The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

Tuesday, August 5, 2014

Dealing with Unnecessary Worry


Two favorable characteristics of IMRT caused me to go for the procedure. First, the fact that the radiation does not interfere with normal tissue it traverses but only affects targeted cancerous cells. Second, the fact that the process of cell death or apoptosis continues for a year-and-a-half to two years after IMRT is completed.

In the just over a year (June 27, 2013) since I finished the 45 sessions treatment, I have watched my PSA fall from around 26 to—at last reading three months ago—a PSA of 2.81, an impressive drop to a level I haven't seen in a quarter of a century.

A week ago I went in to doctor's office for another PSA. I have not heard the result, which is unusual since I usually get the results in a day or two. So when a week had passed, and still no word, I began to worry. Is he holding back because the results were not favorable? By all counts, the PSA ought to have dropped below two. Has it actually gone up?

I found myself growing more and more anxious with each passing day. I remembered what Lisa Chaikin, MD, an admirable and patient teacher, who is in charge of St. Johns Hospital’s IMRT program, had told me: that the cancer cells turn over slowly. More and more die off with the passage of time. The impact of the radiation, the damage, is done. But the process takes time.

In my anxiety, I called Dr. Chaikin and told her about my new concern. She told me, “The cancerous cells try to reproduce, their radiation-damaged DNA blocks their reproduction.  So the rise is expected to slowly decline over a period of a year or two. However, the PSA does not decline in a straight line.  It can bounce up and down a bit before it stabilizes. So even if the PSA has gone up a little there is no reason to worry. It's the long term trend matters."  

So being made aware of the possibility of a PSA bounce relieved my mind.  Took the worry away.  Enabled me to wait without concern.

When the PSA report finally came in: 3.0, a bare rise and no reason for concern.  And I had already given up worrying.  A big step!  Waiting for test results is always a difficult time.  Even if the results are not what you want to hear, knowing in advance what to expect makes the uncertainties easier to deal with.

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