I was supposed to start chemo this week, on Thursday, but that’s now changed. I’ll be taking less intense oral medications instead.
My treatment plan has changed a few times, after having cancer for almost 2 years. I’ll explain more about that, but first, I need to give credit to the people who made and changed my plans. They’re oncologists, sometimes medical oncologists and sometimes radiation oncologists.
The more I work with them, the more I respect them. For starters, think about the tough conversations they have. Each week or each day, they tell people that life is shorter or less comfortable than planned. It takes a special person to have that conversation so often. I’ve also been impressed with the cautious attitude my oncologists have had with treatment. Too often, I heard well-intended people say something like, “All doctors want to do is give you another pill.” That hasn’t been the case with me at all. My oncologists have suggested that I keep exercising, eat well, and they have a lot of caution when considering medication.
Getting back to the treatment plans that have come, gone, and stayed. The table below sums it up.
| Approx Date | Treatment | Reason for changing | Comments |
| Feb 2016 | Surgery to remove my prostate | Spots showed up on a bone scan, suggesting the cancer had spread to my bones | After a few months, we confirmed the cancer was not on my bones, so I had surgery. |
| Sep 2016 | Monitor PSA after successful surgery | My PSA kept rising. That meant the cancer had spread, so we couldn’t just monitor PSA. | That was one of my toughest moments because we thought surgery took care of it. |
| Aug 2017 | Radiate my pelvis | A new scanner at the Mayo showed my cancer had spread to more places than radiation can treat | This was another tough moment, since it meant the cancer would grown and be incurable, with current treatments. |
| Oct 2017 | Chemo | My oncologist at the Mayo recommended a different treatment based on 2 factors. First, he described my disease as “low volume.” It’s still incurable and risky, but I still like that kind of volume. The second reason my Mayo Oncologist gave comes from the results of a study that’s just being completed at the Mayo, with guys in my situation. | My Oncologist in the Twin Cities is on vacation in India. His recommendation will determine the next treatment plan. |
Overall, I consider this good news. I’ve heard the phrase “low volume” a few times now, which beats the alternative. I was willing to take the discomfort of chemo if it could have hit my cancer hard when it is low-volume, but I learned that the recent study from the Mayo showed that chemo only helped in high-volume cancer.
Ruth summarized my situation well when we spoke on the phone a moment ago. She said this latest change is “unsettling.” That’s accurate, and has a wonderfully British tone. My cancer is still dangerous, but new information is clearly showing up often, like the recent study at the Mayo. With a little luck, more information and studies will continue to give new treatments. Some unsettling moments are worth it when they come from new research and treatments.
Another realization is facing the tough realities that come from being someone who deeply respects rigorous science. In that science, published studies include all the details needed to critique and replicate a study. If the study doesn’t hold up to criticism and can’t be replicated, the scientific community rejects the findings, and sometimes the scientists who published them. Science is still messy, and of course, it can’t explain everything, but it has extended our lifespans for decades or longer. In my case, the results of a new study changed my current treatment plan.
Back to simpler thoughts, this change in plan means I can enjoy the upcoming days and weekend. That’ll involve writing in the morning, cycling in the afternoons, and good times with friends and family. All those will feel even better since I thought I’d be down with chemo, during those days.
If you’re interested, my cycling blog will soon describe a wonderful ride Ruth and I had in Louisiana last week. Normally, I enjoy writing in my bike blog during a bike tour, but during last week’s tour, I didn’t have time to write. There were too many other bits to enjoy, like other cyclists, sights, and wonderful Cajun food. This bit of stress makes the memories of that cycle tour even better.