Andre, a cyber security specialist with the Houston police department, is the new freshman in the "gown room."  It's his first day on Tuesday.    He's fresh meat for good natured ribbing from us wizened elders who've walked the gauntlet earlier.  Andre wants to know if any of us have experienced side-effects in the course of our treatment.  Tom, the high school teacher, who stands about 5'6" fully decked-out in his gown and cowboy boots, says:  "Well, Andre, before I started treatment, I was a lot taller and better looking."

Most of us have come through so far relatively unscathed.   One fellow has developed a few lesions at the radiation point on his hip.  There is some unavoidable skin irritation from radiation, but mostly minor for the rest of us.  Others report some urinary sensitivity upon evacuation of the bladder.  Cranberry supplements and ibuprofen are recommended for remedy.
 

Talking, laughing, joking eases our time together as we wait our turn in the gantry (that's what they call the radiation room).   Sometimes we're backed up.  As each person arrives for treatment the first questions usually asked:  "Are we on time?"   "Are you ready?"  There are occasional breakdowns.  A power surge put the gantries out of commission for two-hours a couple weeks ago.   Being ready refers to the "fill" of the urinary bladder prior to treatment.  It must be at optimum level.  If not, the person next in turn, if perked, leap-frogs and gets on his way earlier.  The skipped-over guy will start guzzling water in frenzy to makeup the deficit, oftentimes getting over-filled as he endures a prolonged wait and receives bogus empathy from the gowned chorus.  (On my first day of orientation, I'm forewarned by the nurse: one new patient was needled into drinking twelve glasses of water.) That's the nature of the games we play to pass the time.

Andre, the newbie, is 52 years old.  It's a poignant reminder that prostate cancer, or any cancer for that matter, respects no age.  My wife sees it perhaps more than I as the children and their parents come and go through the Proton Center waiting room.  Some of the young are no more than babies.  There's a teenager I see now and then in her wheelchair as she and her parents leave following treatment.  Her head slumped down, eyes covered by the bill of a ball cap.  She's asleep.  (Some are put under to avoid movement under radiation.)  She is warmly covered under a blanket of bright orange and yellow.  I am thinking when she awakes that the hue will perhaps bring an aura of sunshine and hope into her life.

I make it a point to discuss the correlation of PSA levels and the occurrence of prostate cancer with Dr. Lee at my "see" this past week.  Most of the men say they had much lower levels than I did when they were biopsied with positive cores.  Their cancer was caught at a much earlier stage which greatly improves their chance for a successful outcome.  I'm told PSA (prostate specific antigen) is not an entirely reliable predictor of prostate cancer.  Some men, such as me, can have a higher PSA for a variety of reasons, none of which may be associated with cancer.  The best that can be understood is that an abnormal reading or a rising PSA over a period of time would suggest the need for confirmation by biopsy.  Other analytical methods are currently under study.  Until something better comes along, PSA is the best we got.  (http://www.cancer.gov/cancertopics/factsheet/Detection/PSA).

Our family money manager, Michael, was in town yesterday, Saturday, for a partners meeting to update us on hedge fund performance and to introduce staff and third party administrators.  I suspect some of you may not have a totally positive regard for hedge funds (aka: Madoff).  But, I can tell you that there are conservative hedge funds, and there are speculative HEDGE funds.  Michael's is of the former.  I can also tell you that it has been a very honest and successful partnership.

I have known Michael for more than 16 years.  He's a retired Navy Captain who turned his penchant for investing into a full-time business after retirement from the military.  He is also a prostate cancer survivor for the past six years.  In fair disclosure to the partners, he discusses his health and reassures us of his well-being.  He also comments that for the majority of men it's not a question of will you get prostate cancer, but when.  It is something all men should take seriously and monitor carefully.  He attributes his successful treatment to his oncologist, Dr. Charles Meyers, whom he recommends highly to anyone seeking guidance in determining their options (http://www.prostateforum.com/about-dr-myers.html).

During the past six weeks I have matriculated from freshman to senior, and in two weeks to graduate.   It's a metaphor for my progression through the treatment process - a feat that college tuition paying parents wish their children would accomplish with similar expediency (although the final cost may not be that much different).  Tomorrow I receive my second hormone injection in a series of three month intervals that I may have to endure for the next three to five years.  Hot flashes are the worst of it so far and something I may have to live with for the duration of my treatment.

Today, Sunday, we took advantage of one of the warmer days we've seen in awhile and finally visited the zoo in the park across from our apartment complex.  The good news is the lions and other predators are well contained.  The bad news: Good Old Bob is still on the loose. 

Gene February/March 2010