Me and Mean Mr. C

If you don't want to read this, I totally understand...

Last October I posted an article relating to the fact that both my parents died of cancer during the 64th year of their lives. Now that I was in my own 64th year, I was more than a bit concerned. If you didn't see it, and want to see it now, here is a link. 

I scheduled an examination by just about every specialist I could think of. I'm very happy I did that, because I immediately found out I had aggressive prostate cancer, a pre-cancerous polyp in my colon, and ten pre-cancerous spots on my skin. The spots on my skin were frozen off, the polyp was removed, and my prostate was removed. Here is a link (if you haven't already seen it) to the post relating to the prostate procedure.

At this point I'm feeling good! Everything has been taken care of, and I'm out of the woods (relative to my 64th year).  At least that is what I thought at the time.

I recently went to a one year follow-up appointment with my dermatologist. I figured he'd give me a look over and that would be that. Nope! I hit the skin cancer trifecta.

1. Melanoma
2. Squamous Cell Carcinoma
3. Basal Cell Carcinoma

Melanoma - A mole on my back that had gone from "keeping an eye on it" to a moderately aggressive (as per a biopsy) early stage Melanoma in less than a year. It was dealt with first, because if ignored, it will eventually kill you. The procedure was done under local anesthesia. A pretty good chunk (15 stitches to close the incision) was taken out of my back and sent out for pathology. The results indicated that the margins were clear, and that was that. Two weeks later we dealt with number 2.

Squamous Cell Carcinoma - This was on the right side of my neck (photo below). There was nothing on the surface that would indicate anything. I asked him to look at it because the area got kind of red when I shaved, or scratched there. The biopsy he took came back positive for cancer. Squamous Cell is sometimes referred to as "head and neck" cancer. This is the one I was most worried about, because it doesn't have to travel far to get into the neck muscles and/or the lymphatic system.  This surgery was also done under local anesthesia. The procedure is called Mohs Surgery. They take out chunk of tissue around the biopsy spot, and then do "on the spot" pathology. If the margins come back clear, you're done and they close the incision. If it's not clear (meaning that it has spread) they take out more tissue in the direction the cancer cells were headed. The tech then does pathology on the margins of that piece. Once again, if the margins are clear, you're done. If not, more tissue has to come out. He had to do it four times before the margins were clear. He called it "chasing the cancer." The REALLY good thing is that it had spread quite a bit, but traveled down my neck, instead of deeper INTO it. It took a bit over 2 1/2 hours from start to finish. Lot's of stitches to close it up. Nine days later we dealt with number 3.

Basal Cell Carcinoma - This was on the left side of my neck. The surgery went pretty much the same as with the Squamous Cell cancer surgery. It only took two tries to get it all though. After the margins came back positive from the first try, I asked if he would just go ahead and take out a much bigger chunk out and hope for the best. He agreed, and it came back clean. He closed it up (also with a lot of stitches) and hopefully, I'm done with cancer. 

 Basal Cell before. The red spot is from the biopsy. There was no other indication at all.

 Basal Cell after. 

The stitches come out tomorrow. Geez, when did I become an old man?

Squamous Cell after

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1. Capillary Thyroid Carcinoma
2. Prostate Adeno Carcinoma
3. Basal Cell Carcinoma
4. Squamous Cell Carcinoma
5. Malignant Melanoma
6. Pre-Cancerous Polyp in colon
7. 10 Pre-Cancerous spots on my skin

        All in five years, and four of them in the last 10 months.

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I almost forgot to mention that the first thing I did was get a complete physical exam. Everything came out perfect. Contrary to the fact that I seem to get cancer, I'm really healthy. Vitals and blood test results were all fantastic. 

There is some good news.  I got a bit of a "neck lift" from the two surgeries!

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Part 2 - Adeno-Carcinoma of the Prostate

I walked into my initial visit with the urologist, thinking that it was only going to be a consultation. Based on my high PSA level, he advised that I should have a biopsy of my prostate done. I agreed, because I'd rather have a biopsy done and find out that everything was okay, than to not have one and find out later that it wasn't. Just to be sure, he wanted the PSA checked again. Then he told me to "drop trou" and turn around. We all know what happened next. Right?  He said it felt totally normal and that he wanted to do one more thing. That "thing" was to get a sample of the bacteria in the lower areas of my large intestine, using what looked like a large, long Q-tip. He explained that they get the biopsies by going through the intestinal wall directly into the prostate, and want to make sure that I'm already on appropriate antibiotics when the procedure is performed.  Oh joy of joys...

Ultrasound Assisted Needle Biopsies
I wasn't watching, but it felt like they drove a submarine up my bum and then fired torpedoes though the intestinal wall, into the prostate, and then retrieved the torpedoes. TWELVE times. Of course they were needles, not torpedoes, and each time they came back, they had a core sample of tissue. The submarine injected lidocaine first to deaden the area, but each biopsy still felt like a small bolt of lightning. Not much pain, but very uncomfortable.

Biopsy Results
Four of the twelve biopsy samples were malignant. They were all on one side, but both sides still had to go. Prostate cancer is rated (from five to ten) using a measurement called the Gleason Scale. Five is the least aggressive and ten is the most aggressive. Most of mine were in the middle, but unfortunately, two of them were aggressive.

Options
Do Nothing:
Prostate cancer is initially pretty slow growing, and if none of it is at the aggressive level (and subject to spreading), then it is fairly common to only monitor it while frequently checking your PSA.

Chemo:
Generally used if the cancer has metastasized (spread). Mine was advanced, but had not spread. Not for me.

Radiation:
The nerves and other items that control many of the body's functions either run through, or are immediately adjacent to the prostate. Radiation damages, and sometimes destroys them. Not for me.

Traditional Surgery:
Very invasive. Done either through the area from the navel to the groin, or in the "taint" area. Both surgeries are difficult, not easy to recover from, and have the potential of leaving you incontinent (both #1 and #2) and/or impotent.  NOT FOR ME!

Robotic Surgery:
The Da Vinci Robot is used for several types of surgeries now. It changes prostate surgery to something that is minimally invasive and totally eliminates even the tiniest tremors in a surgeon's hands. It seems like something that is totally science fiction. Here is a link to a video about the robot. If you are interested and have the time, check it out.

 This was the ONLY choice for me. Minimal, if any side affects. 

One night in the hospital, was all I needed. I had a follow-up appointment with the surgeon 10 days later. He told me to come back in three months. That was nice to hear, BUT the best news was that the 14 lymph nodes, bladder sample and assorted other bits and pieces of the margins he removed, were all biopsied, and all were NEGATIVE.  That means, no chemo, no radiation, no nothing! I've now dodged the big "C" bullet twice and am very thankful for it. My surgeon's name is Moses Kim. Another stroke of luck for me, because he is one of the pioneers and most respected surgeons performing surgery with the Da Vinci Robot.

There is clearly a lesson to be learned here...

 My PSA level was pretty high. I've had the PSA blood test done before and also the more traditional "digital" exam several times. Many doctors (and even some countries) don't believe that the PSA test is necessary unless there is some irregularity detected by the "digital" exam and/or some other indications. Both my doctor and surgeon said that my prostate felt normal during the traditional exam. Without the PSA test, I'd still be walking around with an aggressive cancer, that would eventually kill me.

If you are a male, or in a relationship with one, MAKE SURE that you/they get a PSA test done whenever they get a physical, or have blood work done. It could save your/their life.

For those of you who already know about what has been going on with me, I thank you for all the prayers and positive thoughts.   The next article you see here will be a normal one!



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An Interesting and Very Scary Thing Happened on the way to 65 - Part 1

I'm baaaaaack...

In nutshell (a darn big one), here is the primary reason that I haven't posted anything for several months. I don't usually publish personal stuff about myself here, but because of my long and unexplained absence, I feel compelled to do so.

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After battling lung cancer, breast cancer, and finally terminal brain cancer, my mom died in the 64th year of her life. 

My father had a couple of different cancers and ultimately died of throat cancer, this also occurred during his 64th year. 

I recently completed my 64th year and have to admit that I was a bit worried going into it. Being a proactive sort of person, I embarked on a grand tour of all the "specialists" I could think of. What follows is a list of them and what they found (also some conditions that I already knew about).

Rheumatologist (ongoing) - I've had a ton of injures and several broken bones in my life, so it's no surprise that I have arthritis in several places. I've yet to enter into any treatment yet.

Neurologist (ongoing and recent) - I have a herniated disc in my lower back at L5-S1. An update revealed that it has been made worse by the addition of several bone spurs in the area. Surgeries at L5/S1 are difficult, recovery is very painful, and they are usually at least partially, if not fully unsuccessful. In fact, sometimes the condition is worse afterwards. My surgeon (that did my earlier spinal surgery), is a great one, and he advises against having it. I agree. I have a pretty strong disposition and can tolerate and/or ignore a lot of pain. So far, I've pretty much learned to live with it (with no pain killers). 

Orthopedist (ongoing) - I've had a ruptured ACL in my right knee for a long time. I've just lived with it, but once again, I've grown some bone spurs in the area. As you know, I hike a lot and don't really allow it to slow me down much. 

Dermatologist (recent) - A top of head to tip of toe examination, resulted in him freezing 12 precancerous things off of me. 

Gastroenterologist (recent) - As recommended, I get a colonoscopy every 5 years. It has only been three years since my last one, but hey, it's my 64th year and my insurance will pay for it. He has found and snipped out a couple of polyps every time he's been "in there." The polyps have always been benign. NOT this time though. I had three of them and one was precancerous. 

Endocrinologist (ongoing) - As many of you know, I had thyroid cancer several years ago. Two surgeries later and my thyroid and related cancer was removed. The endocrinologist now monitors my blood and prescribes medication to keep me alive and functioning. A lab does a complete workup on my blood and this time it came up with an abnormally high PSA (Prostate Specific Antigen) reading. He strongly advised that I immediately contact a urologist. If you are so inclined, here is a link to post 1 of 4 relating to my thyroid cancer.

Urologist (recent) - My first visit to this specialist made the danger of my 64th year a reality. 

  

To be continued....

Don't worry, I'll be back to my regular posting afterwards!

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