.
January 21, 2004

February 11th, it will be exactly 5 years since "Diagnosis Day" and my urologist made that heart stopping pronouncement: “Ric, you have prostate cancer and it has already metastasized.” If you haven't already, or are so inclined you can click on the 5 links above and by way of poems, musings and medical tidbits, follow me through five years of surgery & denial (‘99 - 2000), chemotherapy (‘01-‘02), radiation & RT side effects (‘01 – ‘03) with all the cul-de-sacs and side roads this nasty disease has chased me into. Taxotere spills, radiation bone destruction, chemically induced depression to name only a few. But here I am, alive, relatively well and ready to carry the campaign into year six.
>>>>Needing a title, what first came to mind was YEAR SIX - OLD DOG - NEW TRICKS but I whittled it down to YEAR SIX – WHAT NEXT?
>>>>The first “What Next” was an appointment with my oncologist Dr. John Hausdorff, Tuesday January 7th. We reviewed PSA and CEA numbers taken on 12/31/03, and also discussed how I was feeling in general.
>>>>As some of you know I have had a repeat onslaught of depression recently when I decided, without consulting my psychiatrist Dr. Marshal Blatt, that I didn't need to continue the expensive mood altering drug Celexa when my supply ran out. After all I was feeling great (not stopping to consider why) — Not a good idea! Two months later I was deep in the dumper again. Marshal put me right back on the drug saying sternly. “From here on Ric, we work together. Right?” “Right, Doc!!!!!” After two months it is just now beginning to kick back in. Once again this “PCa Job” is up for life and ready for whatever waits around the bend. So let the games begin again.
>>>>As for my ongoing PCa saga — The list of little nagging complaints I ended ‘03 with have essentially all vanished. Certainly the hip replacement has me walking my walk again. The PSA & CEA numbers are still drifting up a bit (PSA 0.23 up to 0.72, CEA 12.2 to 12.8) but I believe the slight rise in my PSA was due to my going off DES. I learned that this drug can also have depression as a side affect so I d/c'd using it until recently when I was confident that the Celexa was doing its job. And how did I know that it was? Well, I have always been an avid nail biter so when I noticed my nails beginning to grow again I resumed DES 3mg/d secure in the knowledge that the Celexa was once again a bridge over troubled water.
>>>>The CEA number is the one I pay close attention to as my PCa has mutated and produces the CEA blood marker as well as PSA. When I suggested to John that it was hard to get worked up over a CEA of 12.8 when it once had been a sky high 898. He reminded me that the amount of the number takes a back seat to the direction it is moving. But together we decided to continue to use DES for the next six weeks and on week five I'll have labs again. I also have a CT scheduled. My next appointment will be February 23rd. If called for, of course, I will go back on weekly Taxotere infusions but for now “enjoy the vacation” Dr. John said.
>>>>Re-reading the above paragraph I realize that I’m not being entirely honest by intimating that I am quite blasé around the PSA & CEA numbers. Most of the time I’m not acutely paranoid while waiting for the lab results but I must admit that there is always a low grade apprehension if I allow my mind to wander in that direction. “Don’t go there!” I keep reminding myself but often it’s like being told not to think about elephants. I have dubbed this disturbing phenomenon “PSA Dread.” When I posted it on my weekly Words & One-liner page a female reader immediately clicked on the “talk back, touch base” link sending me a message stating that she has “Mammogram Dread.” She went on to say that lately she even has “Annual Check-up Dread” concluding that perhaps it is really all just “Old Age Dread.”
>>>>I only know that by taking this debilitating feeling head on I wrote it right out of my system. I believe all cancer survivors should be keeping a journal, putting all aspects of their dis-ease on paper. At least it works for me

March 26, 2004

>>>>Saw my young onco, Dr. John Hausdorff last Monday Feb. 23rd. He now
addresses me as the "Sweet poet." Together we reviewed my new numbers and reviewed the CT scan. We decided to continue to fly on DES 3mil/d for another six week period - until I see him again on March 30th. He is delighted about the lab numbers - PSA down to 0.59 and PAP down to 0.9 - and he doesn't seem at all excited about the rise in my CEA up to 16.8.
>>>>Funny, I just can't get Doc John to pay much attention to the CEA, even though back in the dark days, he told me to regard my high CEA 898.6 number as "simply an aberration." I suppose to concede that the CEA might be important in my case would also be to admit to himself that I would be dead if I hadn't taken matters into my own hands, cheating on him by sneaking off to Oceanside, CA for a CEA scan and Prostacint scan. But like a clever circus pooch, in the end, he will always jump through the flaming hoop I have decided I want to jump through. Wait a minute; just which one of us is
the jumping dog here, me or him? Both my left and right pubis are tender to the touch. No ache - just
sore. So John suggested we have a bone scan (it has been 8 months since the last one) before I leave for NY, NJ on April 28th. When I get back May 10th, we will review the new blood numbers and bone scan and proceed accordingly.
>>>>If there is a marked uptake in the bone mets or any new ones he suggests that before I go back to chemo we try focused RT. The last time I did IMRT it did a great job on the lesion in my groin but also took out the head of my femur - thus the hip replacement. My new mantra is: "What helps here hurts there." It also badly burned my urinary track, creating scar tissue which sends me to my urologist, Tony Shaheen, who smiling sweetly runs a baseball bat up my penis every three months to open things up. Ouch!
>>>>As far as the neuropathy goes - no pain in my toes, just a numb, tingly, on-edge feeling in the tips. Fingers are fine thank goodness but I can't stand to have the bed covers touch my toes at night, so I bought one of those metal tent affairs that keep the covers from touching my feet. It works fine. At the next appointment I'm going to get Doc Hausdorff to do tests to find out why my CT shows "Coronary artery calcification." I will have serum calcium and the spot urine tests done. I don't eat any dairy products at all, as I'm told that consuming dairy products is like throwing gas on a stove fire when it comes to PCa. But I do take a 1000 meg calcium supplement each day to help my monthly Zomeda treatment work. Zomeda helps drive calcium into the bone. I'm in touch with my on-line HRPC guys every day but unfortunately for me none of them have the specific kind of PCa that I have - producing CEA rather than PSA. I really do feel like I'm all alone out here in left field
when it comes to my particular PC battles. Also, no one in our local PC Support Group can relate to my case, and I am a first for my oncologist. I guess I really am eunuch. Whoops, I mean unique.
All in all I feel great and am looking forward to the two poetry trips I'm putting together. The one back East and one to the Los Angeles area in late May. Also, I'm beginning to write again. Just finished this one loosely based on an e-mail message that I recently received..

-----------------------------MAN AMONG MEN

-----------------------------in a note thanking me
-----------------------------for sharing my
-----------------------------Prostate Cancer Odyssey
-----------------------------she wrote
-----------------------------my husband….
-----------------------------my ex-husband….
-----------------------------the only husband I ever had
-----------------------------I’m not sure
-----------------------------what to call him now
-----------------------------I’m only certain that
-----------------------------he was a man
-----------------------------among men
-----------------------------who “didn’t want to know”

-----------------------------Lennie is — was his name
-----------------------------and for many years
-----------------------------I begged him to see a doctor
-----------------------------about the pain in his gut
-----------------------------the chronic weakness
-----------------------------and wobbly legs
-----------------------------that wrecked his tennis game
-----------------------------I hoped his love of tennis
-----------------------------might prompt him
-----------------------------to go to the Doc…. but no

-----------------------------he died of prostate cancer
-----------------------------it spread and grew in Lennie
-----------------------------the way untreated latter day
-----------------------------cancer can grow
-----------------------------and then he knew
-----------------------------and now he’s gone

-----------------------------chalk up
-----------------------------one more man among men
-----------------------------who “didn’t want to know”
-----------------------------+++>

April 10, 2004

>>>>The two major blood numbers that I watch came in – PSA flat at 0.59 and the CEA drifted down a bit from 16.8 to 14.8 . I had requested the whole battery of tests to be done but my request got tangled up in office inter communication folderol. Doc Hausdorff never got my message but we will have all the numbers done again in a week. This time I watched while he filled out the CHOMP Requisition form. On April 26th before I take off for NY & NJ we scheduled – CBC, CMP, PSA, PAP, CEA, NSE & CGA blood work and also I'll have a bone scan. It has been eight months since the last one so we need to take a look at what the known bone mets are doing and if there are any new ones developing. When I get back from the East Coast, May 10th I’ll see Dr. John the following day and learn all the test and scan results.
>>>>As John was about to leave the examination room he looked at me thoughtfully and said: “With cancer patients there is usually what we refer to as the “honeymoon." That euphoric period where the treatments seem to have the cancer well under control. But in your case Ric, we haven't really had a honeymoon. One problem right after the other — Diagnosis discovering the PC was already metastatic, Orchiectomy, Casodex failure, discovering my PC mutated into the very aggressive SCPC, Chemo, Taxotere spill, Radiation, Femur deterioration due to steroids and RT, terrible sciatic pain, oxicontin addiction, steroid frenzy leading to a nervous breakdown , hip replacement.” John stood there looking at me solemnly. “Doc,” I grinned batting my eyelashes — flirting outrageously, “How would you like to sneak off with, get married to, and honeymoon in the South Seas with PCa’s Job?” He just walked out of the room shaking his head and closed the door behind him.
>>>>In cogitating about why I and most of the men I know avoid going to the doctor and having that routine medical check up, I came to the conclusion that "medical reluctance" is in our genes – our Levi western cut jeans. Had I not been such a Gary Cooper – John Wayne wantabe my prostate cancer would have been detected and treated long before it became the metastatic incurable disease that it has become.

-----------------------------WAGON MASTER SYNDROME

-----------------------------I often find myself wandering around
-----------------------------in the wrong century
-----------------------------a stage coach pony express kind of guy
-----------------------------having to constantly explain why
-----------------------------I'd rather die than see the ole saw bones

-----------------------------I don't need no bespectacled geezer
-----------------------------thumping, peering
-----------------------------and putting his cold stethoscope on me
-----------------------------ain't no gunslinger worth his salt
-----------------------------puts up with sissy claptrap like that!
-----------------------------no-sir-ee!

-----------------------------what kind of wagon master
-----------------------------would scare the women and children
-----------------------------telling them a Comanche war party
-----------------------------is out there, just over the next hill,
-----------------------------or that his belly constantly aches?
-----------------------------only a yeller streak coward
-----------------------------talks about being frightened and ill

-----------------------------when a Texas Ranger
-----------------------------steps forward in the wild West
-----------------------------best he keep a tight lip
-----------------------------and a flinty glint in his eye

-----------------------------can you imagine a circle
-----------------------------of leather faced cattle drovers
-----------------------------hunkered down around a prairie fire
-----------------------------spitting tobacco juice
-----------------------------discussing erectile dysfunction
-----------------------------and what brand of diaper
-----------------------------incontinent men should use

-----------------------------out here
-----------------------------on the modern medical frontier
-----------------------------the prairie schooners
-----------------------------have all disappeared
-----------------------------and no one I know ever had one
-----------------------------so what kind of a man still adheres
-----------------------------to the wagon master syndrome?

-----------------------------... a dead one!
-----------------------------+++^

>
June 5, 2004

......I've been slow posting this “Latest Entry” as I have been, as Willie would say, “on the road again.” The best part of this fact being that I felt good enough to once again be able to do and enjoy what I have enjoyed doing for the last 40 years. No more than a year ago I would have told you that my touring days were over. Follow the bouncing ball.
......The blood numbers came in from the most recent blood draw on 04/27/04. PSA 0.74, CEA 17.8, PAP 1.1, NSE 8.6, CGA 5ng/ml. PSA and CEA drifting up a tad but nothing to get all worked up about yet. Also I have the results of the bone scan done on 04/26/04

......“When compared to the previous exam of 10/28/02, the increased uptake in the right pelvis may be minimally more prominent. Progressive increased uptake are now noted at the L3-4 disc space. Small focal areas of increased uptake are now noted in the right pedicles of approximately T6 and T12. Degenerative changes are present in the cervical spine.

......A couple of things to keep an eye on here so I will be having another bone scan in 6 months. However all in all a pretty good report.

......When it comes to health issues I’m beginning to change my thinking. A couple of years back when I fell into that dreadful period of Steroid Frenzy (my NYC friend Mario Menelly calls it “Roid Rage”) and became suicidal Doc. Hausdorff said that this “non cancer related” illness almost did me in. And it is easy to convince oneself that, since diagnosis, every ache and pain is somehow related to this damn incurable disease — yet the more I think about it the more I think that they really are.
......In my case, the “Roid Rage” was the result of the steroids I was taking to handle the side effects of the weekly Taxotere sessions, plus three 80 mg steroid epidurals for the sciatic pain that turned out not to be back related but the result of the radiation treatments on the bone mets in my groin — IMRT doing a fine job shrinking the cancer leisons but also taking out my right femur head. This RT side effect shortening my right leg and twisted my spine causing the unbearable sciatic pain leading to an obviously "cancer related" hip replacement. From here on out it is going to take a lot to convince me that not every future health issue isn’t somehow “cancer related.”
......But then, death is the result of being born and I certainly wouldn't want to have missed the roller coaster ride between those two extreme positions just because it was destined to end in a mortuary. I only need to keep bringing to mind a term given us by William Hoyt, Jr, a long time cancer survivor.

-----------------------------A WORD FOR SURVIVAL

-----------------------------The man who coined the word
-----------------------------Had a terminal disease
-----------------------------A realist who knew that language
-----------------------------Strengthens, heals and frees
-----------------------------Fear — the silent assassin
-----------------------------Will bring you to your knees
-----------------------------While faith can pull Excalibur
-----------------------------From stubborn stones with ease

-----------------------------The outcome of any illness
-----------------------------Is never absolute
-----------------------------No matter what the odds are
-----------------------------The end is always moot
-----------------------------It’s only in uncertainty
-----------------------------That true hope can be found
-----------------------------And you can bet a sure thing
-----------------------------Will always let you down

-----------------------------He fought the “Big C” monster
-----------------------------With spunk an attitude
-----------------------------Another cock-eyed optimist
-----------------------------You should not conclude
-----------------------------So like the fallen colors
-----------------------------I’ve taken up his word
-----------------------------I’ll shout it from the hill tops
-----------------------------Till the echo can be heard

-----------------------------He was no Pollyanna
-----------------------------His word no platitude
-----------------------------To things considered saccharine
-----------------------------He was abrupt and rude
-----------------------------In the present day vernacular
-----------------------------He was a righteous dude
-----------------------------Let’s hear it for the man
-----------------------------Who coined the word
-----------------------------Spiritude!
-----------------------------+++

.
August 5, 2004
.
......Saw my oncologist, Doctor Hausdorff on August 3rd and before we got down to the PCa nitty gritty we talked politics a bit. John becoming quite agitated and passionate as he spelled out where he, as a doctor, was on the subject. Luckily, I agreed with him wholeheartedly and was relieved that my blood pressure had been taken before our hand wringing political conversation.
......Next, John and I reviewed how I was feeling – good – and the latest blood marker results, which, no surprise, are still drifting up but as always just a tick or two. And these creepy numbers have moved me to a completely new place in the game I’m having with advanced prostate cancer – I almost said “playing,” which makes it sound like fun, which it ain’t. – I have begun referring to where I am now as “Damned if you do (back to chemo and the awful side effects I have experienced) or Damned if you don’t.” (ignore the numbers and let the disease get out of hand and kill me)
......And how am I deciding which course to take? Well, at the bottom of this page you will find my PCa Digest, the detailed history of my battle with what is for me an “incurable” disease. This record makes it easy to review dates and medical events that I’ve chronicled since being first diagnosed back in 3/19/99. And it certainly comes in handy at crucial cross roads such as these.
......I had a high PSA 81 before they pitted my apricots (orchiectomy). That, and the medication Casodex knocked the PSA number down to 0.02 for nine months. But when the PSA started doubling up again my urologist sent me to an oncologist as I had become hormone refractory (androgen independent) "incurable."
......On 2/12/01, just before I began the chemo regiment, my numbers were PSA 2.3, CEA 898.8, PAP 20.7, all rising. Then for essentially 23 months, with only a couple of five week vacations, I underwent weekly sessions of chemo (Taxotere 25mg/M2, Decadron 10mg every Monday). Also during that time I had five weeks of Conformal Radiation. Together, these treatments knocked my numbers down to PSA 0.4, CEA 4.7, PAP 1.0 on 2/10/03 when I was taken off chemo because of steroid frenzy (Roid Rage), which brought on an emotional break down. (click HERE if interested)
......Since February 2003, 16 months ago, I have only been doing Zomeda (to strengthen bones) once a month and DES 3mg/d. My markers have stayed low but continue to creep up to there their present levels — PSA 1.18, CEA 22.9, PAP 1.5. Really not much movement over 16 months. And on top of that, I feel just fine. No pain since the hip replacement, and so far the known mets aren't hurting at all.

SO WHAT'S TROUBLING YOU BUCKY?

......At this point in the game it is the “known” not the “unknown” that lies at the core of my dilemma. The weekly infusions of Taxotere were working well when I quit sixteen months ago, so doc Hausdorff and I feel fairly certain that the treatment will turn the numbers back around again. At least for a while.
......So, why don’t I jump right back into chemo and drive those numbers back down immediately? Well, the first time around I was an ignorant nubie — didn’t know what a Taxotere “spill” was and the painful boils that led to an operation where a port was implanted in my chest. Or about the weekly nausea and then the painful peripheral neuropathy – I’ve permanently lost the feeling in the tips of all my toes, loss of hair and fingernail and toenail disintegration. Worst of all, is the awful debilitating fatigue that accompanies chemotherapy. Each of these unpleasant surprises were tolerable as the treatments were killing cancer cells and knocking the numbers down. Like it or not chemo has kept me alive and kicking. The same can be said about the radiation treatments. It did a wonderful job killing most of the cancer in my groin but probably caused the scar tissue in my urinary track, (causing a real pee problem) and RT was the main reason the head of my femur deteriorated leading to the hip replacement. Not knowing what to expect I dealt with these negatives as they came along. But now when I consider the “known” side effects, perhaps you can understand my reluctance to bring these monsters on board again.
......I am still here, however, and glad to be present and accounted for! Perhaps a bit tired due to the lack of testosterone but so far I am able to find the energy when I need it – Energy being an interesting phenomenon in and of itself. When I was a kid and then as a young man courting the girls, energy came to me in a pipe – when I needed more I just cranked on the spigot. But as an old dude I now find that energy comes in a bucket with just so much to dip up on a day — a bucket that holds a little less each morning. And during chemo I remember the ladle banging around in the emptiness. The game is quite different now because I am fully cognizant of all of the above.
......So here is the game plan John and I have come up with — In six weeks I’ll have another bone scan to compare with one done six months ago. We will of course look at the new numbers to see how fast the cancer growth is accelerating. If it is beginning to look dangerous I will bite the bullet and begin chemotherapy treatments forth with. But for the next six weeks I’ll make the most of this good QOL (Quality of Life) I’m enjoying now and have been enjoying for the last 16 months. The only thing that can ruin my QOL is ME, continually worrying and dwelling on things like “Damned if I do; Damned if I don’t.” So, I have decided to dump it all here in my “Prostate Cancer Odyssey” and am now off to see the Wizard and all the good things tomorrow will surely bring!

October 7, 2004

......I am bringing my 10/10/'04 WORDS & ONE-LINER over to begin this "Latest Update"

......For nearly a year now, I've been doing a minimum of things in my fight with incurable advanced prostate cancer. DES 3mg 1/d, Dostinex 0.5mg 2/w & Diet. All the time nervously watching my numbers steadily creep back up from where I stood 2/10/03 with a PSA 0.04, CEA 4.7, PAP 0.9 to the last blood test done eight weeks ago PSA 1.18, CEA 22.9, PAP 1.5. On September 30th I had another panel of blood tests and a bone scan to compare with the one done six months ago.
......My appointment with Dr. Hausdorff was last Monday morning. I wrote BOXER (fighting cancer) Sunday evening.

-----------------------------A BOXER
-----------------------------(fighting cancer).

-----------------------------I was deathly afraid
-----------------------------when the match was made
-----------------------------and it was determined that I
-----------------------------would be put in the ring
-----------------------------with this heavy weight brawler
-----------------------------notorious mauler who has put
-----------------------------more than a few good men down —
-----------------------------by comparison I’m a light weight
-----------------------------a dip and dodger, bob and weaver
-----------------------------dancing my way through
-----------------------------the first two rounds

-----------------------------but like they say
-----------------------------“you can run but you can’t hide”
-----------------------------this ruthless foe
-----------------------------raining blow after blow
-----------------------------through the third, the fourth and the fifth
-----------------------------“Keep counter punching!” my handlers yell
-----------------------------as I answer the bell for round six
-----------------------------fatigued — done in — worn out
-----------------------------it’s tough to keep slipping punches
-----------------------------in a bout you know you can’t win
-----------------------------in a fight where the fix is in

-----------------------------at the moment I’m down on one knee
-----------------------------taking a breather
-----------------------------the referee counts Three! Four! Five!
-----------------------------I’m aware of the numbers
-----------------------------and staying alive but this time
-----------------------------I don’t feel like bouncing back up
-----------------------------Six! Seven! Eight! I see the oncologist
-----------------------------in the morning at Nine!
-----------------------------tonight I write this
-----------------------------and wait
-----------------------------+++

......Since the very beginning I have had my blood checked every six weeks and for the last 10 months the numbers have been climbing steadily. Not rapidly but up. Each result showing an upward trend, PSA up about >0.30, CEA (which is the most important number in my neuroendocrine PC case) up three ticks and the PAP up about >0.1 at each blood draw. And this time we decided to wait eight weeks between the tests so I figured that the numbers would all have risen a bit more. I also expected the new bone scan to reflect this and reveal new uptake over the last six months.
......Because of this I figured I would soon have to be making the decision about going back on chemo and maybe having some more radiation. And folks, I honestly didn't know what I was going to do. On the one hand decide to start up heavy duty treatments again and wreck my recent QOL. (Quality of Life) or on the other decide to do nothing and keep feeling good as long as I could.
......You see, I now know about the devastating effect chemo and RT can have on me. The first time around everything was unknown and new and in a way exciting. A surprise, an unpleasant one, but still a surprise. This time around I know the ropes and have stood toe to toe exchanging blows with this damn disease, much like the boxer in my poem — down on one knee wondering if I wanted to get up and start taking a pounding again. I truly haven't known what I was going to do. I remember that the steroids taken to reduce the side effects of chemo put me in the loony bin. I have always been an energetic guy and the chemo had me so fatigued I could barely lift my arms let alone think of taking my act on the road again. During RT I took a lot of calcium (still do) and I developed a kidney stone that had to be removed. Peripheral neuropathy (I lost the feeling in my toes — the fingers could be next!) Because of the blood thinners to avoid blood clots I developed severe inner eye problems. Radiation deteriorated the head of my femur bone and I had to have my hip replaced. And then there was the Taxotere spill which led to an operation to implant a port-a-cath, the nausea, etc., etc. I know now up close and personal that the treatment can be harder on the mind, body and spirit than the damn disease itself but of course to do nothing would be like taking a giant a step toward the end.
......Well what do you know!!! For some miraculous reason (perhaps because of you who have told me that you keep me in your prayers) the numbers were flat or went DOWN a tick or two (PSA 1.11, CEA 22.8, PAP 1.5) and the bone scan revealed no progression in known metastases and no new mets could be found. And this with out doing anything new other than the DES 3mg 1/d, Dostinex 0.5mg 2/w, Zomeda IV 1/mo and diet and standard supliments.
......In the April 10th “update, you will see where I describe Doc Hausdorff shaking his head and saying that as a cancer patient five years out I never have had the traditional honeymoon period. There was always some new complication that left me without a moment of peace or rest. Well, I'm honeymooning now!!. I left John's office feeling like I felt after asking Billie Barbara to marry me with BB saying "Yes."
......"For now you seem to have a 'stable disease'" said the good doctor, putting his arm around my shoulders and giving me a beard to beard peck on the cheek.

November 8, 2004

......My six-week appointment with Doc Hausdorff was last Monday morning. We always have my blood drawn a week before the doctor appointment. First question out of my mouth is usually: “How did the numbers do?” Six weeks ago the important ones for me came in at PSA 1.11, CEA 22.8, PAP 1.5. Last Monday they were PSA 1.28, CEA 23.9, PAP 1.3. PSA, CEA a tiny bit up. PAP a tiny bit down. So we discussed medical philosophy for the rest of our time together.
......We got to talking about a PC specialist that I once had call John back in the dark days of my disease. According to John that call never got off the ground, as the specialist did not allow him to get a word in edgewise during the first two thirds of a ten minute conversation. Though they are approximately the same age, John felt that the specialist lectured him as if he were a know-nothing hick doctor. I hear from the specialist from time to time and he is still annoyed and a bit angry at John for not falling right in line behind all of his cutting edge “specialist” suggestions.
......Somehow the fact that these two doctors don't get along makes me feel a bit guilty. The specialist is a genius at what he does and perhaps more knowledgeable about prostate cancer than anyone else in the country, but two weeks before my hip operation he e-mailed me accusing me of being stupid for not finding another oncologist. His timing helped me understand why I never dumped Dr. Hausdorff. The dunning message was the kind of thing a caring physician would not do on the eve of a patient heading into major surgery.
......Of course my friend at PCRI "Helpline Harry, a fellow PC survivor, also made many of the same suggestions that the specialist made. So I took them in to Dr. John myself and he bucked a bit but in the end did essentially what the PC specialist wanted me to do.
......Now, I like both of these men and am sorry that they didn’t hit it off so I decided to talk to Doctor John about it. Something I didn’t know about John was that his mother had been an oncology nurse for 30 years. She is now retired and living in NY. John said that his mother always complained about how nurses are often treated like non-beings, and yet nurses are called upon to do much more than stick needles in to the patient. They do most of the palliative care. They must be part psychologist, philosopher, good listener, etc., etc. In other words, oncology nurses are called upon to do most of the human side of medicine.
......I look at it this way: the American medical system is a class system. The specialists talk down to the rank and file docs who in turn don’t treat nurses on any kind of equal footing. John said that at no time during his medical training was he taught how to listen to nurses and how to communicate with other doctors. I suspect that secretly doctors live in fear of the patient wanting a second opinion.
......Perhaps I’m painting with too broad a brush, but in my own medical history I’ve seen this happen more times than not.
......When the appointment was over I left Monterey Bay Oncology wondering what could be done about all of the above. Is this just the nature of the beast, something each of us must deal with like it or not? Or is there something we can do to alleviate this troublesome situation? Talking about it patient to physician. Bringing the problem out into the open is a start I guess.
......My numbers are stable at the moment. Doctor John describes my disease as presently “indolent” but if and when things go sour I do have another specialist up my sleeve and I guess all of this is me doing the necessary ground work. Preparing for the future.

......Stay tuned!

.