The prostate cancer post

I can’t express how uncomfortable I am writing this, but I think it might be useful to other men in the same fix, so here goes.

I spent about eight weeks in the fall of 2015 at the Mayo Clinic having 36 doses of pinpoint radiation to kill off a recurrence of prostate cancer I’d had surgery for in 2011.

I didn’t deal with my original diagnosis especially well. Denial, confusion, a weird reliance on personal good luck, an uncomfortable reliance on (quite good) doctors who seemed to be flying blind themselves, and after a failed surgery, anger, depression, and fear. Turns out pretty much all of that is entirely normal.

What also turns out to be entirely normal is for a large percentage of prostate surgeries— somewhere around half—to fail to do the trick. In my case, my PSA reading never went quite to zero, and it moved gradually but inexorably up. My Connecticut urologist could offer nothing but what sounded to me like shooting-blind radiation of my pelvis.

Back when I got my original diagnosis in the summer of 2010, I’d broken my own resolution, formed when I’d spent time taking care of our new granddaughter while our daughter was at Mayo Medical School. I’d had the chance to see how amazing the Mayo Clinic is. If I ever have a serious issue, I told myself, I’m not fooling around. It’s right to Mayo for me. And then I didn’t do it. Part of the denial, I suppose.

But when I lost faith in my original doc, I did do it.

While I was at Mayo, I lived at The Sandra J. Schulze American Cancer Society Hope Lodge, a place where the normal niceties seemed ridiculous. We’d walk up to each other and ask some variant of, “So, what kind of cancer have you got?” A natural question, under the circumstances, and it led to some deep and intimate conversations.  Some of us were being radiated, some of us were having chemo, some of us were doing both. A lot of what was going on was cutting-edge. Most of us were at Mayo because either we’d lost faith in our docs back home, or our docs themselves had run out of options.

A fair number of the guys had something in common. Prostate cancer, yes, but especially our doctor. We all had tremendous faith in him.

“You got Kwon?”

“Yeah, I got Kwon.”

“He’s the best, man.”

“The best.”

I’d had several consults with Dr. Kwon, who explained his approach (aggressive), the imaging technology he and his team had developed that was then available only at Mayo (it still may be, though it won’t always be), and the steps and schedule he thought we should follow. At one meeting, there were four Mayo docs in the room, working out the plan.  Somewhere along the line, Dr. Kwon looked at me and said, “We’re going to find the cancer, and then we’re going to kill it.” Which, after all the “well, we can’t be sure” talk I’d been hearing back in Connecticut (not exactly a medical backwater) sounded pretty good to me.

Then they found it.

Then, over those eight weeks, they killed it.

Short version: imaging is key.

Rather than explaining the science myself, and getting half of it wrong, here’s Dr. Kwon himself, talking at a couple of conferences.

C-11 Choline PET Scan (a little over 8 minutes)

Oligo metastatic prostate cancer (about 28 minutes, with a very key section from about 20:25 to about 21:45—you might want to watch that one minute segment first—and a good summary starting at about 25:00)

Prostate cancer will almost certainly touch your life somewhere along the line. I hope this information helps.

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