Another Dispatch from the Front

BY RALPH BLUM

In my Blog “Nervous Moments” I wrote about the sinking feeling in my gut—half panic, half “Oh s--t!”—when I learned that my PSA had spiked to 26. Since then I have done a course of Cipro, in order to determine whether the hike was a result of an infection (Jeanne and I had both had the flu). And I made an appointment with Dr. Duke Bahn for a color Doppler MRI.

If I had a significant bout of the flu, it wasn’t severe enough to effect my PSA which, on re-checking after the course of Cipro, was undiminished. The result of Dr. Bahn’s test showed a small but discernible progression of the cancer. Not what I wanted to hear, and as a result of his findings (pointing out on the images the enlarged dark cancer patches) I began to entertain serious thoughts of finally getting treated. But before determining the type of treatment I had to determine that the cancer hadn’t spread to my lymph system, or to my bones.

So it was back into the clickety-clack, thumpa-thumpa-thump of the MRI machine, with Vivaldi’s “The Four Seasons” soothing my ears. I admit, I rather enjoy the contrast: flutes and strings and kettle-drums. Directly following the MRI, I went next door for a bone scan.

The first results were provided by the same dayfollowed  the next afternoon by the results of the bone scan (“No evidence for any spread of cancer.”)  The news was great. Both were clear. Big sigh of relief. Thank you, God! So now the question is: to treat or not to treat? I started this journey back in 1990 when I was 58 years old, and apart from 15 months on hormone blockade (a single drug protocol with Lupron when my PSA last spiked in 2003), I have monitored my cancer with Active Surveillance. And now, at eighty I still have options.

I’m still in the process of decision-making. But I’m getting tired of the uncertainty, and I’m leaning toward placing myself in Dr. Lisa Chaiken’s competent hands. Dr. Chaiken is the chief radiation oncologist at the Santa Monica Treatment Center, a state-of-the-art facility for Intensity Modulated Radiation Therapy (aka IMRT) at St. John’s Hospital in Santa Monica.

So, finding myself at the decision point once again, in my next Blog, I will take a closer look at IMRT.  The odds are that it will become my treatment of choice.