Where Do We Go From Here?

So after staring at the 2nd sample for a few minutes, I continue reading the other 11 samples. All are clear. Yet somehow this only brings so much comfort. My eyes keep going back to sample B. I take my tablet up to my wife's office and show her the results. This isn't just because she's my wife and should know but also because she spent 15 years as a nurse and has been invaluable with health-related things, especially “medical-speak”. She confirms my interpretation of the results. So now what? Well, I've read sample B several times now but I don't know what it means. So I do what any technical person would do...consult the internet. Time to break down the terms so that I could try to understand what I have. Now I'm sure there are people who have issues with googling one's medical conditions, but my goal here was not a substitute for my doctor's knowledge of the subject. Rather I just want to be able to ask intelligent questions. I saw this as a business meeting and wanted to be prepared and make the best use of the appointment time, an appointment that was in two days. Maybe that's a strange early reaction, but learning is an important part of my life and, in times of emotional stress is a comfort to me. For example, when my mother died, I found great comfort in learning how the probate and estate system worked in my state as I was to handle her estate. Is that coping by avoidance? Maybe, but it works for me.

So the first thing to figure out is prostatic acinar adenocarcinoma. That's just the most common type of prostate cancer. Ok, got it. Now, the next thing: my Gleason Score and Gleanson Grade Group. That looks important. Feel free to click on the link for more details but what's relevant here is that my score was 3+3=6. The 3+3 refers to the configuration of the cells, and the total is used to put it into a risk profile. 6 or less is the lowest risk group, called grade group 1. That matches the result on my pathology report. This makes me feel a bit better as everything I can find says that Gleason Grade Group 1 is the lowest risk of spread and not particularly aggressive. That is probably as much as my non-medically trained brain can handle but at least I have some clue before going to see my urologist.

In the mean time, I decide to reach out to my father to see if he's aware of any family history. I was not aware of any but, I suppose, I never had much of a reason to know. There was breast cancer in the women on both sides of my family but, from everything I've read, that doesn't appear relevant to my case. Of course, when I ask the question my father naturally asks me if I have prostate cancer. I told him I did and he tells me that he was unaware of any in our family...until 2 days ago when he got a positive biopsy result. How's that for coincidence? So not only do I find out that I have cancer but that there is family history of it, both discovered on the same day. He, of course, tried to be comforting, telling me that a lot of men get prostate cancer and many die with it rather than from it. This is true, but it's still a lot to take in on a day that started like an average Tuesday.

So my urology appointment arrives and I wait to speak with the doctor. After being shocked at the timing of my family history she tells me everything I found on the Internet complete with Gleason charts, etc. So at least my research was accurate. But now the bigger question that the internet can't answer...what do we do? She explains the possible courses of action:

She says it's ultimately my decision but, as of today, her recommendation is active surveillance. Taking into account my Gleason score as well as the fact that I'm relatively young she would prefer to watch it while keeping me as fully functional as possible for the longest period of time. She said some don't handle the news well and just want to cut it out for mental relief as much as anything else and if that was me, she would do that for me. I was a good candidate for surgery so she wouldn't recommend radiation. I agree that active surveillance is the way to go. She wants me to come back in six months for another PSA test.

This is all well and good, but the reality is still bouncing around in my head. Even though it's not a critical case, I still have to get used to the idea that I'm a cancer patient now. Having watched my mother fight cancer for decades including having her move in with us for her last 2 years definitely weighed on me. Of course, my case is very different, but it brought up old feelings. Then there's telling other family and close friends. But, to be honest, that helped me process it better. Within a few weeks it wasn't on my mind much. The only big difference in my life at this point is that I can no longer donate blood or platelets, which I've done for 20 years. I called and asked if it mattered that I wasn't actively treating it. It did. It's kind of silly when you think about it. If I hadn't known I had cancer, they would have gladly agreed to take my blood products. But just the fact that I know changed that. That bothered my engineer brain, but I understand it's more a matter of scale. Blood donation places like the Red Cross can't evaluate everyone's individual situation so they make blanket rules just to be functional and safe. I can respect that. Still, that was an big part of my life which, at a minimum, will have to be put on hold. At worst it's over and I will never donate again. I take solace in the fact that I gave as much as could while I could with the idea that this day may come. Unfortunately, that day has come...at least for now.

Please note: This blog is based on one man's experience and is for educational and support purposes only. Nothing in this blog should be considered medical advise. Always consult a physician to properly evaluate your particular health issues.