by Tom Dirsa
I have always considered myself quite fortunate when it comes to my body’s health. To date I still have all my body parts that I arrived with including my tonsils and appendix. As a teacher and school administrator I worked in an environment that was constantly deluged with flu bugs but rarely came down with the flu even without having a flu shot.
When I turned fifty I began to celebrate my birthday with an annual visit to my family doctor for a physical. Then just before I turned sixty we began to notice a shortness of breath and an EKG showed I had developed a heart murmur. To make a long story short we discovered that the wall of my mitral value had pulled away causing a serious backwash of the blood flowing through the heart. During another more extensive examination a further discovery showed that five of my six arteries supplying blood to the heart were anywhere from 40 to 100 percent blocked! When asked why I had not suffered from a heart attack due to the artery that was 100 percent block the doctor told me my body had built a number of capillaries to bypass the blockage.
The good news is that I never felt any pain from the blockage and the bad news was that if it was not repaired then a sudden increase in activity could result in a deadly incident. So shortly after 9/11 I found myself preparing for a heart operation and six weeks later I returned to my job as principal and was walking down the hallways of my school.
Now what does all this has to do with cancer? As part of the moderating of my heart every three months they tested my blood for cholesterol levels. My family doctor decided to also throw in a check on my prostate-specific antigen (PSA) level as well. For years my PSA level sat in the 3 to 4 range, which is considered within the normal range and my yearly physical was also negative regarding my prostrate.
Then a little over three years ago my PSA level began to climb into the 6 to 8 range and my prostrate showed it wasn’t as soft as previous exams had indicated. An appointment with an urologist was arranged and an entirely new world was opened where we learned things we had hoped to have never have to become familiar with.
We learned that around 24,000 Canadian men get diagnosed with prostrate cancer every year and 4,000 each year die from the disease. We learned that there are four stages of prostrate cancer and that most men would die of other things, had the prostrate cancer not been detected. We discovered what a Gleason score was and why a biopsy is required to determine the level of the cancer.
In our first meeting with the urologist after all the tests were completed he explained the various courses of action we could take from active surveillance to the various, more aggressive treatments. It seems that prostrate cancer has four stages called T1, T2, T3, and T4. T1 and T2 are for cancers that have remained within the prostrate and have not migrated beyond. T3 and T4 are more serious in that they have “left the building” and have spread to other parts of the body, usually into nearby bones or the lymph node system. Our doctor did an excellent job of explaining the various stages and the options available for treatment. To our relief our tests showed us to be in the T1/T2 stage and we decided that active surveillance was the best option.
For over a year we had regular PSA tests taken every three months and noticed that the PSA levels were slowly increasing and when the level reached the mid teens in the Fall of 2014 it was time to re-evaluate if we should take a more active approach.
A biopsy and ultrasound revealed that the cancer was still contained within the prostrate but it had increased to the T2 stage. I have always been a proactive individual and was no longer willing to sit around to see what could happen. After reviewing all the options available to us we decided to enter a study that used brachytherapy.
This approach has three stages. The first was the use of hormone therapy, which we started at the beginning of 2015. Hormone therapy reduces testosterone from reaching the prostate as the cancer cells rely on testosterone to grow. Stop the supply and the cancer slows down and might even die.
Then stage two was a series of 25 daily radiation treatments that began in late February and concluded last week. The use of an external radiation beam is a bit like using a shotgun. Most of the target gets hit but some of the pellets can miss and hit other objects. One of the reasons that radiation has been found effective is that healthy cells have the ability to repair themselves from the deadly affects of radiation but cancer cells do not have this ability and it destroys cancer cells ability to reproduce. There is a tradition that at the end of your external radiation treatments you can ring a bell three times to let everyone know you have completed your treatments. Last Thursday I had that privilege.
The third stage will occur next week when 70 to 150 low dose-rate (LDR) seeds are implanted into my prostrate. Because these radioactive seeds are implanted directly into the cancer they deliver high doses of radiation without affecting the healthy tissue surrounding the cancer cells unlike the recent conventional radiation we received.
The seeds will dissipate in a few months but there are some interesting side affects. One is that the seeds are encased in titanium and we will be required to show a card indicating that fact every time we walk through an airline metal detector. Also for the first few months we will be “hot” and will have to avoid holding babies on our lap. Fortunately all our grandchildren are well beyond their baby bouncing years.
So hopefully by using the three strike method we will be able to strike out my prostrate cancer.
We wrote this article because we have become aware that too many men take the attitude that it “can’t happen to me” and do not do the simple things that could detect a situation before it becomes a major problem. One of my favorite writers, Vince Flynn, died from prostrate cancer in 2013. He was 47 years old! So it can happen to anyone, you don’t need to be an “old man” to get it. So please use your birthdate as a time to have your body checked out and get a simple PSA test once a year. I’m glad I did. We will provide an update later on down the line. Oh my PSA levels are now in the 6 range and dropping.