HIsmones 05/03/26

I'm within two months of completing the first (and last?) round of treatments intended to extend my life and perhaps end the progress of my prostate cancer for my practical lifetime. So I'm starting to reflect a bit in my second-guessing way of how I would have approached treatment differently had I known in 2024 what I know now. I read a statement by a patient and skillful pundit that seems worth sharing: "Your best move is the treatment strategy that gives you the strongest expected outcome across survival, disease control, side effects, quality of life, and your ability to live with the consequences." Exactly. "Cancer" is a panicky word; the tendency is to act quickly and aggressively without thoughtful contemplation of the possible or even certain long term effects. I acted quickly and aggressively to take a longer and stronger treatment series in the hope of preventing spread of a cancer that supposedly but could not be absolutely proven to have already begun spreading, along with a tinge of resentment toward a primary care doctor who discouraged me from further investigation due to increasing PSA scores that suggested but could not prove cancer activity "at my age." So, where am I at seventeen months into hormone deprivation therapy and after 44 prostate/pelvic radiation treatments? There is definitely a "new normal" in daily life: I have increased the intensity of daily exercise by adding weight training and stubbornly forced myself to tackle work projects at home regardless fatigue or weakness. I have not been able to beat (yet!) the effects of radiation proctitis which sends me to the toilet multiple times each morning, includes copious amounts of intestinal gas, and is more than willing to interrupt sleep on occasion. But life goes on. Rain falls, sun shines, flowers bloom, and I am seeing a hummingbird at our feeder again after winter. I get to spend time with my wife, daughters, and grandchildren, and enjoy many blessings of retirement. God is nudging me deeper in my relationship with him and in my acceptance and compassion toward others. And just maybe after ending treatment mid-summer, I'll gain some energy and won't have to deal with cancer again at least for a while. If I live long enough for it to return, we won't burn that bridge until we get to it, so to speak. So what would I have done differently? Maybe nothing, but maybe I would have chosen less treatment and more risk in exchange for fewer changes in daily life, lesser side effects. So if you're facing a similar diagnosis, take a few extra moments considering a cancer that is typically slow growing and weigh your length of life and quality of life priorities and treatment options. It may be worth your time. My next PSA measurement is in the next two weeks, and if the results remain as they have been throughout treatment, I will go off medication at the end of June, be tested again in September, and be monitored quarterly to confirm that the cancer is dead or remains dormant. Don't wish me luck but prayers are appreciated. I still belive in a God who hears and answers.