It has been a little over a month since I finished 45 sessions of radiation therapy for prostate cancer at UCSD. The radiation therapy itself was a follow up to a surgery that I had in March to remove my prostate. The good news is that I’m doing great! I’m about where I was prior to radiation therapy, which, although is nowhere near where I was before prostate cancer, makes me incredibly happy nonetheless. To put it another way, I can live like this.  This week I had a follow-up appointment with Dr. Rose, my radiation oncologist to discuss my recovery and the road ahead.

For the foreseeable future my cancer ( or ideally, lack thereof )  will be monitored by PSA tests. If you’ve been following my posts you’ll remember that the PSA blood test measures prostate inflammation. A normal PSA score is below 3 ng/mL for men my age. However, since my prostate was surgically removed my score should be undetectable, or less than 0.01 ng/mL. If my score rises above that threshold it means that the cancer wasn’t eradicated and managed to survive.

“If I have a recurrence will it be in the same area in which I received radiation?”, I asked.

“No, usually the cancer will metastasize somewhere else.”, Dr. Rose replied.

“And if it does, can I receive additional radiation therapy?”, I asked.

“Yes.”, he replied.  He then continued to list a variety of scenarios. Bone metastasis. Lymph node metastasis. Each scenario could potentially be treated with radiation, albeit with much shorter spans. 

“So, no more 45-day benders?”, I reiterated.

“No.”, he shook his head.

“Good. I mean, you’re a great doctor … person … and all, but I hope I never have to see you again.”, I joked.

The big test will be after I complete my two-year course of hormone therapy next November. The therapy, also known as Androgen Deprivation Therapy, or ADT, has been starving my cancer of testosterone, which it requires to grow. Once I’m off ADT my body will start producing testosterone again which will provide fuel to any remaining cancer. The big milestones for long term remission are at the 5-year and 10-year marks. However, I’ll always be at risk of a recurrence. 

“I, like most doctors, really don’t like using the word ‘cure’….”, Dr. Rose started. 

For a doctor it’s got to be rough not being able to confirm the one thing that every single cancer patient wants to know.

“….yeah, I get it. You really just don’t ever know. It’s too bad, but I get it.”, I interrupted. 

“So, is there anything I should be doing”, I asked.

“Are you still doing Kegel exercises?”, he countered. 

“Twice a day for the rest of my life.”, I replied. “It sure beats diapers!”

My prostatectomy had eliminated a valve in my urinary tract. Radiation had weakened it even further. Strengthening the muscles in my pelvic floor have been essential in keeping me dry.

“Anything else?”, I asked.

“Well, at this point we’d kind of like for you to get your life back to normal.”, he smiled.

I smiled back.

Normal. 

Yeah, I like the sound of that.

Take care. Stay healthy. Live life.

– Scott

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