by Hugh Gilmore
In 2016, my urologist told me that a cluster of prostate cancer cells had started colonizing my lower belly. The news came via a simple PSA (prostate-specific antigen) blood test. My score was high. A biopsy was suggested.
Yep, cancer. I had my prostate gland removed in order to evict those cells. They came back in small numbers, but multiplied rapidly, which was a bad sign. So I accepted the necessity of Phase Two: raining down death rays on my aggressive tenants by having 37 sessions of lower belly radiation.
That, too, lowered my PSA, but within a year, the numbers had doubled five times. It was disturbing news when I learned in January that my PSA had jumped from its original level of 0.18 to 2.8. Something had to be done or I would die of cancer. In a year? Five? Seven? Unknown, but the middle and final phases of that death would probably be painful, because prostate cancer is inclined to slip into one’s bones.
Is there treatment? Yes. But I’d had surgery and radiation, which are the first lines of defense. The third type of treatment, based on the idea that testosterone fuels prostate cancer, is to offer the patient castration to shut down the supply. Castration is carried out either in physical or chemical form. Sometimes both.
As you might imagine, quality of life issues follow. Either choice struck me as being like a razor-wired lifebuoy. The physical option didn’t sound good. And I did not want to have so-called chemical castration, followed by hormone therapy – though I would probably submit to it as something I owed my family.
What a miserable five months followed my 2.8 PSA score last January. My doctor had agreed to my request for another PSA and some body imaging to look for tumors or other signs that the cancer had spread. He also cautioned me that my PSA would probably rise to a 5, maybe 6, in that time.
I had my medical testing done at Chestnut Hill Hospital six weeks ago. The staff was competent, friendly and professional. A few days after testing, I went to the hospital’s Release of Information office and asked for a printout of my results. I accepted the envelope and walked out to the car, where my wife, Janet, waited, and we opened the report quickly and calmly (with pounding hearts, though).
MRI: Normal. No metastasis.
Ct-Scan: Normal. No metastasis.
PSA: Not 5, not 6, but 2.23, down from 2.83
Anything negative would not have surprised me. I was not prepared, however, for … for what? Was this good news? I guess it had to be. It wasn’t worse. What would the doctor say? Would I still be asked to see a medical oncologist for hormone fiddling?
On May 7, after two anxious hours in the outer waiting room, I was called back, my wife with me. Perhaps 15 minutes later, my doctor came in.
In effect, after reviewing my test results with me, he said, “I’ll see you in a year. You can have your PSA tested again in six months if you like, but you seem OK for now.”
He had no explanation for the cancer’s regression. His attitude seemed to be “Take your good news and run, if you can.”
So on the drive home, I thought, “What? Am I really OK? Was he just blowing me off? A helpless case?”
I had become so accustomed to being hovered over, sort of, being monitored closely, that I almost felt unsafe and uncared for without it.
For years, my climbing PSA score had ruled the back of my mind. I had not been able to think about my future, or my wife’s, and especially my son’s, without regret that my life’s work wasn’t done yet. That disease had sat in the back of my mind like a web my flashlight had caught deep back in my home’s crawlspace.
My compulsion to “put my affairs in order” has slackened a lot as I write this. Last summer at this time, I was doing what is called “Swedish Death Cleaning.” (“The Gentle Art of Swedish Death Cleaning: How to Free Yourself and Your Family from a Lifetime of Clutter,” by Margareta Magnusson, 2017.) Grimly, objectively, I was selling, giving away and throwing away whatever was not essential to my life. Including, I must confess, some personal files, family photos and souvenirs that hurt to discard.
This will sound funny, but I miss no longer having an excuse for being impatient or feeling my patience is being exploited.
As in, “I don’t have time for this nonsense. I have cancer. I’ve only got a few years to live.”
Actually, I had bricked myself up by taking control of my fate and announcing a specific number – three years. And I’d been doing a monthly countdown.
Moreover, I either shrug at or avoid the things that used to annoy me. I feel great sympathy for the human race. I laugh at the notion of social status, and the need for it. No matter what I’m doing, I almost immediately say, “Yes” if my wife asks me if I want to take a walk or go to a movie. I love life with intensity.
I still have daily, weekly and monthly goals. And vacation plans. But the long-term future is vague, and its limits move as I move, like a vanishing prairie horizon.
If you want to make the gods laugh, they say, tell them your plans.
Hugh Gilmore is a Chestnut Hill resident and the author of several books, both fiction and nonfiction, found most easily on Amazon.