Do I have Prostate Cancer or not?

I’m beginning to write this now, July 7, 2017; however, I won’t finish it until after I’ve had a visit with a Urologist to which my primary care physician referred me. Each year I have a conversation with my primary care physician about prostate cancer and the blood test (PSA) that’s routinely given to detect problems with the prostate. She normally gives me the argument that the PSA isn’t a test that’s dependable for discovering whether a patient has cancer of the prostate. She quotes research published in medical journals that site cases of false positives, and trying to reassure me that most cases of prostate cancer involve slow progressing cancer that has a very low risk of death. Being a Multiple Myeloma patient, I’m faced with regular blood draws to analyze my blood chemistry for abnormalities related to the disease. My oncologist used to order a PSA as part of my blood analysis; however, he stopped ordering the PSA six years ago. The PSA that was done the last time was scored at three.

This year the conversation with my primary care doctor went a bit differently. I questioned her extensively about the statistics that tell us that African American men are more likely to die from prostate cancer than other ethnic groups. She would come back with the argument that all the body scans and comprehensive tests I’m subject to twice per year, as a Myeloma patient, would probably detect some abnormality in the prostate. At almost sixty-seven years of age, and being intimately familiar with what cancer can do to the body, I wouldn’t let the decision this year be based on my doctor’s opinion alone. I asked her to order a PSA. Later the day of my physical, I went to my computer to access my patient records. The result of the PSA had been posted. It was scored at six. This number didn’t alarm me in the least bit. I’ve had problems with my prostate before. About three decades ago, my primary care physician at the time, ordered a PSA, which came back with a number much higher than six. He was very alarmed by the reading and quickly referred me to a Urologist. Fortunately, there was no cancer, but just a bad infection. The Urologist took tissue samples. Tests showed no cancer. For a good while after then, I would return for follow ups, and things would be fine. My diagnosis with Multiple Myeloma and the treatment associated with it have taken a front seat, resulting in me not focusing as much as I should have been on prostate screening over the last few years.

Today, July 7, I had my visit with the Urologist. I had a lengthy conversation with him about my history of difficulties with my prostate. The normal approach for someone with a prostate reading as high as the one that brought me to him is to conduct a digital exam and a tissue biopsy. Since I’m a Multiple Myeloma patient, he decided to forgo causing that amount of trauma to my body. He chose instead to conduct a liquid biopsy, testing a urine sample to see if cancer cells were present. If this approach proves to be inconclusive, he will conduct a tissue biopsy. The results of the test should be available in a couple of weeks. In the meantime, I’ll continue life as usual. One thing I did find somewhat shocking. The PET Scan and MRI scans I’ve been having would not have shown any evidence of cancer in my prostate. These scans aren’t effective at showing whether a patient has prostate cancer. This makes it very clear to me that patients should question their doctors extensively. I’m glad I pushed the issue of having a PSA done this year. Until the results of the liquid biopsy come, my prayer is that I don’t have prostate cancer, or if I do, it’s a non-aggressive type, which won’t require treatment.

Today, July 24, I received a call from the Urology Clinic. I was busy doing chores around the house, so I missed the call when it came in on my cell phone. The call was from the advance practice nurse, who performed my digital examination a little over two weeks ago. His message indicated that the test results had come back and that I was at “low risk”. They wanted to follow-up with another examination in six months. He went on to say that I should call if I had any questions. Obviously, I had questions. The term “low risk” wasn’t clear and generated the following question: …low risk of what? After making several return calls to the number left in the message, and getting no answer, I decided to look up the number to the clinic on the University of Arkansas for Medical Sciences website. I could connect with someone there. The lady who answered told me that the APN was in clinic and that she would have him call me back. Later, I received a call back from the clinic; however, it wasn’t from the advance practice nurse. The call was from an RN, who thought she should get back to me sooner than the APN would be able to.

The RN explained to me that the test performed indicated low risk. I asked what that meant exactly. Did it mean I had prostate cancer or not? She said the test indicated that I had low risk of having a malignancy. The safe thing would be for me to return to the clinic in six months for another PSA, digital exam and liquid biopsy. She assured me that this is the normal protocol for someone with test results such a mine; however, I could have tissue taken for a biopsy if I felt it was necessary. Suffice it to say, I certainly didn’t want to undergo such a procedure. I’ve had it done before and it isn’t a walk in the park.

I started this blog with the title question: Do I have Prostate Cancer or not? I think I can say that the term conclusive doesn’t fit either side of that question. At this stage of my life, believe it or not, that does provide me a certain amount of comfort. At least now, I’m on a medical specialist radar screen, and I’ll be followed closely. This is another example, among others I’ve experienced over the last seventeen years, of why the patient needs to take some responsibility his healthcare. Doctors, though knowledgeable about a lot of things, aren’t repositories for all there is to know about all medical issues. I’m sticking with my primary care physician; however, I’ll be as noisy about her looking under the hood as I am when my mechanic looks under the hood of my well-kept 2005 Chrysler Crossfire convertible.

I’m old and blessed…hope you will be too.

Honest people are still around: Thank God!

With all the alternative facts being bandied around these days, it’s oftentimes difficult to believe there are honest people in the world. I had an experience that convinced me, without doubt, that there are some. My wife has been a Girl Scout Troop Leader for over thirty years. Her troop has gotten somewhat small over the years, but she continues to hang tight. This year they decided to take a trip to Savannah Georgia to visit the birth home of Juliette Gordon Low, founder of the Girl Scouts, U.S.A. From Little Rock, Arkansas, this is an eleven-hour drive. Since only three girls were going, my wife and two other parents decided to drive. Two parents were taking their daughter, and I would help drive two other young ladies, whose parents weren’t going.

I had never been to Savannah. I had heard before going that it was a beautiful city. After we arrived, the beauty of the city was evident. Young teens like malls, so we decided to go to the Oglethorpe Mall for dinner the first evening in town. The food court had a nice selection from which to choose. I decided to eat Chinese. We all made different selections. I had driven most of the distance from Little Rock to Savanah; therefore, I was tired and hungry. After finishing our meal, and feeling a bit rested, we meandered about the mall for a short while before returning to our hotel.

My wife made sure the two young ladies, for which she had charge were safe in their room. Their room was next to ours. I was physically exhausted; however, before getting completely comfortable for the evening, I decided to check my emails. Then, I reached for my wallet, which should have been in my back pocket. It wasn’t there. There was no need to panic, since I often get a bit scattered when I travel. I figured I must have mistakenly left it in the car. I went down stairs, searched the car from front to back…no wallet. I went back to the room, and gave it a thorough going over…no wallet. Then, I panicked!

It was about 8:20 PM, when I finally realized that I must have left my wallet at the mall. Although I wasn’t sure where. Thoughts of chucking it into the waste basket came to mind, as I thought I might have placed it on the food tray after paying for my meal. The mall was closing at 9:00, and the drive back would take me about twenty minutes. My wife and I, tired as we could be, rushed to the car and drove back to the mall. Once at the mall, I asked her to check with the mall offices to see if they had a lost and found. Meanwhile, I went back to the food court. There were two custodial workers in the area where we had eaten earlier. I told them why I was there. They told me that the waste baskets are emptied often, to keep from having overflow. The basket I had emptied my trash in was empty. I’m in a state of real panic at this point, thinking about someone making themselves welcome to all my credit cards, cash and driver’s license. The idea of returning to the hotel room and trying to make calls to cancel credit cards made me even more exhausted.

One of the custodial workers suggested I check with mall security. If someone had found my wallet and turned it in, it might be there. The security officer was very nice. She looked through a drawer that had many wallets…none of them were mine. I did the only thing I could do at that point, I left my name and cell phone number. Here I am in a city in which I had never been before without money, driver’s license, and surely to be the victim of identity theft.

The mall was about to close, but I decided to return to the Chinese food place where I had bought my meal earlier. There was an older Asian man working at the cash register, and the young Asian woman who had served me earlier. I approached the man, and began to explain why I was there. He immediately started to say no before I could fully explain my predicament. The young lady overheard me and told the man my wallet was in the counter drawer. The man took it out and handed it to me. A heightened sense of euphoria came over me. If you’ve ever been convinced beyond doubt, during a specific experience, that there is a god in heaven, this was one of those moments for me. I offered a twenty-dollar tip to the young lady, but she refused to take it. The older gentleman, evidently convinced that I was not up to some sort of shenanigans was quick to chime in to let me know that I was a customer, taking money from me wouldn’t be right.

When I arrived back at the hotel, I was more exhausted than I had been in a long time. I slept all night without getting up even one time. The rest of the time in Savannah was wonderful!

I’m old and blessed…hope you will be too.

It’s hard not to celebrate a birthday

It’s July Fourth, 2017. I had planned to just rest this day, not make a big deal out of anything. This morning when I got out of bed, I was moved to make a trip to Wal-Mart. Not burning up some hamburgers and hot dogs on the grill just didn’t seem right. Though things in the country are out of kilter, I can’t let that deter me from celebrating the 241st birthday of our country. The late author, Alex Haley was known to say, “Find the good and praise it.” With that phrase in mind, I found myself thinking of all I’ve been blessed to experience in America during my sixty-six years of life. Although politically and socially my country is going through a period of dissonance, there is still an overwhelming amount of positivity in our nation.

When I consider just a few facts: 1) I’m a long-term cancer survivor; 2) I was born into poverty, and I’m a product of an educational system that prepared me-with God’s grace- to lift myself out of that state; 3) I have family that loves me; 4) I have lived a productive life over the last seventeen years as a Multiple Myeloma patient, and 5) I have hope for the future. There are so many more things I could list; however, the point is that I really don’t have to look very hard to find the good that has been a part of my three score and almost seven. As I write this piece, I’m basking in the joy that came from watching my family eat the food I prepared for this day. We didn’t eat anything fancy, just hot dogs, burgers and a few chicken drumsticks. I added a bit of cole slaw, baked beans and potato salad to round out the spread. As I said nothing fancy, just some basic food stuffs with the family. It wasn’t hard to find the good in the experience of this day. Blessing are wonderful and even more so when you acknowledge them.

Birthdays provide an opportunity to celebrate; an opportunity that shouldn’t be passed up. July Fourth is the day we celebrate the birth of our nation; it’s also an opportunity to look around at all God has provided. A personal survey of what you’ve received in sacrifices made by others in service to our country; of how you’re still alive given all you’ve gone through, and the hope for a brighter future, make it easy to celebrate our nation’s birth. God bless America!
I’m old and blessed and I hope you will be too.