My 2016 Prostate Cancer Predictions

...and a few musings.
After 13 years of "Adventures in Prostate Cancer," I believe I have earned the right to make a few predictions--sometimes tongue-in-cheek. And even if I don't have the right, here goes.

Q-1. Will there be a cure or partial cure for prostate cancer or any other cancer in 2016?
A-1. Very unlikely. Very complicated. And it probably has nothing to do with the astronomical profits from cancer treatment medications.

Q-2. Will new and more effective prostate cancer meds be approved by the FDA in 2016?
A-2. Yes and No! The FDA will probably approve a drug or two (the YES part). And NO, the new drugs will not likely be more effective than the current selection. This leaves room for even more drugs in 2017.
But it's a good bet they will be more expensive in 2016 (unless you can buy them in almost any other country).

Q-3. Am I really as jaded and skeptical as I sound in these first two predictions?
A-3. Again, Yes and No! Yes, it seems that in many ways cancer treatment is just another big business. Costs, treatments, and medications are prohibitively expensive and out of reach for many cancer patients who do not possess the needed resources. Big numbers trump (not that trump) individuals. No, my personal experience has included excellent medical care from doctors and nurses I consider friends. I believe they are looking out for my best interests (in spite of the fact that I am a "problem" patient). I have never had to go without the best treatments currently available.

In my head, I'm still a cup-half-full kind of guy. I believe that the increasingly serious side effects I am experiencing can be managed. I've undergone procedures I never knew existed--and there are more to go.

I'll post a step by step explanation of all my newest adventures in the new year.

axman

Cancer Patients are Living Longer!

Longer that what you ask?

 

A recent article, published in JAMA Oncology, reported an analysis of more than 1,000,000 cancer patients diagnosed between 1990 and 2009. The study started with people diagnosed between 1990 and 1994 and then compared their survival with those diagnosed between 1995 and 1999, 2000 and 2004, and 2005 and 2009. Each five year segment showed a better five-year survival rate than the previous five year segment. 

All cancers are not equal, however, and survival rates vary greatly. Prostate and breast cancer survival rates increased significantly. Liver, pancreatic, and lung cancer survival rates were lower, but there was still an improvement. Any overall improvement is a bit of good news in a disease that has been and continues to be extremely hard to manage and cure.

Age is a factor

Younger patients—50 to 64 for this study‑‑had better survival rates than older patients—75 to 85, but the older group also showed a significant survival increase.

What should I do?

Is there a magic bullet that we should all know about to improve our survival? Probably not. Nobody has identified any one thing that will work for everybody. Preventive measures can impact some cancers such as skin and lung, but in other cases it is likely a combination of early diagnosis, new medications, and overall improved treatments.

Bottom Line

The best option is to NEVER GET CANCER. Most of us with cancer didn’t imagine that we’d ever be diagnosed. The longer we survive (12 years for me) the better the likelihood that there will be new drugs and other treatments that can help us manage our disease. The drugs I am now taking did not exist five years ago. The drugs I will take five years from now are probably still experiments in a petri dish in some basement lab. So, hang in there.

A cure would be nice, too.

axman

Getting Older—an Exercise in Extremes

As I get older (and older) the dialogues in my life have changed. It is interesting and a bit amusing, in a black humor sort of way. Several times someone has said, “You’re looking pretty good‑‑for someone your age!” Meaning if I were younger they might be concerned? I can opt out of jury duty because I qualify as too old. Some of my friends have been told they’re too old to drive (they’ll have to pry my keys out of my cold dead hands). 

Recently my Doctor became concerned that my heart rate was too slow (as a lifelong runner my heart rate has always been slow—in the 40s and 50s). Turns out a low heart rate can be a concern for old geezers. I’m often too cold (takes a long time to warm up), too hot (hot flashes), too tired (fall asleep

while watching TV), and always too stubborn (so says my wife). Extremes all!

Then there are those extreme “trigger” words that all of us cancer survivors dread to hear in any form: terminal, incurable, late stage, life threatening, inoperable, off the charts, etc. The older you are, the worse they sound.

More than once I have redefined what I mean by “a good quality of life.” When I was 40 it meant everything worked at 100%. At 60 maybe 80% was OK—a few aches and pains. Now, in my 70s, my requirements for “a good quality of life” are less stringent. If I can stand up, get dressed, eat, lift a glass of wine to my lips, walk (albeit slowly), drive a car (at least for now), and remember who I am and approximately what day it is (most of the time) it is a good day!

Trying to focus on what I can do and not what I can’t do is a challenge, but worth the effort when it works. A fading memory is an asset in this endeavor.

axman

You Can Always Go Home Again...

Especially for the holidays

We just returned from two great and glorious weeks in Hawaii. It was relaxing and refreshing. I noticed that I was far enough away from home for my pains to subside, my stress level to drop, and I even slept better. Coming home was good, too, it always is, but it was cold and all that work that needed to be done was right there...waiting. On the bright side, it's time for the kids and grandkids to come by for dinner and gift giving and a little sherry and egg nog.

In Hawaii we reconnected with some old (really old) friends from 20 or 30 years ago. Most of them, like me, were in various stages of disease and decline but it didn't seem to matter. There were strokes, knee replacements, an abundance of arthritic pains, and even one friend with Stage 4 prostate cancer. He's in chemo and weakened but still has his irreverent, self-deprecating sense of humor and was constantly cracking jokes.

I came home inspired to be as strong as they all seemed. I intend to laugh more, focus less on my aches and pains, and especially to avoid morbid thoughts about my own mortality. Sounds like New Years Resolutions - time will tell.

So, Merry Christmas, Enjoy Life, and have a Healthy New Year

axman

Living Life Three-Months at a Time

Maybe three month segments aren’t so bad…

My life is arranged around when I see my various and sundry doctors. Over a period of several years I have managed to get all my appointments set for a one-week period every three months. That leaves two and a half months to travel, camp, read, write, and totally forget my trials and tribulations – mostly.

I have long believed – but not necessarily practiced – that worrying about my physical ailments does absolutely no good. Over the past couple of years I have noticed that I rarely think about the progression of my prostate cancer or arthritis or even senility (I forget that I might be senile) when I don’t have a pending doctor’s appointment. Then, about a week before I see my doctors I do a quick check to see if I’m still alive and functional.

Most of my medical consultations are rather boring:
“What hurts – on a scale from one to ten?”
“Things haven’t changed much – that’s probably good.”
“Here’s your prescription.”
“See you in about three months – if I’m not on vacation then.”

Then, for almost three more months, I’m free (and healthy in my own mind) again. And my circle of medical life goes on and on. Does this kind of thing happen to you, too?

Axman

The Benefits of Winter Sun

…if you can find some

One of the many benefits of retirement is the opportunity to choose my own climate of residence. Each winter we try to spend a month or two in a place that’s warmer and dryer than western Oregon. So far - so good.

Spring, Summer, and Fall are tolerable most anywhere but Winter is a season of a different color. Fog, rain, ice, clouds, and short days are not high on my pleasure meter.

So, we try to spend a month or two in a warmer climate each winter – Arizona most of the time. It’s not perfect – nights are cold and the wind blows a bit – but overall 70 degree days and lots of clear skies tip the scales for me.

And don’t forget the health benefits of sunshine and vitamin D and such. I have to admit, however, that the major benefit is mental! Somehow waking up to sunshine, daily walks without rain, sitting in the sun, and picnics in January improve my outlook. From my wife’s point of view that means I’m less grumpy and that improves her mental outlook. That’s a two-fer.

axman

Oh No! It's Back! Not Fair!

My PSA started to increase almost immediately after my prostatectomy in 2003. So other than the immediate shock, anger, and feeling sorry for myself, I have lived with the reality of recurring prostate cancer from the start.

In the past several months two old (with prostate cancer the 'old' part goes without saying) friends who underwent treatment five and eight years ago discovered that their PSA had started rising again. In fact their PSA had doubled every several months for quite a while. Both thought they were cured. For years their PSA had been near zero. They were sure they were cured.

When confronted with 'recurrence' they were understandably devastated. This happens to thousands of men every year - recurrence after five or ten or more years of being cancer free.

Being diagnosed with prostate cancer 'again' can be more emotionally difficult than being diagnosed the first time.

"It can't be happening again!"

"It must be a mistake!"

"I'm going to check with another doctor - one who will get it right!"

"I'm sure it will be OK when I get re-tested next month."

"OMG, I'm gonna die!!"

What can You Do?

First of all, stay calm. In the world of prostate cancer there is usually no reason to hurry up and take action. There are many treatments and the options vary depending on what treatment or treatments you had originally. Surgery or radiation or radioactive seeds might be options if they were not done previously. Hormone therapy may be appropriate. Or maybe your oncologist will recommend watchful waiting - at least for a while. There is bound to be SOMETHING you and your doctor can agree on. Don't panic. Don't rush to do something before you think it through. Keeping a positive attitude (not always easy) may be the best therapy of all.

axman

Watch Out for that BUS!

Just after I found out my prostate cancer had 'recurred' after the surgery to end all surgeries and cure me forever, I was feeling pretty sorry for myself. Why me? It's not fair! I'm going to die a horrible death! My urologist didn't seem so upset. I was just one of 50,000 American men who was diagnosed with recurrent prostate cancer every year.

He told me, "Don't worry, you'll probably get hit by a bus before your prostate cancer kills you." Somehow that was reassuring. Nobody knows what will happen next. I actually could get hit by a bus tomorrow or I might live to 97. Men with prostate cancer die every day of all sorts of reasons other than prostate cancer. And most men with prostate cancer survive every day.

All I can do is get up every morning and do something I want to do and then repeat the process tomorrow morning. Easier said than done, but my level of anxiety is much reduced over these six years even though I still have prostate cancer and it is relentlessly, but slowly, progressing.

So I do what I can, try not to worry about what I can't control, and I stay far away from rogue busses. So far - so good!

axman

Positive Attitudes - Bah Humbug

I keep running into guys with prostate cancer - I actually seek them out. My mercenary side tries to sell them a book or two. My warm and fuzzy side wants to share information on the secrets of survival.

To a man, they seem genuinely optimistic. "I'm figuring they'll find some better treatments in a year or two." "I feel better than I did six months ago!" "I'm not dead yet!"

I've even noticed subtle changes in my own skeptical, curmudgeonly life style. For a couple of years now I've made an effort to reconnect with old friends I hadn't seen in 20 or 30 years - or even more. The reunions have been great - even a little emotional sometimes. And, a high percentage of those old geezers have prostate cancer or some other cancer. Nobody ever complained; just shared. Maybe that cup is half full after all.

axman