Spring Rushing Waters Moon
Kate was in the dentist’s chair for 3 hours. Four crown preps. All that drilling. Exhausting. She has temporaries on now. May 13 she gets the actual crowns. Much shorter visit.
Snow much less than predicted. Maybe 3 inches rather than a foot. Weather5280 reeled back their forecast, but we still got less than their numbers.
OK. New pastime. Looking up data about prostate cancer reemergence treatments. Ugh. So much information, so little of it digestible by this non-medical, non-science person. Imaging studies like the axumin scan have competitors. The data comparing those competitors is available, but mostly in journal articles. I can only read them for so long before my attention rate drops.
Another issue that arises is availability of certain imaging modalities. A promising new isotope based on gallium is not yet approved by the FDA. Only two , a choline based isotope which the Mayo Clinic uses, and the amino acid based axumin, have passed FDA trials. Even then, the trials vary in their consistency and in the type of information gathered. The gold standard of evaluation in imaging studies is histologic examination of their findings. That is, the sites identified by the imaging have biopsies and the pathologist determines if the cells are cancerous or not. Difficult to pursue in any numbers.
Once the imaging is done, which can produce 3-D maps of cancerous lesions, but with real caveats, especially the lower the presenting PSA rise, like mine, treatment plans are next. After a radical prostatectomy there are two treatments: hormone therapy (think chemical castration) and radiation. A huge issue in choosing treatments, especially newer ones like Cyberknife is the slow growth of prostate cancer. Statistical studies must be conducted over 10-15 year periods. If your new treatment is less old than that, the likelihood of good studies following actual patients are difficult to impossible to find.
So in both cases there are problems. This isn’t big news to those in medicine. Docs have to work with incomplete and unverifiable data all the time. That’s a major part of what makes practicing medicine such a high wire act and something I’ve come to admire the more I’ve learned. Even so, as a patient, I prefer certain knowledge and definitive options. Just. Not. Possible.
One more issue. Where to get treated. Right now my urologist has referred me to Anova Cancer Care. Anova and Urology Associates (my urologist’s group) are in the same organization. The more I think about it, the more I want a second opinion. Not because I distrust anybody, but because I want the chance to explore options other than the Cyberknife.
Although. Cyberknife does match up well with what I understand about my reemergence. The confounding factor with is the necessarily imprecise nature of the petscan. Cyberknife can kill lesions and tumors it knows are there. But, not ones that the petscan can’t find. There’s more, but I’m tired of thinking about it for now. Gonna go have breakfast.
We hit month 7 since Kate’s bleed yesterday. (To quote the Grateful Dead.) Procedures and imaging. Trips to the emergency room. Trips to doctors. The gradual shift in roles at home. Things have gotten clearer, some solutions have appeared, but nothing certain right now.
Synagogue shootings. Mosque shootings. Church shootings. I’ve not read of any Hindu temple shootings, but if they’ve not happened, it seems inevitable. A Southern Baptist clergy said, “…no one should be gunned down in worship.” 
Phone call today from buddy Tom Crane. In referring to the current kerfuffle within my body, those cancer cells, he said I was “wrestling with a dark angel.” That is so.
Recalled as I wrote this that I had a dream:
It’s a blue sky, sun shiny Colorado day. We get a lot of them though in recent months we’ve also had our share of dark and gloomy. I like both. The sunny days lift my spirit; the gloomy ones inspire my creativity.
Back to mussar yesterday. First time in quite a while. It was a gift, as was the minyan for Debra Copes’ mother’s memorial the night before.
Being away for a while makes me more aware of these moments. Yet Debra wanted me at her mother’s minyan. She did a universal worship service which consists of lighting candles for Hinduism, Zoroastrianism, Christianity, Buddhism, Islam, Judaism, and a general candle for other witnesses to the divine. Rabbi Jamie said, at a meeting a couple of weeks ago, “This ex-Presbyterian understands Reconstruction better than anybody else around this table.” Around the table were key leaders of the synagogue.
The Jewish approach to death, too. Sitting shiva with someone after a death. Having those in mourning stand and be acknowledged during the mourner’s kaddish at every worship service. Celebrating each year the yahrzeit, the year anniversary of a loved ones death. Calling together a minyan as Debra did for honoring her mother. Those who knew it, repeated the mourner’s kaddish from memory. A vital and key part of maintaining community, acknowledging that the dead live on, not gone, just absent.
Jupiter hangs west of the Rushing Waters Moon while Antares sits below it, also to the west. Black Mountain has a faint reddish glow as dawn sun pushes up the Shadow Creek valley. In this light our lodgepole pines look lush, a vibrant healthy green against the red-tinted Black Mountain. Another Rocky Mountain morning.
Swimming in denial. That’s me. I sent an apology e-mail to Dr. Eigner saying I had misstated my PSA. I wrote it to him as 1.2, but it was really .12, I said. Just got a call from Anna Willis, his PA. Nope. I had it right. It was 1.2. Guess I wished it to be .12 so I decided it was. Nope. The second PSA I had was, in fact, 1.3. Well.
I have a sort of buzzing in my head, a feeling of my body as more of a barrier to the world, heavy. Staring, sort of off into the distance. As I’m writing, I stop. Then, realize I’m stopped. Go again.