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.

The tests were not that Bad!!

I arrived at the hospital right at 8:30 AM. I proceeded to the admissions office to start the "paper work" and pay my co payment. After these steps were done, to my surprise there was no waiting I was ushered to"Nuclear Medicine" were I was to get an I.V. inserted in my arm and then an injection of some high test nuclear fluid. This fluid needs about 2 hours to travel to my bones for the bone scan. The nurse hooked me up and I was told to go to the 2nd floor for my CAT scan. It was quick trip up the elevator and 2 right turns and I was there. I delivered my "papers" and was told to wait in the waiting room. I pulled out my Ipod and the technician called my name before I could even boot up.

But before the CAT scan I was told lets do the chest x-ray thing first. So now I am off to get my chest x-rayed. It was about 5 minutes of hold your breath and turn this way and don't move.

Now back to the CAT scan room. I was instructed to lay down on this machine that appeared to be that portal that transports you back in time in the show I think it's called "Journey to Atlantis". Anyway the bed portion of the machine traveled me back and forth inside this "Hulla Hoop" on steroids halo section thing. At one point the technician had to inject contrast in the I.V. in my arm. Now the fun starts because he informed me that the I.V. was not working. What does that mean I asked? Well he had to remove the I.V. and stick me again in the other arm. This one worked! Now it's back and forth again. The process takes about 30-40 minutes. He was done and I was told I could finally eat which was a good thing. I was ravenously hungry. As a matter of fact I had progressed beyond hungry to "hongry" as said in the hood.

I had lunch. I was told to return to the hospital at 11:30 for the bone scan. First I sat on this one scanner which scanned my butt. They call this the "moon shot". This was about 10 minutes. Then on to the most boring scanner that takes about 45 minutes. You lay on the this bed and this "wand" of sort scans you from head to toe very very slowly. How slow was it? It goes so slow I actually fell asleep. The bone scan film was very interesting in that I could now see all of the areas/joints that are sore as a result one, me getting old and two, golf! The result was not bad for a guy my age when it was all said and done.

My last stop for the day was with the radiation oncologist. Again more paper work and another co payment. Bottom line, I was impressed with the office, the staff and the doctor. The doctor took the time to review with me all treatment options and we had our Q&A session. One comment was made by the the doctor was that given the size and my early detection, "If we were in Europe, the recommendation would be to do nothing". He made it clear he was not advocating that plan but it was important for me to know that I was very curable and I have options. So again a testament for early detection......EARLY DETECTION is a key so any of you men out there reading this.......get your butt checked out!!

My treatment choice continues to be IMRT and Proton therapy. IMRT has taken a slight lead at this point. My assessment is both are very similar in actual treatment, side effects, and cure rates. I can get the IMRT local to my home. There is still additional vetting needed relative to my doctor, this therapy center and the Proton therapy center at Loma Linda University. Stay tuned. http://www.radiologyinfo.org/en/info.cfm?PG=imrt&bhcp=1 and http://www.protons.com/

Preparing for tomorrows test!

On Wednesday I have a bone scan and x-ray to make sure the cancer has not spread. Both doctors say the it is a high probability that it has not due to early discovery. So to prepare I have to drink 2 bottles of Barium Sulfate suspension each bottle is 450ml. It says on the bottle it is a berry smoothie...yea right! Yummie!! After scans and x-rays. I visit my radiation Oncologist with a ton of questions I need answered to make me smarter which will help me make my therapy selection.

10/29/08

To further clarify 10/29/2008@ 4:00 I got the bad news; confirmation of something I felt for about a year!! That said, actually the news for me was not as saddening as one would think. It was empowering. Now I know and now I know what I have to do. No more speculation. It is time to shift gears and focus on a treatment.

October 29, 2008 A date to remember

I am writing this in the hope that it will save my life and others as well. I clearly understand the reluctance of men to avoid this subject. But postate cancer is on a death sentence it the man chooses that outcome. It is is caught soon and you don't procrastinate you can beat it. I will chronicle my journey and post treatment and general PC information. It is projected that 28000 men will die of this cancer this year. Plus if you live long enough you will get it. 1 in 5 men will get by age 65. the most trusted indicator that something is going on is a simple blood test and the dreaded DRE.

This all began August 27, 2007. Well actually it began about 10 months earlier when I got an un- characteristic call from my personal care doctor. He indicated his concern that my PSA level was elevated. Being Black this is a problem. He recommended me to a urologist. Yuck now I had to sit down with him and discuss my options. But first came the the words most men don't want hear, he said "Drop your pants and place your elbows on the table. I need to do a DRE. I don't mean the department of real estate. A digital rectal exam. The digit is his finger. Not a fun thing. He did not feel anything abnormal on my prostate but given that I am Black he suggested that I get another blood test to check my PSA. I did and it was still high. 0-4 is the guideline. I was a 4. Yuck again.

After doing some research and speaking with friends in the medical profession. I had to face the reality of a biopsy. I will spare you the details but on 8/27/07 I got my first one. Clearly this is not a good experience. It only take about 15 to 20 minutes but the longest 15-20 minutes in my life. Now I must wait a week for the results and deal with the side effects of the procedure for about a month. One week pasted and another meeting with the urologist to discuss the results. They came back inconclusive. The suggestion was lets do this again in 90 days. Yuck!! I did and it was the same result!! Then the suggestion was lets do this again in 90 days.....hell no! I am not interested in being a frequent flyer!! So I decided to wait one year. Read, take all of the vitamins and make myself as smart as I could on this because clearly there was something going on.

On 9/2708 I got the results of my blood work and bad news my PSA was the highest it has ever been. Yep I must do a third biopsy! how fun!! I gues the third time is a charm because this time cancer was found. I really surprised myself because in my heart I knew I had it. So I really did not freak out. Now I knew. So I needed to meet with my urologist and discuss my treatment options. 1. Total removal....not! 2. IMRT...maybe 3. Cryosurgery....will my insurance cover? 4. HIFU....nope! and Proton Therapy......hmmm posible but still questions. I figured my next step was to see an oncologist. I had my visit with my oncologist and the short response is positive. It's small, it's early, it's very treatable and I am one of the most informed patients he has spoken with. I love the internet!!! My next step is a bone scan, x-rays and a visit with my Radiation Oncologist to help me decide on which treatment I will select. I am down to 2. IMRT or Proton therapy. So 11/12 will be doctor day. I am getting this all done on the same day and getting it out of the way.