Tuesday, September 16, 2014

PART XXVI: follow-up PSA testing - it was a poor result

We went into Ottawa Hospital, left at 10:45 - home by 5:30. Seriously.
The appointment was for 1:45. Got to the hospital by 1:20, we weren't seen by the doctor until 3:20 - he was called to emergency to do some surgery.

It wasn't all doom and gloom. We were laughing in the waiting room, he didn't mean to look so grim!

Good to go as a team.
He was watching as I concentrated trying to take the photo. There is a fabulous nurse, Leonard, who makes us all grin. He ushered us into a cystoscope appointment, as ever saying 'Come on in, make your bladder gladder!' I took Leonard aside yesterday, and quietly told him how he lightened the mood in the waiting room. People catch one another's eyes, strangers, and giggle as he does his shtick!

Then there was the woman who came in on a stretcher, pushed by an orderly. He stopped, took a huge binder (her records) and handed it to the people at the counter.
She lay there, we looked at one another, the sheet was up over her face. She look very old and very sick. I wondered if she was alive, but she had to be.
The nurse came over and asked if she could remove the sheet and if she was ready to wake up! We were relieved!

Test result: His PSA is far too high for someone whose prostate has been removed (0.58). Dr. says he wants two tests done to see if they can pinpoint the prostate cancer cells that remain. This should happen before late October. At which time we go back to the doctor to agree to a treatment plan.

The last time both tests were done at the Civic, which is a difficult place in which to get a parking spot. The doctor is the Urologist Specialist at the General. He is very good.

 The quickly rising score, PSA 0.28 in early 2014 after surgery, to June 0.46, to this one of 0.58, indicates that it's distant cancer, meaning it has metastasized. The scans will let us know if that is the case, and where it is.

 Micrometastatic disease is present, possibly in the lymph nodes or bone. There is also a possibility of local recurrence. The doctor wants to do another CT scan and Bone Scan, to look for possibility of disease. If they see signs of distant disease, he'll be put on hormone therapy (androgen therapy – i.e., chemical castration to limit the testosterone in his system). If no signs, sit tight. Or radiotherapy for a local treatment. Won't help if it's distance disease, with a Gleason 8 score it is likely metastatic, i.e. spread. Radiation treatment: 5 days/week for 7 weeks. I just shudder. Symptoms: Hair loss (but how would we know?!), fatigue, upset stomach (which is likely with his stomach issues).

Bless his heart, he's never asked, "Why me?" Nor played the pity party. We really don't know why cancer cells begin to grow.

The cystoscopy was interesting.
Bladder from the inside from Jennifer Jilks on Vimeo.
Cystoscopy: to quote our nurse, Leonard, "Make your bladder gladder!"

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