You’ll be happy to know that I’ve been thinking about this blog post since Friday. No, it hasn’t helped but it has helped me pick my topic for the week: Elephants.
You know those big gray things that show up in your living room and won’t go away until you talk about them. If you think about it, it is a bit of a strange expression, “The elephant in the living room” or “talk about the elephant in the living room.” Which is to say the thing that is so big, it just can’t be ignored – by the way, I did a quick google search on the phrase and it seems that the phrase entered the American lexicon in or about the year 1959 although some sources cite earlier examples.
Also while looking up the elephant phrase I remembered another saying by the respected alcoholic, Father Martin, when he said, “Variety is the spice of life, but routine in the essence of life.” I’d explain more, but the elephant is getting restless. Of course you understand that this is simply a delaying tactic so I don’t have to name what the metaphorical elephant represents.
Well, can’t put it off any longer. The name is: I had my six month PSA test.
Exciting stuff and enough to occupy my full emotional life for a couple of weeks with a host of irrational fears, deep paranoia with a touch of serious, and possibly clinical, depression. In all of this the voice of reason has been silenced and comforting sounds of sea shanties have been drowned out by the stormy seas of uncertainty and doubt.
I figure in matters such as this, I just go for the melodramatic and hope for the best.
So why the drama? Well, you see – this whole prostate cancer thing is a bit unnerving and while the treatment I had in February was appropriate and skillfully administered, there is still always that tiny bit of doubt. In prostate cancer the treatments are a numbers game – a gamble – based on probability and best estimates with no guaranties. The problem is that there are just so many variables that the problem can’t be simplified to, “Do X and you’ll get result Y.” The problem usually comes down to, “do A, B and C and there is a 95% probability that Y happens.”
What does this have to do with PSA? Everything. This simple blood test shows how well the treatment is working, or if the treatment failed. My first follow-up PSA test six months ago showed that the PSA had fallen by half which meant that the radiation did start doing its job.
The good thing and the most frustrating thing about prostate cancer is that it is a slow-growing and also a slow dying cancer. Slow growing is nice because it gives you time to get the right tests and select the best treatment, but zap the darn thing with radiation and the cells take their time about dying. The strange thing about radiation is it doesn’t kill the cancer cells outright. What it does do is to disrupt their DNA so they can’t reproduce and in time they die off. Before the bad cells die they pump PSA into the blood stream and this then becomes the measure of how many bad guys are left.
So for the foreseeable future I’ll have to get a PSA test every six months to measure how many prostate cells still live. As long as the number goes down or stays the same, life is good and I need no further treatments. But in the strange math of statistic probabilities and cancer cells there remains always the slight chance that some cancer cells escaped certain and final death to become a problem again. An event that would again change my life and send me seeking even more annoying and painful medical procedures.
Hence my fear of the test – it’s result. The little number in an email and the uncertain math, whose change dictates the quality and quantity of my remaining life.
The good news is that this time results came back low – dropped by half from the last reading and down to a quarter of the highest reading last year. In fact the level is slightly lower than for a man of my age, indicating that the radiation treatment succeeded and that I have every reason to hope that the cancer is gone.
From fear to hope. That is the theme of my week – the lens through which I am now looking at the world. And I can’t seem to find that elephant – he was right over there.
Hope and the realization of how precious life is.
So as we approach the Christmas season and the weeks pass I say to all of you, live life, enjoy the world around you and fill your days with love.