Tag: Cancer

Me too, Joe!

The news that Joe Biden, ex-President of the U.S.A., had been diagnosed with an aggressive form of prostate cancer hit close to home for me. There was a lot of doom-and-gloom reporting, which seemed to me to miss the mark.

I received a very similar diagnosis just over three years ago. After my annual physical, my family doctor ordered a number of routine tests, including the standard marker for prostate cancer, Prostate-Specific Antigen (aka PSA). Normal PSA is 6.5 or less, and mine turned out to be over 300. After a couple of scans, my doctor called me to come in and discuss things. It seemed that I almost certainly had prostate cancer, which appeared to have spread to many points on my bones. He referred me to a specialist, who immediately ordered a biopsy, which then confirmed the diagnosis. The biopsy was perhaps the most unpleasant episode in the whole story (don’t ask!)

There are a variety of treatments for this disease. If the cancer is confined to the prostate, surgery is the treatment of choice, perhaps followed by either chemotherapy, radiation, or both. If the cancer has spread to other places such as bones, there are other treatments available, depending on the actual type of the cancer. My variety is of the type that typically responds well to Androgen Deprivation Therapy (ADT), using drugs that suppress the body’s production of male hormones. Testosterone in particular provides fuel for the cancer’s growth.

I had a short course of radiation (5 sessions) to treat two of the larger bone metastases. This was pretty easy to bear, although the radiation oncologist I saw was the gloomiest of all the doctors I saw, giving me 3 years or 5 if I was lucky. (I’ll come back to that).

The actual course of ADT is pretty easy to deal with. I get a shot in my belly every six months, and take a pill once a day. The shot suppresses hormone production, and the pill (as I understand it) enhances resistance to hormones that might still be floating around. I had a bit of a reaction to the pill — an unsightly rash on my scalp, causing me to lose most of whatever hair I had at the top. It passed, and some of the hair has grown back.

What has been the upshot of this treatment? Four months after the initial diagnosis, my PSA had dropped to around 8. Three months later, in September 2022, my test results said <0.1, which means it’s undetectable. It has stayed there ever since. That’s as good as that gets. Adding to it was a follow-up bone scan in November 2023, which found that almost the spots on my bones had disappeared — a “dramatic reversal” was the radiologist’s comment. Last fall, my urologist said that my cancer is “deeply suppressed.” He didn’t say “in remission,” but that seems to me to be close enough for all reasonable purposes.

The doctor who gave me 3 years or so to live was wrong, thanks be to God. It’s now over 3 years since I saw him, and I’m doing fine. I have heard reports from other men on the same treatment regime, many of whom are also doing fine, some after 15 years or more.

The specific treatment I’m on only became generally available about 6 years ago, so I’m benefiting from the continued advancement of medical knowledge. Many types of cancer used to be short-term death sentences, but people are living happy and productive lives much longer than could have been imagined a few decades ago.

Joe Biden’s cancer is more advanced than mine was at diagnosis, but I believe my story and those of many others give reason for hope. It is said that more men die with prostate cancer than die of it. I’m hoping that will be true for me, and also for Mr. Biden.

There are naturally some mildly bothersome effects of my treatment. They’re a bit personal, but suffice it to say that it pushes the male body back to pre-puberty conditions. The most obvious is the loss of body hair, which curiously does not include facial hair. My beard is more or less as it was before, if a bit grayer. (I am almost 77, after all!). It this is what it takes to stay alive, I’m OK with it.

For me, the important thing is to greet each new day as a gift, trying as much as possible to keep active mentally, spiritually, and physically. The last one is a bit of a challenge, due to an arthritic hip which predates the cancer. I’m probably not a candidate for a hip replacement, because the cancer damaged the femur below the affected hip. So it goes!

The other annoying thing is that I can’t travel outside Canada. Because I was diagnosed with metastatic cancer, no insurer will give me travel insurance. The irony is that I traveled many times without giving any thought to such insurance, thinking I didn’t need it. Now that I know I would need it, I can’t get it!

I have no idea what causes cancer, but what I do know is that early detection is hugely important. Regular screening by your doctor is vital in this regard, and it troubles me that many people (about 1 in 5) do not have access to a family physician, and often don’t get the early detection and treatment that they need. My wife and I were fortunate to find an excellent doctor who was taking new patients when we relocated to Edmonton. Others are not so lucky, sad to say.

And now for a political comment, directed mostly to the province of Alberta: our current government has been at war with the health care system, including the medical profession, for as long as it has been in power. This is shameful and dangerous behaviour, leading to the deterioration of care across the board. Our current premier says she is fixing the system by carving it up into subsections. I don’t understand how a major top-down re-organization helps the folks who are not getting the care they need. Fix things at the bottom — starting with support for family doctors, nurses, associated professionals, and all the people on the ground who make our health care system work.

If you’ve read this far, more power to you! Share it with your friends, especially the male ones. As the old radio show theme song said,
“Keep happy! Keep healthy! To heck with being wealthy!”

Cheers,

Robin

A special anniversary

A short reflection on living with cancer.

A few days ago I realized that the day was a kind of anniversary. Three years before, I had received a diagnosis of prostate cancer. One doctor said that I would have about three to five years left. Well, three years have passed, and I’m still here, still going reasonably strong. I am profoundly grateful for every day I am alive, the more so when some medical people said it was very unlikely.

My treatment has been state-of-the-art, almost totally medication-based and non-invasive. My PSA (The basic diagnostic test) level has been <0.1 since Sept. 2022, which really means it’s undetectable. Normal is 6.5 or lower: when I was diagnosed its was over 300. A follow-up bone scan last fall showed that the bone metastases they had found in the spring of 2022 had almost completely resolved. My current doctor has never used the word “remission,” but says that my cancer is “deeply suppressed.” The side-effects of my medication are a bit personal, but the one thing that has caused a life-style change is reduced energy. I tire easily, and tend not to be much use in the evening. I can live with that, although it sometimes irritates my dearly beloved when I doze off while we’re watching TV.

So what do I take from this?

First, more than ever before in my life, I am able to see every day as a gift. If one’s man’s opinion was that I wouldn’t be here today, that his opinion. I’m here!

Second, I am really grateful for the advances in medical science that have made this possible. A good friend died of the same disease right around the time I was diagnosed. He was originally given 6 months, and lasted 6 years. The drugs I am taking were not available when he was diagnosed. If they had been, he might still be here.

Third, but not least, I will forever be grateful for the support of friends and family as I dealt with the uncertainty of the situation. It’s still uncertain, of course, but I have much more confidence in the future now than I did three years ago.

Thank God for all of this — friends, family, medical science, every new day. Thanks be to God!

Surfacing – with thanks!

Late in his life, the great composer Ludwig van Beethoven poured his soul into a work for string quartet, the third movement of Op. 132 in A Minor. He subtitled it “Heiliger Dankgesang eines Genesenen an der Gottheit, in der Lydischen Tonart” (“Holy song of thanksgiving of a convalescent to the Deity, in the Lydian mode”). I was privileged to hear a riveting performance of the whole quartet recently, which helped the Isidore String Quartet win the first-place prize at the Banff International String Quartet Competition (aka “BISQC“). If you have 15 minutes available, give it a listen here.

When I heard this performance, I was recovering from an ailment that had troubled me since mid-June. Most of the summer had been lost, while I sat and stared at the walls, without the energy to do much of anything except pant for breath after walking from the living room to the kitchen. The doctors were puzzled, running all sorts of tests, all normal, but finally one came up with a symptomatic remedy, which I was still on when we went to Banff. I was doing much better by then, but it took until mid-September for me to feel almost myself again.

During these long months of the COVID-19 pandemic, I have heard many people lament the virus and its effects, especially from those suffering with “Long COVID.” Fortunately, my wife and I have both escaped it to date. When I first got sick in June, I tested for the virus five times in ten days, and all were negative. While I did not have the “virus of the day”, I was experiencing ill-health in a way I had never done before.

For much of my earlier life, I saw myself as a healthy person. I have had only one in-patient operation, a tonsillectomy when I was five, which was the only time I have ever been hospitalized. I have never broken a bone that I know of for sure. (I might have broken a toe some years ago, but I was able to get around well enough that visiting the doctor seemed pointless.) In 26 years in parish ministry, I never once missed a Sunday due to illness. Prior to about three years ago, I had experienced only one blip in my health, during my second year of my theological studies, when I was diagnosed with a mild case of lupus. Regular medication, reasonable precautions, and some modification of my life-style kept the disease at bay, until 25 years after diagnosis, when I was declared disease-free. Hallelujah!

I retired a few years later in good health, with a lot of energy which I proceeded to pour into various activities. All was good until I started to have severe pain in one hip, which was determined to be osteoarthritis. This is almost certainly traceable to when I fell while skiing at the age of 16, and tore up my knee. Some years later, a physiotherapist noted that I walked crookedly, turning my left foot out. It appears that the old injury had never properly healed, so I had been twisting my hip and knee for decades. Result? A knee which occasionally hurts, and a hip which hurts most of the time. I have had to learn new physical habits, which have helped the condition become more or less manageable, although a hip replacement was a possibility in the early times after my diagnosis.

A hip replacement is very probably off the table now, because of the next diagnosis, which I received last February. It was found that I had prostate cancer which had already spread to various bones, including the femur just below the arthritic hip. I doubt very much that I would be seen as a candidate for a hip replacement, when the bones around the joint are not in good shape.

In the meantime, I am dealing with the cancer diagnosis. It was devastating at first. A horizon had appeared in my life in a way that I had never before experienced. The doctors gave various predictions of time-lines, but all of them had an end-point. They said that this condition is not curable, but it is controllable. Because of the bone involvement, I was not a candidate for surgery, so I am on Androgen Deprivation Therapy (aka “Hormone Therapy”). All appearances seven months later are that this is having the desired effect, but I will be on the medication for the rest of my life, or until it ceases having effect.

I had not previously been very public about this, because I was really unsure about how things were going to go. Things now seem more predictable and manageable. I’m not looking for sympathy or an outpouring of prayer intentions, but if that’s your inclination, so be it.

The effect on my life has been to spur me to get some things done that had been left lying for years. People often call this “putting your affairs in order.” The realization of the need was made very real to us right around the time of my initial diagnosis, when our son-in-law died suddenly and unexpectedly at the age of 54, leaving no will.

Aside from some rather intimate matters (Permit me not to overshare!), the main physical effect of the cancer and the treatment has been a general reduction in my energy. I have found it necessary to back away from some activities, especially some that take place in the evening. I was just getting used to this new normal when the other thing happened in June, and I was knocked flat on my backside for the next two months. You might understand if I describe my state of mind in most of this time as depression and anxiety. I would sit down to a meal, often not feeling much like eating, and try to give thanks, when I really could not see much to give thanks for.

The last few weeks have given me new hope, new energy, and a new resolve to live my life to the fullest as I am able in the months and years ahead, however many they may be. I was invited to preach at another parish on October 9, the weekend of the Canadian holiday of Thanksgiving, and prepared for it by pondering Paul’s exhortation in Philippians 4:6 to “…not worry about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.”

The message? Even when things seem awful, there is still much for which to give thanks, which should underpin the whole of our approach to God. As the medieval mystic and theologian Meister Eckhart said “If the only prayer you say in your life is ‘thank you,’ that would suffice.”

I listen to Beethoven’s wonderful music, and I am reminded that the call to give thanks becomes very profound when one has faced one’s destiny. I wasn’t anywhere close to dying last summer, but there were times when I wondered if I would ever recover. But now…

I am surfacing. I feel well. I am enjoying life more.

Thanks be to God!