Every day, I go on

From The Daily Post

By Dave Nelson, 53, of Longview (WA)

Prostate cancer has no symptoms, and for the most part, its victims have no clue.

When I was diagnosed on Valentines Day, 2007, I was shocked to learn that an agent of death had been growing inside me for years.

The instant the urologist said my name and “cancer” in the same sentence, I took on a new, unwanted identity defined by “victim,” “survivor” “remission” and “recurrence.”

My head was suddenly filled with numbers and scores —- PSA (9.74), Gleason (9) and ‘T’ scores. And I was faced with several treatment options that two days earlier I had never heard of.

Now, within four weeks I had to choose between the radical slice and dice, brachial mini nuke, external macro nuke, freeze it or wait. Except for wait, they all have the same unacceptable side effects: incontinence and sexual dysfunction.

And so began a journey I did not choose but nonetheless must travel. Almost immediately I was surrounded by cards, and friends, and prayer and fear. In the U.S. every year, 200,000 guys are diagnosed with prostate cancer. I felt the need to convince my kids, my friends, anyone, not to blame God, but to let God help us through.

The diagnosis brought into focus how temporal my life was. I realized that if I remained my easy-going wait-and-see self, I would never live the life I wanted. I began to feel the need, even the urge, to make changes —- and that urge continues today.

Some cancer victims lose their hair and their weight. I gained a scar and the ability to wet my pants at inopportune times. Every time I sneeze, cough, or wake up, I am reminded that my life has been invaded by an unwelcomed guest. And every day I silently, though sometimes awkwardly, go on.

I am sure that to my family and friends, my life over the last 18 months has appeared erratic and selfish. But cancer tore away my identity and I am still trying to find a new one. The truth is, my cancer tore away their identity also, as everyone who knows me tries to make sense out of the senseless.

But what I, my family and friends share, is courage. Courage to face life’s uncertainty. The same courage shared by every cancer victim, and everyone who has known and loved a cancer victim, as we all try to make sense out of the senseless.

"The Night I was Almost Eaten by the Wasilla Bear"

Things have been quiet with my cancer treatment for the past month. This afternoon, they kick back into high gear as I go for my radiology "preparation visit". As I understand it, they will take a CT scan of the "prostatic bed" (where my prostate once lived) and place some tattoos on my abdomen for them to line up the radiation machine for my 35 treatments which begin two weeks from today.

I am allergic to CT and MRI machines, because I am CLAUSTROPHOBIC! But by the grace of God, and your prayers, my dear friends, I will get through it.

I'll just remind myself of the night I was almost eaten by a bear in Wasilla, Alaska. (I kid you not...you cannot make this stuff up!) Would you like to hear the story? Ok, if you insist. And yes, this is the same Wasilla, Alaska where Gov. Sarah Palin lives and served as mayor. (Now that the election is over, I feel free to tell the story.)

You ask, "What was a guy from Yazoo City, Mississippi doing in Wasilla, Alaska messing with bears in the first place?" Good question; I'm glad you asked.

It has long been the tradition in the Mississippi Conference of the United Methodist Church that clergy who are ordained go on a mission trip. In 1995, when I was ordained an elder, a group of about 25 of my fellow ordinands and I were assigned to go to Wasilla and Willow (about ten miles away) to help build the Willow United Methodist Church. When I say build, I mean build (Jimmy Carter style, hammer, nails and all).

We were there ten days, sleeping in tents in a screened in pavilion. I recall taking two showers during those ten days in a shower stall in which I had to jump around to try to get wet enough to wash the soap lather off my body. Thought I was back on Graball Hill back in Yazoo City: outdoor toilet and primitive plumbing.

To make a long story even longer, one night my fellow church carpenters decided to go salmon fishing, as it was salmon season, and the sun was up past midnight. Being the oldest person in the group (and the tiredest) I elected to go to sleep while they fished.

I crawled in my sleeping bag in my tent inside the screened-in pavilion. As I was just about to fall asleep, I heard the screen door to the pavilion open and slap shut. "Wow, they are back early" I thought. As I listened for voices, I heard none. What I did hear were grunts, sniffing, and finally the roar of a GREAT WASILLA ALASKAN BLACK BEAR! Let's call him LUCIFER, The Wasilla Bear, because he scared the DEVIL out of me! Now he was trapped inside the pavilion WITH ME; unable to open the inside-swinging screen door by himself...and I surely wasn't going to escort him out. I was too busy trying to make myself INVISIBLE, no make that NON-EXISTENT, as I hid inside my tent.

I had zipped my small tent shut, but could tell when the bear got next to my tent, walking all the way around sniffing. I wondered if I smelled (well, of course I smelled...only two showers in ten days) like his next meal. I recalled the verses of scripture where the apostles were fed to the wild beasts, and wondered if that was to be my sacrifice and lasting legacy. I could see the Yazoo Herald headlines: "Yazoo Native Pastor Eaten by Alaskan Bear". Probably would sell a few more Heralds: You don't see a headline like that every week.

Finally my colleagues returned from their great Alaskan salmon adventure to play a heroic role in my great Alaskan Bear adventure, and chased the bear out the back screen door. I took my first real breath in almost TWO HOURS and finally felt free to let my heart start beating again.

So this afternoon, as I try to get through the CT Scan, I will remind myself that it is not quite as bad as almost being eaten by Lucifer, the Wasilla bear.

What a life. What a ministry.

Still here...

These daily updates have been more like weekly updates lately. Take that as good news, becuase if there was anything to say, I would be saying it here.

The healing is continuing to go well. I have full mobility, and easily go up the stairs at work and home. The biggest problem continues to be fatigue. I read an article yesterday that said fatigue for cancer patients is not being extra tired. It is more like not being able to walk across the room, or carry on a conversation. It hits at random times. Sometimes, I can take a nap at lunch...but sleep does not always work with fatigue. Not to worry, it is manageable.

I'm marking time until my radiation treatments start. Anita and I will stretch this weekend into five days (our "flex Friday" all the way through Veterans Day). I plan to rest up big time and get ready for the initial radiation setup on November 17. Then the 35 treatments begin two weeks later.

I read an article online that says a study of men who have radiation treatment after a prostatectomy have an incread risk of developing bladder and rectral cancer.

Oh well, what choice does a person have?

God is good, and in control!

I'm Back

Sorry I went silent for a few days, but honestly there has been little news to report. Over the past week, I have felt extra good on the outside. What I mean by that is with all the internal healing that has taken place, my focus has been on the inside. But now, I am feeling good on the outside, meaning I walk with my normal gate, am able to bend over without worrying that I will open the inscision, and just generally feeling more like my old self.

May God make you aware of His loving presence today.

Radiation Schedule

I saw Dr. Reza Shirazi, my radiologist, this morning. We mapped out plans for my "adjuvant" radiation treatments. That means it is a precaution, not "salvage" radiation treatment where there is known evidence of cancer after surgery. Adjuvant radiation usually begins 8-12 weeks after surgery, allowing time for the body to fully heal before suffering another trying, but necessary procedure.

I will begin a seven week regiment of daily radiation treatments on Monday, December 1. Dr. Sharazi's staff will administer the treatments Monday through Friday. They only take about twenty minutes, including prep time. I am fortunate to have them close by at Alvarado Hospital Medical Center, and should be able to continue working through the full seven weeks. Of course, I will miss a couple days Christmas and New Years, but those treatments will just be tacked onto the end. So I will get 35 treatments in all.

One of the biggest side effects is fatigue. I spoke with a few men in the doctor's waiting room before my appointment. One said fatigue was worse at the beginning, another said it was worse for him at the end, and another staid he experience no fatigue. So it is different for each individual.

Thank you all for your continued prayers as I begin this next phase of my journey.

Oncology and Radiation

I visited my oncologist this morning, and decided that I will have radiation therapy after all. It makes little sense to have the surgery and hope that we got it all when we can be as sure as possible. So the regiment should start in a couple weeks. They will consist of daily (Monday through Friday) treatments for about six weeks (about 30 treatments). There are a few side effects, but I will be able to continue work as long as my old nemesis "fatigue" doesn't get to me. They tell me the daily radiations take about 20 minutes (most of that getting prepped and in place - the actual radiation is only a minute or so).

A friend of mine at Healing Well said he "fired all torpedos" when he learned he had prostate cancer. So that is what I am doing. As Dr. Kossman suggested at the onset, we should be as aggressive as possible. For me that will now include hormone therapy, surgery and radiation. No reason to return to the airport with unused bombs still on the plane when we are in all-out war.

I hope you are all doing well today.

Thank you, Lord, for every blessing.

Pathology Report

I saw my urologist/surgeon today and received the pathology on my prostatectomy (September 15).

Here goes:

Staging: pT2c pN0 MX (Stage 2 Cancer)
Interpretation: pT2c (Bilateral disease, tumor involved both lobes of prostate)
Interpretation: pN0 (No positive regional nodes)
Interpretation: MX (Distant metastasis cannot be assessed (but earlier CT and bone scan saw no metastasis)
Gleason: 3+4=7 (biopsy indicated 3+3=6)
No discrete tumor mass
Bilateral involvement (both sides of prostate involved)
No capsular penetration (carcinoma extends into but not through capsule bilaterally)
Perineural (around the nerve) tumor invasion: present
Perineural margin: Free of carcinoma
Bladder neck: Free of carcinoma
Distal (urethral) Margin: Carcinoma present
Seminal Vesicle: None present
Lymph Nodes: 18 nodes free of metastatic carcinoma

I am pleased with the results. Cancer staging went down from Stage 3 to Stage 2, and Gleason went up from 6 to 7. But they seem to have taken all of the cancer out. Excellent news that seminal vesicles and lymph nodes were not involved. The only area of concern seems to be Distal Margin. My surgeon says he thinks he got it all. Pathologist is not so sure.

I will see my oncologist Monday to get his take on the path report.

The plan now is to see what PSA shows. May follow up with radiation, if indicated.

Some white blood cells were in my sample today, so I am on a week of Rx CIPRO. Not uncommon with catheter patients post op.

Thank you all for your wonderful support.
Bless you, all.