February 18, 2017

Today marks the 8th annivery of my last cancer treatment and I continue to be cancer free.  My blessings continue as well!

February 18, 2014

Today marks my 5 year anniversary. Five years since my last treatment and no signs of  cancer. Thanks for joining me on this journey! I am truly blessed and happy. Operation Hope Beating Prostate Cancer is over.

The End!

February 18, 2013

Well today is my anniversary. It has been 4 years since my last treatment and I continue to be cancer free. One more year until it is official from a medical perspective. It has been a while since my last post. In my  case no news has been good news. My doctor visits have been mostly uneventful. The roughest part is visiting The City of Hope and seeing people much sicker than me. I bought a T- shirt on one of my visits with the words "Cancer Sucks". It is a reminder of my journey. 

I have had check ups every 6 months. (I am so tired of needles)  My last visit was  October 2012 and  my PSA levels have remained very low. My doctor continues to praise my progress and the anomaly of me having very little side effects.  So much so that I don't see him again until September 2013. Well that assumes that I don't run into him at the golf course again. (yes that has happened)

Anyway I appreciate all of the support and prayers from all of you on my distribution list. Today I am only going to do what makes me happy and so should you. That's how I will celebrate!

Peace,

Barron

July's Results 2011

I will keep this short.... in the words of my doctor "You are doing excellent". My PSA level remains at a constantly low level. So I am elated. I return to COH in January 2012 for another check up. This will be one month from the 3 year anniversary of my last treatment. I am cofident that things will remain constantly low and I will continue to be blessed. Thanks for your support and prayers.

Januarry 2011 Good News!!

Well it has been 2 years since my last treatment. (the actual anniverary date is February 18 to be exact) I had my second annual exam on Friday January 14, 2011. Annual exams are a little more involved. I approached the day with some anxiety thinking about the needles and the other elements of this full-on examination. But I am very happy to inform you that all went well. My PSA level dropped an impressive .28 points to .52!! The "normal" range is from 1.00 to 4.00. But for Black and Brown males a number above 2.00 is worthy of closer scruntiny. I will not bore you with the medical controversy that surround the PSA numbering measuring data.

Anyway, hearing the excellent news of my continual downward trend was very exciting and emotional for me. I had thoughts of how far I have come and all of the mile markers I have encountered during my journey. I am still basking in the glow of the wonderful news on Friday. That said, I am more than happy that my blessings continue and thanks for your support and prayers. One more exam in July and then hopefully I will be on an annual schedule. The goal is to reach my minimum level and establish that number as my benchmark for annual exams and then progress to a two year exam cycle. I am out..... and off to celebrate at a golf course!!!

Peace out until July!!

Two years and counting

Yesterday October 29th was my anniversary. It was two years ago yesterday when I go the news that I had cancer. The bad news stops there! Two years later and my blessings continue. I am fine and my PSA levels are as if I never had the big "C". I wish my golf score would drop this fast. That said I just thought I would share this since I have not posted any messages in a while. I don't return to my doctor until January 2011 so I'll holla in January.

PSA screening tests Pros and Cons!

This is a recent article from Fox News....You be the judge!

New advice from the American Cancer Society puts a sharper focus on the risks of prostate cancer screening, emphasizing that annual testing can lead to unnecessary biopsies and treatments that do more harm than good.
The cancer society does not recommend routine screening for most men, a stance that hasn't changed since the mid-1990s. But its new advice goes further, to warn of the limitations of the PSA blood test that millions of American men get now. It also says digital rectal exams should be optional, rather than part of a standard screening.
Prostate cancer is the most common cancer in American men other than skin cancer. The new advice is the latest example of experts casting doubt on the value of routine screenings in the hunt for early cancers.
However, not all doctors agree with the new prostate cancer screening guidelines.
Dr. David Samadi, a Fox News contributor and chief of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine in New York City, said he thinks the new guidelines could cause unnecessary deaths.
"In my practice, we find men in their 30s and 40s that are at high-risk and develop prostate cancer," Samadi said. "Knowing your PSA is power, it is educational; you follow it all the time. You can find a silent prostate cancer that will not affect you, and there is a possibility to over-diagnose, but that's a risk the patient needs to take. You could also find cancer that could lead to death."
The number of prostate cancer deaths continues to decline because of regular screening, Samadi added.
"I really recommend (the age) of 40 as a baseline age," Samadi said.
The recommendations come on the heels of a government task force's recommendation last year that most women don't need mammograms in their 40s. At about the same time, a doctors group said most women in their 20s don't need annual Pap tests.
American men have long been urged to have prostate cancer screenings, but over time, studies have suggested that most cancers found are so slow-growing that most men could have avoided treatment.
A statement from the American Urological Association said it also disagreed with the new guidelines.
"(This) may cause significant confusion for patients," according to the statement. "The AUA feels there is no single PSA standard that applies to all men, nor should there be."
The Atlanta-based cancer society is perhaps the most influential group in giving screening advice. Its new guidance released Wednesday on prostate cancer urges doctors to:
— Discuss the pros and cons of testing with their patients, including giving them written information or videos that discuss the likelihood of false test results and the side effects of treatment.
— Stop giving the rectal exam as a standard prostate cancer screening because it has not clearly shown a benefit, though it can remain an option.
— Use past PSA readings to determine how often followup tests are needed and to guide conversations about treatment.
Dr. Andrew M. Wolf, associate professor of Medicine at the University of Virginia Health System and chair of the Advisory Committee, agreed with the society.
"Two decades into the PSA era of prostate cancer screening, the overall value of early detection in reducing the morbidity and mortality from prostate cancer remains unclear," Wolf said.
"While early detection may reduce the likelihood of dying from prostate cancer, that benefit must be weighed against the serious risks associated with subsequent treatment, particularly the risk of treating men for cancers that would not have caused ill effects had they been left undetected."
Prostate cancer is the most common non-skin cancer in American men. An estimated 192,000 new cases and 27,000 deaths from it occurred last year in the United States.
But it is a slow-growing cancer in many cases, and depending on a man's age, he may be more likely to die of something else. Major studies have suggested routine screening doesn't save lives and often leads to worry and unnecessary treatment.
The Associated Press contributed to this article.

Almost One year now!

I am about to come up on one year since my last treatment. I was due for a visit in February. But due to changes with my job situation which impacted insurance coverage, I had my doctors visit and lab work one month (1/19/10) earlier than the originally scheduled date.

Bottom line my PSA continues to rapidly go south and with a treatment (APC) I had done in December, the side effects mentioned in an earlier post have diminished greatly. So in the words of my doctor, "You are doing excellent". So he does not need to see me for at least six months! My road to complete cure and recovery continues! Yahoo!!

Oh by the way if you are wondering what is APC? Google Argon Plasma Coagulation I will not bore you with the details and is not as bad as it sounds.

Good News!!

Just a quick note. On 11/12 I had a check up at COH to review my blood work and check my general progress. The good news is...better yet the excellent news is my PSA levels continue to drop and this time it was lower than the industry age dependent normal window of 2-4 ng/mL. This is super excellent the lower the better!! So this resulted in fist bumps galore between me, my doctor, and his assistant. This is a clear indication that the treatment is working and I am healing. The other good news is no more blood work until 2010! ( I hate needles) So my blessings continue. Additionally I received a prescription to address the side effects mentioned in my 10/30 posting. At this point I am noticing improvement. I now drive by my usual pit stops with welcomed disdain. Yahoo!!



I welcome your comments, happy holidays and we will chat next year if not sooner!!!

One Year Later

Well yesterday was the anniversary of me receiving the news that cancer was found. In addition to an initial "OMG" or something simular; as I have said the news was a mixed blessing. On one side no more biopsies and on the other hand now I know the mystery is over. So now what? What are my next steps? I must now formulate a game plan and put all of those months vetting this disease to work. So that is exactly what I did.

It's been 8 months since my last treatment and as expected, here comes some annoying side effects. Without giving to much information, I think I can be a virtual Mapquest for locating rest rooms any where between the valley and Pasadena. Oh and Imodium is my new best friend nowadays. But given the side effects associated with other more invasive treatments, I'll take the Imodium. Over time this will pass (no pun intended) and per my doctors I am doing better than most as my PSA levels continue to decrease.

Anyway just venting. My next doctors appointment is on 11/11/09. I continue to assume that it will be all good and I will keep you posted with a shout out after that visit.

My 6 months check up!!

Well it has been six months since my last Tomo Therapy treatment. So it was time for two hospital visits August 10th and 11th. I am happy to say that my doctors are pleased. My PSA readings are down considerably and the numbers are trending in the correct direction. As I heal I am starting to feel some expected but minimal side effects of the treatment. At the risk of giving TMI, I will not share specifics. I am just happy and blessed that by the accounts of my doctors, I continue to be exceptional especially as far as treatment side effects go.

As I mentioned I had to make two trips to the hospital. On each visit I had flashbacks of the 43+ trips I had to make. I began to feel somewhat depressed as I observed the sickness that surrounded me as I entered the hospital. As I waited to have my lab work done and the next day as I waited for my doctors it again resonated just how life really is so fragile and I am so very lucky. One particularly poignant moment was when I over heard the canned speech of the reception assistant checking in a lady and preparing her for her treatments. I could not help but think, " I remember that speech, been there done that and man I don't want to do it again". At any rate I am elated. That part of my journey is behind me now and I am doing fine. Things are going as planned and I get to have a happy birthday in a week or so.

I have to return in another 90 days for another check up, so I will update and give y'all a shout out in November. Peace out!

Monoclonal Recheck

This is just a $50 word for my 90 day follow up which included lab work. I am very happy to say that my PSA is clearly moving in the correct direction and is well within normal limits. Yahoo!! Those 43 treatments seem to be working. Again I am truly blessed and fortunate. During this journey I have had none to minimal side effects. Little if any of the fatigue, skin irritations, GI and other problems and dysfuntions most other patients seem to experience.

I return for another check up at the end of June. You will hear from me then!!

New prostate cancer drug Provenge

Study bolsters hopes for prostate cancer vaccine rejected by FDA
The vaccine, Provenge, extended life an average of four months, nearly twice as long as the best available chemotherapy, researchers say.
By Thomas H. Maugh II April 29, 2009
A controversial prostate cancer vaccine that previously had been rejected by the Food and Drug Administration improves survival of patients with the advanced form of the disease more than existing treatments and should be brought to market, researchers said Tuesday. The therapeutic vaccine, called Provenge, extended average survival by four months compared with a placebo, nearly twice as long as the best available chemotherapy, and increased three-year survival by 38%, researchers said at a Chicago meeting of the American Urological Assn.
"This is going to change the way we treat . . . metastatic prostate cancer," said Dr. David Penson, a urologist at USC's Norris Comprehensive Cancer Center. "Any patient who has this form of cancer, this is the drug they are going to want, and it is going to be first-line therapy.""This will be much easier for patients than going through chemotherapy because there are no side effects," added Dr. Stanton Gerson, director of the University Hospitals Ireland Cancer Center in Cleveland. Prostate cancer patients "have never had cell therapy or a vaccine as an option before. Now they will."Dr. Jonathan W. Simons, president of the Prostate Cancer Foundation, said in an e-mailed statement, "The results validate 16 years of modern research to harness a patient's own immune system to fight their prostate cancer."
Both Penson and Gerson participated in the study, but neither has financial links to Dendreon Corp. of Seattle, which developed Provenge. The foundation provided support for some of the initial research on the vaccine.As a therapeutic vaccine, Provenge is designed to treat the disease rather than prevent it. Physicians collect specialized immune cells called dendritic cells from the patient's blood, mix them with proteins collected from the surface of tumor cells and inject them back into the patient in three doses at two-week intervals.In a previous study released in 2007, Dendreon found that the vaccine increased survival in patients with metastatic disease by 18 weeks compared with patients given a placebo. After three years, 34% of those in the vaccine group survived, compared with 11% of those in the placebo group.An FDA advisory committee recommended that the vaccine be approved for marketing, but the FDA disagreed, arguing that the study did not provide evidence the vaccine slowed progression of tumors. The decisions provoked outrage among cancer patients. "Since 2007, I have watched men who could have been helped by Provenge suffer and die from prostate cancer," Thomas A. Farrington, founder and president of the Prostate Health Education Network, said in a statement. "I urge FDA to move as quickly as possible now to make Provenge available to patients."The new double-blind study involved 512 patients with advanced prostate cancer. Two-thirds received Provenge, and the rest received a placebo. Dr. Paul Schellhammer of Eastern Virginia Medical School in Norfolk, Va., said that median survival in the Provenge group was 26 months, compared with 22 months in the placebo group. That may seem like a short time, experts said, but drugs that provide shorter survival are routinely approved."The ability to boost survival for patients is the gold standard end point in prostate cancer clinical trials," said Dr. Ira D. Sharlip, a urologist at UC San Francisco, a spokesman for the urology association.The current treatment for such patients is Taxotere, known generically as docetaxel, which extends survival two to three months at most and has often-disabling side effects. Many men refuse to take it, Penson said. He has seen many patients taking it end up in a wheelchair from its side effects, which can include bone and muscle pain, allergic reactions, decreases in white and red blood cells, and neuropathy.But with Provenge, "they might have a little fever, and the next day they are out playing golf," Sharlip said.Dendreon officials said they would reapply to the FDA sometime this year. They have not said how much the therapy might cost. An estimated 186,000 American men develop prostate cancer each year, and about 28,660 die of it.

LA Times...A second Opinion on Prostate Cancer

This is an interesting Op-Ed from the April 1 edition of the LA Times. Prostate cancer can be an enigma. Recent studies clearly fuel the controversy. But I'd rather error on the side of caution.

However he writes:

I probably have prostate cancer. There's no need to feel sorry for me -- so do about half the men my age (I'm in my mid-50s). We doctors have learned this from microscopic examinations of the prostates of men who are autopsied following an accidental death. And the older men get, the more likely it is that they have prostate cancer. Autopsies of men in their 70s have found that about 80% of them had the disease.

I almost certainly won't die from prostate cancer, however. The lifetime risk of prostate cancer death for American males is only about 3%. So, although the prevalence of the cancer may sound alarming, 97% of men will die from something else. These two observations have forced doctors to rethink what it means to have this cancer. Some have envisioned the problem to be like an iceberg. In the past, we only saw the part of the iceberg above the waterline -- the cancers that caused disease and death. With early detection, we can see below the waterline -- and there are a lot more cancers there. Many of these will never cause problems. They would have been better off undiagnosed. But doctors can't tell who is better off undiagnosed. We can't reliably distinguish between prostate cancers that will never cause symptoms and those that are deadly. So we tend to treat everyone. The bulk of men who are treated won't benefit from it, because there is nothing to fix. But many of them will be harmed. Treatment causes significant side effects in about 30% of those treated, most commonly a decline in sexual function, leaking urine and/or rectal irritation. That's why prostate cancer screening is such a challenging issue. Yes, it may save some men's lives, but it will harm many others along the way.

Two weeks ago, we learned more. The results of two large, randomized trials of prostate cancer screening were published. The studies represented an enormous research effort: almost 20 years of work, involving more than a quarter of a million men and many millions of dollars. Yet there is still some uncertainty whether screening saves any lives. The European study said yes; the U.S. study said no. That in itself tells you something: If there is a benefit, it is undoubtedly small. In contrast, researchers in the 1960s were able to convincingly demonstrate the benefit of treating very high blood pressure by studying about 150 men over a two-year period. Why were they able to do this with so few men so quickly? Because the benefit was huge.

I believe there probably is a benefit to prostate cancer screening. But it is accompanied by a substantial human cost. Let's assume the European study is right. Its data give us some idea of the magnitude of the trade-off: For every man who avoids a prostate cancer death, about 50 are treated needlessly (some of my colleagues might say the number is closer to 30, others might say it's closer to 100).

Being 50 times more likely to be diagnosed and treated needlessly than being the one man who avoids a prostate cancer death doesn't strike me as a good gamble. To the extent I have control over my cause of death, avoiding a prostate cancer death isn't my top priority (I'm more concerned about a lingering cognitive decline in a long-term care facility.) And death is not the only outcome that matters to me. I place considerable value on not being medicalized and suffering the side effects of treatment any more than I need to. But it doesn't matter what I think about the trade-off. What matters is what you think.

American men have been engaged in prostate cancer screening for almost two decades with relatively little effort given to communicating the trade-off between the benefit and the potential harm of unnecessary treatment. The time has come to make that trade-off clear. There are a lot of bad arguments out there for screening. They include:

* Doctors who tell you they don't want to go back to the era when all their prostate cancer patients had advanced disease. It is true that the typical prostate cancer patient in the past had advanced disease. But we now know that the primary reason these patients now seem so rare is that they are being diluted by the many new prostate cancer patients who would have never been diagnosed in the past -- the majority of whom had cancers that weren't destined to progress.
* Media messages that highlight the tremendous improvements in survival. It is true that over the last 50 years, the five-year survival for prostate cancer has increased more dramatically than any other cancer (from less than 50% to almost 100%). But we now know that these numbers too are largely an artifact of over-diagnosis -- diagnosing a lot of men with prostate cancer who were never destined to die from the disease.
* Friends, family, acquaintances or celebrities who "owe their life" to screening. There are now a lot of men who appear to be in this group. But once you understand the problem of over-diagnosis, you recognize an alternative explanation: They never needed treatment in the first place. Some have labeled this the popularity paradox of screening: The more over-diagnosis screening causes, the more people who feel they owe it their lives and the more popular screening becomes.There is no imperative to be screened, or not screened, for prostate cancer. The only imperative is that men be informed about the consequences of either choice.

H. Gilbert Welch is a professor of medicine at the Dartmouth Institute of Health Policy and Clinical Practice. He is the author of "Should I Be Tested for Cancer? Maybe Not and Here's Why."

The First 30 days

Yesterday I had my first check up since my last treatment. It was good news! I am doing exceptionally fine!! (per my doctors) All side effects are gone and I seem to be back to normal. I don't have to return for another 60 days. So again thanks for your well wishes and prayers. It appears that I am on my way to being a cancer survivor.

As a side note I am a support volunteer working with COH. Yesterday I had the opportunity to speak with a fellow prostate cancer patient. The agenda was to provide him with support from someone who has been there and done that. Also to try to give him the reassurance that one, he has chosen the best facility and people to help him beat this disease and two, provide him another conduit to just vent and share his journey with a fellow traveler. My analysis after our talk is he seemed to have gotten to another comfort level with the treatment center and the treatment choice he made. Plus now I have made a new connection on my journey as well. In addition to the good news mentioned above, our talk made my day.

I will post again in another 60 days. May 20 will be a real bench mark day because this visit will really be a true measurement as to how things are progressing and are the "trains running on time" sort of speak.

Graduation Day and Easter!!

Wednesday February 18, 2009 is a day that will remain in infamy for me for the rest of my life. It was the day of my last therapy treatment. I am done with this phase. YAHOO!! I am not fully cured yet but let’s just say I am curing as we speak. 2/18/09 was my graduation day and 2/19/09 was my personal Easter of sorts. But before I continue my epilogue of the last eight weeks I must say that I cannot say enough about the doctors, nurses, radiation therapists and staff at The City of Hope. These are the most caring, professional and on point people I have worked with as a customer/patient. From day one they worked with the precision of Swiss watch. These guys are clearly the brand and a model for any business, health related or otherwise. They give you a reassuring feeling that we are all in this together. I became a part their team. On my last day I received a gold medal acknowledging the completion of my treatments and a bevy of good bye genuine hugs and handshakes and it got a little misty in there. (On my part as the reality of that day’s events sank in) So COH if you are listening, you are the best!!!!
But anyway as I enter my curing stage which involves a check up in 30 days and then a check up 60 days after that. The agenda is to make sure the side effects are gone and my PSA is moving in the right direction. Then we shift to 6 month intervals for checkups. I define this as my Easter because this is a beginning. This journey has touched me deeply. This has clearly been a metamorphosis of my view of life and where I am it. The only things that are really important in life are your personal health, the health and love of family and friends and of course your faith. I have had eight weeks to ponder this and reset my own mindset. I am certain that I will be 100% cured but I can’t help but think about those patients I left in the oncology treatment waiting room. I can’t help but think about my Aunt who is battling liver cancer and how chemo therapy is ravaging her body and slowly sapping her strength each day. That said I am in full acknowledgement that I am very blessed in many ways. In retrospect my overall treatment regiment was not that bad comparatively speaking. Thank God this is not my Grandfather’s Radiation treatment from back in the day.
I hope I don’t sound selfish but my front burner goals are to be cured, healthy, happy, and share my experience. Maybe I can save a life. I have offered to volunteer as a support group speaker/helper at COH. Again thanks to each of you for your prayers, and positive thoughts and I will update you in another 30 days. So let the curing begin. But I must leave you with what I believe to be very profound dialogue from the movie “The Curious Case of Benjamin Button”. This was an excellent film, long but excellent.

"What I think is, it’s never too late...or, in my case, too early, to be whoever you want to be...There’s no time limit, start anytime you want...change or stay the same...there aren’t any rules...We can make the best or worst of it...I hope you make the best...I hope you see things that startle you. Feel things you never felt before. I hope you meet people who have a different point of view. I hope you challenge yourself. I hope you stumble, and pick yourself up. I hope you live the life you wanted to...and if you haven’t, I hope you start all over again.”

The treatment end is near...Yahoo!

Friday February 6 was treatment #35. I am thankful again that things continue to be uneventful with minimal side effects. Plus my doctors say that I am doing exceptionally well. But there was a minor glitch discovered when I mentioned my count for my remaining treatments. The schedule given me on day one showed my last treatment date as February 17th. But I learned that it is really the 18th. After a recount of my appointment schedule dates and a review of my weekly lab work/doctor visit print out, it was clear that the appointment schedule showed only 42 treatments and it was not the correct number which is 43. Of course you know I questioned the accuracy and why the discrepancy. I will not go into why the differential, but please believe that I had to be made comfortable with a make sense explaination. Anyway Wednesday the 18th is my last treatment date. So I guess an additional day is not the end of the world at this point. The bottom line is I have 8 more to go..... and I will be done!

So keep sending up those positive thoughts and prayers. As I said in the begining of this jouney....."I am going to be fine". We will chat next week!

Treatment # 30 and 12 more to go!!

Fortunately not a lot to update and that is a good thing. I met with my doctors and I was told that I was doing better than average especially given that I am having minimal side effects thus far. Your prayers and well wishes are clearly working. I even got to skip my weekly blood draw another good thing since I hate needles. So keep those positive vibes coming my way and I will keep my fingers crossed that on the remaining treatments I don't develop any new side effects.

As February approaches, my sights are set now on my last day of treatment, February 17. I can see and feel a degree of finality for this phase of the treatment process. Since cancer cells do not die immediately after treatment there is a 90 day period to allow the radiation to do its thing. Then I am checked at 90 day intervals twice. Then that shifts to a 6 month check and then I come back in 2 years to make sure my PSA level is going in the right direction. Given my early detection and the minute nature of the cancer cells, I should be OK.

#25

I had treatment # 25 yesterday. I am doing fine. Also on Thursday’s I have my doctor’s appointment and the doctor says “I am doing very very good”. On Monday’s I get a weight check I have lost 5 pounds. On Wednesday’s it’s blood draw day and everything is reviewed on Thursday. I was feeling a bit fatigued on Wednesday so I went home early. I think is was due to lack of sleep while partying with Obama. You know I got it like that. Now I am good to go!

Interesting facts

Here are some interesting facts worth noting.
Did you know that the cancer of prostate is very often is not lethal? Did you know that some men never suffer the symptoms and actually have the disease? About 1 out of 6 American men will at some point be diagnosed with prostate cancer, yet only about 1 in every 35 will actually die of it.
Many prostate tumors are slow growing and low-grade, and if detected in its very early stages cure rates can be as high as 98% in some cases. Where the cancer has advanced beyond the prostate to nearby regions it is more difficult to cure but survival rates for many men can still be prolonged for years. Where the disease has metastasized that is spread to other organs like the liver, lungs and bones average survival time is 1- 3 years but many patients live longer some often dying of other causes.
If the cancer recurs after initial treatment and is still contained within the prostate, it can be cured. And even if it has spread beyond, hormone treatments for such recurrences will prolong life for many years.
Amazingly survival rates tend to get higher the longer a patient with advanced cancer lives. 2 years is the average survival rate for patients after diagnosis of prostate cancer advanced. 26 months is the average survival rate for patients with advanced prostate cancer who are still alive 2 years after diagnosis. 34 months is the average survival for patients in advanced prostate cancer stage who are still alive 5 years after diagnosis.
As far as death rates are concerned, only about 17% of men who have prostate cancer will die of it. In America each year approximately 234,460 men will be diagnosed with cancer of prostate and about 27,350 will die from it. The average life years lost form prostate cancer is 8.9 years.
And now finally the good news. Today, at all the stages of the disease, prostate cancer prognosis as concerns cure, survival and life expectancy has increased in the past 20 years from 67% to almost 100%.

Treatment #20

Well after 20 treatments I am happy to say after #20 I am doing fine. The Tomo Therapy is working so far with only the for mentioned side effect which required more frequent visits to the latrine. Otherwise I am fine. I did however find out in my atempt to obtain more protein by drinking milk with Carnation Instant breakfast ( I hate milk) (Well not totally hate) but it is not my drink of choice. Anyway I am a little lactose intolerant. I also found out (via my dietitian) that 95% of all Blacks do not have the enzyme needed to digest the enzymes in milk. So I guess I am in the 95% group.

Anyway my next up date will be at #30. Well baring any surprises!! I will chat with you on January 30. Thanks to all of your prayers and best wishes.

Treatment #10

Well first of all Happy New Year. My treatment #10 was today. No problem. However as I sat in the waiting room I was saddened as I looked around at people who were sicker than me. For some reason my heart sank much further today as I reflected on how blessed I am on this New Years Eve. The sight of very weakened and emaciated patients really depressed me today. I see some of these folks each day but today there seemed to be additional cases in attendance. Cancer is one debilitating foe. I attend my treatments with a positive attitude and with a smile. I get fist bumps and high fives from the people (Radiation Techs) I have become acquitted with over the last two weeks. I have a playfulness when I visit the hospital. But the folks I viewed as I waited my turn don't have the same visible spark as I. I feel a semblance of guilt and At the same time a thankfulness. Today I can't help but acknowledge how serious things really are for me. As I view my fellow patients I am so thankful that I am a blessed man. Some were old , some were teens and some even younger. This could have been me is a thought that resonates deep inside. But at the same time I feel Gods blessing that I was vigilant and proactive and that this cancer is the most treatable and curable of all cancers.

My Doctor says that this will be a 2 year odyssey once my treatment ends to make sure I am totally cured. COH pull so punches however my cure rate is very very good.

So again the next update will be at treatment #20. Oh and the only side effect which was predicted, is a little diarrhea sorry if this is TMI....butt this is life and nothing that a little Imodium A-D won't fix!

Now here is some really sad news. Can you say death sentence in more ways than one. Bi, Gay, or straight Black men need to recognize.

HEALTH: Black Gay and Bi Men Less Likely to Get Prostate Screening December 31st, 2008
Black gay and bisexual men are less likely to get screened for prostate cancer than men of any other racial and ethnic backgrounds regardless of their sexual orientation, a new study by a researcher at Charles Drew University of Medicine and Science reveals. Citing his study, which is published in the December issue of Medical Care, Medical News Today reports that Kevin C. Heslin based his examinations of prostate and colorectal testing rates on race, ethnicity and sexual orientation. Using telephone interviews with 19,410 men who participated in the California Health Interview Survey, he discovered that there was no overall difference in the use of the prostate-specific antigen (or PSA) test among gay, bisexual and heterosexual men. Still, he found, “the percentage of gay and bisexual Black men who received the PSA test was 12 percent to 14 percent lower than heterosexual Blacks and 15 percent to 28 percent lower than gay and bisexual Whites,” Medical News Today reports. Said Heslin: “Gay and bisexual Black men had the lowest use of the PSA test, compared with every other group of men in the study. For Blacks, being a member of both racial and sexual minority groups represents a kind of double jeopardy when it comes to getting PSA testing.” So why are the findings so significant? Heslin notes that Black men are more likely to be diagnosed late with prostate cancer and, as a result, are more likely to die from the disease than any other racial or ethnic group.

Treatment #1 and #2

12/18/08 was my first treatment and the next day was treatment#2. I must say each treatment was fairly uneventful. The City of Hope is clearly the brand for cancer. They function with military precision and at the same time they are very user friendly. This is very important given that every patient in that facility is very sick! Some sicker that others but nonetheless sick.

I know this is early but so far no side effects. This is one of the benefits of the Tomo Therapy. Tomo Therapy has minimal side effects given how the radiation beams are pin point focused and directed only to the specific target. It is amazing. They align me using the tattoos marked on my body. (I look like lil Wayne now) Actually it’s 3 pencil dots. I have my own personalized lower body mold they place me in and they scan me to make sure things are on target. If not on target the computer tells the machine to make adjustments and then ….show time for 6½ minutes at 275° I am basted with butter and turned often until done. No seriously it’s six minutes of listening to a loud clicking noise and then I am soon putting on my pants and out the door. They say I can bring my IPOD next time.

The most interesting part is disrobing in front of 2 women who were radiology technicians and a third person, a guy a physicist. I have to remove my pants, and shoes. I was put off on day one when I asked for a gown and the 2 women told me no we will give you a blanket and you will get used to us seeing you in your boxers or briefs.

Anyway I will not bore you with every treatment. I will update you guys at 10 treatment intervals or if there is something noteworthy like glowing in the groan area. :-) So that's 2 down and 41 to go. I go Monday through Friday with the exception of 2 Sundays, today and the 28th because the unit is closed on certain days for the holidays. My last treatment day is February 17th the day all TV's go digital. There has to be joke in that coincidence.

Anyway I am done for the day. I keep a very positive prospective on my current situation but as I visit the City of Hope I get a clear prospective of how delicate and sometimes unfair life can be. You have to value each day and savor each moment because things can change in a instant. A very good friend once told me "We all have to live in the moment because nothing just happens". I am blessed with early discovery and world class treatment, some are not so blessed.

A PSA primer for the men and the women who love them

This is and interesting explanation of PSA the DRE by a doctor. I thought this could be of value and clearly edifying. The only comment not mentioned is that the PSA levels mentioned do not reference the significance of ethnicity relative to raised PSA levels. Nonetheless this is good primer.

The PSA, or prostate specific antigen, is a protein made by the cells in the prostate gland. The prostate gland is located right next to the bladder, and provides some of the liquid that is part of semen. The urinary tract passes right through the middle of the prostate gland, like the hole in a doughnut, so if the prostate gland gets enlarged, the urine flow can be reduced or cut off.
A certain amount of PSA circulates in the blood, and this is measured as a rough estimate of the size of the prostate gland. The larger the gland, the higher the PSA level. Prostate cancer usually causes a high PSA level, but not always. In general, the worse the cancer, the higher the PSA level. The most common reason for a high PSA level is the benign growth of the prostate gland that occurs commonly in middle aged and older men.
It is important to remember that certain activities can make the PSA level rise, even sky high. The highest PSA levels have been measured in bicycle riders right after a long ride, or right after horseback riding. The bouncing of your bottom on the bike or the horse releases a lot of PSA into the blood, so do not ride your bike or horse to the doctor's office before your test! The prostate exam, where the doctor feels the size of the gland, can raise the PSA level if the doctor massages the gland, something I am careful not to do for routine screening. If I do massage the prostate gland, for example in a man with engorgement of the prostate (a type of prostatitis), I do not measure the PSA level at that time. Ejaculation can also temporarily raise the PSA level a little, so do not get your PSA right after sex. Overnight wait is ok. So, be mindful of what you did, or what was done to you, before getting your PSA level.
The concern about prostate cancer begins at age 50 in most men and that is when the PSA level is often drawn for screening. In African American men, and in men with a family history of prostate cancer, this screening begins at age 40. There is controversy as to whether getting a PSA level is a good idea, and whether it truly saves lives. There are a lot of false positive elevated PSA tests (elevated tests and no cancer present), and the follow-up test is invasive and expensive, an ultrasound exam through the rectum usually with biopsies of the prostate. Also, in older men (over age 70), prostate cancer may grow so slowly that the man may be better off not knowing it is there, since the man will suffer and die from other things. Treatment of prostate cancer is intensive and often reduces the man's sexual function.
If you do choose to get a PSA test, you will be relieved if it comes back low. Mine was 0.5 this year, and any level below 2 is low. One of the most useful things is to measure the change in PSA over time. With age, and with the slow development of benign prostate enlargement, the PSA level goes up very slowly, 1 point or less a year. With prostate cancer, the PSA rises quickly, such as 2 points or more in a year. When a man's PSA level goes from 0.5 to 2.5 in one year, I am concerned even though 2.5 is still considered a normal level. This trajectory, or rate of rise of the PSA, is even more useful than an absolute level. Above 5 is definitely abnormal (not necessarily cancer), but how I interpret a level of 4 is greatly helped by what it was last year. If your PSA is in the "borderline" range of 3-5, it would be useful to follow it more closely, like checking it again in 6 months to see if it is rising.
The PSA is a tricky test to interpret. I hope this information is helpful.

The Planning Session

Well today 12/11/08 was the day to get my treatment planning done. All I can say is each step of the process was done with military precision. I will not go into complete detail but step one was to build a body form to hold me into position once the actual treatment starts. Then a complete CT scan and then Tattoos were placed on my body as permanent register marks. This allows for exact positioning each time I have a treatment. Step two was lab work which was a blood draw. Step three was a meeting with a radiation nurse. She advised me as to what to expect in the coming weeks and what to do and not to do during the treatment period. Plus we discussed my treatment schedule, possible side effects and she gave me additional literature to further educate me. Finally step four was the MRI, 30 minutes of claustrophobic bliss. Well actually it was not blissful but the time went relatively fast especially with the headphones as I listened to Power 106. A station selection that surprised the MRI technicians. I was delighted that I did not need an IV or any type of contrast solutions. So now it's all done. Next stop treatment-ville!!

Planning and Treatment

Saturday I got notice from the City of Hope that we are good to go!. My treatment planning appointment is 12/11/08. This includes an MRI and CT scan. Since the prostate moves it is important that they focus on the exact target each time. Tomo Therapy is a very focused and customized form of high tech radiation therapy. So the objective is to map my prostate so they make sure the radiation only goes where it suppose to go and not damage any healthy tissues and thus minimize side effects. Once the mapping is done the radiation oncologist team will analyze the computer data and customize my treatment area and dosage. COH has done over 20k of these so I feel comfortable they know what they are doing. Once this mapping process is done it takes a week to analyze the information. So my actual treatment will begin on 12/18. I will visit the hospital for these treatments for 35 days Monday through Friday. The treatments and set up last about 15 to 20 minutes. The good thing is I get an head start on my insurance coverage before everything resets on 1/1/09. This will save me $$$ on my deductibles and co-payments. YaHoo! More is more and less is less.

The One!! City of Hope Tomo Therapy!!

Well it appears that The City of Hope is the one. The place is "first boat". Yesterday 12-3-08 I arrived at 1:00 for my 2:00 appointment because you need and hour to fill out all of the paperwork before the real appointment.

I was greeted at the new patients desk with a user friendly "Hello Mr. Delaney we were waiting for you". The guy who greeted me has been a volunteer for the COH for 25 years. I was identified and escorted to another office to start with the paperwork. After a zillion questions designed to keep us out of court, I was tagged and escorted to the radiation oncologist department. I was still filling out paperwork from the last stop. I was examined by a nurse with more paperwork and Q&A. She took my BP and weight as well. Whew I need to lose weight I was 214.2 pounds. Once she was done I got a visit from the Physicians Assistant and she performed another generic exam. Heart and lungs etc. Then I was interviewed again. This was somewhat redundant but required I guess. But anyway I was left alone with more paperwork to complete. This form/s focused on (without getting beyond PG 13) lets just say functionality of equipment below my belt. (hey we are all adults here)

I completed the forms and soon the door opened and the P.A. returned with the doctor. The Doctor introduced himself. I immediately felt a warmth. We talked about my situation and he quickly reassured me of how small and curable my cancer was. We discussed treatment options as mentioned in an earlier post. We spent 1.5 hours focusing on the pros and cons and side effects. I am convinced that The Tomo Therapy is for me. It is enhanced IMRT that produces a more sculpted and curative dose to the cancer with lesser side effects, reduced damage to surrounding normal tissue and fewer complications for me. Plus it is done in one machine; the standard IMRT uses 2 machines.

I called them today and said lets move forward. So now I wait for a call to set an appointment for my Treatment Planning. Treatment Planning involves an MRI (ouch! another I.V. injection) and a 3-D CT image scan to establish the percise contours for each regions of interest (tumor site) and regions of risk. (sensitive organs) It will take one week for the staff to evaluate the computerized mapping data and then my appointment for the first treatment is set for one week later.

COH is clearly a brand for cancer treatments. Plus they were the first on the West coast to offer this technology and they have performed 20k+ Tomo Therapy procedures. Now that is a confidence booster for me!! Next....... treatment planning!!

Choices and Options

West Hills, Loma Linda, The City of Hope are my treatment center choices. My insurance has approved my treatment and now I know my out of pocket expenses and my coverage floors and ceilings. It is recommended that the facility select be relatively close to home. Treatments can range from 35 to 45 visits. Once everything is mapped on my first visit, I should be in and out within 30 mins. Since I have met my deductible for the year I am pushing for getting started in December. This should save me a few $$$. I have vetted all of the following treatment centers and they all are top rated and have pros and cons as does my treatment choices. So all I have to do is ponder the concerns listed below and make a decision soon being careful not to get analysis paralysis. The treatment will be IMRT or Proton Therapy. I ponder the following:

• West Hills close to home highly rated doctors and facility IMRT. New equipment state of the art. The staff seem user friendly. This is important given that we are all dealing with some very serious "stuff". This is not like going to the dentist. This is life!!
• Loma Linda Proton therapy a long drive from home and or office. These guys are very professional and attentive. Clearly there seem to be a lot folks out there with cancer issues and want this treatment. They are taking treatment appointments for mid to late March. Plus it will be 3 weeks before I can have a one on one counseling session. All of my chats have been by phone or e-mail. That's a little long for me and my plans, but we will see. It will take 45 treatments so that means 45 trips Monday through Friday. Sometimes you have to do what you have to do.
• The City Of Hope is not to far but far enough. These guys are new to my decision mix. COH is world renown and a very recognized brand. I started a conversation with them on Wednesday of last week. They want to review all of my information...scans, reports and such. That said I still need to have a sit down with them. I have had long data dump conversations with a nurse so now I wait for an appointment.

LLU

I got the call from LLU. My treatment consultant advised me that I was accepted as a candidate for Proton Therapy. It's not like getting accepted to Harvard but I'll take it. She advised me that the next steps were to check with my health insurance to determine coverage and then set a consultation appointment. I should hear from them in approximately a week. Then I can make my treatment decision. Hopefully I will have completed my vetting relative to the IMRT treatment, my doctor and facility by then. So far I have not found any negatives.

Not Bad for an old man!!

I got my x-ray and scan results back yesterday. Whew!!! I am very happy to say everything was normal. Now days there is a certain degree of "now what anxiety with doctor visits. All vital organs are "good to go". So next steps are to fax my info to Loma Linda, which was done this morning. I assume I will get a call from them for a consultation. If I don't get a call by Monday, I will shift into proactive mode.