Tuesday, August 15, 2017

Four Reasons It's Difficult to Make A Prostate Cancer Treatment Decision


It took seven emergency room visits, two urgent care visits and two private appointments before doctors understood why I was suffering from bouts of excruciating pain. My chest X-rays, lab tests and an abdominal CT scan all came back normal. Then I had a sonogram.
The day after the sonogram, I was immediately referred to a surgeon. He felt my abdomen, and told me my gallbladder was swollen to the size of a melon. Then he pulled out the sonogram and he showed me a large stone lodged in the neck of my gallbladder. He said, “I’m sorry to tell you this, but your gallbladder has to be removed.” I had surgery the following week.
As I compared and contrasted my experience with gallbladder and prostate surgery, the differences were striking. With my gallbladder, I experienced painful symptoms. I knew something was seriously wrong. I saw many doctors and went through blood tests and diagnostic procedures. It took time, tests and multiple doctors before I received a diagnosis.
With prostate cancer, I was symptom-free. I went in for a prescription refill. A doctor I’d never seen before insisted on performing a prostate exam, even though I’d already had this exam within the previous six months. I was stunned when he told me that he felt “a suspicious lump” and that he needed “to schedule [me] for a biopsy.”
It took time and multiple exams and physicians to get a correct diagnosis for my gallbladder. My prostate cancer was discovered on a routine visit to a urologist, then confirmed with a biopsy.
When I went to a surgeon to discuss the results of the sonogram of my gallbladder, the surgeon made it quite clear that my gallbladder had to be removed as soon as possible.
With my gallbladder, I wasn’t asked how I wanted to treat this problem. My doctor made the treatment decision based on my diagnosis. All my life, I thought doctors were trained and paid to make treatment decisions.
When I went to my urologist to discuss my prostate biopsy results, he asked me how I wanted to treat my prostate cancer. I thought he was joking. I didn’t feel qualified for or capable of making that decision.
I left the appointment with my urologist frustrated, angry, frightened, confused and scared that I was responsible for making the treatment decision about the most serious disease I’d been diagnosed with in my lifetime. What’s more, I knew absolutely nothing about prostate cancer or the ways in which it was treated. How could I possibly make the correct treatment decision, based on my diagnosis, when I was totally ignorant?
All I knew was that I wanted to be treated as soon as possible. When he told me to come back in a week to discuss my decision, I felt as though I was living a nightmare.
I met my urologist a week later to discuss my decision. There was no way I was going to make a treatment decision before I heard from the doctor, whom I trusted with my life.
When he adamantly refused to tell me how I should treat my prostate cancer, I had to get his opinion another way. So I posed a question to him: “If you just received my biopsy results, how would you treat your cancer?”
Without hesitation, he said, “I’d go for surgery.”
That’s the treatment option my wife and I were thinking would be best. With his input, our decision was confirmed.
With the variety of treatment optionsavailable, how to treat your prostate cancer may be one of the most difficult decisions you’ll make in your lifetime.
For the majority of men, taking weeks or months to consult with a variety of doctors will not affect your outcome or long-term survival. But it is important to ask your doctor if delay will affect your outcome or survival.
Several factors make it difficult for men to decide how to treat their prostate cancer. Among the challenges:
  • Cancer is a frightening word. By the time you are old enough to receive a diagnosis of prostate cancer, the odds are that you’ve known a friend or family member who has died of cancer. Your personal experiences with cancer will influence how you perceive your diagnosis and how you should treat your cancer.
  • If you know little or nothing about prostate cancer, it’s nearly impossible to understand how to treat your disease based upon your diagnosis rather than your fears.
  • So many treatment options exist that it’s difficult to know and understand which treatment option would be most effective.
  • Quality of life issues are associated with different treatment options. Losing urinary control, sexual desire, experiencing penile shrinkage or erectile dysfunctionare frightening possibilities.
If someone were to ask me what was one of the most difficult decisions I’ve had to make in my lifetime, there’s no doubt I’d say choosing how to treat my prostate cancer is right up there.
There’s no single right way to treat your prostate cancer. Before you make your treatment decision, consult with a variety specialists. Take time to read about the various prostate cancer treatments. Talk with men who’ve chosen different options.
Us Too is one of the many helpful organizations around to help men diagnosed with prostate cancer get the information and support they need.
If you base your decision about treating your prostate cancer on your specific diagnosis and information, rather than your fears of cancer, you’ll discover the right treatment choice for you.

This blog originally appeared in Prostate Cancer News Today 

Friday, July 28, 2017

Coping With Cancer Gracefully-Lessons Learned From My Aging Dog

My last year with Cheri, a 16-year-old black Labrador retriever, was a difficult year. Her deafness progressed to the point where she couldn’t hear or respond to my voice. I began screaming at her, hoping my volume would penetrate her level of deafness. I came to the realization that screaming at Cheri contained elements of anger and frustration, which was inappropriate to the circumstances.
At first, I thought my reactions were due to the frustration and difficulty of trying to communicate with a dog that couldn’t hear me. It took almost a year to realize I didn’t like the changes that occurred in Cheri. I was equally unhappy, frustrated and angry about the changes that occurred in my own life post-surgery.
It became very clear to me that unless I learned how to treat Cheri kindly, there was no chance I’d learn to treat myself kindly. Therefore I became highly motivated to find a different way to communicate with Cheri. I needed to communicate in a way that involved kindness. Because her sense of smell was intact, I paired a gentle nudge with a piece of cheese by her nose.
When she’d get up to follow the scent she was rewarded with a piece of cheese. Eventually, Cheri would get up with a gentle nudge. We’d found a way to communicate!
Toby, our King Charles spaniel, found his own way to communicate with Cheri. If he wanted Cheri to come outside with him, he’d go to where she was lying down, sniff her and circle around her until she got up and followed him. I paired Toby’s behavior with a command and a treat. Eventually, I could tell Toby “Get Cheri,” and that’s exactly what he’d do. Finding one kind way to communicate, led to another.
In the process of learning to communicate with my deaf and partially blind dog, I discovered it’s a colossal waste of time, effort, and energy to rage against the inevitable changes that aging brought to Cheri — and that a prostatectomy brought to me. Making peace with the changes in Cheri’s life was the first step in making peace with the unwanted changes I experienced after prostate surgery.
If you’ve been treated for cancer, or you are the partner to someone treated for cancer, the odds are you’ve experienced more than one unwanted or unpleasant change.
Have you found kind, graceful and loving ways to cope with those unwanted changes? If so, would you share how you’ve done that? If you are stuck in negativity, I hope you’ll reach out to someone further along in the journey to find new ways to cope.
I never expected an aging dog would be my teacher.

Why Waiting for Test Results Gets More Difficult

I went to my doctor a few weeks ago complaining of pain on my right side. He thought it was a hematoma. He told me to use a heating pad twice a day. He wrote out a prescription for me to have a sonogram, which he said he’d place in my file. I was to call his office for the referral in two months if the pain didn’t go away.
Because of a mistake in his office, I received my referral for a sonogram in two weeks rather than two months. You have to have faith to understand what I’m about to share.
Before I could tell them the referral was a mistake, I heard from the Holy Spirit. It was made clear to me this was God’s way of overruling the delay and that I needed to get a sonogram now. So, I made the appointment for a sonogram.
My sonogram was on a Monday. I was told my doctor would receive the results by Wednesday. I expected to hear from him by Friday.
As I waited for the results, I asked my wife about an issue I found troubling. With all the waiting for test results we’ve been through over the past six years, I asked her if waiting for test results became easier or more difficult over time?
Without hesitation, she said, “Much more difficult.” I breathed a sigh of relief because I wasn’t alone. Waiting for test results is significantly more stressful for me now than it was before I was diagnosed with prostate cancer.
It’s obvious to both of us that we are not getting better at waiting as we gain more experience. I’m certain the reason for this has to do with our experiences with prostate cancer.
It took no effort on my part to imagine I had colon cancer or some other type of cancer. When you worry about receiving news of a reoccurrence, a spread of cancer, or any other life-threatening possibilities, waiting for your test results becomes highly stressful.
Losing sleep, becoming preoccupied and irritable, withdrawing from people or the world, and using drugs or alcohol are some of the things people experience or do as they wait for test results.
The morning after my sonogram, my phone rang. I wasn’t able to answer the call so it went to voice mail. At noon, I listened to the message. It was from a surgeon’s office asking me to call for an appointment!
Hearing that message sent me into a full-blown panic. A day after taking a sonogram, my first phone call came from a surgeon’s office rather than from my doctor. When you receive a referral to a surgeon one day after a test, there’s good reason to be concerned.
I imagined the news was so awful that my doctor wanted a surgeon to discuss the test results with me. I immediately called the surgeon’s office. They were closed for lunch.
It would be 90 minutes before they returned. My wife and I tried to come up with any positive possibilities, but the suddenness of a referral to a surgeon frightened us both. Waiting 90 minutes seemed like an eternity.
At 1:30, I called the surgeon’s office to make my appointment. After we set a date, I asked the person I was speaking with if she’d mind looking at the referral and tell me what type of surgery I’d be discussing with the surgeon. She put me on hold, checked the notes, and told me I was coming in to discuss gallbladder surgery.
My gallbladder is the third organ-removal surgery for me. First was my appendix, then my prostate, and now my gallbladder.
I decided to throw myself a pity party. I called to invite a friend. When I shared the news about my surgery, he said; “God is bringing you home one organ at a time.” His comment caused me to be abruptly evicted from my own pity party.
Guests who laugh are not allowed at pity parties, even if you’re the guest of honor. His comment was a great reminder of the power of laughter and humor as we cope with health issues or unwanted change.
His comment also reminded me of my faith. How I got in for a sonogram was a “God thing.” God wasn’t calling me home right now — He’d intervened in a way to hasten my healing. That’s a call to gratitude. Laughter and gratitude are two powerful ways to get through any unwanted changes.
A few questions to consider:
1. Has waiting for test results gotten easier or more difficult over time?
2. Whatever your answer was, what are you doing that makes it easier or more difficult to wait?
3. What, if any, role does your faith have as you wait?
4. Have you ever brought humor or gratitude into your time waiting? If you have, did it make a difference? If you haven’t, will you try to the next time you wait for test results?
I hope you’ll share whether waiting for tests results is easier or more difficult as you’ve gained experience with waiting.
Originally published by Prostate Cancer News Today 

Saturday, July 8, 2017

Don't Let Erectile Dysfunction Steal Your Manhood

“Erectile dysfunction is a thief. ED takes away physical and emotional intimacy. ED steals your confidence in the bedroom. ED robs you of your manhood. ED walks off with your self-esteem. Left untreated, ED has the power and potential to destroy lives and end relationships.”
I never realized the powerful association between my ability to maintain an erection and my sense of manhood, until I lost that ability. From that point on, I was trapped in a cycle of negative thinking that opened the door for ED to steal my manhood.
Here are some destructive thoughts brought about by ED:
• I’m worthless as a man.
• I’ll never be able to sexually satisfy my partner.
• My partner would be better off without me.
• There’s no point to maintaining any type of sexual relationship.
• I’m a total failure.
• I’ll never enjoy sexual pleasure again. (At age 58, I had no idea a man could have an orgasm with a flaccid penis.)
Any one of these thoughts has devastating effects on a man’s sense of self-esteem, his confidence, his sexuality, and his relationship with his partner.
In an effort to avoid thinking any of these painful thoughts and corresponding emotions, men typically withdraw from their partner emotionally, physically and sexually. All forms of physical affection disappear. Verbal expressions of love and tenderness also vanish.
As his partner become increasingly unhappy as a result of being abandoned, a man with ED mistakenly views this as proof that the’s lost his ability to please his partner. Men use anger or stonewalling to shut down any and all discussions about erectile dysfunction. Shame and embarrassment fuel their resistance to seek outside help.
It’s important for men to understand that ED is powerless to steal your manhood without your permission. Like me, most men open the door for this thief as a result of getting trapped in a cycle of negative thinking that comes from coping with ED.
Breaking that cycle and reclaiming your manhood involves overcoming your shame and embarrassment in order to seek help. Here are places to go to receive that help:
Your doctor or urologist is the first stop. After that, here are some other resources:
I’ve discovered it’s possible to develop a healthy and mutually satisfying sex life without erections. You can, too, if you are ready to challenge your shame and embarrassment in order to seek help. It’s embarrassing to admit this, but I never knew a man could achieve an orgasm with a flaccid penis.
There’s much to learn in order to reestablish an enjoyable sex life when you are impotent.
Wherever you are in your journey coping with ED, your thoughts and comments are welcome.

This was reprinted with the permission of Prostate Cancer News Today 

Staying Together in Sickness and in Health

On June 7, my wife and I celebrated our 37th anniversary. For six of those years, we’ve been coping with the quality of life issues associated with my prostatectomy. For many years, these issues had a negative impact on my self-esteem and our marriage. In order to preserve our marriage, we sought professional counseling.
Every year since my prostate surgery, it seems I’ve had a new health crisis or surgery. Here’s a few of those medical challenges.
I suffered lots of wrist pain for a long time. Finally, I went in for an exam. Turns out I needed surgery for carpel tunnel syndrome.
Sometime after that surgery, I tripped over my dog, fell, and injured my shoulder. I was in constant pain and unable to sleep well. It took almost a year to get a diagnosis and finally have a rotator cuff repair. After surgery, I spent almost two months in a sling, then three months in physical therapy.
Each year, a new health crisis has a negative impact on the quality of my life and the ability to enjoy time with my wife. For these reasons, I wrote my wife the following on her anniversary card:
“Today we celebrate our 37th anniversary. I’m not sure whether our best days are behind us or whether our best days are yet to come. Either way, I’m blessed to journey through life with you.” 
Shortly after I wrote that note, I received the unexpected news I need surgery to have my gall bladder removed. My wife and I stopped counting the number of surgeries I’ve had after I reached my tenth surgery.
All of these storms, unwanted changes, sleepless nights, months of chronic pain, multiple surgeries, physical therapy, and illness have taken a huge toll on me, my capacity to function, my ability to enjoy life, my energy level, and my capacity to love my wife.
I have no idea whether we will get a break from health challenges or whether this is the new normal for me and for us as a couple.
If this is our new reality, I believe the best is behind us, rather than yet to come. This is certainly not how I hoped to spend my “golden years.” There’s one thing that has been a blessing through all of these trials.
Thirty-seven years ago, my wife and I made a vow to each other before our friends, family, and God. We promised to stay together in “sickness and in health.” In our youth, and in good health, we had no idea how difficult and challenging keeping that vow would be.
For many years after my prostate surgery, I was convinced  my wife would be better off without me, rather than with me. I’m blessed beyond measure to be married to a woman who is committed to keeping her wedding vows.
How you treat your partner as they recover from an illness or surgery can affect how quickly they heal. A recent study found that patients whose partners displayed empathetic behaviors like emotional support, affection, and attention showed improved physical function over time.
There’s a reason your marriage vows included the promise to stay together in sickness and in health. We need each other, and we are more likely to successfully navigate through the storms of life as a team.
I pray those couples tempted to break that promise will reconsider and get help in order to preserve your marriage and keep the marriage vows you made to one another.
It’s my prayer that couples facing the challenges of coping with the unwanted changes brought about by cancer and/or the quality of life issues couples face after treatment, will enable you to grow closer together, rather than further apart.
If your partner made a difference (positive or negative) in the way you coped with cancer, I hope you’ll share your story so other couples can learn from your experiences. 

This was reprinted with the permission of Prostate Cancer News Today 

Redeeming Unwanted Change

In my younger days, driving an RV 600 miles in a day wasn’t my favorite thing to do, but I had the energy and ability to do so.
As my wife and I drove to Yellowstone National Park, we planned to arrive at our campground in three days. This meant we needed to drive approximately 350 miles a day. I expected this to be an easy task to accomplish.
I’m not a fan of unwanted change. Whether those unwanted changes come naturally as a result of getting older or from my prostatectomy, I tend to react with frustration and anger. The first things I do are born from desperation and a futile attempt to get back what I’ve lost.
On our first day, we had to drive 375 miles to our campsite. I became seriously fatigued before we drove 250 miles. With the help of three cups of coffee, we made it. Since I don’t like drinking coffee, I purchased caffeine pills for day two.
Day two was a 325–mile drive. I thought it would be easier for me. I was wrong. I was exhausted before we drove 200 miles.
When it took two caffeine pills and coffee to get to the next campground, it became very clear to me something had permanently changed. I was no longer capable of driving 600 miles; in fact, 300 miles was a push.
I have a family history of high blood pressure and strokes. I’ve had high blood pressure for decades. It’s only a matter of time before I experience a stroke. Overdosing myself with caffeine — not once, but on multiple days — will hasten the day I’ll experience a stroke, which is why my first thought was to quit RVing.
After talking to my wife, my perspective was radically changed. We came to the conclusion of slowing down our pace in order to have time to enjoy God’s creation, our campgrounds, our day, and each other. It’s taken me 65 years to figure this out. I couldn’t decide whether to laugh or cry.
I believe successfully coping with this unwanted change due to aging set the stage for me to successfully cope with a change brought about by prostate surgery.
Years after regaining urinary control, I’ll still leak. A cough, bending down, lifting something, an unexpected sneeze, all can cause me (and most men living without their prostate) to leak urine.
I’ve experienced another issue I haven’t found discussed in the literature. After I’m finished urinating, I can experience a delayed leak of a significant amount of urine. When this happens I wet through my pants.
While on a tour of Yellowstone, that’s exactly what happened to me. My shame and embarrassment went through the roof. Not only was I with strangers, but also my oldest son and daughter–in–law were on this tour with me.
As I examined the noticeable wet spot, I thought about my options. My preferred option wasn’t possible. If I had a private restroom I would have removed my pants and put the wet spot under the electric hand dryer. Since there were others in the restroom, that option was closed. Option two was to towel dry the spot and hope that I didn’t end up smelling like urine. Option three was to wash the spot off, towel dry my pants, and walk back to the tour van with a much larger and noticeable wet spot on my pants.
I was surprised that the decision was easy. There was no way I wanted to risk smelling up the tour van with urine. I took soap and water, washed the urine spot, then towel dried my pants. My wet spot was significantly larger and more noticeable as I left the restroom, but I didn’t care.
I realized I’d put the welfare of others ahead of any potential shame or embarrassment I might feel. If anyone asked me how my pants got wet, I was prepared to say, “I spilled water on my pants,” which is exactly what I did. There was no need to add that I spilled water on my pants because I’d leaked urine on my jeans.
Just as I’d come to accept my limitations on driving my RV, I came to accept the reality of occasionally leaking urine on my pants. I’d come a long way since surgery. When I leaked through my diaper and wet my pants in public, I refused to have friends visit and I refused to leave home for an entire month.
What unwanted change has your treatment of prostate cancer brought into your life? Are you still unhappy or at war with those unwanted changes, or have you made peace with them?
This was reprinted with the permission of Prostate Cancer News Today 

The Blessings of a Redo

Two days after my disastrous Florida vacation (read my last blog), I had a second vacation scheduled. My wife and I planned to meet our eldest son and his wife on a 10–day RV trip to Yellowstone. They were flying in, while we drove our RV.
Unfortunately, I returned home from Florida so sick that we had to cancel the trip. I was devastated. My illness ruined not one, but two vacations. Since our daughter–in–law is expecting in October, this was our first and last opportunity to camp together without children.
Sometimes life gives us a redo. To our delightful surprise, my son was able to change their flight reservations without penalty, and my daughter–in–law was able to reschedule her vacation.
My wife and I are meeting them in Yellowstone in two days! I’m on the road to Yellowstone as I write this blog. My heart is brimming with gratitude for this opportunity for a redo.
Sometimes life does not allow for redos. When that occurs, we are stuck with the negative, sometimes tragic consequences. A dear friend of mine was taking a shower when her phone rang. Rather than allow her answering machine to pick up the message, she decided to answer.
On her way out of the shower, she fell and broke her hip. She experienced multiple complications following surgery, which led to her death. She died because she hurried out of the shower to answer a phone call that didn’t need to be answered. She might still be here today had she allowed her answering machine to pick up the message.
In the last six years, I’ve heard from many widows whose husbands never bothered to have their prostate checked until they were experiencing symptoms of advanced prostate cancer. According to this survey, nearly seven in 10 men ignore these symptoms and further delay treatment.
There is an ongoing controversy whether prostate cancer screening does more harm than good.
As I drive my RV to Yellowstone to camp with my eldest son and daughter–in–law, we plan to create memories that will last a lifetime. In October, we plan to see them again to meet their first child.
Ironically, my diagnosis of prostate cancer is the reason this trip was possible. After recovering from my prostatectomy, I decided there were things I wanted to do that couldn’t wait until I retire. Buying an RV and traveling were two things on my bucket list I wanted to do while I was blessed with restored good health.
In June, we are scheduled to celebrate the first birthday of our second granddaughter with our youngest son and his wife. They asked us if we could host a swim party at our home.
I believe I owe my survival and opportunity to enjoy these blessings to my yearly prostate cancer screening. With early detection and treatment of my prostate cancer six years ago, I received the biggest and best redo of my lifetime.
When it comes to prostate cancer, the path for a redo involves early detection. I get a lot of flack whenever I advocate for prostate cancer screening, but it’s the only way I know for men with prostate cancer to get a redo.
So men, if you are over 30, I urge you to get tested for prostate cancer. I know this may sound crazy, out of touch, or paranoid, but the incidence of aggressive prostate cancer in younger men is on the rise.
There’s nothing to lose and everything to gain when you can rule out or treat aggressive cancer earlier, rather than later. Find me a widow who would disagree. They’d give anything to experience a redo. I wake up every morning feeling grateful for my redo.
If you’ve experienced the opportunity for a redo due to early detection and treatment of prostate cancer, I’d like you to share your story here. Perhaps with enough encouragement, we can motivate those men who’ve resisted prostate cancer screening to make an appointment for this potentially life-saving exam.

This was reprinted with the permission of Prostate Cancer News Today