It almost seems anti climatic. I have just passed 5 years cancer free. No hint of my prostate cancer. No serious effects of the surgery.

In light of current reports suggesting that no one be screened via PSA, I must say, " I'm glad I was screening and I am thrilled to have made the choice I made." I can't imagine living everyday knowing that there is a cancer eating away at me at and unknown rate. A veritable sword of Damocles, threatening to break loose at some unknown time, for some unknown reason and falling upon me.

That would make me something that I have never felt that I am, a victim. I feel like a heart attack survivor and now a Cancer survivor. But I have never felt like a victim.

Would I Do It Again?

It is hard to believe that three years have passed since my prostatectomy. I am still cancer free. I am less fit physically; but in better health. My Diabetes is under fantastic control with an A1C of 6. My LDL is 67 my HDL is 58 and Triglyceride is 75! PSA is .004 (negligible). BP is 120/70.

Additionally, I am enjoying my family and friends. My spirit is positive. The side effects I have are impossible for me to pin on a cause. It could be cardio meds, diabetes meds, BP meds, or surgery. I honestly don't know.

I do know that although I cannot do what I did eight years ago, before a heart attack, before diabetes, and before cancer, I can pretty well function as a man in his early sixties. I can't labor all day with the best of them, as I once did, but I can take care of myself and family.

My long bout with idiosyncratic constipation has finally ended. Without clinical proof, I believe it was started with very strong antibiotics and hydrocodone 7.50/750. It was finally ended with a month long course of pro-biotics. My intestinal flora are back in balance and moving.

There has been a lot of talk lately about the efficacy of screening for cancer of the prostate or other organs. I wonder who is behind the studies and analysis of old study data. Is it possible that they are funded by insurance companies? Are the doctors compensated now or have they ever been compensated by insurance companies? What are their political philosophies?

Another Six Months and ...

August 23, 2009 I checked the bicycles for a Labor Day trip to Michigan. I checked Sally's bike, inflated the tires and lubricated the chain, adjusted the brakes and rode it around the block. It worked good. Then I did the same for mine and rode it around the block. I got the bike rack out and mounted it on the truck and got the tie downs out. I am ready for Grand Haven!

Monday morning I had blood in my urine and a couple of clots floating in the bowl. I didn't have any pain of note. Just some mile 'awareness'. It became less each time I voided during the day. Tuesday onward I didn't see any and assumed it must be from the bike ride. I wasn't too alarmed other than to remember to mention it on my next visit with the doctor.

I have been in a diabetes study group for the insurance company. I don't know what that is for; but it has required closer monitoring. The insurance company has not paid me. They have required me to visit the doctor every three months for blood test and check up. So it has actually cost me more. But this time I was going to the doctor on Friday, August 28, and would mention the blood then.

The doctor ordered a urinalysis and PSA; it did show microscopic hematuria. If you see it with the naked eye it is gross hematuria. If it is detectable but not visible it is microscopic. He said a lot of people have that and it is probably nothing. He didn't think it was from the bike ride. He wanted to see me again in a week and we would check again.

So it was back to the doctor again on Friday, September 4. Another urinalysis, another positive for microscopic hematuria. The PSA was .004 (zero) so it isn't a return of adenocarcinoma of the prostate. Better go to the urologist to see what the continuing bleeding is from. Referral was ordered and I made an appointment for September 23, Wednesday.

They too found blood in the urine and asked for an abdominal and pelvic CT with and without contrast and a cystoscopy. Since I have BCBSIL HMO my urologist can't order tests. That means another trip to the Primary Care Physician. He ordered the tests and I waited for the referrals. Nothing by Friday so I called IPA and she said, "They are working on it right now. It will be ready by Tuesday, September 8, because of the holiday.

Wednesday, September 30, the imaging lab called to make an appointment. They had the referral and we are all set for the week after I return from my trip. We are going to my reunion and to visit family. (The trip was a blast)

The Scans were done. I got the cystoscopy. My urologist said I healed great. Except for the absence of the prostate you couldn't tell I had any work done in there. The scans were good. The old granulomas are unchanged, the one lymph node is unchanged and the Abdominal Aortic Aneurysm has not grown beyond 3.6 cm. I am cancer free and good for another six months. The bleeding was probably from riding the bicycle for the first time since the surgery. Adjust the seat to provide relief for the urethra and take it easy.

Keep up with your checkups. Live well and stay tuned.

Only One In Fifty

Here is an article in MSNBC on Prostate screening efficacy.

http://www.msnbc.msn.com/id/29745004/

If you read it, or if you have heard in the news lately, there is a circulating tale about screening. The story is that: the PSA blood test is of no benefit and may be a negative. DRE (digital rectal examination) is not a benefit, is embarrassing. Screening for Prostate cancer is not worth the cost, the embarrassment nor the harm.

Now a larger European study indicates a 20% improved survival. So the American studies release early to counter.

Read it for yourself and make-up your own mind. For my part, I am certain that I made the right choice. I am glad my doctor screened . I went to the doctor for my health. I didn't like having blood drawn. I didn't like getting poked in the bum. When the PSA was positive I was very apprehensive about the biopsy. I was thrilled the first time the biopsy was negative.

My doctor screened again and the PSA was elevated further. The DRE indicated that my prostate was smooth and still small. But the PSA warranted another visit to the urologist. We did another biopsy. It was positive.

I made the treatment choice. That is as it should be. My choice for surgery saved me from later treatment. The American proponents put forth the idea that my cancer may have been slow growing. They think I may not have needed to do anything. If I died at 73 I would only have suffered a short spell of symptoms. They may be okay with that; but I'm NOT.

My personal opinion is that the Insurance industry is behind the claim that screening does not save lives. For years it was touted that early detection made cures possible. Catch cancer before it metastasizes and before it gets out of hand, while it can be effectively treated.

Now they claim that is not true. That defies logic for me. I urge you to ask your doctor for screening. If they refuse then find a new doctor. I can assure you that having screened when I had no symptoms found cancer while still contained in the interior of my prostate. Removal of the prostate left me cancer free. Da Vinci robotic assisted surgery spared nerves and retained full function. I have no negative impact, save a small scar a bit over one inch below my umbilicus.

And when I see those advertisements on television for Flomax or Avodart, I know that I will NEVER have BPH or a need for those drugs. I won't be getting up multiple times per night to go. I won't be stopping my activities when out with friends to find a toilet. I don't see the negative.

If It Wasn't For Insurance ...

Well, it's been six months since my last follow-up. I've had no urinary issues at all. The plumbing is all working fine. All those things the urologist asks you about, good stream, good control, no issues with starting or stopping, etc. are great. PSA is 0.001! They apparently took all of my prostate and with it ALL of the cancer.

We will check again in six months. I couldn't be more satisfied with the outcome. There is no worry about a recurrence, metastatic cancer or as a bonus no future BPH (Benign Prostatic Hyperplasia). I am not going to have a need for Avodart or Flomax. I won't have a need for any of those uncomfortable prostate procedures. I have met some very skilled people who are a pleasure to talk with.

If you wonder why you have any issues with your insurance, remember they view themselves as financial companies. And we all know how well they are run. Get your checkups! It isn't embarrassing; it is science! And it's good for you! Contact me if you have any questions or just want to share your woes.

It Really Is Important

You shouldn't play George in Capra's "It's A Wonderful Life" thinking the world would be better off without you or that you don't matter. Do it for yourself, do it for a friend; Find a reason and get screened.

There is discussion now that PSA tests should not be done on men younger than fifty. And should not be done on men over fifty who are not for some reason in a high risk category. I don't understand that logic. It's as if 'they' are willing to lose one family member, of YOUR family, before the remainder of the family should be tested.

The argument is that the test does more harm than benefit. That isn't obvious to me. The claim is that a false positive result causes further testing with a TRUS or even a biopsy. The biopsy is slightly invasive and carries some risk in rare cases. But I don't understand not giving men a choice to test or to treat. If caught early you can be CURED. If not treated you MAY live fifteen years. Or it may be an aggressive form that will not give you fifteen years. But the final years will be hell.

Some argue that it is not imperative to treat immediately. In their argument, treatment may improve in several years to cure it later with far safer methods. They seem willing to make the bet with YOUR life that you will be treatable later or in fact may DIE of some other cause before you die of cancer. How BRAVE and generous of them.

Stay watchful and aware of the politics as well as the science of medicine. Especially your health.
Talk to your doctor about being screened soon.

August 6, 2008 Fifteen Months and Counting

Well, it's always something. I wanted to make an appointment with my primary care provider to get a blood draw for my PSA and A1C. Should be a snap after six years with her. But nooooo.

My doctor, whom I loved, left the group and they just said it was her choice. But, they have two doctors there to replace her and ... Oh wait a minute, they don't take your insurance "administrator". Yes they take my insurance but not through that admin group. But I can just call BCBSIL Customer Service.

No, you can't switch. The BCBSIL offers two HMO plans. They are both the same coverage, the same co-pay, the same drugs. One is about sixty dollars a month less. So of course I chose the one cheaper. OH, I see said the blind man. The difference is that the cheaper one has fewer doctors. All on HMO Illinois did not sign up on BLUE Advantage. And the Administrative group the new doctors are on don't accept BLUE Advantage. So I cannot switch.

I searched the Internet and found my original doctor very near. When I called the office the receptionist said, "Sure, just come in." Not so fast Maria. I didn't see my insurance on the web site and need to verify that first. Well she can't do that. She will have the office manager call me back.

Two days later I get the call. They do take BCBSIL but not with Tri-country (sic) claim administrator group. They only work through Advocate. (same as the 'new' doctors at the old medical group) And I can't switch to Advocate. In the Fall during open enrollment, I could select HMO Illinois and select Advocate. Just pay the extra sixty dollars, if it is still just sixty dollars. Or who knows if the offer will be the same companies.

The hoops you have to jump through are worse that the illness and treatment. Hopefully the insurance and doctor selection will work out as well as the health issues.

I went to another doctor in the medical group I've been with and had the blood tests. It went well. The referral is done and I was all set for my visit to the urologist.

That visit was easy and without issues. The PSA is perfect. There is no sign of cancer from the prostate. I have no issues to speak of. I am totally continent and without urinary problems. Good enough that I don't need to follow-up for six months.