“Sigh… what is it Timmy?”
“Mummie, why is that strange man running uphill shouting ‘Hamster Power’?”
“I don’t know, just keep a safe distance”
Timmy’s quandary will be resolved by the end of this post, but first, September is prostate cancer awareness month, and OMG, I can’t believe it’s already been 11 months since my diagnosis. Suffice to say I’m doing much better than the unlucky minority that don’t survive their first year past diagnosis.
Generally I’m doing exceptionally well, with a couple notable footnotes. First and most annoyingly, my hot flashes are getting worse, and starting to interfere with things such as sleep. I’m either uncomfortably cool, or hot and sweaty, and seem to be losing the ability to spend any time feeling pleasantly warm. It’s a problem to be solved, but so far I haven’t found a simple solution.
The other footnote is that my blood pressure seems to be inching up. This is a very common side effect of my medication, and it’s something to keep an eye on. It’s also a great example of something that for most people changes slowly over years if not decades, but when you’re battling cancer these changes can happen in just a couple months.
Most of this is due to treatment to suppress testosterone, and not the disease itself. Let me try to explain how prostate cancer treatment feels. Imagine for a moment you’re a healthy and relatively young man. You think about sex frequently. You’re active and loud and brash, sort of like this:
Tommy Shaw is an excellent guitarist, but Ted Nugent is on a whole different level. Anyhow, now imagine that you find yourself in middle age and without testosterone. Sex is no longer a pre-occupation. You feel more sedate somehow. You’re still upbeat and enjoy smiling, but it all somehow seems a bit weird, and like your body is speaking an entirely different language:
Prostate Cancer Awareness
Semen. Specifically, semen with a slight pink tint. That was the first sign that something was not right in my body. I had a PSA screening test about six, maybe eight months earlier that came back at 2.0, completely normal. Prostate cancer is a slow growing cancer and with a low PSA this couldn’t be cancer. Must be an infection. This symptom didn’t repeat itself so the infection must have cleared up and I went on with life.A few months later, the start of my urine stream had a slight brown tint to it. I wouldn’t have noticed except that the first drops landing in the urinal looked different. Gonna have to keep an eye on that. Oh look, it went away for weeks. Now it’s back again. Sigh. I looked up urologists on Google, but the ones I found on my first try seemed to be vasectomy factories.
Eventually, I found a urologist near the office that had good reviews and made an appointment. Around this time, that niggling running injury turned into back pain that made sitting very uncomfortable. On Friday whenI had my appointment, I got the dreaded DRE. “Digital Rectal Exam”. This is the reason why men sometimes seek out women urologists for their generally smaller fingers. I had a nodule on the right side of my prostate, better get some blood and schedule a CT scan.
To make a long story short, my PSA had gone from a happy 2.0 to a “worrisome” 216 in 13 months. The CT scan and a subsequent bone scan showed widespread metastases. The biopsy report indicated “intraductal carcinoma”, which is a rare form that is very aggressive and doesn’t output much PSA, and thus tends to avoid the screening test until it’s way too late for a cure.
A quick word about survival statistics: They apply to populations and not individual patients. Prostate cancer has about a 90% five year survival rate. But, 90% of prostate cancers are caught when removing the prostate is curative, and the five year survival for those cases approaches 100%. It’s the unlucky 10% like me that have advanced disease at diagnosis that account for nearly all the deaths within five years of diagnosis.
My personal message to you is not a simple “get screened and everything will be okay”. Screening is important, but the PSA test is far from infallible, and failed me miserably. You must also be on the lookout for symptoms that indicate something is wrong and further investigation is warranted. Back aches are a plague of middle age, but they can also be a symptom of metastasized cancer.
The other part of my message is to be aware that tomorrow is not guaranteed. Screening tests aren’t perfect, and neither are doctors. A careful balancing act is required here. It is wise to get screened for cancer and be aware of symptoms that aren’t right, but on the other hand you can’t live your life worrying that every ache and pain is a potentially fatal symptom.
It’s something I still grapple with. I just finished telling you about how I ignored the early symptoms of my cancer. Do I wish I went to the urologist sooner? Definitely. Would it have made a significant difference in my diagnosis? Probably not. There would have been the advantage of starting treatment sooner, and I may have been able to skip the radiation treatment to my spine, but that’s about it. I’m convinced my cancer was widespread before I had any symptoms.
Let’s go back to those survival statistics one more time. Have you seen the long term survival rates for prostate cancer? Virtually nobody with my diagnosis is reaching the age of 100. Despite all the millions spent on research, death continues to be our number one killer, and I’ve reached the limit of how much cancer awareness I can write about without getting silly.
Hamster Power
It was finally the day. I went out the door and ran and walked my way through two states, four towns, 650 feet of elevation change, and covered 12.7 miles. It was my longest run in over three years, and it felt great, at least for those of us that enjoy sore feet, aching muscles, and heavy breathing.This was only four days after getting injected with “hamster juice”, which is my new term of endearment for Xgeva, the bone strengthener produced in genetically engineered hamster ovaries. Hamster juice is intended to help my bones heal from the damage caused by the cancer, and is what allows me to continue running. Of course, the running further strengthens the bones, so it’s a very synergistic combination.
In a way, it’s a bit silly to push my running to the next level while the side effects of a hamster juice injection are at their peak. On the other hand, I’m finding that getting out and moving while the body is under duress due to other issues eventually leads to bigger gains in fitness. I honestly was pushing through the joint pain and fatigue by shouting “Hamster Power!”, but of course my vocal cords wheren’t engaged, so it was a whispered shout.
This route starts with a long uphill stretch, with a payoff at the top of the hill. There are several horse farms with pastures that provide a view of hills and mountains way off in the distance. At one farm they were setting up folding chairs for what looked to be an impending outdoor wedding with a view. It’s just one of the ways that you can run the same route repeatedly, and it’s a little different each time. It’s why I enjoy running outdoors instead of on a treadmill.
From the view it goes downhill for the next mile and into New Hampshire. I skipped a walk break or two and glided down the hill to gain back some of the time lost on the uphill section. My toes were taking a pounding here as they repeatedly slammed into the front of my shoes. At the bottom I stopped to tighten up the laces. That reduced the toe pounding, but tight laces can lead to foot cramps. Longer runs leave less room for errors in mundane things like how tight you tie your laces. Okay, still a couple more hills to get over.
Cranking up one of the last real hills, I started thinking to myself “Keep those feet turning. Keep moving. Go Forward. Move Ahead. It’s not too late, to whip it! Whip it good!” Did I mention I get silly on long runs?
After the hills the road gets lumpy. It’s never flat, there’s just an endless series of short ups and downs. Not quite high enough to be called hills. Not enough to get into a rhythm. Just enough to make the route a real challenge.
At about mile 11 the endorphins really started kicking in. I was going to finish this route for the first time in years. Fuck the cancer. I whisper-shouted “I FEEL AWESOME!!!”, and then sucked in a bug on the subsequent inhale. Gag, cough!
After my free protein supplement from mother nature, it was mostly downhill back home, and nothing of importance happened. I finished my run feeling tired and sore, but not really any more tired and sore than I would be after running a dozen miles years ago. The problems I’m having with sore feet and inhaling bugs are running problems, not cancer problems.
A few days after that long run, I took a run/walk/hike in Vermont. That went down an all but abandoned stretch of road, past a couple abandoned houses, and ended at a field next to what appears to be a well maintained but off the grid house. I honestly don’t know if the field is owned by the house, or is simply part of Jamaica state forest. But since there was nobody at the house, I “trespassed” onto the field which has one of the best mountain views in the area.
I wish I had my camera to capture the view. However, the lack of a camera didn’t stop me from posing for a few photos that weren’t taken. I was really hamming it up. I hooted and hollered, for real as there didn’t seem to be anybody around for a mile in any direction. I was feeling great from the run, and such antics only improved my mood further. I did handstands and cartwheels. I used yoga powers to levitate. Nobody was around to confirm or deny these claims.
Such silliness keeps me from dwelling on other aspects of my situation. About the hot flashes, somewhat disturbed sleep, and increasing blood pressure. About the unlikeliness of celebrating my 100th birthday. About how my mom probably won’t be around for that birthday if I do reach it (who knows, maybe she will live to 130+). For a moment, I’m just a guy enjoying the moment.
Because really, at the moment I’m doing very well, and I’ve shown a new found ability to deal with things as they come up. When I get entirely absorbed in a run, or in a video game, or even a problem at work, it shows some ability to not worry about things that haven’t happened yet and don’t need to be dealt with until they happen. If I can do that for a moment, perhaps I can do it for another moment.
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