Cancer testing, the tale continues


Peggy had a migraine and was exhausted when we left the urologist's office (see photo), so when we got home, I rubbed her back until she went to sleep, but as I was tiptoeing from the room, I broke a piece of pottery and had to rub her back a second time. She couldn’t return to sleep, so we talked about her fears of me having cancer—if I have cancer—and possibly dying. I like it when Peggy shares her fears, but she worries that they will scare me, although I don’t remember a time when this was soI can anticipate problems as well as she can. I tend to focus on percentages, so the better they are, the less scared I am. Peggy is so afraid of cancer that this doesn’t work for her. Some other disease might be easier.

I’ve had two previous cancer scares, but Peggy is more afraid this time, maybe because it’s the first time that I too thought I might have cancer. In fact, I wouldn’t have had my last two biopsies if she hadn’t insisted. They were both big deal biopsies that just scared the shit out of me—especially the one where the neurologist cut through the front of my throat to get a piece of bone from the back of my neck. Those two times, I just knew I didn’t have cancer. Feelings don’t constitute proof, so I recognized that I still might have it, but my natural confidence was such that I couldn’t get beyond seeing cancer as a remote possibility not worth the risk of a biopsy.

The more I learn about doctors and hospitals and the bad things they can do to a person, the more I try to make sure their proposals are necessary. Of course, when a book, the Internet, or a government panel’s report (like the one this week), tells you that a PSA-based biopsy (a PSA is a blood test) puts you at greater risk of harm than of good, and your doctor (along with two different urological organizations) tells you the opposite, whom do you believe? I should think the government panel would at least be objective in interpreting the data, whereas the urologists have a financial incentive to be biased--note that I said "biased," not dishonest. It’s also true that a person just naturally tends to believe in what he does all day. For example, Peggy is a nurse, and if the government had also announced that some standard nursing procedure did more harm than good, I’ve no doubt but what the nurses would be as enraged as the urologists. It’s hard to admit to yourself that you’ve been hurting people for years while trying to help them. Yet, none of this necessarily means that the government is right and the urologists wrong, nor does it take away my own doctor's power to influence my decision making. If I trust a doctor, I will generally do what he saysI just might not do it right away.

I’ve grown accustomed to orthopedists and neurologists, but this was my first urologist. Peggy went with me to the doctor as she always does (I do the same for her). She usually sits in the corner and says little, but today she sat between the doctor and me and read from a list of questions she had prepared and had me type. My first observation was that the waiting room was filled with old men, some with their wives, and I felt like I had walked into my next new club—Old Fuckers Who Dribble. I had known for some time that age would bring increased pain (even children know that it brings increased disability), but I hadn’t considered the indignities of aging. Old people have the kind of problems that gross out young people who are themselves certain that they will never have them. I reflect upon the fact that these indignities come to everyone if they live long enough, and this enables me to better accept them. Then too, death seems so near at times that nothing much matters to me anymore other than the fact that I have to fight to stay alive because I don’t want to leave Peggy alone.

I was prepared to mistrust Doug because statistics go against me trusting any new doctor (which is why I cling to the ones I do trust). He also works in a clinic with lots of other urologists, and I expect large clinics to be impersonal, rigid, and take a one-size-fits-all approach. As it turned out, I’ve never had a better first impression of a doctor. Changing doctors is a pain in the butt, so this meant a lot to me. He said that my odds of having cancer are 25-35% and suggested that I either go ahead and have a biopsy or, if I’m on the fence about the biopsy (prostate biopsies are another big deal kind of biopsy), that I have a blood test called a “free PSA” and base my decision upon the results. I jumped at the PSA. I don’t need government reports to tell me that I live in a test-happy/surgery-happy society in which I don’t dare subject myself to risk without doing what I can to avoid it or at least mitigate it.

Peggy and I have long agreed that it would be better for me to have cancer than for her to have it because she's so terribly afraid of it. She also fears death more than I. Yet as I see it, the one who dies has things relatively easy because the survivor will have suffered with him or her until the end at which time the survivor will embark upon an an even worse period of suffering while alone. I’ve always had doubts that I would survive without Peggy, but I always thought she would pull it together without me. To my surprise, things right now are so hard for her that I’m unable to console her. Yet, I’ve seen her handle loss before, and she always pulled herself together, so I think it likely that she will get her sea legs under her this time too.

It’s interesting how unpredictable Peggy is to me even after 41 years. Of course, none of us really know how strong we will be until we’ve been tested, and that’s mostly hindsight. Each new bad situation is never quite what I expected. There’s always fear, pain, anger, despair, and so forth, but it’s never the same fear, pain, anger, and despair because no two situations are ever the same. I’m not the same either, but at least I’m tougher than I used to be. Now, I just try to sit quietly and watch it all go by. 33,000 Americans die of prostate cancer each year, and another one is diagnosed every two minutes. I think of each of those men as being all alone in his own movie theater, just as I am all alone in mine. It’s the human condition. We can never feel another person’s life from the inside, so we are forever separate.

I’ve already gone through so much that a little more isn’t likely to hurt me unless there’s some unfortunate medical outcome. With every new ailment, there are new and interesting things to learn, and the tests and surgeries are often quite interesting too once you get past the fact that you might bleed a lot, will probably be in pain, will be exposed to noxious substances, and might very well die. I have grown increasingly able to make the best decision I can and to let it go at that, although I’ve lost faith that everything will go right because it's usually the case that so many things can go wrong, that there’s a pretty good chance that one or more of them will go wrong.

I panicked when I realized what a crapshoot modern medicine is even when everyone performs at their peak, but I’ve gradually grown fatalistic. The worst part is when I’m having trouble deciding what to do. For now, I know. If the free PSA test comes back bad, I’ll have the biopsy. That’s as far as it makes sense to plan right now. Yet, it’s emotionally hard to stop studying, and the subject is interesting if wearisome. 

18 comments:

The Bipolar Diva said...

We went through a couple of prostate cancer scares with Jeff. In the first one the ER doc, dumb ass, told my husband, based on his PSA level, that he had advanced, incurable cancer. Turns out he just had an infection. He was on antibiotics for the better part of a year and all was well. Then it happened again, and again it was only an infection. He does tend to have prostate problems...his urologist said Jeff's prostate has it's own zip code because it's so large, but he's cancer free. You damned well better keep me informed!

The Elephant's Child said...

Poor Peggy. Worrying about someone else is just awful. Particularly when your worry can't change anything and any necessary action is in someone else's hands. I find that frustrating and frightening as well.

I am very pleased that your initial impressions about your urologist were positive. I find that makes a heap of difference.
I hope that the blood test means no further action is called for, but please let us know either way.
Sending many, many good wishes to you and Peggy.

All Consuming said...

" I had walked into my next new club—Old Fuckers Who Dribble" - As usual you post had me laughing in parts but was also quite sobering too. I've had all dignity stripped of me over the years, partly due to the awful standard of care, and partly due to the fact that, when your condition is such that you are dribbling in public, have your arse out, have bits of your insides shoved outside you body for crowds of junior to goggle at. It's easier for me to face the fact that I'll be there when I'm older because of that I think. Although it all sounds like hell on s stick, I'm glad to hear the percentage of the chance of you having cancer is that low. Keep your chin up and give Peggy lots of cuddles. xx

Marion said...

Ahh, Snow, this is so tough for both you and Peggy. Of course, I hope the blood test comes back with good results. I know four men who have had prostate cancer...only one took a few months to recover, while the others were well very quickly.

Please give Peggy a huge hug from me...I'll be thinking of you both. xx

Charles Gramlich said...

Lana has been going through that studying phase as well. And we've had our share of doctors who couldn't be trusted. I so wish the state of health care wasn't so byzantine.

Carolyn said...

Snowbrush, I realize from past remarks you aren't open to alternative healing methods but it won't hurt for you to read about this Italian doctor and his treatment for cancers.

http://www.curenaturalicancro.com/therapy-simoncini-short.html

I'm a firm believer and user of soda. Keeping the door closed causes one to never know what may be behind it. As you may have read in my posts, my brother lived through some excruciating times having colorectal cancer two years ago. I had little hope for him but he is gaining ground every day and doing fairly well. Most days he stays busy working on his son's house with a break for a fishing trip once in awhile. Let's hope your test shows you clean of any 'heavy duty problems'. I too have a horror of cancer but try not to worry about developing it someday. Attitude certainly figures strongly into our heath status, as I've learned over time.

A very well written post here. Is it an edited exercise or your streaming consciousness? I can't tell but I sure enjoy reading you.

Snowbrush said...

"I realize from past remarks you aren't open to alternative healing methods"

That's too broad a brush you're using. I just like to have scientific evidence that a treatment will work before I lay out money for it. In the absence of such evidence, it's good if it at least makes sense, and many of these alternatives don't (homeopathic remedies and craniosacral therapy, for example). That said, if there's no proof and the treatment doesn't make sense, I might still try it if it's cheap and harmless (I wore magnets for awhile). I looked at the link, and noticed that it contains an ad for Oregon's Knight Cancer Center (named after Phil Knight of Nike fame) at Oregon Health Sciences University, which is a cutting edge place regarding scientific treatment for a number of things. I have no knowledge regarding baking soda as a cancer treatment (it rather sounds like one of those ideas that's just too good to be true), and I hadn't heard that fungi caused cancer (neither had the American Cancer Society), but I guess that if I had no other reasonable options, I would look into it more. Right now, I would be getting ahead of myself.

"we've had our share of doctors who couldn't be trusted."

People who haven't been through it just don't know how bad it is. When you're hurting and frightened, you rather expect that the people you go to for help will treat you with compassion, but they often act a bit bored and even annoyed that you're taking so much of their time. And then theres' the fact that your options are often limited with none of them sounding good.

"I've had all dignity stripped of me over the years..."

Yes, marriage can do that. Oh, wait, you mean by modern medicine! It can do that too.

Thanks, Child, for your well-wishes. I really appreciate them.

middle child said...

Hey Snow! Read your own comment at the end of comments and you pretty much covered what I was going to say.
I always tell everyone to get all the information they can. That way they are able to make an informed decision. And everyone involved should respect that decision.
Wishing you peace.

Snowbrush said...

"And everyone involved should respect that decision."

There's always the desire for safer and more effective options, and modern medicine kills people everyday, but I think it's probably the best we've got.

"As usual you post had me laughing in parts..."

I have no idea that most people can even tell when I'm being humorous. Then again, if not for a little humor from time to time, why would anyone read this blog because it's frequently heavy? As I see it, there has to be some relief from that.

Mim said...

OFWD. A wonderful new acronym.

Old age ain't for sissies. Sometimes I look at the young and think "haha - it doesn't last long suckers - enjoy it while you got it".

I hope your free PSA is normal. Hugs to Peggy

rhymeswithplague said...

Both my mother and my father died of cancer, so I had quite a fear of going the same way. until I had mononucleosis back in 1976. The doctor said, almost as a throwaway line, "You'll probably never have cancer or leukemia." When I questioned him (my memory is a bit fuzzy here) he said something about the mono acting almost like an immunization against cancer and no leukemia patient had ever hada history of mononucleosis. I don't know whether the guy knew what he was talking about, but my fear of cancer left me, just like that. I am objective enough to know that I may still one day die of cancer, but fearing it went out the window that day. Silly, I know, but it is a true story.

Maybe I misinterpreted your sentence "I've seen her handle grief before" but to say she is grieving at this point is a bit premature. It's just that old fear and all the "what ifs" involved. She shouldn't give up. Easier said than done, I know.

I love you, Snow, and you know me well enough by now to know I must tell you something, which you can either ignore or treat as a lifeline: "For as in Adam all die, even so in Christ shall all be made alive." (Paul to the Corinthians in First Corinthians, chapter 15). And no, I have no scientific evidence.

Strayer said...

My father got it in his later years and somehow got some experimental treatment where he wore something that delivered chemo or radiation directly to his prostate in small doses for a few months. He reported no side affects and his cancer was quickly gone.

Snowbrush said...

Thanks, Mim.

"to say she is grieving at this point is a bit premature."

I changed the word to loss, although the fear of someone dying does strongly resemble the grief of them having died.

"I love you, Snow"

Oy, you're getting mushy, so I know I must be in real trouble. Seriously, thank you.

"'For as in Adam all die, even so in Christ shall all be made alive.' And no, I have no scientific evidence."

Or even historical evidence. In fact, there is no evidence of any kind, yet you believe it, and you would have me believe you. My mind reels.

"He reported no side affects and his cancer was quickly gone."

Unless it's an aggressive cancer that has metastasized, my odds of survival are excellent--and that's assuming I even have cancer. I know that radiation beads have been implanted, so I suppose that's what your father had.

lotta joy said...

When I was 39 I was dying and the doctor kept me alive by giving me an ileostomy.

The first UOA (United Ostomy Association) meeting I attended was FULL of crypt keepers and I ran out. An ileostomy is bad enough at age 39, but to be thrown into the social security group was too much and I bawled my head off, then got on with business.

Through the years, I've had a number of "something wicked this way comes" auto-immune diseases wanting to kill me, but my only fear is of cancer.

I always feared having to make the choice of chemo or cancer. LUCKILY *insert chuckle* all my auto-immune diseases preclude having chemo.

Now I won't have to listen to everyone saying "tsk. tsk. Aunt Helen's neighbor's cousin took chemo and is still alive".

I understand Peggy's fear. If the number of diseases I have counts for anything, I'll be going first and leaving my husband to clean up the mess.

CreekHiker / HollysFolly said...

Snow, Still hoping for the best. I too understand Peggy's fear. I've seen my sister go through so much with her breast cancer that when I had a strange "shadow" on my own mammogram (I had tripped walking the dog and landed on a boob!), I sobbed so hard they could barely perform the sonogram!

If it does come back bad... please look into proton radiation... It was developed as a way to treat prostate cancer and I've seen many miracles performed with this radiation!

Ed Pilolla said...

you have really thought through the psa information, and articulated the motivations very well. when i was a kid i remember telling my dad i didn't want to get old. he was like, it's better than the alternative. that's one of those one-and-done conversations. doesn't it make sense that the majority of poor people are elderly and disabled? other cultures have multi-generational living, and that's where we're headed here, i hope.
i hope the test comes back well.

Helen said...

... just thinking about you this Sunday afternoon, wishing you a good week!

RNSANE said...

I haven't visited for awhile, Snow, and I am sad to read of this latest turn of events. Several of my friends have gone through this prostate cancer business in recent years...two physicians who waited far too long to seek treatment and a forensic toxicologist friend who also did the same. What is it about those in the medical fields! I am glad you are taking the best care of yourself possible and I pray that all goes well for you and Peggy. 41 years, huh....amazing, I think.

I enjoyed my four months in India and am going back for six months after only 2-1/2 months at home. It is a strange country...such overwhelming poverty but people would give you the last bite of food on their plates. You may not be a movie goer but you and Peggy should see, "The Best Exotic Marigold Hotel" - it really was a delightful movie, filmed in one of my favorite parts of India.

I'm cheering you on, Snow.