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| Each man's Journey is listed under his BASIC treatment. When you click on one of the names to read a particular Journey, you may see one or more different treatments in bold lettering immediately above the Journey text. You will see (Recurrence) if they are due to a recurrence. Otherwise, they will be treatments used in conjunction with the basic treatment, i.e. Lupron with External Beam Radiation or External Beam Radiation with HDRT/Brachytherapy, etc. | |
Active Surveillance Alternative (Natural) Therapy Cryoablation - Freezing Hormone Therapy Radiation - Brachytherapy Radiation - External Beam Radiation - HDRT Surgery - Open Surgery - Robotic |
NOTE: Lance has quite a multi-faceted "Journey" to relate. It involves several medical conditions, one of which is prostate cancer. Those of us who had "only" prostate cancer to deal with at the time can be grateful for small favors...after reading what Lance went through. We think WE have problems - read on. In 2009 I noticed that I was frequently feeling extremely fatigued, waking up from a drenching night sweats and always felt that I had not had enough sleep even though I slept for eight or more hours. I also noticed a pair of weird bumps at the base of my neck on the left shoulder that had been steadily getting bigger as time went on. In January 2010 I had my annual blood draw at the VA Clinic in Eugene and saw the VA doctor who assured me that even though my PSA was a little elevated at 7.5 everything was okay. He also mentioned that the PSA test and digital examinations were no longer considered good indicators of Prostate Cancer but he would perform the digital if I so desired. Since I knew that there was nothing wrong with me (other than borderline diabetes), and I really did not care to have someone with his finger in that very personal spot, I declined and went on my way. In February, 2010 I lost 30 pounds within a 30 day period and was also the victim of an extreme case of diarrhea. This was surely due to a really bad case of food poisoning. At least I thought so. In May 2010 I had another blood test and an appointment with a civilian doctor. He examined my blood work and promptly told me to strip and lay down on the examining table with my face toward the wall so he could perform a digital exam. (Note that he did not ask me if I was in favor of this or not). After the exam he scheduled me for a "just-in-case" appointment for a colonoscopy and also with a urologist at the Oregon Urology Clinic. Since this was already starting to get personal, I decided to ask him what the bumps on my neck were. He examined them and set me up with a consult with Dr Sorom (an Ear/Nose/Throat specialist) for the following Tuesday. I met with Dr. Sorom on the appointed day and he explained to me that the bumps were lymph nodes, they were swollen and that he would like to biopsy them to see what the problem was. Since I was already in the office, I asked him to do it right then and there so that I would not have to make any extra trips. He deadened the area and proceeded to excise them. I had had a biopsy on my leg a few years ago and it was such a small incision the doctor hadn't even bothered with deadening. I was really surprised at the size of the he objects cut out. They were the size of large marbles. He asked me to return in a week to get the results of the biopsy. I was still under the impression that I didn't have anything really wrong with me. The wife was much more worried than I was. We were back the following Tuesday and the news he had was outside of even my imaginative abilities. He said that I had a form of Lymphoma and that it was one of "Chronic Lymphocytic Leukemia" (CLL), "Small Lymphocytic Leukemia" (SLL) or "Mantle Cell Lymphoma" (MLL). Of these three, CLL was the most survivable and MLL was really bad. The biopsy had revealed that I was the proud possessor of a blood cancer but it did not reveal the exact type. He scheduled me for a consult with Dr. Sharman, an oncologist with the Willamette Valley Cancer Institute, for the following Monday. Now my wife and I are really worried! I never thought that I would pray for cancer, but we sure were casting our lots that it would be CLL and not one the others. The next week (my 64th birthday), I had a blood draw and my wife and I were escorted into Dr. Sharman's office. We held our breath until he told us that, yes, it was CLL and if you have to have cancer, that is the one to have. I was put on a watch-and-wait status. With watch-and-wait you have a periodic blood test and doctor's visit but nothing else is done (unless the blood test shows something is seriously wrong). I didn't feel any better but at least my wife and I weren't worried any more. That same afternoon I had my appointment with a urologist. He turned out to be Dr. Bryan Mehlhaff. He examined my PSA numbers and since they were a bit high (8.0), he asked me to strip for another digital rectal exam. With the last few weeks as worrisome as they were my hemorrhoids were in really bad shape. I balked, but he insisted. I will admit that I was glad that Dr. Mehlhaff has skinny fingers. He said that he found a rough spot on my prostate and that he would like to schedule a biopsy. At that time I saw no problem with another biopsy since I now had had a leg and a shoulder biopsied. In mid-August I had my colonoscopy. Since MLL has something to do with the colon and CLL is a close relative, I was fairly concerned about the results. I went through the procedure as smooth as glass. I woke up with my wife standing by me and the doctor telling me that everything was normal. I celebrated by going to a lakeside park and just sitting back and relaxing. Now I'm ready for that prostate biopsy. In September I did all the prostate biopsy prep work, started the Cipro, gave myself the enema and appeared at the Oregon Urologic Surgery Clinic. I was absolutely not prepared for this one event in my life. I should have known what was coming when I saw the squeeze toys that Dr. Mehlhaff supplied. One was a malleable plastic head and when you squeezed it, the eyes popped out. Inside the eyes were rats. I still had a super case of hemorrhoids and the ultrasound/nipper tool they use was a tad too big. To make matters worse they need to twist it around to change aspects. I had asked what the nipper would feel like as it poked a hole in the colon and grabbed a chunk of meat from the prostate. I was told that most people do not feel a thing and those that do, feel as if someone was whacking the prostate with a rubber band. I was one of the rubber band guys. To make matters even worse, I lost count (there are 12 samples taken) and just when I thought I was at the end, I had two more to go. When it was all done, I was pretty bloody but refused the man pad. I healed fairly rapidly and only had a day or two of peeing bright red urine. After the biopsy, I had pretty much forgotten about cancer other than my quarterly blood draws for CLL. My wife had had a serious hand surgery during this time and was pretty much restricted to bed. The Sunday evening following the biopsy I was watching TV and talking to my daughter on the phone when it beeped to let me know that I had another call. I excused my self from my daughter and answered the call. It was Dr. Mehlhaff. I wondered why on earth he would be calling me, maybe just to let me know that everything was okay. No way. He let me know that they had detected cancer on the left side of my prostate and that one of the samples had a Gleason score of eight. The right side had no prostate cancer but the samples showed Leukemia. The world suddenly stopped. He said that he was setting me up with another consult, a radiation oncologist named Dr. Barry Blyton. I decided that I would not tell my wife until she was much better. She had gone through a lot with my CLL and then her surgery. On Tuesday while I was at work I got this call from home. "Do you have prostate cancer?" she asked. I didn't realize that the clinic would send the results by mail to our home. I think that when she asked that question, that really was the low point in all this. I was actually more worried about her reaction than I was about my own future. In the first part of October I had a bone scan to see if the cancer had metastasized and then within a couple of days I had the appointment with Dr. Blyton. While we were waiting for Dr. Blyton to see, his nurse came in asked if we would like some coffee or a soft drink as we were going to be in conference with Dr. Blyton for quite a while. She was right; Dr. Blyton talked to us for an hour. He did his best to explain to me my choices and to distill any fears that my wife had. While we were there he did a phone conference with Dr. Mehlhaff and Dr. Sharman to determine what they thought the best course of action would be to combat the cancer. They all thought that I should have hormone shots and radiation. CLL patients have a difficult time healing so they did not want to perform surgery on me. It was still up to me (and my wife) and I elected to do as recommended. I also felt that I would not have the problems with incontinence that those who elect surgery experience. The radiation treatment (called Image Guided Radiation Therapy or IGRT) uses an image guided high-power X-Ray beam to zap the prostate with as much radiation as is necessary to kill the cancer cells and still leave the surrounding organs with as little damage as possible. The following Tuesday my wife and I saw Dr. Mehlhaff again. He mentioned to us that "if you have to have Cancer, this is the one to have." Now where had we heard that before? His nurse gave me my first shot of Lupron (in the right cheek). Once I saw the needle I tensed up and got a nice bruise and a sore butt for it. When I got the second shot in January I learned to take all the weight off of the "soon-to-be" affected cheek and to relax. No problems. I had heard that since Lupron stops production of testosterone, it also takes away your sex drive. For the next three weeks I felt more amorous than I had for quite awhile and thought that something was wrong. I talked to Joe at the support group and found out that Lupron actually puts testosterone production into overdrive which eventually causes it to stop entirely. Unfortunately Joe was right. One of the side effects of Lupron is the lack of a sex drive. The good thing is that you really don't care since it not only turns off the mechanics it also shuts off the desire as well. One week later (the following Tuesday) I went through the process of having the fiducial marker seeds installed in my prostate. These are used during radiation treatments to help determine the exact location of the prostate. They are installed by using an ultrasonic device in the colon and then inserting a gold marker seed into the prostate via a long needle inserted through the "taint" (don't ask). Dr Blyton felt sorry for me and my hemorrhoids and I was able to go through this with a minor general anesthetic. When I woke up, I felt fine. I did feel a little sore that evening when I sat down to read a book. Another week later,the following Thursday, I went through a process called "CT Simulation" which is used to map the locations of the prostate and surrounding organs and to prepare a Cancer patient for the IGRT treatments. I was instructed to drink 32 oz. of water just before I left for my appointment. I've never drunk that much water at one time in my life but I managed it. My wife and I live in Junction City just a little over 20 miles from the clinic. When we arrived, I was dancing a jig and couldn't wait to get it over with. When I checked in, the girl at the reception desk said, "I hope you don't mind, but your appointment has been delayed for at least a half hour." No, I was not a hero and held it, I ran for the bathroom, emptied, and then had to slowly fill up again with their water. We were finally taken back to the waiting room to wait our turn and I noticed that every man that came out of the CT room was running. That was odd. Finally my turn came. To determine the exact location of my bladder the techs first inserted a syringe of radioactive dye into my urethra and then popped a spring loaded ring device over my penis to ensure that nothing leaked out. No pain but lots of embarrassment. Next I was run though a CT scan and my organ locations recorded. Lastly the techs made a small tattoo on each side of my torso that corresponded with the location of the gold in my prostate. As soon as the tech removed the spring device and let me sit up, I found out why the other men had been running. I've never had to pee so badly in my life. For the first time since we started this journey my wife thought something was funny. I had talked to Dr. Blyton about going elk hunting before my radiation series began and he thought that it would be a great idea. The first week in November, my son and I and five other folks from the other side of the Cascades trekked to an area just outside of Juntura, Oregon. Not sure what caused it but I spent most of the entire week looking for a place to use the bathroom. I have never had diarrhea so bad in my life. I still had the wonderful hemorrhoids on top of everything else. The hot flushes had started so at least I kept warm. The last day in November I began my ten weeks of External Beam Radiation Therapy (IGRT). Of course, each session begins with me filling my bladder just to the point of just needing to pee. My wife would pick me up from work and drive me to Springfield for my session. Delays were disappointing. Luckily, my waits were usually less than ten minutes and sometimes there was no wait (those were the best days). My IGERT series consisted of zapping me in seven positions. With each position but one I received two zaps with the IGRT (13 total for every each session). As soon as the techs positioned me, they would go in the booth and I could hear the system cranking up. Before the actual therapy begins, the machine positions itself directly over the prostate and snaps off an X-Ray. The techs come back in and make the final adjustments to ensure that I am lined up exactly as programmed. After that the IGRT rotates 90% to a point on my right side and snaps another X-Ray. This confirms the position of the prostate. With confirmation the machine begins in earnest. A light starts flashing over the doorway and the machine moves to each of the predetermined positions. I got to a point where I could actually time each beam by counting 1, 1000, 2, 1000, etc. It takes less than ten minutes in all. During the IGRT sessions I still had the hemorrhoids. Frankly I was getting rather tired of hurting. I was using the meds Dr. Blyton prescribed and using a hot sitz bath every evening. Helped some but never totally got rid of them. The last few weeks of IGRT I could feel two of the beams. That was when they were in a certain position relative to the "rhoids." Funny thing, two weeks after the last IGRT session, my rhoids were all but gone. I had another Lupron shot in January, didn't even feel it. By now I have lost all interest in sex. It wouldn't have mattered. With the daily IGRT sessions, by the sixth week I was starting to get extremely fatigued. I spent the weekends just relaxing (doing nothing). I think that this and my wife's 24/7 support really helped me get through all of it. In the last week in February my arms and legs broke out with a fiery red rash that resembled hives. Talked with both docs and they said that it was probably stress related and should eventually go away. Used T-Tree oil, lavender and olive oil to keep it in check. After seven months, I still have some of it on my right leg. Started going to the local Us TOO Prostate Cancer Support Group where I met Joe (mentioned above). Talk about a wealth of information. You will always find some guy that went through the same thing you did. It was also wonderful for my wife to meet other wives that experienced the same thing. You could always tell the new ones. The wife would have a "deer-in-the-headlights" look and the husband was just trying to macho his way through it. Each meeting has social half hour and then a talk by one of the local urologists. Time well spent. I had to wait until April to see the results of the blood test. Docs say that you need to wait at least that long for the results to be accurate. My PSA was 0.1. Yippee! It looked like having my rear nearly burned off, shot at and incapacitated was really worth it. Besides the good news from Dr. Mehlhaff, he gave me another shot of Lupron. Well, at least the prostate cancer is either in remission or gone but I still had the leukemia (CLL) to deal with. The first week in May my wife and I went to see Dr. Sharman (the hematologist) to see what the CLL was doing. We were seated in his office when he came in. He turned on his computer and monitor, brought my records up and practically ripped the monitor out of the wall he was so excited. My numbers were all in the normal range! After some discussion, he said that he believed that since the hip is the biggest manufacturer of blood and all of the IGRT beams (except two) went through my hips, the radiation must have killed off the CLL cells as well as the prostate cancer cells. Wow! I had one more shot of Lupron in July and might have another in October. I have been slowly getting back my energy and strength and am elated to still be here and healthy at that. I can not be thankful enough for the support, treatment and good will I received during all of this. I owe my life to my doctors and my wife who stood by me every step of the way. This cancer is very survivable but only if it is caught in time. My wife and I eventually started going to the Oregon Urology Us TOO Prostate Cancer Education & Support Group. Talk about a wealth of information. You will always find some guy who went through the same thing you did. It was also wonderful for my wife to meet other wives who experienced the same thing. You could always tell the new ones. The wife would have a "deer-in-the-headlights" look and the husband was just trying to macho his way through it. Our group meets the first Wednesday of each month in the Oregon Urology Radiation Center, 1457 G Street, in Springfield. Each meeting starts with a social half hour followed by members sharing their personal experiences with prostate cancer. Finally, there is a talk by one of the Oregon Urology doctors or specialists. These meetings are time well spent. Wrapping up my prostate cancer treatment, I had one more shot of Lupron in July, 2011. With a PSA of 0.01 following my IGRT, I feel the prostate cancer is either in remission or gone. It is a great feeling having the treatment for one of my diseases out of the way and behind me. I cannot be thankful enough for the support, treatment and goodwill I received during all of this. I owe my life to my doctors and my wife who stood by me every step of the way. Prostate cancer is very survivable but only if it is caught in time. But, I still had the Chronic Lymphocytic Leukemia (CLL) to deal with. The first week in May, 2011, my wife and I went to see Dr. Sharman (the hematologist) to see what the CLL was doing. We were seated in his office when he came in. He turned on his computer and monitor, brought my records up and practically ripped the monitor out of the wall he was so excited. My numbers were all in the normal range! After some discussion, he said he believed that since the hip is the biggest manufacturer of blood and all of the radiation beams (except two) went through my hips, the radiation must have killed off the CLL cells as well as the prostate cancer cells. Wow! Jumping ahead to April 5, 2012, this latest meeting with Dr. Sharman didn't reap such good news. My CLL has returned but is still at the base line, putting me back on watch and wait, or active surveillance as we now call it with prostate cancer. With either disease, this approach is used to determine the rate of progression of the disease and assess for development of symptoms. During this time, my blood count will be monitored and physical exams will be performed on a regular basis. If the CLL shows signs of worsening, active treatment would then begin. I don't feel too sorry about this. I knew it was back as I am fatigued again. I am just happy that it looks like the prostate cancer is really a thing of the past and no more hormone shots. I know I will have the same support as I face CLL as I did when dealing with prostate cancer. That gives me many reasons to be optimistic as I go forward. |
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