread of the surgery but by the possibility that it could be postponed.  Much can happen in four months, as it did.  COVID raged and accelerated, postponing elective surgeries.  I was lucky enough to have my surgery deemed a necessity due to the life-threatening nature of cancer.  What if my surgeon got ill?  What if he broke his wrist during his spring vacation?   I was vigilant in taking precautions from getting sick, not so much out of concern of getting COVID, but avoiding symptoms that would postpone my prostate’s date with a 6-clawed robot.

The surgical procedure and recovery put my life on pause for a few hours.  I was carted off to the operating theater a little before noon by the anesthesiologist, with whom I discussed the tastiness of Philly cheesesteaks.   I was extolling the virtues of fried onions bathed in Cheese Whiz as he placed the plastic mask over my nose and mouth.   An instant later I found myself in post-op at around 3:00pm, groggily lazing about with several other patients, some of them groaning.
On my way to surgery


The kind nurses gave me lots of saltine crackers and soda for the nausea, which soon subsided.  The catheter was a great convenience that allowed me to drink heavily without needing to get up to use the bathroom.  I fired up my iPad at 5:00pm (at about the time the morphine finally wore off) to answer work emails and to text family and friends (no visitors were allowed because of COVID), then walked almost a quarter of a mile around the hallways of our hospital wing by 7:00pm.  My roommate was a heavy snorer, keeping me awake most of the night so at 5:00am the day after my surgery, I took a three-quarter mile walk in the dark hallways, pushing my IV pole in front of me – the squeaky wheels grabbing the attention of nurses at their stations as I walked by.  By the third circuit, they smiled in my direction as I passed by.  I was discharged shortly after noon and was working at my computer at home by 3:00pm.
Getting in the car after being discharged


Most of you never noticed.  The day after I was discharged, I had a couple Zoom meetings.   The first several days after surgery we ran into several of you while taking a walk around Pullman.  A week later, just after the catheter was removed, some friends visited to drink beer and snack on our back deck to provide social distancing.

Just had my final test results a week ago, and things are looking great.  One needs to be clean for 5 years to be considered cured, but I will not be holding my breath.  Rather, I have already returned to the pleasures of life and my work without any thought as to what lies ahead not because I am actively fighting negative thoughts, but because the joys of thinking about physics and doing research, spending time with family and friends, and working on our cabin in the wilderness keep me occupied.

The Details


``You have cancer.”

I was relieved.

Early 2018, my PSA results alerted me to the possibility that I had prostate cancer.  My MRI showed a dark spot that the radiologist determined was likely cancer, a result that I got on my 60th birthday.  That meant a biopsy was needed, which turned out to be an intensely unpleasant experience because the local anesthetic did not take.  Each of the 12 spring-loaded needles bit through my prostate, gouging out a long thin cylinder of prostate tissue.   On the bright side, a week later I was told, “No cancer!”

I played floor hockey the night after my morning biopsy, ignoring the blood that was accumulating in places that I am too polite to describe.  I was more than annoyed at the graduate student who taunted me for not being as fast as usual – you know who you are.

About thirty percent of the time, all twelve cores of a standard biopsy miss the cancer, giving a false negative.  To avoid the trauma of a second biopsy, I was administered a genetic test, which starts with a vigorous prostate massage on a full bladder (mine was on Valentine’s day) to induce the appropriate secretions that are collected in a urine sample, which is a huge relief to provide.  The result: Low Risk!  Chance of cancer <2 again.="" br="" i="" nbsp="" relieved="" was="">
But my PSA continued to increase so another MRI was ordered, which showed the dark spot had noticeably grown over 16 months.  To make a long story short, an improbable sequence of events got me an appointment with a highly competent urologist in Spokane who specializes in oncology.  He looked at the MRI and immediately concluded that it was cancer, that it was localized and that it should be easy to treat.  “Of course the biopsy was negative,” he said, “because the cancer is in a place that normal biopsy needles don’t reach.”  He scheduled a 29-core biopsy to get plenty of samples and he would use the transperineal procedure, which would reach the suspicious region, but was invasive enough to require general anesthesia – fine by me!

I had the procedure early in the morning of December 31st, 2019, celebrated the new year with friends – who were unaware of the blood once again pooling in many places of my body.  We then visited our son and his wife and their new baby girl in North Carolina the rest of the first week of January.  On our return, we visited my daughter and her family then saw my oncologist for the results.

``You have Cancer,” he said, and gave the details.  I was relieved to finally have a definitive diagnosis.  Now the facts could be used to determine the best course of action, which ended up being a radical prostatectomy.  I am pretty much back to normal aside from the occasional pang of minor pain in my gut or the itch from one of the 6 incisions on my abdomen.

I am cleared to play hockey again.  Cannot wait to start, so watch out!