August is my Prostaversary. As of my writing this, it has been a year since I heard the four little words every man hates to hear: "You've got prostate cancer." What better way to prepare for Prostate Cancer Awareness Month than getting your own case? Just when I thought 2020 couldn't get 2020-er.
I celebrated 2021 by getting a second biopsy that had the same results as the first, so 2021 has been 2020 redux in more than one way. Now that it's a year later, what have I learned?
Active surveillance is a two-edged sword
I was told that I was a Gleason 6, that a bone scan indicated there was no metastasis, and that a Prolaris test indicated a slow-growing tumor. "There's time to make a decision," said the urologist, who also encouraged me to talk to the local radiation treatment center right after the tests came back.
Of course, slow-growing still means growing, no metastasis yet doesn't mean no metastasis ever, and Gleason 6 still means PCa. The sword of Damocles has made its presence known.
Two opinions are better than ignorance
My urinary oncologist wasn't fully pleased with my urologist's work. There was no MRI, for example, and the number of samples was less than what most insurance would pay for. There was a part of me that was definitely Gleason 6, but that may not be representative. So an MRI was done to help plan a second biopsy.
The result, however, was the same: Gleason 6. So, "You don't have to make a decision now" is still the mantra, with, "you should get PSA measured every 6 months and consider another biopsy in the 18 months or so." Move directly to go, and spend the $200 towards co-pays.
That's an improv comedy principle: listen to understand what's going on in your scene. Listen for the text, but also for context and subtext. I have listened to a lot of patients and doctors this year, and follow ProstateCancer.net for ideas and support. I haven't heard what I want to hear (either "while you were surveilling, someone developed a cure," or, "our bad, the lab made a mistake").
Focus on what you can do
"There's only so much you can do, but you have to do that much." – Garrison Keillor
My day job is therapeutic humor, so I can also take a dose of my own medicine. I can write a joke a day about PCa in September 2021, just like 2020.
Déjà vu all over again? There's a lot of that in active surveillance, and that's when things are going well!
Do you feel heard and understood by your doctor?