We all walk ancientrails. Welcome to the journey.

Cancer Returns

Written By: Charles - Apr• 15•19

Spring                                                                  Rushing Waters Moon

cancer-cell

Cancer cell

Had to go at this head on, today, while it’s fresh. When I got to my appointment with Anna Willis, Dr. Eigner’s P.A., the first person in the room was Eigner himself. Grayer and thinner, he smiled, shook my hand. When I said it was good to see him, he said, “It’s good to see you, too, but I’m not happy about the reason.” When I told him my anxiety made me move the decimal place on my PSA, his relief was obvious, “Thank god.” Anna came in about then.

They both remembered me. Anna remembered my glasses and our visits. Eigner remembered me partly because I’d sent him a couple of emails over the years thanking him, telling him about my life. It was one of the warmest visits I’ve had in a doctor’s office and that felt good.

Davinci_roboticArm_skyRidge_Low

Davinci robotic arm, Sky Ridge (where I had my surgery)

Turns out though. “When you’ve been perfect (a .1 psa which means essentially undetectable) and that changes, it’s scary.” He went on to say that it most likely does mean a recurrence, a relatively rare thing for those who choose prostatectomy, even rarer if the pathology report read, as mine did, clear margins. Clear margins means no cancer was found on the outside of the prostate. The best news.

Dr. Eigner took out a piece of paper and drew a sort of oblong on it. “This is the prostate. They can’t take sections from every part, so they take representative slices. If the cancer is between those slices, it won’t show up on the path report.” Oh, shit.

Since it is three and a half years since my surgery, and since the number for the uptick is relatively small, it means the recurrence is probably local, that is, in the area where the prostate used to be. That’s good news, much better than metastasis.

The plan is to redo my PSA in three months, doing the super sensitive one that can take the numbers 3 or 4 places rather than just two. If it’s still rising, I’ll get a referral right away to the oncologists to discuss radiation. “We’ll just go in there and kill it,” he said. “If you were older, I’d tell you not to do anything. This will take ten years to manifest anyhow, but at 72 you’ve still got a lot of life ahead of you.” That’s my opinion, too.

the Prostate Specific Antigen

the Prostate Specific Antigen

Radiation has some potential downsides, so I hope we don’t have to go that route. But, as I said to Kate, I’ve always chosen treatments that offer the best chance to remain active, and alive. I chose repair for my torn Achilles even though it means two months of no walking and crutches for a good while after. I chose knee replacement over other treatment options because I wanted to continue exercising. I chose a radical prostatectomy because that gave me the best shot at a cure. Likewise here, if radiation is the option that gives me the best chance to survive and thrive, I’ll choose it. No doubt.

All that’s the rational side, and that’s pretty damned important because these are high risk, high reward decisions. But they’re not all of it.

On the way back from Eigner’s I drove through Deer Creek Canyon. When my biopsy confirmed my prostate cancer in 2015, I drove Deer Creek Canyon, too. Going through there I felt the rock, rock so old that our human scale word ancient is quaint. This rock rose millions of years ago and it will slowly soften, the rough edges frozen and thawed, rained on, plant roots will crack them, and Deer Creek will carry the pebbles and sand to the Platte River on its way to the Gulf. Not only will I be dead long, long before then, it may be that the human race will have ended itself well before then, too. This comforts me.

Laramide Orogeny, 70 million years ago, begun. 35 million years ago, ended. Built the Rockies

Laramide Orogeny, 70 million years ago, begun. 35 million years ago, ended. Built the Rockies

William Cullen Bryant’s “Thanatopsis” came to mind. See the opening stanza below.* He goes on to make the point that the earth itself is a great tomb, holding all those who once lived. Again, this comforts me. Death has not chosen me for a special fate. No, death itself is a universal for all who live. It seems harsh and cruel, yet it is, rather, the opposite. Death ends suffering. Allows the world to carry many creatures, but not all at once.

Here there were Utes and Apaches, Comanches, too. And even they were not the first. Older humans preceded even them. And before all came the Rockies, then the trees, the lodgepole pines and the ponderosa and the bristle cone, the aspen. Mountain lions, deer, elk, rabbits, raccoons, pikas, prairie dogs, bison, moose, wolves, fox, martens, fishers, beaver. All here before humans, most will be here after we are gone. I can look at the lodgepoles in my front yard and know that their direct ancestors flourished here thousands of years ago and will do so after I’m dead.

All this brackets whatever troubles I may experience, even cancer. And cancer may be that friend that carries me off to the mighty sepulchre. Or, it might be something else. Whatever is my death-friend will not be an enemy, but the specific cause of my life ending. And that is, for all of us, in spite of our fears, a good thing.

 

Kindred Spirits by Asher Durand William Cullen Bryant and Thomas Cole

Kindred Spirits by Asher Durand William Cullen Bryant and Thomas Cole

* “To him who in the love of Nature holds

Communion with her visible forms, she speaks
A various language; for his gayer hours
She has a voice of gladness, and a smile
And eloquence of beauty, and she glides
Into his darker musings, with a mild
And healing sympathy, that steals away
Their sharpness, ere he is aware. When thoughts
Of the last bitter hour come like a blight
Over thy spirit, and sad images
Of the stern agony, and shroud, and pall,
And breathless darkness, and the narrow house,
Make thee to shudder, and grow sick at heart;—
Go forth, under the open sky, and list
To Nature’s teachings, while from all around—
Earth and her waters, and the depths of air—
Comes a still voice—
                                       Yet a few days, and thee
The all-beholding sun shall see no more
In all his course; nor yet in the cold ground,
Where thy pale form was laid, with many tears…
The oak
Shall send his roots abroad, and pierce thy mould…
Thou shalt lie down
With patriarchs of the infant world—with kings,
The powerful of the earth—the wise, the good,
Fair forms, and hoary seers of ages past,
All in one mighty sepulchre.”

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