GLOUCESTER CITY, NJ (December 5, 2022)(CNBNewsnet)--This past May, I received a call from my doctor's office that I needed to see a specialist because my prostate-specific-antigen or PSA test results were high. A high PSA is one of the signs of prostate cancer. As soon as I heard that the level was high, my thoughts went to my brother and father, whom both had prostate cancer. Prostate cancer is hereditary and is slow growing. Some of the telltale signs of that cancer include:
- Blood in urine
- Blood in semen
- Unexplained weight loss
- Erectile dysfunction
- Bone pain (typically associated with advanced prostate cancer)
- A weak urine stream
- Needing to pee more frequently, often during the night
Twelve years ago, I was diagnosed with kidney cancer. Fox Chase urologist Robert Uzzo removed the tumor.
Fortunately for me, the biopsy of the tumor revealed that it wasn't cancer. But, Dr. Uzzo found another tumor on my adrenal gland during that operation that didn't show up in any of the x-rays. Over the past 12 years, further testing has shown that the tumor hasn't grown.
There are three words a doctor can say that will crush most people, and they are “You got cancer." I had a feeling that I would hear that sentence shortly. In June, another PSA test was taken at Fox Chase, which led to an MRI of the prostate in July and a prostate biopsy at the end of August. Both the MRI and the biopsy results confirmed that the tumor was cancerous. It was aggressive but localized to my prostate; in other words, it hadn't metastatic. That was the good news; the bad news was that my cancer had a Gleason score of 8 and a Grade of 4. Those numbers meant little to me until the doctor explained their significance. Referring to the Prostate Foundation graph below, my cancer would fall into the High/Very High category.
According to the Prostate Foundation, a critical component of staging your cancer is the grade of cancer. While the stage of your tumor looks at where the cancer is present in your body (how it is behaving at the macro level), the grade describes what the actual cancer cells look like under a microscope (how they are acting at the micro level).
image courtesy of PennMedicine
Proton therapy, also known as proton beam therapy, is a type of radiation therapy that uses high-energy protons (positively charged atoms) to damage the DNA in cancer cells. This type of cancer treatment is non-invasive, painless and precise. By targeting the genetics of the cancer cells, it destroys them and prevents them from multiplying.
Looking for a second opinion, I contacted the Penn Abramson Cancer Center in Philadelphia. An appointment was made with Dr. Arum Goel. Penn also offers a reasonably new cancer
treatment called Proton Therapy. That treatment consists of external beam radiation that can treat prostate cancer tumors with a stream of protons (small, positively charged partnstead) of X-rays. They also use hormones in the treatment.
This radiation kills prostate cancer cells by altering the genetic material that controls minorlls growth and divide with minor damage to nearby tissues. Ultimately, this means that cancer cells are targeted, and healthy tissue is impacted less compared to other treatment options available.
In October, I met with Dr. Goel, an Assistant Professor of Clinical Radiation Oncology. He treats prostate cancer as well as numerous other cancers.
One of the side effects of hormone (androgens) therapy is enlarged breasts. Hearing that was a shock to my system. Thinking that I might have to wear a bra if my breast got large, I took a moment when Connie went out to try on one of hers. I don't know how women wear those things; it was very uncomfortable. Right there and then, I decided if my breast did grow, I would go braless.
Because androgens affect many other organs besides the prostate, ADT can have a wide range of side effects, including:
- loss of interest in sex (lowered libido)
- erectile dysfunction
- hot flashes
- loss of bone density
- bone fractures
- loss of muscle mass and physical strength
- changes in blood lipids
- insulin resistance
- weight gain
- mood swings
- growth of breast tissue (gynecomastia)
As I feared the side effects, I decided to take the pill. You can receive the hormones by a needle that lasts for three months or take medication once a day. If I took the needle and developed a side effect, I would have to wait three months for the drug to leave my system. With the pill, the medicine would be gone in 24 hours.
The cost of these drugs is not cheap. A Google search revealed a single shot of Lupron Depot, (leuprolide) could cost as much as $35,414 for the first and $38,398 for the second. The newest drug is a pill, relugolix (Orgovyx). I started that pill 25 days ago. My PSA dropped from 7.170 in October to 0.487, and my testosterone went from 380 to <20. Marijuana also lowers testosterone.
Orgovyx is also expensive. My insurance carrier initially told me they would not pay the $2600 for the 30-day supply. A few days later, I was told they would pay all but the $700 co-pay. My doctors want me to take it for two years. Thanks to a friend who found a coupon that cut the cost to $10 and Dr. Jason Shpilsky, one of the doctors treating me, I got a two-month supply for free.
Tomorrow, Tuesday, I begin my 28-day radiation treatment regime at the Perelman Center for Advance Medicine. The process takes 90 minutes. Am I afraid? I am. Anyone who would say they are not trepidatious would be lying. I don't know how my body will react to the radiation. I am told the side effects are minimal, but everyone is different. Someone said I don't have to worry about losing my hair since I am already bald, which is a good point.
I hope and pray this will be the last time I have to deal with this terrible disease. I am delighted that after all these months, I am finally on the backside of this unpleasant experience. After tomorrow there will be only 27 more days of treatment.
I (you) have no control over tomorrow; what happens is in God's hands. As the saying /song goes, Take One Day At A Time. That thought has helped me in the past and will help me in the days to come.
Thank you to everyone who has said or will say a prayer for me. I got this, don't worry.
As far as CNBNews, I have no intention of stepping down. As long as I have breath left in my body, I will continue reporting the news during and after this process.