I am just coming off a 2-day “PSA-Dread” hangover.  What that means is that we went to see DH’s radiation oncologist at Sloan-Kettering (MSK) on Tuesday to see whether his salvage radiation (sRT = radiation after failed surgery) had worked.   You know that feeling of anguish that builds up as “D-Day” draws near.  Your mind twists itself into pretzels going over the possibilities . . .

What I really think we need is a “Manhattan Project” to conquer the “PSA Monster” so that we can live a relatively anxiety-free life.  The Declaration of Independence gives us the right to pursue “happiness,”  but isn’t peace of mind just as worthwhile a goal? 

Most cancers come with fears of recurrence, but I think it’s particularly noxious with prostate cancer.  So I want to repost  something I wrote about this subject before DH had a recurrence.  Virtually all of it still applies.  Then I would like to talk about our experience getting T’s results the other day (separate post).  BTW, the doctor said T’s PSA is undetectible.

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I  want to share with you my theory about what makes the PSA testing process so wretched.

I think it is because, unlike with some other illnesses, you, the patient, have no CONTROL over the outcome.  And the less control you have the more anxious you’ll be.  For example, I don’t know of anything reliable that you can do to prevent a recurrence of PC. You could be the most virtuous person and do everything right, but it probably wouldn’t change the outcome.  Therefore, you feel powerless.

Second, there are no WARNING SIGNS of a recurrence.  It’s not like you get a get a nagging feeling that something in your body is not right.  Like something is leaking or stopped up.  This just adds to the sense of helplessness. 

Finally,  if you get a positive PSA, and have it verified, it can mean only one thing.  (I would now say a positive PSA can indicate a benign condition, but doubtfully in the later phases.)

I am only familiar with one other cancer.  My husband had a melanoma, or skin cancer, some years back, and so I am comparing my experience with the two cancers thus far.

A lot of time skin cancers are out there in the open.  If DH hadn’t shut his eyes so tightly, he would have noticed the oozing sore on his chest and done something about it. Eventually, I got him to a derm who diagnosed a melanoma.  T, had surgery, and the tumor was removed along with the lymph nodes in his left arm.

This all wasn’t a picnic and I remember that every time I see the huge scar on his chest shaped like a tic-tac-toe grid.

The difference between the melanoma and PC is that in the above situation you feel you have much more control of the disease.  I don’t know of any way to prevent a recurrence of melanoma.  But you can certainly examine your body regularly to see if  anything looks suspicious, and if you find anything, you can check with the doctor   It happened that once I saw a strange-looking pimple on T’s  forearm that turned out to be one of those “less-aggressive” skin cancers. 

My point in all this is that with melanoma  you have a way to detect a recurrence of the cancer potentially, and therefore you have a greater sense of control and less anxiety.  Chances are, if you’re vigilant, you will catch the problem before the doc does.

On the other hand, the docs say early PC has no symptoms.  My husband found out he had it because he was  having some normal prostate problems for somebody his age: you know, getting it started, keeping it going, etc.  The doctor did a PSA test and found that DH had a 10, so he referred him  to a urologist.  The rest is history.

The doctors swore up and down that DH’s symptoms had nothing to do with the PC —  it was all a coincidence. This doesn’t make any sense, because you would think a diseased organ (blocked by a tumor) would malfunction in some way.  Anyway, it what the docs say is true, there’s nothing that could alert you to the presence of PC, not even BPH (“enlarged prostate”).

I hope I made my point about why PSA testing is so agonizing.  The only thing that stands between you and eternity is this one blood test.  And it is FATE that determines the outcome.  All you can do is hope for the best.

I am not saying this to depress anybody. For me, it feels a little better know there are a lot of people in this same boat, unfortunately, and most of them will make it to shore. 

If *you* have any tips about quelling the “PSA Monster,” I would love to hear them.  Am posting Curtis’ next.