Treatment, recovery and remission . . .

what does this all mean?  Excellent question my friends, but first, a long over due update;

My last bone scan in January was clean of any signs of recurrence/metastasis of prostate cancer, and my PSA blood work still shows no significant increase - remaining at near non-detectable levels.  This news, along with the long awaited and slow return of my energy levels, is all very positive.  I'm finally beginning to feel like "myself" again.  My next blood test is in mid-April, along with follow-up appointments.

So back to our question of the day, "What is remission?" According the the American Cancer Society:

"Some people think that remission means the cancer has been cured, but this is not always the case. Remission is a period of time when the cancer is responding to treatment or is under control. In a complete remission, all the signs and symptoms of the disease go away and cancer cells cannot be detected by any of the tests available for that cancer. It is also possible for a patient to have a partial remission. This is when the cancer shrinks but does not completely disappear. Remissions can last anywhere from several weeks to many years. Complete remissions may go on for years and over time be considered cures. If the disease returns (recurs), another remission may be possible with further treatment."

So basically this reminds us that at this time there is no true "cure" for cancer - any cancer. For nearly every cancer patient, and their loved ones - no matter the type of disease, there is the possibility that the cancer can return at nearly any point in time.  Of course, we all live with the hope and faith that if cancer ever returns we can once again fight the beast off and return to living our lives once again.

I have not yet heard the words "cured" or "remission" from any of the doctors I have been treated by, but the tests results since my surgery have all been good news.  I suppose that there is some standard period of time that needs to pass before anyone will utter any term like that - two years, five years, 10 years . . .   In the meantime you just do everything you're supposed to do - eat healthy, get lots of rest, stay/get fit, take your meds and see the doctor(s) every 3 months.

There's also the hope that comes with the months and years that pass where there are no signs of re-occurrence. In that time, we all hope that science and medicine have made forward progress in the detection and treatment of cancer that will ultimately improve a patients' chance of a long and healthy life.

We either have be designated clear of cancer - or are able to live with it under managed medical care and medications.   No matter what, we are thankfully given another chance - and it's time to live life again.  It's almost Spring.


Cheers!

It's the holiday season . . .

For my family and I, it's another year of blessings. It's December already and time seems to just keep flying by - which is a good thing at times.

We're all looking forward to celebrating Christmas and the New Year with family and friends. The tree goes up this weekend, the shopping has already started in our household - when my wife got me to join her on "Black Friday".  It really wasn't so bad as we stayed away from the malls and stuck with the local stores getting a good deal of shopping done.

As for me, I'm keeping my chin up and doing everything I can to stay positive and upbeat - just living life as I should be.  Though at times it's not always as easy as it may seem.

One of the things I've discussed here in the past has been how difficult the "not knowing" part of all this can be.  For some patients, and even for my wife and myself early on, it was almost paralyzing.  The waiting on test results, waiting for and then deciding on the next steps, can all just be rolling around in your head constantly.  You just have to do your best to put it all aside . . .  laugh, enjoy time with friends and family, put your best efforts in at work or your favorite hobbies.

It's been nearly four months since my last radiation treatment and ADT hormone injection. Outside of dealing with the occasional hot flashes, lack of any sustainable energy level and trying to fight off the additional weight gain from the medications - I've had little to actively do - medically - to fight the cancer.  First it was all the tests, bone scans, MRIs, doctors appointments and the like - the surgery and recovery, the eight weeks of radiation and six months of hormone meds.  Then suddenly, it all comes to a stop and you feel like you're on your own.

Sure, if I had any issues or real concerns I could call anyone of my 5 doctors and speak with them, but somehow asking about the occasional insomnia, the difficulty keeping my weight down, the odd pains/aches I sometimes feel deep in my shoulders, lower back and legs - all seems trivial and not worth the phone call in comparison to what I've already been through.  Besides, I'm not in my 30's anymore and I've been through all that before I had cancer.

In addition to having been four months since my last treatment and doctor's appointment, it's also been four months since my last PSA blood test.  Yeah, sure . . . my PSA level had thankfully remained at <0.05 since my sugery 14 months ago.  Awesome and blessed news (as I've said countless times here), but knowing that my diagnosis had been changed in March of this year to "metastatic" disease - I have to admit I've been a bit anxious about not being tested for a while.  At some point I will only be tested once or twice a year, but it's one of the simplest things that I can have done for my own peace of mind.  It kind of makes you think twice about those little pains you feel every so often.

My next PSA test will happen soon enough as I meet with both my medical and radiation oncologists at Memorial Sloan-Kettering Cancer Center late next week for follow-ups.  Of course I don't expect any earth or life shattering news, but at the same time I realize that I'm a bit of a crossroads.  As much as I want, and need, to know what my PSA level is - the holidays are here. However unlikely as it may be, I'm honestly afraid to hear that my PSA may have increased as we approach Christmas.  The last time I got the bad news about it, my wife and I had just celebrated our 25th anniversary.

So there's my paradox.  Of course, I can ask the doctors to not let me know until after the New Year's holiday, and I'd have to fight my urge to check my test results online, but at the same time I'd hardly want to wait to begin any kind of treatment that may be necessary.

OK, maybe I worry too much about all this, and I'm sure everything will be fine.  But this is what a cancer diagnosis can do to you - how nuts everything can make you. You just need to stay focused and active in life.  Find a prostate cancer advocacy or support group to become involved with like the Prostate Cancer Foundation, Pints for Prostates, Us TOO International or Imerman Angels to do what you can to offer help to others facing what you've experienced in your own cancer battle. It can mean a world of difference to someone who is facing a new diagnosis or about to begin treatment if you would only take the time to talk to them and share your own experiences.  I've become involved with each of the above organizations at some level, and I know that I've not only helped other patients, but it's helped me as well.  After all, it is the season of giving.

Thanks again for all your love, prayers and support over the last year. It has meant the world to my family and I. Merry Christmas and Happy New Year to you all.

CJP

How time does fly . . .

whether you're having fun, or not.

This Thursday, October 14th, marks the first anniversary of my prostate cancer surgery. I have to say, it's been an interesting 14 months since my diagnosis.


The good news to this point, is that there's nothing much to report. I completed my last radiation treatment, and my last hormone injection, more than two months ago. Still dealing with some post-surgical side effects, things I'm just going to have to learn to accept and live with as difficult as it may be.  Hey, I'm still here and that's what matters.

My next follow-up and blood tests will be done in early December. Looking for "free" PSA levels to continue on the low side.  My PSA level has remained at <0.05 since my surgery.

I find myself trying to really comprehend all that I've gone through in the last 14 months.  It has been one heck of a rollercoaster - one I don't encourage anyone to ride if you can avoid it. The hardest thing to deal with these days, and it really seems stupid when I think about it, is that there's nothing really for me to be doing now. After a year of going through countless blood tests, doctors appointments, MRI's, bone & CT scans, laparoscopic surgery, recovery, counseling, more doctors appointments, meds, daily radiation treatments and hormone therapy - it's quite a change, and sometimes difficult to adjust to.


As a Christian, we are taught, or know, in difficult times that we need to turn everything over to God; all our fears, our worries, our pain and just let it all go.  Let God take it all on Himself and know that He is taking care of it all. As a cancer patient, you do a lot of praying through your whole ordeal - even those who don't call themselves "Believers".


In the early days of my diagnosis, and as the day for my surgery approached, there was really only one time that I really felt any kind of concern and anxiety. That happened during the walk to the operating room. Until that time, I felt very much at peace with all of it.  There was of course some sleepless nights, and some tearful discussions with my wonderful wife, Janet.  But, my heart and mind were very much prepared (seemingly) for anything about to come.  I know where that strength and sense of calm was coming from, and I was not afraid of whatever the outcome may have been.  There was still a great number of unknown factors until the surgical team were able to get a good look. I knew that the possibility that this could be "really" bad was real, and I did what I could to prepare myself for whatever news may come once I was out of the recovery room.

My prognosis remains positive even though my diagnosis had the "metastatic cancer" tag added to it back in March of this year.  It's a sobering thought knowing how close I came to this disease reaching a level of incurable. For now though, I'm focused on all the positives, on my family and my Faith.

Thank again to all our friends and family for all of your love, prayers and support over the last year.  One year down, and, hopefully, many more to go.


Cheers!


CJP

An anniversary . . . but one of celebration?

This weekend marks the anniversary of a moment in my life where everything just stopped.

The air stood still. The sounds around me just seemed to fall silent, and disappear. The only thing I was aware of was Janet's hand in mine - her grasp having suddenly become just a bit tighter.  It was the day I found out about my cancer.

That news was far from expected, and the timing couldn't have been more ironic. But there it was, and it was time to get to work and start the "good fight". Through a battery of blood work, MRIs, CT and bone scans, multiple doctor visits, followed by more blood tests and xrays, and scans . . . .  then surgery, eight weeks at home recovering, more doctors visits, blood tests . . . . .  two more doctors, testosterone reducing injections, eight weeks, 300 doses of radiation, and 56 blog entries (make that 57) later . . . .    here I am.

I get exhausted just thinking about it all again.

Oddly enough, through everything my family and I have been through, this last year seems to have passed quickly.  Now generally, I'm not a fan of life just moving out of control like a New York driver heading east along the Merritt Parkway. But, I have to admit that in a certain context, I'm very happy it's moved along at such a rapid pace.

Last week I've had, what I believe, is my last injection of Lupron (probably to just extend these wonderful side effects I've had the pleasure of experiencing). My PSA levels have remained at <0.05 since surgery, down from 62.7 a year ago. This is very good news, and a strong indication that the cancer has not spread anywhere else.

So what's next? A very good question indeed. The month of September is the first month in a year that I don't have a doctor's appointment or tests scheduled. Certainly a bit of a happy note there.  My next followup is with my medical oncologist in October, and then another with the radiation oncologist in December.  Hey! I don't have an appointment in November either!

I'm looking forward to fall in New England this year.  I've always enjoyed the change of the seasons and the beautiful fall foliage we have in this part of the country. It was something I could really only experience through the window, and during my short walks in the neighborhood, last year as I recovered from surgery.

This year, I've got the added bonus of joining many of my classmates from Acton-Boxborough Regional High School for our 30th reunion. I've been in contact with some of my old friends over the last year, and they've offer so very much support to my family and I during my treatment and recovery.  It's going to be nice to thank them in person, and to share some great memories and, I'm sure, embarassing photos.

The most difficult part of it all has been the not knowing what was happening, and what to do about it.  Well, I've done everything I was supposed to do, and been everywhere I've supposed to be when I was supposed to be there in this last year.  And now, like when this all started, it's time to just keep on living life and enjoying my family and friends.

Thanks again to those of you that have followed these ramblings.  It's provided a way for me to get things off my chest, and perhaps even helped other prostate cancer patients (actually, I know for a fact it has) in coping with their own new diagnosis.

I thank God for the amazing doctors, nurses, family and friends that have been brought into my life.  I am very blessed.

Done, and DONE.

Eight weeks, five days a week, 300 doses of radiation . . . DONE! 
One year to the day of my tell tale PSA blood test that started this whole thing. 

A quick note of thanks to some of the staff of MSKCC I've become very familiar with while undergoing my cancer treatment; Dr. Bertrand Guillonneau (Surgeon), Dr. Heidi Rayala, Dr. Lewis Kampel (Medical Oncologist), Dr. Brett Cox (Radiation Oncologist), Janey Regan (Radiation Nurse), the radiation therapists (Paul, Matt, Heather and Joe), and of course the great staff of nurses in each of the respective departments represented above.

The level of care, professionalism and compassion was not only the means by which I believe I can now look to a long, and hopefully cancer free life, but provided a great personal sense that I couldn't have been in better hands.

Thanks again to those of you who have offered your words and prayers of support, and who have followed these ramblings over the last 12 months.  This blog has been a way for me to get some of the craziness of everything out of my head.

To my wife Janet, and our three sons Jason, Evan and Ryan, my parents and in-laws, close friends both here in Connecticut, and in Massachusetts;  thank you one and all.  I couldn't have made it through the last year without you.

There's still a fight left ahead of me, and tests down the road to be performed to keep an eye on this disease. I won't be declared "cancer free" for some two to five years, but I'll go with what I know now. This is done.  It's time to put it behind me, and just focus once again on life.

Cheers!

Oh so very close . . . and a call to refocus on what really counts.

At this point, I have now completed six weeks (30 sessions) of radiation treatments.


There really isn't much more to say about it quite frankly. It's just become part of a daily routine that will thankfully be ending in a couple of weeks.  There's really no pain involved that's directly related to the radiation - just some resulting side effects that should all clear up in the weeks following my treatment.


The only disappointing part is that I was hoping to be able to at least have 4 or 5 days of my vacation to spend time with Janet and the boys. I originally expected the last treatment to be on Wednesday, Aug. 4th during my week off from work for "vacation", but now my final treatment is scheduled for Friday, Aug 6th. - meaning that each day of my vacation time will include a near 4-hour door-to-door round trip into the city - and about two hours of hanging around the hospital.


Don't get the wrong impression.  I am fully aware that there are much worse things than what I have been dealing with  - a fact brought to light very harshly by the news this weekend of a good friends' brother being mowed down by a car while walking across the street; and by the news that the mother of one of my sons' friends suffering a stoke/heart attack and then during treatment the doctors discovered the woman has extremely advanced cancer. But, if I've learned nothing else from this experience, it is the reminder of precious and short our time with our families and friends truly is.


Our careers and jobs should be the manner by which we are able to provide food, clothes and a roof over our heads, and the means to be enjoy the people closest to us, and more importantly to help others less fortunate than we are.  We who spend 70 and 80 hours a week working are missing out are what is most important in our lives.  And those who demand these hours from us, they too need to reevaluate priorities. Much of what we toil over in our jobs is for the here and now. Something that in many cases in the bigger picture, is nothing more than vapor.


The employees that work so diligently to make a business successful need to be allowed the opportunity to make their personal lives just as successful - actually, more.  Weeknights spent working until the wee hours, or even working at home, weekends recovering from hellish pressure filled work day, and maybe two weeks off for vacation each year isn't nearly enough. Otherwise, what's the real point of it all?


Look at your kids,  your husbands, your wives . . . .  is all that comes to mind memories of time gone by?  What about the time you have right now? It all passes by in a relative "blink", and it can be interrupted, or taken away, even faster. Sometimes tomorrow is far too late, or is never given the chance to come around.

Halfway home.

I thought I'd drop in and leave a quick post as today marks the halfway point in my radiation treatments for prostate cancer. Four weeks went by pretty quickly, and I'm holding up well.

I have a few issues due to the radiation, but I've been able to deal with them pretty well.  Most of it's been related to fatigue, and some other minor physical discomfort.  All of it is pretty much what I was told, and read, to expect.


As these next few weeks approach, the fatigue may become more of a factor. I've already noticed it increasing this last week. In fact, when I went to Sloan-Kettering for a treatment earlier this week, I was asleep within 2 minutes of sitting down after checking in.  One of the techs had to wake me up to let me know to start drinking the 20oz of water I'm supposed to drink before my treatment, and again when it was my turn to change for my treatment about 45 minutes later.  The triple digit temps we've had here in the northeast this week may have had an added affect on my energy level, but I've noticed my energy level decreasing pretty early in the day these last two weeks.


Anyway, that's pretty much it for now. I just thought I should make note of yet another milestone along this long road.  Once again, thanks to everyone for their continued support and prayers.  Even though this has been one of the most difficult times in my life, your friendship and support has made this trek much easier to tolerate.  I am truly blessed with a wonderful family and some great longtime friends.


Enjoy the weekend!  Cheers!


CJP