Sunday, December 19, 2010

Winning The Battle With Prostate Cancer: a very personal story, part II

Part II

After getting over the shock of the diagnosis, as I wrote about in the previous blog, it was time to map out a battle plan.

Because my prostate cancer- -a slow growing cancer- - was diagnosed as being in an early stage, Stage T1C, I knew I had time to fully research my treatment options. So, I sat down at the computer did the requisite Google search for "prostate cancer treatments" and came up with a mind boggling array of entries, well over 10 million! Rethinking the search and changing it to "best prostate cancer treatment centers in the US" reduced the results to about 2 million entries- -still too much to wade through. So, I started with the first place everyone in the US thinks of when you think of first-rate health care, The Mayo Clinic. And to be sure, they had a wealth of information readily available on the web for free. But not satisfied with relying on only one source for information- -no matter how outstanding a reputation they may have- -I called my doctor and asked for some other sources. He suggested the Cleveland Clinic and Tampa's own Moffitt Cancer Center.

I had already known Moffitt's reputation as a cancer treatment center and through a friend had been referred to the chief of urological surgery there. And while I was quite certain that whatever treatment option I selected I would have done at Moffitt I wanted to be completely satisfied that I was selecting the right treatment for ME and the way I wanted to lead MY life. In order to do that I needed information, lots of information. And that information needed to be current, clear, understandable and statistically definitive. I didn't want it to be full of weasel words and terms such as; may, might, in some men, in some cases, no one can say, there is some anecdotal evidence, and so on. So without boring you with stats on the number of hours I spent sitting at this computer doing research let me tell you the 4 places I found to have the greatest wealth of information about prostate cancer and its treatment.

4. The Cleveland Clinic- in terms of general health care in the US, these folks are second only to The Mayo Clinic in Rochester, Minnesota. Here's where you start with them:

3. The Mayo Clinic- everyone knows the Mayo Clinic. For their info set on prostate cancer start here:

2. Memorial Sloan-Kettering Cancer Center- this famed NYC hospital has probably treated more VIPs than any clinic in the US other than the Mayo Clinic. For their take on prostate cancer start here:

1. Johns-Hopkins University- This Baltimore, MD medical center is the first choice of our nation's political leaders and foreign leaders as well. You can start here:

Again, since the point of writing this is to help men navigate their way through information in order to make a better decision, let me tell you bluntly that, in my opinion and based on countless hours of research, Johns-Hopkins has the greatest wealth of comprehensive, clear, concise, understandable and straight forward information about prostate cancer treatment available- -period. Their "health alerts", bulletins, "special reports" and white papers are complete, current, candid and most importantly, they are unambiguous and totally devoid of weasel words and terms. One of the best decisions I made in my battle with prostate cancer was to immediately download their report "Choosing the Right Treatment for Your Prostate Cancer." You can get that report here:

The decision to download this report and other reports published by Johns-Hopkins led me to make choices that helped me overcome this disease in just six short months instead of the 18 to 24 months I had been given to expect. Let me tell you about one other decision- -a very important decision- -that also contributed greatly to such a positive outcome. A simple and logical decision, really.

I've always been a pretty active guy and at the time of my diagnosis I was going to the gym and working out 3 days a week. My work outs were complete- - -lower body, upper body and core - - -and my aerobic health was reasonable but, I knew I could be healthier and it seemed logical to me that no matter what treatment option I chose and when I had it done, the healthier I was going into this battle then the healthier I would be coming out of it. So within a week of my diagnosis I stepped my gym workouts up from 3 days a week to 5 and increased them in both intensity and duration losing about 25 pounds and gaining in aerobic, therefore cellular, health in the process. I cannot over-emphasize how important this turned out to be.

Then after digesting all the information I had gotten from Hopkins and satisfying myself about issues like:

. Treatment risks
. Success ratios
. Duration of treatment
. Appropriateness of treatment for early stage versus late stage cancer
. Radical removal versus other options
. Loss of bodily functions
. Loss of intimacy
. Quality of life after treatment

I discussed my options with my doctors, other men who had won the battle and with certain members of my family. I asked for their opinions and got them.

My doctors were somewhat predictable. I could do nothing- -the watch and wait approach- - and reasonably expect to live another 12 to 15 years or so but with a very poor quality of life in the last 3 to 5 years. I could opt for intensive external beam radiation and expect complete remission but run the rather high risk of long-term incontinence, poor bowel function and a permanent impairment of sexual function. I could also choose radical removal and because of an early diagnosis I would be almost 100% certain of complete remission but still face the same body function issues or . . . I could opt for a less invasive procedure, radioactive implants.

The men I talked to were about equally divided. Approximately half of them opted for either radical removal or intensive external beam radiation because they wanted the cancer out of their bodies as quickly and expediently as possible- -all the other consequences didn't matter to them. Of the other half, about 50% opted for radiation implants and the remainder chose to "watch and wait". Much to my surprise my family felt that whatever option got the cancer out of my body and put my recovery chances as close to 100% as possible was the best option. The rest didn't matter to them. Keeping me around for as long as possible was their main goal and they were completely clear about their feelings.

But in the end it was my choice and mine alone. I DID NOT want to wind up wearing Depends nor making 6 to 8 trips to the bathroom during the day and 3 or 4 more at night. I DID want to preserve my options for intimacy and I DID NOT want the disease and it's treatment to dictate to me on a long-term basis in what activities I could- -or could not- -take an active part. So, radioactive implants became my choice and the procedure was scheduled for May 28, 2010. . . the scariest day of my life. Why? Well, I guess that is next week's blog.

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