Ladies, Gentlemen, friends, family and best buds . . . .

As the last page of the 2009 calendar is torn off the wall and run through the shredder (with some extreme prejudice I might add), we look forward to yet another new beginning.

As we enter the last year of the first decade of the 21st century, we all once again face the usual challenges. Some of which we will even make attempts to address  these with our annual, and often repeated, New Year's resolutions. Some face bigger challenges.

As many of you will look to change your lives for better physical and financial health, improved relationships with your spouses,etc. These are the things that you can see and are aware of 

every day of your lives. It's time to look toward the things you can't see.

I know I'm sounding like a broken record, but for my guy friends out there I ask you to be sure to have your PSA level checked during your next "annual" physical. If you're not going to do it for yourself, do it for your spouses and families.  You can be in perfect health and not experiencing any symptoms, yet still the early stages of prostate cancer could exist.

Some statistics:

- 1 in 6 men in the US are diagnosed with prostate cancer in their lifetime

- The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69. In fact, more than 65% of all prostate cancers are diagnosed in men over the age of 65.

- Caught early, prostate cancer is nearly 100% survivable

- According to the American Cancer Society, in 2009 about 192,280 new cases of prostate cancer were expected to be diagnosed, and 27,360 men will die of prostate cancer

- African American men are 61% more likely to develop prostate cancer compare with Caucasian men, and are nearly 2.5 times as likely to die from the disease

For the women out there . . .  ask your husbands to just get the blood test done. If your relationship and life with him means as much as ours means to Janet, do all you can to convince him to just get the blood test done.  Even if you have to schedule the appointment and bring him there yourself using some other means of encouraging him to go.

My family and I wish you all the best for good health, prosperity and many blessing in this new coming year.

Happy New Year to you all!

PSA Level update . . .

Merry Christmas to all of you out there.

I had my 2nd post surgical blood test done yesterday,  and I am happy to say that my PSA level remains at a "near non-detectable" level of <0.05.

Thanks once again for all your prayers and strength.  It has been a true source of support and encouragement to Janet, myself and the boys.

We hope that you'll all enjoy Christmas with your families and are blessed with good health, love and prosperity in coming New Year.   (personally, I'm happy to see 2009 come to an end)

Cheers!

According to the Prostate Cancer Foundation . . . .

According to the Prostate Cancer Foundation:

One in six men will develop prostate cancer.

A Man is 35% more likely to get prostate cancer than a woman is to develop breast cancer.

Prostate Cancer is the most common cancer in America, striking 186,000 men each year.

As baby boomer men reach the target zone (age) for prostate cancer, the number of cases is projected to increase dramatically. By 2015, there will be more than 300,000 new prostate cancer cases each year.

----------------------------------------------

Gentlemen, if you are in your 40's have your PSA tested the next time you have your annual check-up. If there's a history of prostate cancer in you family, you should consider having your PSA checked in your mid to late 30's.

Caught early, prostate cancer is 100% curable!

For more information visit:
http://www.prostatecancerfoundation.org
http://www.pintsforprostates.org
http://www.cancer.org

Work week number 2

and 2 full months since my surgery.

All in all, everything seems to be improving. Most of the discomfort that remains is now at a tolerable level so I was able to return to work last week. I'm still experiencing leg pains due to nerve related issues from the surgery, but with meds I'm able to get it to a workable level. My lack of energy hits me a bit later in the day than it used to, but usually by 5pm, I'm ready to lay down for about 4 hours. (not unlike many I'm sure)

 As you know one of the reasons I started this blog was to try to get the word out about this disease.  Yeah, we all know that cancer is bad and can happen to anyone. But did you know that the odds of men getting prostate cancer in their lifetime is 1 in 6?  Many of the cases are in men in their mid-fifties and older, but there is a larger number of cases beginning to show up in men in their 40's  - and even some in their 30's!

As always, early detection is the key. Detected early, prostate cancer can be successfully treated nearly 100% of the time. The later the diagnosis is made, the higher of a chance that surgery is the only option - and long term side effects due to the surgery, incontenience and impotence among them, can come in to play.

I have been in contact with an organization called Pints for Prostates and US Too International.  Us TOO is a grassroots organization started in 1990 by prostate cancer survivors to serve prostate cancer survivors, their spouses/partners and families.  Pints for Prostates supports educational and advocacy efforts in support of US Too.

Pints for Prostates is a campaign founded by prostate cancer survivor Rick Lyke  that uses the universal language of beer to reach men with a critical health message. Pints for Prostates has reached more than 60 million people with a message about the importance of PSA testing and regular prostate health screenings.

I am in the early stages of planning sponsored Pints for Prostates fund raising events in Connecticut. Thanks to the connections and friends I've made through my hobby of home brewing, the first of these should be taking place in early February 2010 with others to follow in the coming months through the year.

I'll be in the midst of my radiation therapy when this first event takes place.  It will be something I am going to use as positive motivation as I progress through my treatments.

As always, thank you all for your continued support and prayers. It has meant a great deal to myself, Janet and the boys.  May you all have a safe and Merry Christmas, and a healthy and prosperous 2010.  I know I'm certainly looking forward a new year . . . .  SHEESH!!!

Cheers!

 

First day back to work . . .

It was a good first day back to work yesterday, though I may have stayed a bit too long.  As 6pm approached I was feeling pretty wiped out, so it may have been an hour or so too long.


Today I'll see how it goes again, try to gauge how I feel through the day and not push things too quickly. It's not that what I do is physically exhausting, but can be mentally exhausting and stressful due to tight deadlines and volume of work.


My co-workers gave me a huge welcome back card (4 feet x 3 feet ), and included a new Red Sox jersey with my last name and the number 25 on the back.  As you may recall, Janet and I celebrated our 25th anniversary back in early August.  A very nice gift that was much appreciated.


My next blood test will be in another two weeks to follow-up on my PSA level.  Indications are that it shouldn't be climbing up at all based on the previous results.  I have an appointment with a specialist tomorrow to help address some post-surgical issues to help speed up recovery and address some of the pain issues I'm dealing with,


That's pretty much all for now.  Thanks again for all your support, and I'll update you all again soon.


CJP

Happy Thanksgiving friends!

Even though these last 3 months have proven to be a bit of a roller coaster for us, my family and I have been blessed countless times this year; our 25th wedding anniversary in August, our family trip to Canada, great doctors and nurses, fantastic post-surgical test results, and supportive family and friends like yourselves.


We wish you all, and your families, a blessed and safe Thanksgiving Day.


Turkey for everyone!  Cheers!

Drum roll please . . . .

Today was my 6-week post surgical follow-up appointment.

After a more than two hour delay sitting the waiting room, Dr. G's nurse practitioner, Anna, came out to talk to us.  With a big smile on her face, she says "Isn't that great news?". What is she talking about?

As it turns out, she was talking about the PSA level from my recent blood work. Assuming we had called to get the results, she came in with a big smile on her face and excitement in her voice. Anna went back to her office to get the paperwork.

There's another great reason to be thankful this Thanksgiving.  My PSA level is at a "near undetectable" level.  This means that the surgery was successful and that it seems as if the cancer has all been removed.   YAHHHHOOOOOOOOOOOOOOOOOOOOOOOO!!!!

So for now, we're thrilled and feel very blessed with this news.  In the coming months I'll continue to to have PSA tests to be sure that the level doesn't rise.  Once the 3 month healing process has passed, I'll begin radiation treatments to assure that any cancer cells that are roaming around are killed off.

Happy Thanksgiving!

Tests, news and yet another personal word or two.

Today I have my six week follow-up appointment. The results of my first blood PSA test since surgery should be in and we'll know from those results whether or not there's a significant amount of cancer still in my system.


Overall I'm feeling really good and just dealing with some extended discomfort from the surgery. I'm only able to sit comfortably for about 2 hours or so, but this is improving. Far from the amount of time I sit at my work station when at work.


I'm walking about 2 miles each day - weather dependent - in order to get some exercise and help the healing process. I am hoping to be able return to work soon, but my office seems to want me to wait until I'm able to work the full 10 hour day though I could come in and work about 6 hours or so and be pretty productive in that time.


 - - - - - - - - - - - - - - - - - - -


With all that drivel aside, a more important thought , , , 


As we in the US approach a national holiday where we reflect on the daily blessings of our lives and on the country, those of us who are facing a cancer diagnosis, nearing a surgery or are under treatment have many things to reflect upon. In honor of the Thanksgiving holiday, and for the battle that many of us here are facing, I'd like to present these words from Ralph Waldo Emerson.


"Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day; begin it well and serenely and with too high a spirit to be cumbered with your old nonsense."   –– Ralph Waldo Emerson

Peace, blessings and good health to you all.  Enjoy this day of Thanksgiving with your family and friends.

CJP
<><

Five weeks out . . .

and getting better. Yesterday marked the 5th week since my radical prostatecomy on Oct. 14th.


Time has passed kind of quickly, though boredom has crept in on occasion.  I sometimes feel like I've missed an entire season as the leaves are now off the trees and Thanksgiving is just a week away.


I feel much better, though there is still some discomfort while sitting upright for extended periods of time.  I'm sleeping a bit better at night, so I'm not nearly as tired through out the day, but I'm usually ready for bed by about 8pm. I'm not sleeping through the night yet.  I still wake up 3 or 4 times a night; get up to stretch my legs a bit, trip to the bathroom, and try to fall back to sleep.


I've been out walking for at least two miles a day for the last week, either around the neighborhood, or at St. Mary's park in Bridgeport along Long Island Sound.  It helps to get my legs back under me and lessen the muscle pain I've been experiencing, as well as some of the pelvic discomfort related to the surgery.


Tomorrow, I go for my first blood work since the surgery.  If all's right with the world, I'll have a PSA reading that is the vicinity of 0.05, down from my pre-surgical level of 63.  Next Tuesday, we'll be meeting with my surgeon for a six week follow-up appointment. We're looking for continued good news.

Almost four weeks post surgery . . .

Did I expect things to progress quickly?   Yes, perhaps only because everything until this point has been happening quickly.  Overall, I am feeling better. . . more mobile, stronger, and lighter having lost 24 pounds since surgery.  (I don't, however recommend, the process)


With my catheter out after 3 weeks instead of one week, my urinary recovery has been delayed and slowed a bit.  It's going to take me a bit more time before I am able to regain any kind of control . . .  which I am only beginning to see signs of.


I am still having some leg pains due to positioning during surgery, but it's beginning to level out and reduce, though it does flare up at times.


It's supposed to make it to nearly 70 degrees today, so a couple of long walks are in my plans. If I was able to drive, I'd head down to the Fairfield beaches or St. Mary's park and walk around down there.


I had a nice surprise yesterday with the visit by some of my "Trainiac" friends.  These "trainiacs" are some of my local friends who I first met when we moved to Connecticut four years ago during my daily commute into New York. Thanks so much to Sheila, Mark, Semi, Ben and Steve for stopping by, and for the basket of goodies and the gift certificate for a dinner out for Janet and I.  Your visit, gifts and friendship mean a great deal to both Janet and I.


Thanks also to my friends Mark & Tess Szamatulski, home brewing authors and shop owners of Maltose Express in Monroe, CT.   When I told Mark and Tess of my cancer and surgery, and the fact that I'll need to wait on my home brewing for a while as I cannot lift anything heavy for a number of months, they made a very generous offer.


Each year they do all-grain brewing demonstrations at their shop for their customers who may be interested in getting into the all-grain brewing process. Mark & Tess have offered to brew one of my recipes - my "Enrico's Holiday Hearth" holiday spiced English ale - instead of their planned ale recipe from their newly published third book. The 10 gallon batch they are going brew during the demonstration will be split into two 5 gallon batches. Five gallons available and be served at the brew shop during the holidays as one of their two samples they keep on tap. Tess and Mark have graciously offered to keg the second 5 gallons as a gift for me so that I have some fresh home brew around the house for the holidays.  A very thoughtful gift from some good friends.


If you're in the area and are interested in seeing the batch brewed, their shop Maltose Express is located in Monroe, CT.  The brewing demo will be done by their staff all-grain guru Dave Fitch and is scheduled to begin about 10am on Saturday, November 14th. Just go to http://www.maltose.com for directions and more information.  Just click on the EVENTS button for additional info.


As I said from the very beginning of this journey, I'm going to make it through thanks to my Christian Faith, family, friends and my sense of humor.  All of which remain totally intact.


- - - - - - - - - - 


As a small note, one of my goals with this blog was to help spread the word about prostate cancer and how important early detection can be.  I've received email messages from as many as 15 people - some friends, mostly strangers - letting me know that the telling of my experience(s) here has provided comfort, information and has served as a call to action for many to be checked during their next doctor's visit.  I appreciate the emails so very much, and I am so very happy that my diagnosis and the story I've shared may help others with an early diagnosis and to prepare others that may be facing treatment and surgery in the near future. My thanks and prayers are with you all.


Chris
<><

OK, here it goes . . . the pathology report.

Did I set this up right?

I got the phone call late Friday morning from Dr. Bertrand Guillonneau, my surgeon at Sloan-Kettering Cancer Center, and he explained the results of the pathology report.

First off, the final Gleason scaling of my cancer is an 8 (grade 4).  This places my cancer in an aggressive category (8-10). At this grade level, the possibility of metastases is common.


The next part of the pathology report is the status of the surrounding lymph nodes that were removed during surgery. At the time of surgery, 20 lymph nodes in the area of my prostate were removed in order to get as much of the possibly affected tissue is removed.


The pathology report stated that 19 of the 20 nodes appeared to be "clear of cancer/metastasis", but that one lymph node showed signs of significant metastasis.  As I am to understand, this node was located very near where the prostate capsule breach had taken place and the high level of metastasis is probably due to this fact.


Dr. Guillonneau believes that even though there is some metastasis, that is has been limited only to what has been found at this point and that this report is very promising and that he is very confident in these results.


The next step will be the blood PSA results in another couple of weeks. If the PSA level has dropped from my pre-surgical level of 62.7 to a "non-detectible" level of 0.05 or better, then I will be facing a round of radiation therapy that would begin sometime In January and will take place over a period of weeks/months. If the PSA level is elevated at all, indicating metastatic disease, then I will go through testosterone-reducing therapy in addition to the radiation therapy.


So for now . . . once again, this is good news that there is little metastasis and that there seems to be little indication of any severe spread of the cancer even though I have an aggressive grade of cancer.   As a matter of fact, I'm taking this (cautiously) as very good news, and count myself as very fortunate and blessed.


Tuesday I should finally get my catheter removed - YEAH!  I will be headed (with Janet) into Sloan- Kettering to be tested to be sure that my sutures are no longer leaking and then have the catheter removed.  After all, it's only been 3 weeks with this thing (it was only supposed to be a week).


Thanks so much again for all your prayers, support and concern. My surgery was only the beginning of what I know is going to be a long road to recovery, and I feel blessed to have so many wonderful friends behind my family and I in support.  We'll update you again soon.

No news is . . .

just downright annoying (i think we've been here before).

We still haven't heard any news about the pathology lab report. I didn't expect to hear from the surgeon's office today as Wednesday is surgery day for the practice. What I did expect to happen today, also didn't happen.

Today was the second appointment to have my catheter removed. And disappointingly, when tested and x-rayed, there were signs of the sutures were still leaking. So for now I need to wait again to have it removed.  This time however it will mean a trip back to Sloan-Kettering instead of having it taken care of locally.

My local urologist, Dr, Jeremy Kaufman, is intelligent, informative, supportive and a really nice guy. But as he reiterated today, he wasn't my surgeon, and not having been part of the surgery and being totally aware of what transpired during my surgery, there is only a certain point to which he can make the call as to the correct time to remove the catheter.  Obviously, if the sutures are leaking, he really can't remove it yet.

So, it looks like there's an early trip back to Sloan-Kettering in New York, and an appointment with my surgeon and his staff next Tuesday.

Tomorrow is my wife Janet's birthday.  I had ordered a few things online for her (which have already arrived), but I truly wish I could do more. She really deserves it after all of this.

'Til next time. . .  cheers!

Two weeks post surgery . . .

Progressing, slowly. Overall I feel OK, but my appetite is still off (good thing for  my weight I guess).

Tomorrow I'm scheduled (again) to have the catheter removed after two weeks. I'm really hoping that the test that will be done will show that the sutures are no longer leaking and that the catheter can finally come out.

Outside of a low grade fever the last 2 or 3 days, which I'm attributing to a flare up of my diverticulitis, and my sleep patterns being totally out of whack, I feel OK physically.

How am I in my head? For the most part I'm doing good.  This has all happened so "fast" that in respects, it still hasn't sunk in that I have cancer.  I don't think I've taken the time to process it for myself.  I've been more concerned for my wife, our sons and my parents.

I've had my moments of feeling overwhelmed, but I'm so wrapped up in being more concerned about my family that it will be some time before it catches up with me. Maybe when that time comes, it won't bother me so much. I know that Janet is having a difficult time, as you might expect. After all, we've been together for nearly 30 years.

I was upstairs the other day and noticed a pile of tissues on the nightstand - she's been crying herself to sleep (I've been sleeping downstairs in a rented hospital bed since I came home). Janet had told me the other day that she had been feeling helpless, that there isn't much she feels she's been able to do to help me.  She's still working and has her classroom and teaching responsibilities. I'm not going to put any additional pressure on her, and there really isn't much she can do to help me get better other than to be there for me when she can.

For both of us, the one thing we are waiting for is the pathology report which is due today or tomorrow.  The results of which will give us the most telling news of everything that's been going on.  It will be the final "grading" of my cancer and give us more of an idea of where we go from here.  It's something I'm looking forward to hearing, but at the same time it's something I'm quite anxious about.

Missed the first milestone . . .

I had an appointment to have the Foley catheter removed this morning.  I still have it in place. It's not necessarily a bad thing, just a disappointment and a delay.

Prior to removing one's catheter after a urinary surgery where the urethra was cut, the Dr's. need to confirm that the sutures have taken and that the urethra is not leaking.  The x-ray with contrast  showed a slight leak at the sutures.

So, I need to wait as along as another week before I can the catheter removed.  Again, nothing serious - just a bit disappointing.

Last night was bad.

From about 12:30am, until about 5:30, I was just about in tears from the pain of surgical gas pressure. The gas pain and muscle cramps were so bad, I was only making it through it all by remember and doing a Lamaze style breathing.

The docs and nurses warn you about this before the surgery, after the surgery, and anyone who that has experienced this type of surgery will tell you similar stories. But, until you experience it (experience delivery of a baby) you have no idea how painful last night was.

I'm so exhausted, I almost feel delusional. Time to try and settle down for some sleep.

5 days post surgery . . .

Again, we wait.  The pathology report should be back by the 23rd, and that will give us the true reading/grading of the cancer (tumor & nodes). Once that is done, the next marker will be the next PSA reading from blood work to be done about 6 weeks from now.

Normally, the PSA (prostate-specific antigen) is a "zero" or at a "non-detectible" level.  In this case, Dr. G is looking for a reading of "0.05" of better.  If there is any detectible PSA, then adjunct treatment of radiation, hormone deprivation or chemo may be required.

For now, that's pretty much it. I'm working on my recovery from  surgery, and then we'll move on to the next step.

Thanks for checking in and caring about myself and my family.  Your continued prayers and support will be appreciated.

a short update . . .

I came home yesterday, and I guess I feel about as well as can be expected. I'm at that gaseous stage from the surgical C02, which is proving to be more painful to deal with than I thought but I"m getting through it.

Not much of an appetite right now so I'm a bit weak and tired. I need to eat some food in order to take the pain meds so I don't get any more nauseous, but I'm already borderline because of the gas pressure so I'm just fighting through it.

The time has finally come . . .

of course that "time" changed yesterday.

Just as we were leaving the house for NYC yesterday afternoon, the hopsital called and let us know that surgery was moved from 8am this morning to 1pm this afternoon. Another half-day of fasting (no food or water since about 9:30 last night).

Janet, Evan & Ryan are downstairs having breakfast while I take care of a few pre-surgical tasks. Jason will have a bit of a tough day. Southern CT Univ. theater department's fall show opens tonight, and Jason is the sound team leader. I know that many are praying for my recovery, for my doctors and medical staff, but I want to also ask you for your prayers for my family, including my parents, Norman & Marjorie Palazini, and my in-laws, Walter & Faith Hicks. I know they are all understandably concerned.

OK gang . . . . it's about time to head out. See you on the other side!

Well then . . .

barring any last minute changes, my surgery is scheduled for 8am tomorrow morning . .  with a bright and early arrival time of 6am.  Which is fine as I'm sure I'll be awake most of the night anyway.

How do I feel about it all? I'm glad that the day is finally here. Am I nervous? I'd be an idiot to not be, but i know I'm in the best of hands in one of the world's best urological surgeons & surgical cancer centers.


I also know that through my Faith, along with the love and support of my family and friends that everything will be fine in the long run.  I'm well aware of the fact that this my initial recovery will be fairly quick, but that there is still a long road ahead.  And the really cool thing?  I'll be back home in time to see the two night Monty Python special on IFC.  Nothing wrong with some good laughs when you're recovering from major surgery!


I guess that's pretty much it for now. I need to finish getting some things together and make a few phone calls.  I'll update this as soon as I can, but it may not be until Friday or Saturday when I get home.


As it's 11:30am now, I'll almost be out of surgery this time tomorrow.


Cheers!

One Week . . .

and counting.

And you think this "countdown" thing is getting a bit boring and annoying for YOU!

I had my last pre-surgical tests on Tuesday, and met with my surgeon one last time. All systems go for next Wednesday.

We won't know what the schedule time for the surgery will be until the day before. So in the event it's a early in the morning, Janet, Evan, Ryan and I will be staying in the city Tuesday night so we won't have to deal with the insane morning traffic issues getting into the city. It will also give us some family time together and help to keep the boys' minds off of everything.

I'm told that the surgery is about three to four hours long, though I'm not sure if the recovery time is included in that.  I've asked Janet to take the boys out for a walk in midtown, maybe near 'Rock' Center, or maybe in the park to help kill the time. But something tells me they're going to just hang out in the family waiting area until they hear from the nursing staff for an update.

Tomorrow's my last day at work for while . . .  about two to three weeks.  I'll head back to work after that, but I don't expect to be able to do my full "normal" 10 work day (on top of my near 4-hour door-to-door daily roundtrip commute).  I'm going to have to ease back into the day, and perhaps try to make arrangements to somehow work from home, though that's a pretty unlikely scenario.

At the six week point, I'll have my first of a lifetime of blood tests to see where my PSA level has settled to. If the level drops to zero (or somewhere there about), I'm going to be in good shape, and will probably just have to go through a short round of radiation and/or chemo to kill off any cancer cells that are roaming around.   If the number is higher than say a 4, then the treatment may be a bit more intensive.

- - - - - - - - - - - - -

I know I've said this numerous times in this blog . . .

but Janet and I have had so many friends - old and new - offer up their "good thoughts", "positive energy", "lifted up in prayers" and love for us both, that we just can't express how much that all means to us.  Thank you.  I'll be back here soon and let you know how things go.

All our love right back at you all.

Chris

One week away . . .

with one last scheduled round of tests, and a pre-surgical visit with my surgeon today. Next Wednesday is surgery day.

How do I feel about all of this?  I'll be honest, it still feels surreal. For now, I'm pretty calm and relaxed about the whole thing. I've been through surgery before, and I know that there's really nothing to worry about.  But in the back of my mind, this is different. There's no doubt about it - this is to save my life.

Yes, the cancer was found "early" and that all the news (MRIs and bone scan) has been good so far. I consider myself quite blessed by all of this. But the fact remains that my cancer has been around for a while and that the capsule surrounding the prostate has been breached, and the cells have begun to spread.

Does that knowledge weigh heavily on my mind? Heck, yes!  I'd be lying if I wasn't concerned that every "odd" feeling or sensation I've felt in the last six weeks didn't give me pause as to what it may have been. Are the headaches and low fever I've been having in the last eight weeks or so somehow related to my cancer?

With all that said, and please don't get me wrong, I really am staying positive through all of this. But I am also aware in the knowledge that this surgery isn't going to bring this all to an immediate end. There will more than likely be a number of months of follow-up treatment by radiation and/or chemotherapy, and that my full recovery is a year or more away.

I said it in my first posting and I'll say it again. You "guys" out there need to get to your doctor at least once a year for a check-up.  And, if you're in your mid-forties, don't wait to talk to your physician about having a PSA test done along with your normal blood work. In most cases this test isn't done until you turn 50. At the age of 47 and a PSA (prostate-specific antigen) test result of 62.7, my cancer has been around for at least 5 years if not longer. I'm lucky that it was caught when it was . . .  earlier would have been better.

Well then . . . . . .

round 3 (or was it 5) of tests are done.  Actually, it seemed like a waste of time.

I had an appointment with a pulmonologist at Sloan-Kettering on Thursday . . . breathing exercises, pressures, stress tests . . .   all passed with flying colors.

Once that was done, I then needed to wait more than two hours for the doctor to see me. After reviewing my test results. the first thing the he asked was "And why are you here?".

Once I explained that I was scheduled for surgery, he then just assumed that this was for clearance for my surgery.  Wouldn't you think that they would know why I was supposed to be there especially as this was a referral from another Sloan Cancer Center docs?  They're all on the same computer system.

Just venting a little bit I guess.  Again, not sweating the "small" stuff.


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

14 days, and counting . . .

and I'll be under the knife.


I'm scheduled for a couple of more tests tomorrow, and then again next Tuesday. Mainly they are just to confirm I'm healthy enough for surgery, and to get baseline readings on blood pressure, blood chemistry, EKG, etc.  All stuff moving closer.


Of course I'm looking forward to getting the surgery over with, but at the same time I have to admit - I'm becoming more anxious about it as time goes on. It may have more to do with the fact that I'm not all that busy at work right now, and it's hard to keep the mind from drifting too much.


I'm not worried so much about myself, as much as I am about Janet and the boys. I'm fully aware of the risks of the surgery, and surgery in general, and I'm worried that they won't be prepared if anything were to happen. It's certainly not something I can speak with the kids about, and of course Janet's staying positive (as I am) that everything will be fine - so the discussion of "what if" won't ever happen between us.


NOW FOR THE MUCH LIGHTER NOTE . . . . .


On a kind of ironic side note, after twice having rescheduled my service for jury duty in Connecticut . . . .   my last rescheduled date is next Tuesday, Oct. 6th.  Of course I can't make it as I have my last set of pre-surgical tests and exams that same day!  


Obviously, I've planned this all along just to avoid serving.  I hope that the State of Connecticut doesn't find out.  ;^) Bwaaaaaahahahahahahahahahaaaaaaaaaaaaa

Now I remember why I don't like Mondays . . .

There are some Monday's that you just want to start over again.  (and I had nothing else to really write)

First, someone spilled some of their coffee on me while on the train this morning.  Not too bad, but the shirt I'm wearing has some stains on it now and I don't have anything else with me.  Grrrrrrrr . . .   not sweating the small stuff any more.

Next . . .  the glass slides from my biopsy were supposed to be sent to my surgeons' office in NYC . . .    the lab (Dianon), after getting the slides back from Yale Cancer Center, sent them back to Yale and not to my doctor in NY.  Major problem, no.  Pain in the neck, YES!!!!

There's a chance that this will cause a delay in my surgery date because the slides need to be reviewed by the pathology lab at Sloan-Kettering to confirm my diagnosis before surgery.  It's just a minor mistake, but it may hold up my surgery another week so to me it's a major screw up.

Then there's the fact the Red Sox allowed the "skankees" to clinch the AL East by being swept.  Yes, the AL East was going to NY, but it didn't have to be the Sox that gave it to them.

Yeah,  tough Monday.

First visible signs of concern . . .

. . . from Evan and Ryan.

Evan (16yo) had made a point this year to once again make the headmaster's list in school for each of this years' tri-mesters.  Between the usual teenage angst, friendship concerns and my cancer, he's already started to show some chinks in his armor.  He's a strong kid, but he doesn't have many strong friendships where we live with all the moves we've had to make due to jobs changes over the last 7 years.  They all came at that critical time when the strongest bonds of friendship develop.

Ryan (12yo) also showed a bit of worry.  Two weeks ago was his middle school's parent open house. All the kids were supposed to write something about themselves; their likes, interests, who they admire, what they want to be and what they want out of this year.

I was the one Ryan said he admired the most. Not a sports superstar or a musician.  Me - even though he's almost 13, it's still me.  When Janet asked him about the rest of what he wrote, like what he might be interested in doing when he got older; "I think it would be cool to learn to fly", he told Janet he was just making things up just to get the assignment done.  He's a pretty quiet kid and doesn't share his feelings much.

As Janet pressed him for a bit more, she noticed his eyes welling up.  He said he wished I didn't have cancer.  It's the first time he's exposed any emotion since we first told the boys almost three weeks ago.

I want to spend as much time with them as I can just doing some fun things with them and hope that they will both open up a bit to me so they aren't holding anything in and getting more worried than they need to.

Ryan is going away for the weekend for a church retreat with ClubJV - the middle school youth group.  He seems to have some small issues with going, but I think I've been able to let him know it's OK for him to go and that he should just have a blast with his friends.

Now that there's a scheduled surgery, some of this may become a bit more real for them and it may be a bit more difficult for them in the coming weeks.

We haven't heard much of anything from Jason for a few weeks - not even for money.   :^)
We've only seen him once in the last month, even though school is only about 40 minutes away in New Haven, CT.  I know he's busy with balancing his school work and the rehearsals for the fall shows at SCSU.  I just don't want his coping mechanism to be "staying out of touch", but I can certainly understand and won't make an issue out of it.

With surgery 3 weeks away from today, I'm even more anxious to get on with all of this than I was before.  I think the wait is going to bother me more than anything else. When the doctor said there was no real need to wait any longer, Janet laughingly asked "Can we do it tomorrow?".  If the doctor's schedule was open, and they had done their own confirmation of the cancer diagnosis from the biopsy slides, they would get us in this week.

Unfortunately, due to hospital insurance reasons - and a recent incident at another NYC hospital where a surgery had been performed, the patient's initial cancer diagnosis was wrong and the prostate was removed when it wasn't cancerous - they need to confirm the cancer in their own lab.

In our meeting with the surgeon, he did let us know that one thing that we should expect is a higher level of pain during recovery.  Though my age is a bonus for recovery, younger patients experience a higher level of pain with this surgery than older ones mainly because of the fact that our mobility isn't as limited as an older patient's might.

I just re-read this and I'm starting to ramble a bit, so that's all for now before you're any more confused.

Thanks for stopping by.

Alrighty then . . . . .

Hi gang -

Yeah! Surgery is currently scheduled for Wednesday, Oct.14th at Memorial Sloan-Kettering in Manhattan. Finally.

There is, however, an expectation that the cancer has moved beyond the "capsule" surrounding the prostate, but there are no specific signs of any major involvement of the lymph nodes (determined in MRI by change in physical size) in the surrounding area. What this means is that the surgical "margins" will need to be wider than anticipated to assure that as much of the cancer as possible is removed by removal of the localized lymph nodes and perhaps some surrounding soft tissue. This is still relatively good news, but we need to remain cautious in the coming weeks and months as we move forward. More than likely there will be a round of radiation therapy, or chemo (or both) approximately 4 to 6 weeks after surgery.

That's pretty much it for now. It's been a long and very emotional day. I'll catch up with you all again soon.

No news is . . .

Well, it's just kind of annoying.  So here I am again. . . .

Janet and I are meeting with Dr. Bertrand Guilionneau at Memorial Sloan-Kettering in Manhattan tomorrow for the first time to discuss surgical options and treatment.

I'll be honest, I'm concerned about the extended wait.  It's just seems odd that I need to wait 6 to 8 weeks post-biopsy.  Of course I STILL HAVEN'T ASKED, so that's my own fault.  This process has just brought a new light to how much I need to advocate for myself and not rely on the physicians to make all the recommendations. I did get surgical recommendations from my urologist, but they were primarily surgeons that perform traditional "open" surgery and not the "laparoscopic" or robotic laparoscopic that are my preference.

I suppose it's possible that I'm not a candidate for the robotic surgery for some reason, but no one has told me that yet even though I've expressed my preferences numerous times. No matter what, I just want to get moving forward with this and not give the cancer anymore time to spread.

All that aside, the family and I made a trip back home to Massachusetts over the weekend for a visit with friends and family.  We had a good time, it was so nice to see some old neighbors and friends from our church in Andover - all of whom wanted updates and are praying for all of us.

Anyway, that's pretty much all for now.  Perhaps after our meeting at Sloan-Kettering tomorrow, I'll have some "forward moving" news.

Cheers!

CJP
<><

P.S.  -  I'd also appreciate prayers for an old friend and co-worker Ken Sjogren from our days at Target Productions in the late 80's and early '90s.  Ken has been a great source of support in recent weeks, as well as a great source of information. Unfortunately it's because he went through this himself exactly a year ago.  His diagnosis came last September, and surgery in November.   Though the surgery itself was a success, his outcome wasn't nearly as good as he had hoped. His PSA level remained high following surgery which is an indication that the cancer has spread.  Ken is continuing with treatments weekly and is keeping an amazingly great attitude telling me he feels good and is still working full days at his job as an effects compositor at Industrial Light & Magic in California (Yes, George Lucas' visual effects company).  He's been a huge help in my first few weeks dealing with this, and I so appreciate all of the insight he's had to offer.

The results of all of Ken's treatment won't be fully known until January when follow-up tests are done.  I'd appreciate a prayer for he and his family and friends as well.    Thanks.

one step at a time I guess.

As much as I would like to just get on with it, I guess there's some waiting involved.

I have made consultation appointments starting in 2 weeks with two surgeons who perform robotic radical prostatectomies using the da Vinci robotic surgical system; one at Sloan-Kettering Cancer Center in Manhattan, another one at Hartford Hospital.

I am told I need to wait 8 weeks after the biopsy date before I can have surgery to avoid any added chance of infection. So at the earliest I can have surgery is the first week of November . . .  ugh!  At that point it's also a matter of the surgical schedule.  Oh good . . . more waiting.

For now, I'm going to go back to work beginning this Monday. I'm hoping for a bit more of a relaxed schedule so when the time comes I can make all my appointments, and be well rested for when the surgery time comes around.

The search is on . . .

I wanted to provide an update as to where things stand at this point. Forgive me if there's any information I may have already passed along to you, things have understandably been a bit of blur these last two weeks.

We gotten some good news late last week in that my bone scan was clean - indicating that the cancer has not spread. I'm still waiting to get the final report on the pelvic MRI which will provide signs of any localized lymph or soft tissue involvement.  The preliminary readings of the MRI also seem to be providing good news in that there seems to be so spread there as well.  So we are staying cautiously optimistic as the reality of the MRI results will only be proven at the time of surgery.

On the surgical front, I am in the process of scheduling and speaking with a few surgeons in NYC, CT and Boston who specialize in robotic radical prostatectomy surgery.  This type of surgery will provide the best treatment and options for post-surgical recovery.  The surgeons I am meeting/speaking with have been recommended by both my urologist as well as a few friends who have gone through this surgery in recent years - one of whom is 5 years younger than I am, and went through this exactly one year ago himself.  

Again, the best news is that this was caught, though not as "early" as one would like to have hoped.  I still feel fine and have not yet experienced symptoms of any kind, which is also good news for post-surgery recovery.  Due to the advanced state of the cancer, there may be a need for either chemo or radiation treatment in the weeks following the surgery, but that will be determined after a couple of weeks of recovery time and additional scans & blood tests.

I made the trip up to Woodstock, CT yesterday to tell my parents the news. They took it as well as you might expect - concerned, but well aware of the advancements that have been made with treatments of this type of cancer. I'm very glad I waited to let them in on the news as I knew what the bone scan & MRI results were in order to minimize the amount of worry they would obviously go through.  I had answers to give them, and a fairly good idea of what's coming down the road.

I am hoping that surgery will be able to be scheduled sometime in the next two or three weeks, I would really like to get this moving along and just the surgery over with.

Once again, Janet and I would like to thank everyone for their concern and support during these last few weeks.  There's a long fight ahead, but I'm ready for it.

Thanks again,

Chris

Nothing new to report . . .

I've been doing some research on surgeons that perform minimally invasive DaVinci robotic radical prostatectomy.  This type of surgery posses the best option for full recovery with the least amount of long term residual effects.


I have an appointment Wednesday morning to meet with my urologist again to discuss the final findings of the MRI and bone scans.


Tuesday, I'm driving up to visit my parents and to give them the news about my cancer.  Now that there's more positive info, and a sense of knowing what's coming down the road, I feel better now about telling them about my diagnosis.  I am so happy I waited to tell them - I have answers for them now.

But, with all that said . . . .   this weekend is about celebrating our son Evan's 16th birthday and enjoying the beautiful weekend ahead of us.

Have a great time with your families and friends! 

Cheers!

CJP

Good afternoon friends . . . .

As I mentioned late yesterday (9/2/09), the bone scan that was done appeared to be clear, and that there has been no spread into my bones. The feeling of relief over this small bit of news was overwhelming.   The first good news in about 3 weeks!

Janet was on the phone talking with one of her best friends (college roommates) when I got back home from getting the scans done, and I didn't want to interrupt her call. . . .  so I waited to tell her. . . and waited,  and waited.  When Janet and Joan talk, they TALK.  When I finally had the chance to tell Janet about the bone scan, it had been almost 4 hours!  She broke down in tears of relief as soon as it sunk in. (She then punched me in the arm for not telling her as soon as I got home). There's just been too much not knowing.

- - - - - - - - - -  - - - - - - - - - - - -

Janet and I met with the oncologist this morning, mainly to walk through the all the test results, and also to discuss the treatment options.

The radiologist still needs to review the MRI to determine if there's any issue with surrounding tissue or lymph nodes being affected before we make any decisions.  But, I'll take all good news as I can get it.

To everyone that has emailed, texted or called - thanks again so much for your concern and well wishes.  I'll say it again - I feel good and I'm not experiencing any symptoms, and I'm ready to get on to the next step to fight this off.  Faith, family & friends . . .  that's what really matters, and that's what will get my family and I through this.

If there's any more news, you'll see it here first.

CJP

BONE SCANS: COMPLETE

Just thought I'd drop something here - mainly for the sake of keeping my consecutive posting record intact.

So the bone scan(s) and pelvic MRI are done.  Two hours of trying to lay totally flat (keep the wise cracks to yourself people) and still. It sounded easier than it really was.

I was fortunate enough to have some great techs & nurses who were very compassionate and informative of the whole process.  The bone scan tech, Kate, asked one of the radiologists to stay a few minutes late so he could look at the scans.  Kate told me that she thought they looked really good, and wanted me to get some good news after two weeks of not knowing.

According to the radiologist, my bones look clear and the cancer looks to be localized to the prostate itself.  The best news I've heard in nearly a month.  It's not definitive, but I'll take what I can get.   Thank you Kate.

The radiologist's had all left by the time my MRI was completed, so I'll have to wait until tomorrow for the rest of the news.  For now, I think I'll be able to actually get a good night's sleep.

DOH!  The oncologist appointment is at 8am  and it's about 45 minute drive (Barring any major traffic issues on I-95 north on the Thursday before Labor Day Weekend.  (Looks like we're leaving about 6:45 just to be safe).

One last, and important note. . . .   many thanks to all our friends out there for their words of support.  You guys are great and we appreciate all the prayers and positive energy.


Cheers!

CJP

Staying positive, and moving forward . . .

Things are moving along as fast as they can, I guess.

I have an MRI and full-body scan scheduled tomorrow (Wednesday) afternoon in order to determine if and how far the cancer may have spread.

I also have an appointment with an Oncologist @ 8am Thursday morning at Yale Cancer Center to discuss the test results.  At that point we will have a much better idea as to what we are dealing with and start to make a treatment plan. No decisions, just a look at where things stand

It's an appointment I am looking forward to in order to get started on fighting this, and at the same time, it's one that I'm dreading just as much.  Janet is taking the day off from work (school started yesterday where she teaches) to come with me.

Just so you understand the reason for the tests; if the cancer has already spread, then surgery to remove the prostate may not immediately be an option.  Either way, radiation and/or chemo may be in the near future. 

I look at it this way.  It's what needs to be done to get me better . . .  AND, I may not have to shave for the first time since I was 13 years old!!   Yeah, I know. . . kind of a weird thought, huh?

In my desire to do everything to keep life as normal as possible for my family, I took the family (except for Jason who's off at school) to a Bridgeport Bluefish game last night. We had a good time, though it actually got really cold out about two hours in.   I didn't bring a jacket - something else I'm going to have to be more conscience about in the months to come.

- - - - - - - -

In my first post I had mentioned something my urologist had said about the PSA test being somewhat over used, but if it wasn't for the test we wouldn't have known about my cancer.

A good and longtime friend of mine back in Massachusetts mentioned to me that there was an NPR story on prostate cancer diagnosis' this morning.  I've included the link below in an effort to provide as much information about this disease and the process of detection and treatment.

(I have no opinion per se about the article, I'm just passing it along as additional source of information)

http://www.npr.org/templates/story/story.php?storyId=112416470

Thanks again for everyone's prayers, love and support.  It helps and means a great deal to my family and I.

Cheers!

CJP

The boys know.

Janet and I broke the news to our 3 sons yesterday morning.  It was the hardest thing we've ever had to do.

Looking at their faces, I could see them trying to be brave and hold back the tears. None of them could look me in the eye. They were definitely in shock. We explained everything we could, trying not to overwhelm them anymore than they already were. There were no questions that came from them.  They just need time.


Janet and I then stood up, held the boys in our arms, cried, and prayed for God to watch over our family.

The rest of the day went on pretty much as a normal Saturday after that.  I wouldn't want it to happen any other way. I took Jason out for some driving practice, and got some last minute shopping and errands done so he could finish packing for school.

-----------


This morning, Jason had the van packed up by 9:30 . . .  ready to get back to school.  I think that it's going to be a place of solace for him this year. It will help him to be with all his friends, and to busy working as the sound team lead for this years' theater program shows at SCSU.

Evan will probably remain the strongest through out all of this.  He's the one that seems to have the strongest sense of "self".  He's always been like that . . .  our "No Fear" kid.

Ryan, I worry about him the most. 12 years old, the "Peanut" has always been the quiet, introverted kid - though he has his break out moments with his amazingly dry sense of humor that just comes out of no where.  He's such an intelligent kid because he processes and thinks through everything, and I mean everything. When we play cards as a family, yes poker, he has ended up the big chip winner more time than I care to admit. I told him we're going to Las Vegas when he's old enough . . . or maybe something a bit more local.


I was considering going into work Monday & Tuesday as there's not a whole lot for me to do right now. My office has told me not to worry about anything, but I can't just sit around the house.  But, as Evan & Ryan don't start school until Thursday, I think I'm just going to stay home and spend some quality time with them. Janet's school starts classes Monday - half days all this week until the holiday weekend - but she's still supposed to stay at school until 4pm.  A day fishing with the kids would be a nice thing to do.  I haven't had the chance to take them out yet this summer.

NOTE:  Some days my posts are going to be pretty much like this - rambling.  Which in some cases will probably be better than what comes down the road.

A Good Morning . . .

Well, at least that's what I was praying for.

At 8:15am on August 28th, 2009, with my wife seated beside me, I got the news. I have prostate cancer - and it's pretty advanced. I'm 47 years young.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

At the tail end of a two-week long family vacation at the beginning of August with our 3 sons - 19, 15 and 12, and the celebration of our 25th wedding anniversary, I went to my doctor for a scheduled routine physical.

Nothing surprising - I'm overweight, my cholesterol is a bit high, I work far too many long days, don't get enough sleep and have too much stress in my job. Not much out if the ordinary for someone living in the northeastern United States. The only other health concern in the previous four weeks (heck, even the previous 20 years) was a first-time diagnosis of diverticulitis. Again, nothing of major concern - and no noticeable symptoms.

The blood test results from my physical showed a PSA level of 62. A "tad" elevated over what should be something around a reading no higher than a three. The ball got rolling from there.

(note: I was told by my Urologist that there is a current thinking among many physicians that too many other causes for a high PSA level leaves this test a poor marker for prostate concerns. Some countries, including many in Europe as well as Australia, have moved away almost completely from routinely using this test. Of course, if it wasn't for my high PSA level as a first marker, I probably wouldn't have directed to following up and finding the cancer until it was too late.)

I met with my newly anointed Urologist for the first time one week later. I went through the initial prostate exam, and scheduled an appointment for a biopsy that took place on Aug. 24th.

Yesterday, we got the news. We spoke with the Doc in his office as he laid out what needs to happen next. The next step is to find out whether the cancer has already spread to the lymph system or pelvic bones. Those tests (an MRI and full-body scan) are scheduled for Wednesday, Sept. 2nd.

Last night, my wife and I went out for a nice dinner to a local restaurant we hadn't been to before. We enjoyed a great meal and wonderful bottle of wine. I promised my wife that I'm not going to let this diagnosis stop us from living our lives. I can't.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

24 hours post diagnosis; here I am on Saturday morning. I didn't sleep very much last night. Tomorrow, we bring our oldest son back to college for his sophomore year, but today I face the daunting task of gathering all my strength to tell my 3 boys that I have cancer. I have no idea how I can face them to break this news.

They need to know, but I would almost prefer to wait until the results of the of Wednesday's tests come back and that there is a treatment plan in place so I can answer all the questions, try to calm the fears and tears that are ultimately going to come. No time is good, but they are all about to start a new school year. This is going to be hard on them.

One thing I can say that will ring true for them, "Boys, your job is to do your school work, help out around the house, and be kids - just like you always have. My job as Dad, is to fight this and get better - and be Dad just like always."

The next step will be in finding more strength to tell my parents. They lost one son, my only brother David, in an accident 30 years ago this coming December. This is going to be harder than telling my sons.

My Dad has had his health issues in the last 7 years - a cancer scare that he's survived, and a quad heart by-pass about 4 years ago. My Mom has mild to moderate Alzheimer's - something that frustrates my Mom, and is proving to be a strain on my Dad. I'm very concerned about what affect this news is going to have on them.  This discussion is going to wait until I know more. . . . and then I decide how much to tell them.

And so my battle, and this blog, begin. I hope that the words and experiences I'll share here will be of some comfort to my family and friends, and perhaps serve as a source of information and solace to those who may also face prostate cancer.