Friday, May 5, 2017

Cure

http://www.afr.com/lifestyle/health/mens-health/provocative-study-raises-possibility-of-a-cure-for-advanced-prostate-cancer-20170424-gvr2ti


 
I had an idea this headline was coming after my meeting with a prominent prostate cancer oncologist in Las Vegas last year. During the course of that meeting the doctor said he felt I was a good candidate for an aggressive form of treatment that very well could eradicate prostate cancer in my body. At the time of diagnosis the word "cure" was not part of my vocabulary. It was a fantasy! It ranked right up there with Santa Claus the Easter bunny and an honest lawyer. Yet, here I am 11 years later and the urology community is throwing around that very word. Amazing! 
   The idea of being cured sounds almost too good to be true. Certainly, it is something I have hoped for since my journey began. I do however wonder about the cost. What price will I have to pay for the possibility of being cured?   
     To answer that question one must understand what the treatment entails. It is my understanding that in order to cure a man with advanced prostate cancer the first step is removal of the prostate and surrounding lymph nodes. This is done by radical prostatectomy. This will not be in most cases, your nice tidy nerve sparing surgery. In cases of advanced disease, they will take everything. After prostate removal patients will undergo A shotgun of therapy to attack and kill satellite metastases. These treatments include androgen deprivation, chemotherapy, radium, and a second line therapy such as Zytiga or Xtandi. After undergoing therapy, the patient will then be takien off all treatment and will be monitored to see what happens. 
   I spoke to my urologist regarding the idea of curative therapy just a few short months ago. I may as well have been talking to the soup Nazi. "No Cure For You "
   The question I find myself asking is this. Do I even want curative therapy?
   The first paragraph of my blog introduction pretty much says it all. Life is really about the quality, not the quantity. I have touched on this subject in previous blog posts. I find myself in somewhat the same situation as the newly diagnosed men who are traditional candidates for curative therapy.
 
   There has been much todo regarding overtreatment the last few years. It has been discussed whether or not men should even be screened for prostate cancer. I get it. Some guy comes in off the street with a G-6 or organ confined G-7, hears the word cancer and loses his mind. The next thing you know he has his prostate ripped out and is facing a myriad of side effect from his surgery. The first thing the poor guy has to deal with is incontinence. Some guys require a year before they can stop wearing absorbent pads. The next thing they have to deal with is erectile disfunction. Penile rehab consists of using a pump and Cialis or Viagra as well as a retaining ring. Sometimes men require self injections to function. Many times, nothing works regarding incontinence or E.D.  and men must resort to having a penile implant to attain a semblance of normal sex life and an Artificial Urethra Spincter to stop werting themselves. Even for men who overcome all of these issues, they are surprised to find that their penis is an inch and a half shorter. I am amazed at what the surgeon never tells you.
   So to the matter of curative therapy in my case........PASS.
   I have a semblance of intimacy in my marriage, I do not pee myself, and if I lost an inch and a half I would have an "inny not an outty"
   My life is pretty good. As they say in the shop, "If it ain't broke, don't fix it"

Todd