I’m sitting in the waiting area waiting for my appointment with the doctor as I write this.
This morning, I was a real grump and didn’t suffer foolish things with any grace. And there were more than the average number of foolish things happening today.
As I walked out to the car, the closer I got to it, the less I wanted to get in it. Perhaps I viewed it as the beginning of the drive to the gallows. (Yes, the mind goes to strange destinations under these circumstances.)
I’ve definitely come to terms with the notion that more tests will be in my future. And I thought I had come to terms with the notion that the cancer is coming back. But perhaps not. Until the doctor actually utters those words, “the cancer is coming back/back,” there’s always a glimmer of hope.
So once again, I wait.
On leaving the doctor’s office, I came to the conclusion that prostate cancer is the medical equivalent of Chinese water torture.
Just as I predicted, another PSA test in four months.
The doctor was concerned about the increase in my PSA, but reminded me that it’s still a low number. She also agreed that the change in test methodology had little to do with the increase. One variable eliminated.
She did another DRE just to be safe and didn’t feel anything that gave her concern.
We did talk about treatment options given where we think this is heading. Her immediate response was hormone therapy would be her first treatment choice, and she wasn’t at all keen on radiation because of its long-term side effect potential. That doesn’t mean she’d rule out radiation if it was something that I was really interested in pursuing.
We talked at some length about the conflicting literature on both radiation and hormone therapy, and she, too, agreed it can be confusing and maddening, even for urologists.
We talked about the timing of any potential treatment and her response was, “I don’t know,” mainly because we don’t have enough information to make a decision yet. The good thing was that she felt comfortable letting things go for another four months, and so do I. We need to better understand what’s happening before embarking on any treatment. She said some patients demand action after the first signs of a PSA increase. That’s not me.
The one last thing that we talked about and agreed on was the value of a baseline bone scan, so she put in an order to have one done. I just have to wait for the call to schedule it.
She never explicitly said, “the cancer is coming back,” but we’re sure behaving as though it is.
So bottom line, we establish a baseline bone scan, wait four months, and let the next PSA determine our next steps. She said to be concerned, but not to panic. Too late.