Involved
I was in Toronto yesterday to be with my dad as he got news of two scans done to see how far along his prostate cancer is. It could have been worse, but not by much.
Both CAT and bone scans showed that the cancer has spread to dad’s bones. “The bones are involved,†in oncology-speak. A variety of sites – the spine, the pelvis – others.
Also, the CAT scan lit up some lymph nodes – which wouldn’t normally be visible, I’m told – though they’re not big enough to consider cancerous right now. Something else to scan and monitor.
So we’re heading to hormone treatment. Some sort of tablets for two weeks then an injection once per month, then every three months.
So it’s Stage Four. How long’s he got? That too depends on how the hormone therapy goes.
If it goes well, it sends his PSA levels down to next-to-nothing and he should be able to pee normally, will gain weight and energy and he could have from five to seven years.
If it goes poorly, the PSA levels go down, but then come back up again and he’s got two to three years.
This sounds grim but ‘bad’ with prostate cancer is still pretty good compared to ‘bad’ with lung cancer where stage four life expectancy is measured in months.
So that’s the question of ‘how long has he got.’ Now the much more complicated and uncomfortable question of ‘how long does he want?’
Because of course, he’s 72, the treatment has side effects and “we all have to go some time.” My vote is definitely for “later”.
We had an intermission between doctors appointments and dad was contemplating the treatment and its side effects.
He was wondering if the cure was worse than the disease. “After all, my biggest problem now is that I’m tired all the time and from they’re saying, I imagine that the therapy is just going to make that worse.”
Fatigue is meant to be a side effect, but, I pointed out, if it fought off the cancer he would find himself with more energy.
The head oncologist said patients’ experience of the side effects ranges from the unnoticable to the unbearable. In addition to hot flushes and fatigue, you also have to deal with:
- weakened bones and osteoporosis
- increased risk of arterial sclerosis
- erectile disfunction
But all in all, that has the potential to be far less dreadful than your average breast cancer regimen. So here’s hoping that he gets the kind where the PSA levels disappear and he barely notices the hormone therapy (apart from a change in taste in movies).
So I don’t know what to do now. He started the pills yesterday, will go in for an injection in a couple of weeks, and may experience a sharp hit of bone pain as his testosterone levels start to fall.
They want him to quit smoking and drinking. There’s lots of questions – should he stay in town? Should he live at the farm and sell his business? I have my answer, but I’m not him.
Around mom’s illness he always seemed to be of the “suck it up and do whatever to live as long as possible” school, as opposed to the “live as comfortably as you can for as long as you have” school. What approach will he take to his own situation?
Being a cancer patient will frustrate him immensely. As the oncologists were rattling off all the things that could happen both as the disease progresses and as the treatment causes its collateral damage, I was keeping a loose running tally of all the tests required to monitor and fix problems.
He’s spent at least a day thusfar – maybe three – hanging out in hospital waiting rooms, waiting to see specialists, waiting for tests, having scans, etc etc. And then there’s the homework: preparation regimens for the various scans and what not can be arduous if not sadistic: drink four litres of chemical-orange-flavoured wallpaper paste and no eating or drinking, breathe only if you must.
I don’t know if he realizes it but he’s about to take on a second full-time job.
I welcome tips on how to deal with the waits apart from my usual “patiently lay seige to the place and bring a book” because I don’t think that’s going to work for him.
May 15th, 2008 at 12:00 am
I'm very sorry to hear this Chris. Let us know if there is anything you guys need. We'll be there!Soha
May 15th, 2008 at 12:00 am
Chris, sorry to hear about the news. I'm here for you too..Hang in there.Myk
May 15th, 2008 at 2:44 pm
Chris, I am so sorry this is happening.
One thing I can speak to is the waiting and I suggest loading up an mp3 player with music he loves or talking books. This serves the dual purpose of passing the time and blocking out stressful sounds coming from the stressed out people around him. Of course, you run the risk of not hearing your name called (some of us will always find something to stress out about) but I would think that nurses and techs are used to having to repeat themselves. Your dad will probably resist taking up knitting but that would really help keep his smoker’s hands busy. ;-) Carrot sticks to gnaw on? Also some people find magazine’s easier to read (they require less concentration). Is there some mag to which your dad has always wanted to subscribe?
Finally, this isn’t true for everyone but I find it helpful to have distracting company most of the time. Is there someone who lives close that you or your dad could ask to provide this support?
Take good care (and your dad, too),
L.
xox
May 15th, 2008 at 4:28 pm
Laurie makes a good point about company, alot of folks bring a buddy to hospital appointments. Even though I’m an extreme extrovert I didn’t usually invite a side-kick along. I *did* like to get a coffee when I could manage it. I tried to pretend I was a lady of leisure instead of an out-patient.
Is your dad the type to sit down or is he a putterer? Too bad whittling indoors is frowned upon.
Take care and thanks for sharing this.
~Jenn~
May 15th, 2008 at 5:37 pm
when my Dad was diagnosed with lung cancer – he was pretty introverted . someone went with him to all the appointments etc .. the timeline thing was much worse though – he was only coherent for about 6 weeks…
anyway he did get a bit of release with acupuncture – it helped him sleep which was an issue..
I am so sorry to hear you are going through this … my thoughts are with you and your family xom
May 16th, 2008 at 12:00 am
Sending big love.n.
May 16th, 2008 at 12:00 am
Thinking of you and your family Chris.. Mike
May 16th, 2008 at 12:00 am
Oh, I am so sorry to hear this.
May 16th, 2008 at 12:00 am
chris, sorry you're going through all of this. big hugs to you all.
May 16th, 2008 at 12:00 am
Chris, my wishes of strength, hope and resilience to you and your family.