Clearly it had become time to either cut bait or fish.
Weeks of intensive Internet searches about prostate cancer, its impact, its treatment and the consequences for doing nothing had built up to the point of agreeing to formulate a life-saving protocol.
With the praise-worthy word that my full-body bone scan was clear I had reached that juncture.
Besides, after sitting for well more than an hour and listening to urologist Lawrence Wolkoff present his case and all the options my butt was starting to get sore.
Much of what Wolkoff offered was material that proved to be a bedspread to the heavy blanket of material sewn by the threads of countless Google “hits” I’ve struck since first hearing the word “cancer.”.
Running through the rather substantial print-out document, Wolkoff pointed out any number of items. What’s a prostate, what’s prostate cancer, Gleason score, PSA ranking and so on; an entire lexicon of terms that dog a mature male who is side-swiped by the disease.
Questions were raised, answers were given; sometimes the former being posed before the latter had an opportunity to express itself.
It is my curse and that of everyone else in journalism, really. We are imprinted at our writing births to probe, investigate, prod and generally make a pest of ourselves.
At least Wolkoff has a great bedside manner. He took my inquiring jabs and thrusts in stride.
For her part my wife, Bev, was the quiet one. She sponged up the presentations that fell to the floor, asking about such affairs as what does radioactive “half life” mean and what about the side effects of radical surgery.
When the document’s menu was exhausted and Wolkoff had spoken his piece, he concluded by saying that Bev and I could take some time to review the material.
We could even seek a second opinion.
On that score I had pigeon-holed in my breast pocket a slip of paper scrawled with the names and telephone numbers of two other urologists.
“No,” I thought to myself.
And with a quick nod to my bride of 40 years I made my peace and gave the green light. My decision would involve the implantation of tiny radioactive metal pins, called “seeds.”
This option was plucked over radical prostate-removing surgery. There, Wolkoff would unsheathe his scalpel, carve away at my lower torso and extract intact the diseased prostate and its two cancerous tumors.
Along with such connecting tissue that includes a pair of lymph nodes.
Noting the advantage of radical prostate-removing surgery that includes once gone, always gone, Wolkoff did not object to my alternate selection of internal radiation treatment.
“You’re an excellent candidate for either one,” he said.
Told that if I were cloned (world: imagine there being two of me. Scary, huh?) and one of me were pried open by surgery while the other one would undergo being zapped by sub-atomic particles each would stand before Wolkoff 12 years hence.
Thus, it was actually a fairly easy decision. I took the fork that I did for several reasons.
For starters, with radical surgery I’d be laid up in a hospital for several days. And I would have to tend to a catheter installed in my penis for up to two weeks, endure likely incontinence and impotence for who knows how long, plus enjoy some other side effects equally too yucky to expound upon.
The placement of radioactive seeds in my slightly larger than walnut-sized prostate does come with a “do not remove” cautionary tag, however.
I’ll have to have my PSA level rated every six months. If it rises above “1” then the cancer has returned and I will have reached a point of no return where the radiation-juiced-up prostate could not be removed.
As a result, I’d have to go into containment/remission mode.
“If you were 52 instead of 62 I’s highly recommend surgery over radiation seeding,” Wolkoff said.
The thing is, says Wolkoff, my diligence at getting a PSA test every year along with my annual check-up in all likelihood saved my life.
For one simple reason, he says.
The recent rectal exams performed by both Wolkoff and my family doctor, Mike Baranauskas, showed only a slightly enlarged prostate. Absent were any lumps, bumps, protrusions, ripples or any other oddity that would point to a too-late, too-diseased organ.
By me assembling a 12-year-long spreadsheet of PSA numbers the doctors concluded that the last figure had spiked. It was as striking a red flag as ever there was one, Wolkoff said.
So this is what will happen next. On June 5 I’ll file myself into TriPoint Hospital. There I will get some sort of chemical poured into my blood stream that causes a dreamless episode of sleep.
During my drug-induced nap time Wolkoff will take up to two hours to remove the side-saddling lymph nodes. A pathologist will examine the nodes and determine whether they've been compromised by cancer, a 10- to 15-percent possibility.
If these nodes are cancer-free I’ll meet with Wolkoff’s partner on June 25 for a consult on how the seeds are to be implanted.
It’s actually kind of cool. In the past when doctors used the medical equivalent of a blunderbuss, rice grain-size radioactive “seeds” were scatter-shot into the prostate gland.
Some of these pellets would land next to each other. Still other seeds would fall by the wayside and not even hit the paper let alone strike the 10-ring tumor bull’s-eye. None of these misplaced radioactive lambs could then find their way home within a tumor’s corral.
On the other hand, today’s seed-planting methodology leaves no cancerous furrow untouched.
What is now the case is a two-person sharp-shooting sniper team that can launch radioactive projectiles directly into the enemy’s camp, taking out the cancer’s command and control center.
Neat, if you ask me. And I was by Wolkoff who said this was the perfect choice for me.
Bev agreed. And now I must wait once again. And pardon me if I say “wait on the Lord once again.”
They say there are no atheists in foxholes. Well, I’m here to tell you there are not too many on operating tables, either.
One step at a time, Jeffrey, one step at a time.
-Jeffrey L. Frischkorn
JFrischkorn@News-Herald.com
Twitter: @Fieldkorn
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