The story of my struggle with cancer began on September 24, 2000 when I had my annual fall checkup with my doctor. One of the tests was for PSA: prostate-specific antigen--the protein secreted by cells in the prostate gland. An elevated level in the blood indicates an abnormal condition, either benign or malignant. (The Reference Guide for Prostate Cancer, Les Winick)
Two days later, my doctor called to say my numbers had jumped since the last test. I had experienced no symptoms of prostate trouble but went along with his referral to a urologist, who scheduled me for a biopsy on Friday, November 10.
In the procedure, the Urologist used ultrasound and a device about the size of a flashlight which contained a large, hollow needle through which he could inject a pain killer, then snip off tiny plugs of my prostate tissue. To get to the prostate, he maneuvered this device up my alimentary wazoo while I lay on my side on a table. It's not particularly painful (unless you're an anal retentive) and I turned the 20-minute procedure into a comedy monologue as I got ''snipped'' ten times.
I was given three days of antibiotic which racked me up and I passed a little blood, so I canceled my Tuesday classes at Fresno State, where I was teaching four classes on a Tues-Wed-Thurs. schedule. What's more, the 162-mile commute on Wednesday left me weary and sore despite a pillow under my keister. The return commute on Friday the 17th was better; and the Urologist gave me good news -- no obvious cancer. He had sent one questionable tissue sample to a specialist lab on the east coast, but he was ''90 percent sure'' I was okay.
I informed my friends and family and really felt thankful on Thanksgiving. However, I continued to hurt as I commuted between Pismo Beach and Fresno; and on December 5th, the Urologist called again. The east coast lab had checked in. Its diagnosis: cancer.
Stunned, I decided not to tell anyone but my wife Polly because I'd already told everyone I was okay and I didn't want to spoil their Christmas. Mine was not entirely spoiled, either. The Urologist said I could wait to deal with the problem until after Christmas and a January trip to London. The news did set me into action. Although I could have taught part-time two more years on my contract with Fresno State, I decided to retire fully on December 30, 2000 and so informed the administration. I also began to sort and dispose of books and papers gathered over 32 years.
I taught my last classes, turned in my grades, and spent a nice Christmas with my unsuspecting family. By January 3, 2001, my prostate discomfort had eased, and Polly and I flew to London for two weeks of theater, concerts and the Royal Ballet's ''Nutcracker.'' We returned to rolling blackouts in California and a decision by the urologist to do a second biopsy February 8th to explore the size and virulence of my cancer. I spent the last week of January cleaning out my Fresno State office, turning in my keys, and signing out. Strangely, I did not feel particularly sad or nostalgic. That part of my life was over and now I had to fight to preserve the rest. Having cancer can wonderfully concentrate the mind, I discovered.
The second biopsy was only five snips, but this time, I was in no mood to crack jokes. Stress was beginning to work on me. So did the three damned days of antibiotics. The biopsy results showed my cancer samples were 3s and 4s on a scale of 1-5, so immediate treatment was going to be necessary. Another PSA was scheduled; and I sank into depression with visions of becoming an incontinent, sexless old man stinking of urine and bitter and retiring into such a situation.
Life went on. I wrote Zephyr columns, tended the library at our Methodist church, and dealt with mundane household chores like leaky toilets. Polly and I went to movies, did our taxes, and tried not to squabble in our tension. My primary care doctor was also concerned about my innards and began a series of tests: upper GI, gall bladder ultrasound. The Urologist took x-rays and decided the best treatment was to remove my prostate completely and some of my lymph nodes. He pooh-poohed my fears of incontinence and sexlessness; but I'd started talking about prostate cancer with survivors and read the book by Norm Winick's dad cited above, and they gave me a different story. My internal checks continued: my liver enzymes were triple what they should be! (No more Pravacol.) I got CAT-scanned and had a bone density test. I gave two units of blood to the Blood Bank to be stored for use in my surgery.
Sadly, I broke the bad news to my friends and my kids. They were stunned but rallied to support me.
In early April, I learned there was a surgical team in the Bay Area which does laproscopic prostate surgery and went to consult with them. It sure seemed better than Slice and Dice, but my HMO refused to fund it and my local urologist was upset. I tried an appeal with the HMO -- but the procedure was ''too revolutionary'' and ''out of my service area.''
I made peace with my urologist, but the prostatectomy was postponed six weeks.
In the meantime, a gastroenterologist decided I had a gall bladder problem and scheduled more tests. I took them (including one which simulated a gall bladder attack!) but never heard one word from him about the results. Life still went on: Polly got a hole-in-one -- her first -- and I learned the Knox College Alumni Association was going to give me a service award in October (assuming I survived). I had to give two more units of blood since my last two had passed their expiration date. I got myself a butch haircut.
On May 16th, I put a Zephyr column in the mail, oiled six squeeky door hinges in the Methodist Church sanctuary, and went to spend five hours on an operating table.
I felt no fear, just resigned acceptance; it was all out of my control now and I decided to just ''catch the curl'' of God's will. I don't remember anything about the operation. I awoke in my room, stapled shut, catheter in my penis, sharing the room with an Alzheimer's patient who tried to go home in the middle of the night. The furor of his capture didn't matter because it was only the first of three nights of ''vitals'' checks, blood draws, pills, IV bags and urine bags. The Alzheimer's patient was sedated and sent to a solitary, non-escapable room; but my sleep didn't improve all that much.
I went home on Saturday, May 19th -- grouchy, gassy from hospital food, and deeply depressed.
I slept soundly through most of Sunday, May 20th and awoke on Monday with big questions hanging over me. Somehow I had to come back -- but how? And even more important, how long would it take?
Winston Churchill used to call his moods of depression ''The Black Dog.'' I've had a few waltzes with that coal-colored canine myself, but none was so bad as what I felt in the week after my prostatectomy a year ago.
There was a ten-inch vertical cut below my navel stapled shut, a catheter in my penis, and a button -- yes, a button! -- sewed to my abdomen with a balloon running through my abdominal wall to keep the catheter in place. The anesthesia I'd received made me dopey and weak as a kitten. I was supposed to walk but my legs were rubbery; and I couldn't manage more than five minutes at a time.
I felt better when the Urologist removed the staples a week after the operation and said there was no sign of cancer outside the prostate, which had been 70 percent involved but only on the surface. The next day, I was able to walk a block, which lifted my spirits as did the phone calls and cards of support I received from family, friends and church acquaintances. I even managed to proofread our church's monthly newsletter, of which I'm editor.
On June 1, the Urologist removed the catheter, button and balloon. My scar was healing nicely, but now I had incontinence problems; and the Black Dog and I did some dosey-does. Gradually, I gained control and my walks became longer. A month after the operation, I was writing a play and chaired a (short) meeting of a church committee. But every third day or so, I'd be weak, sick and/or depressed. Riding in a car, even with a pillow, was very painful.
Frustrated as I was, I still refused to feel sorry for myself. I'd been warned that anesthesia can give you the blues for over six months after a major operation. Accepting that, I paced myself -- working when I could and reading my way through the down days. I continued to write two Zephyr columns a month. Control of my bladder improved until I had to get up only once a night, which allowed me better sleep. My blood pressure was a stunning 110/62 by the end of June. I tried to walk a mile or more every day. To regain upper body strength, I bounced a tennis ball as I walked.
A follow-up PSA showed no sign of cancer but I couldn't ride in a car more than ten minutes. My wife, Polly, went off alone to Ashland, Oregon for a flute camp because that length journey would have agonized me.
The slow slog continued. I compared it to climbing Sunset Crater in Arizona back in the 1960s. The crater is surrounded by a cone of volcanic ash about 1,000 feet high, pink near the top. I thought climbing it would be easy. Was I wrong! For every two steps up, I slid back one; and I eventually gave up not even halfway. My recovery was like that -- but I refused to quit.
By October, I was able to fly back for a Knox Alumni Award at Homecoming even though 50 miles in a DaeWoo Nubira on I-70 from Peoria to Jumer's was a literal pain in the butt. Since the rental car rode like a pogo stick, I got to know every pothole on Main Street, too; but my week in Galesburg was a good one overall and marked the beginning of a sharp up-curve.
I began playing golf regularly -- just nine holes at a time -- but good exercise. By Thanksgiving, I was ready to risk a four-hour drive to the Bay Area. It hurt, but I kept pushing myself. I took responsibility for our 2002 church pictorial directory. Then my doctor discovered in mid December that I was anemic. My father died of pernicious anemia but I snarled back at the Black Dog and took iron pills. Polly and I went to Fresno to share my new grand-daughter's first Christmas then on to the Bay Area for Christmas with Polly's clan. It took me nearly a week to recover -- but on New Year's Eve, we went to three parties. I nearly dropped with the ball in Times Square.
A week later, for Polly''s 65th birthday, I took her to Pebble Beach for golf and Carmel for a shopping spree, then supervised 98 photography sittings across two days for the church pictorial directory. When I survived that, I was sure I was getting well.
With Polly's help, I put together the directory and sent it to the Ohio printer. The next day, all the stress triggered the return of my Bell's Palsy. I lost only about 5 percent of the use of my face, but my left eye was badly affected. For two weeks, I could not read or watch TV. Thank God for my collection of old-time radio shows; I had something to keep me sane. It would be nearly three months before I could open both eyes and see clearly and another two weeks before I could drive.
One-eyed, I proofed the directory, wrote my Zephyr columns, ran my church committee and the library. In March, I began ten weeks of classes with the Pismo Beach Police Department's Citizens Academy. In April, I passed back the completed directories. As I struggled with the palsy, my prostate symptoms slowly went away.
Now, one year after the operation, I consider myself recovered. The Bell's Palsy has subsided, my prostate ''ghost pains'' are rare, and I have few problems with continence. I still must pace myself and I don't consider my sex life satisfactory. But I'm alive; and my latest PSA still shows no recurrence of cancer.
I'll be a citizen volunteer for the Pismo Beach police this vacation season; and Polly and I plan to go to Europe for a month before attending my 45th Knox reunion in October. (Maybe while I'm back, Norm Winick can take a less-weary picture for the head of this column...)
The lesson I'm trying to pass on to you is this: prostate cancer is a dangerous opponent -- but it can be defeated if detected in time. For any man over 40, regular PSA tests are essential; and you can find a way to live meaningfully and make contributions to your community despite cancer and Black Dog attacks during a slow, frustrating recovery.
My thanks to Norm Winick for sending me a copy of his father's ''Reference Guide for Prostate Cancer,'' [Health Education Literary Publisher, Jerico NY 11753] to see me through my trials.