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.
Wednesday, December 31, 2008
Sunday, December 21, 2008
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.
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.
Thursday, December 11, 2008
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 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!!
Tuesday, December 9, 2008
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.
Thursday, December 4, 2008
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!!
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!!
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