The Cancer Diaries, Part 28

This month marks a year since my biopsy that indicated I had an aggressive form of prostate cancer. It’s been quite a year for me, easily the most stressful and challenging of my life. The challenges of dealing with cancer were compounded by the pandemic that spawned lockdowns and restrictive access protocols that soon became a regular part of my and everyone else’s life.

This anniversary is not a celebration, simply a recognition, although Susan and I have raised a glass to my having survived. There are many more people who have not survived their cancer. I am one of the fortunate ones.

I still shudder when thinking about the biopsy, a process both painful and humiliating, albeit necessary. A sampling of 12 pieces taken from my prostate (and I counted every one of them as it was being done) showed ten of them were cancerous. That’s very, very high. I learned of my cancer barely six months after my closest friend had died of another cancer. It was disheartening, to say the least

Once the results were known and the urgency explained to me, my surgery was quickly arranged (barely a month later). The cancer was too far along for subtler treatments, as I’ve explained in earlier posts. . I spent far too much time contemplating my mortality back then. At 70, with cancer, it loomed all too close.

In early July I had a radical prostatectomy. I suppose there’s something to be said for having no prostate: I won’t have to suffer the same biopsy process in future. But there were other, less salubrious effects of the removal.

Once I recovered sufficiently (and had shed my catheter and urine bag), I was given hormone (via injection) and then radiation therapy. The latter lasted seven weeks, every weekday into the early part of January of this year. The former still affects me, as I’ve written in the past.

From surgery to the end of the radiation treatment was an intense, sometimes demoralizing, sometimes depressing, always stressful period of six months. Winter just made it seem darker. Four months later, as the spring brings new life and warmth to the region, I’m feeling optimistic. Cautiously, but optimistic nonetheless.

Last month, I had another PSA (prostate serum analysis) blood test, something I’ll be having every six months for the foreseeable future. I then had phone consultations with both my oncologist (at RVH) and my urologist (in Barrie) about the results and my future.

My PSA, I am delighted to report, is low enough to be undetectable, and that suggests I am recovering cancer-free. That isn’t a sure thing, of course, because cancer doesn’t obey all the rules or behave predictably. I will always have to be tested and examined for signs of its resurgence and metastasizing. But I will not dwell on the negative possibilities.

Even my intestines — which suffered more than any other organ — seem to be getting over the effects from radiation, although they will take somewhat more time to get fully past the atomic blasts. Still, it’s another reason to be optimistic.

Both my doctors concurred in something I wanted to hear: I can be weaned off the hormones. I had expected to be on them for at least the remainder of the year. This will allow my body to slowly recover its natural testosterone balance but will take upwards of a year for that to work itself out. In the meantime, the hot flashes still affect my daily life and most of all, my sleep.

While it’s too late for me, there are new therapies and treatments being developed to manage or even cure prostate cancer. I look for news about them online every week. According to a recent story on Medical Express,

Using a technique called epigenetic reprogramming, investigators altered the tumor and tumor microenvironment by inhibiting expression of a protein known as enhancer of zeste homolog2, or EZH2, which is found at high levels in prostate cancer. This protein helps tumors resist checkpoint inhibitor immunotherapies, which are designed to block certain other proteins that can stop immune cells from killing cancer cells.
…
The researchers’ study findings hold the potential for personalized treatment approaches going forward, which may include combined regimens of EZH2 inhibitors and checkpoint inhibitors as a novel strategy to increase prostate cancer response to checkpoint immunotherapy.

I don’t know how long it might take for new, less invasive treatments to become available, but I hope that in the very near future, men with prostate cancer will be able to receive a vaccination that resolves their cancer and that surgeries (especially radical prostatectomies like I had) will become a thing of the past.

I will post updates in the future as I slowly continue to recover and my future test results are known, but for the next several months I expect this will be the last post in the Cancer Diaries until the next test and consultation. Thanks for following my journey.