Dennis Hopper

Yesterday we lost a great actor and artist - Dennis Hopper -who passed away from complications of prostate cancer. Dennis was diagnosed last October as part of testing during hospitalization for dehydration. By the time his cancer was detected, it had spread throughout his body. Guys - get checked annually!

The Blog

Today I start medication - Proscar. One of the possible side effects is additional body hair, and I am hopeful it will target that thinning spot on the back of my head!

Now that the second opinion is here, I have told the kids. I'm not worried, and neither should they be. I have consulted with my closest friends, family, and both my doctors regarding this blog. All have been supportive. In fact, Jerry said that many men are devastated when faced with the diagnosis. I guess the fact that I have been informed for years makes this easier for me to face. I'm not dealing with it alone - I have a wonderful support team of family, friends, and doctors. In fact, Dave told me today that guys with prostate cancer golf better - I can't wait to take his skins money! I will continue to blog on my progress. Feel free to comment, ask questions, etc. I'll do the best I can to reply.

Side comments

I should say at this point that I am no stranger to prostate cancer. In fact, I met Dave at a Prostate Cancer Education Council golf tournament. As fate would have it, I was placed in his fouresome, and we became golfing pals. I also became involved in the cause to not only educate guys (and their families) regarding prostate cancer but also in the research to help treat and ultimately find a cure. Through my association with Dave and the PCEC I learned that 1 in 6 men will be diagnosed with prostate cancer. If you are a minority, the odds are 1 in 3. Nearly 200,000 American men will be diagnosed with prostate cancer in 2010, and 1 in 35 will die from it - PRIMARILY BECAUSE THEY WILL NOT GET A SIMPLE BLOOD TEST! Guys - this is not a macho thing. You owe it to your loved ones to get checked. Ladies - press your man to get checked! Catch this demon early and the odds of survival are good.

The second opinion

Got the results of the second opinion today. Results as follows:

Prostate, right base, needle core biopsies:
- Prostatic adenocarcinoma, Gleason grade 3 + 3 (score = 6), microfucus involving <5% of 1 / 2 cores (see comments)

A, B, C, E, F) Prostate, left base, left mid, left apex, right mid and right apex, needle core biopsies:
- High grade prostatic intraepithelial neoplasia, focal in right apex
- Acute inflammation, moderate in right mid
- Prostatic tissue with no evidence of malignancy (0 / 10 cores)

Comments: In contrast to the outside pathology report (with diagnosis of ASAP), we consider that there is enough number of malignant glands to confirm the diagnosis of a small focus of adenocarcinoma. Accompanying immunoperoxidase staining for HMWCK+p63 cocktail shows lack of basal cells in the malignant glands. Specimen from right mid shows moderate acute inflammation, which may explain, at least in part, a possible increase of serum PSA. A close follow-up, which may include mapping biopsies of the prostate, is recommended if clinically indicated. Dr. S. Lucia has reviewed this case and concurs.

Lots of big words! I immediately start to research all the big words on the web, in an attempt to tie down just what this doctorspeak is telling me. It's easy to get panicked about the various definitions on the web, but after speaking with both Dave and Jerry, I am reassured that we are moving on the right track. The second opinion has confirmed the cancer. The next step is a mapping biopsy to really nail down the scope of this "bug". We schedule for Aug with Dave.

The results

The results are back, and I'm back in Jerry's office at Ft Carson. Mostly good results. However, the biopsy sample for the Right Base reads: "Small focus of atypical glands, suspicious of malignancy". The comments include "The small focus of atypical glands is suspicious for malignancy and repeat biopsy is suggested." We talk it through and feel that a second opinion is in order. Can Dave's pathologist take a look at the results? I call Dave and he is eager to help. We make arrangements to send the data to Denver.

The biopsy

Biopsy went fairly well today. I had been warned that this would feel like somebody shooting a strong rubber band against my butt, and that pretty much sums it up. 12 samples taken. Doc Limoge and the nurse continue to talk to me through the procedure, primarily to keep my mind off what is happening. Doc said he didnt feel any more abnormalities,and ultrasound was clean. Dizziness after sitting up, but that went away after around 5 minutes. Will get biopsy results next Friday.

I did have some interesting side effects a couple of hours after the
procedure. I went back to work. Started sweating really bad. Whiteouts - I looked out the window and couldnt distinguish anything. It was snowing, but everything was extremely bright. Was drowsy and dizzy but got to my bookcase to grab a golf towel to wipe off sweat. Put my head down on a shelf.
Thought it was only a few seconds but was actually closer to 10 minutes.
All symptoms went away after around 45 minutes. Residual pain subsided maybe 6 hours after procedure. After initial blood in urine, all is now clear. I sent Dave a note describing the side effects, and he said it was a vasovagal event. Basically, I fainted. I always thought that fainting means you just kind of collapse. I never knew there are lots of pieces/parts to fainting!

Telling the family

Picking up the wife tonight in Denver. She has been gone for a few weeks with a family health issue in California. We are heading to the Michael Buble concert in Denver, where we have front row seats! Conversation turns to the testing before we ever really get out of DIA. I tell her what has transpired, and what I think is going on. Then the convo turns to the kids. Should we tell them? I say no - not enough info at this point. Don't worry them. I am considered hard headed.

The exam

I meet Dr Jerry Limoge, who will be performing the physical exam. He immediately strikes me as a good guy, and for this kind of exam, that's important. This is a rectal exam, where the prostate will be examined for abnormalities, such as a lump or hard spot. The procedure is painless, and is over in under a minute. Jerry tells me that there is one area that seems abnormal, and recommends we set up for a biopsy. I find out that he knows Dr Crawford and thinks highly of him. Later, I e-mail Dave and relay Jerry's name to him. Dave's reply: "Limoge is the best, couldn't recommend anyone better." That's really good to hear! Biopsy is set for 23 April.
Later that night, while talking to a friend on the phone, the reality of where all this is going really hits me for the first time. I have a little meltdown, and quickly recover. First time using the "c" word. I needed to get this moment out of my system.

Dr Crawford

I fired off a note to a good friend, golfing partner, and world-reknown urologist, Dr Dave Crawford, who lives in Denver. I'm scheduled for a physical exam next week, and wanted to get his take on things. Although Dave offers to perform the exam, I decide at this point to go ahead with the referral at Evans Hospital.

The checkup

It's time for my annual checkup! Last week I submitted blood samples for this checkup, and today I get the results. I'm expecting to hear the same thing as last year - cholestrol could be better, I need to exercise more, and all the other normal stuff. In and out in 15 minutes! But...the doc has some other news - my PSA level has elevated to 4.49. I know that PSA levels are just an indicator, and not a confirmation that things have taken a turn for the worse. However, more investigation is warranted, and the doc sets me up for a referral.