CANCER, More of It

Pretty kind of, aren't they?  That is a microscopic picture of cancer cells.  Not mine, but some other poor individual's.

This may shock you, but everyone has cancer cells.  Yes, everyone.  Some may mutate into death cells that have the goal of taking over every healthy cell in a body.  Most will not.  Mine have decided to attack.

The past few weeks, I have learned a lot about cancer.  Like the above fact.  Cancer is part of all of us.

I also have learned and am convinced now that the only real cure to cancer is..........DEATH.  The only cure to cancer is death.  There are myriad treatments, potions, drugs one can take to "battle cancer", but none of them "cure it."  They may knock it into submission or they may make it disappear for a while, but it always comes back.  Always.  Some cancers sooner than others.  And many folks may pass on from other causes before it comes back with the assumption that they survived cancer.  But it will come back.

Most treatments kill the "mother cell" or tumor.  But its "offspring" by then are already circulating in the blood stream, waiting to mutate.  Some later, some sooner.  It's just a matter of time.

So the trick is to find the least invasive, yet effective treatment that scares the cancer away for the longest amount of time.

Such is my next quest on my journey.

The results of my recent Transperrenial Targeted Fusion Biopsy under General Anesthesia at the Operating Room were not good.  You know the news is bad when the doctor says "the results will be in on Wednesday, I'll call you" and what you get is an email from his office saying he wants to meet in person to go over the results.  And the results don't post on your "My Chart" cool fandangled on-line medical records page either like they usually do.

First, the doctor chose to drop the "fusion" from the biopsy.  He felt it was important to do a "saturation" biopsy to be able to get a good "map" of exactly where the cancer is in my prostate.  This will help with treatment.  Saturation is done under General Anesthesia so as to not torture the recipient (THANK YOU!!) and he can't do General Anesthesia in his office, which is the ONLY place in this Cow Town known as Spokane that has a fusion machine.  So his targeting part was what he called "Cognitive Targeting", which means he looked at pictures of the results of my MRI on one screen and live shots of my prostate (via rectal ultra sound) on another screen at the same time and could judge where he was poking the 18-gauge biopsy gun.

He took 26 samples, (thus the word "saturation) 8 of which were of the cancer itself, with the remaining of other places hopefully noncancerous in the prostate.

I was sore for several days, but otherwise did not do bad.  Very little blood, which was surprising.  And two days later, took an 8-day road trip to Oregon and did just fine.

And the report is:

- Ten of the 26 samples came back cancerous. 
- One sample showed invasion of nerves, (perineural invasion) which indicates that it has an apparent chance of spreading more quickly to other parts of the body. (Medical researchers everywhere continue to study this fact and statistics are starting to show that this type of invasion may not be as critical as thought, the doctor downplayed it.)
- Eight of the 10 samples tested at a Gleason 7 (3+4) while the other 2 were Gleason 6.
- One of the samples was 90% cancer cells, meaning that the cancer is approaching the edge of the prostate and is preparing to journey to other places and organs.
- The cancer tumor is roughly the size and shape of a little smokey. 
- Treatment is imminent.

The Gleason Scale is a measurement of the aggressiveness of the cancer.  6 is low-risk.  7 is intermediate risk.

My initial testing back in February showed all samples as a Gleason 6.

While this may be alarming, it is just a case of finding out what the cancer really is and is exactly why we insisted on further testing and poking and prodding and opinions.  A cancer is "born" (tempted to find a picture of cancer being born........aaaaa........I'll skip it) as a certain Gleason and stays at that Gleason.  Thus my cancer has always been a Gleason 7, surrounded by some Gleason 6 cells.  It has NOT grown from 6 to 7.  It is just that the first biopsy didn't find the Gleason 7.  It was a "random" biopsy where samples were taken of various parts of the prostate.  And a random transrectal biopsy has a hard time reaching the "top" of the prostate, where my cancer happens to reside.  The Urologist who performed that biopsy confirmed that it was only 75% accurate.  Some call that Russian Rouillette.

This is why it is important to always get a second opinion and ALWAYS test until you know the facts.

I was leaning towards "Active Surveillance" before, or watching the cancer's every move and beginning only treatment only once it is necessary. That is now not an option.  Thus, we are now on the search and exploration of what treatment suits me best.  My doctor has recommended Focal Cryotherapy, which he likens to lumpectomy of breast cancer.  Probes would be inserted into my prostate, using the cool map he has made of my organ and the MRI, and the probes would literally freeze the cancer cells to death.  Minimally invasive.  Great recovery time.  But fairly new so no real long-term track record of what happens ten years down the road.  But, since it is minimally invasive, it can be repeated if the cancer comes back.

He also has referred us to a radiologist specialist to have us look at radiation therapy.  I'm not too interested in a cancer procedure that causes more cancer.  But we'll listen to the schpeel anyways.  Education is a good thing.

There are tons of options out there.  And this is a slow moving cancer, so we have months, literally, to decide what to do and when.  We'll take our time and get it right.

Our search will obviously include areas outside of Spokane, the small little Cow Town full of homeless people that thinks it is a huge medical community.  We want the best care possible and have had too much of the "I'm the only doctor in this town that does this" and the "we are the only office in this town that has that."  MD Anderson.  Mayo Clinic.  John Hopkins.  There are lots of great cancer medical centers out there that we now get to explore.

Meanwhile, we will keep living our life to the fullest.  Road Trips, work, grandkids, and lots of veggies.