Less Common Prostate Cancer Treatments

… that I Myself Didn’t Experience
(draft*) 2015, Davd

“I got the usual.” What you’ve read about this Movember, in the previous 4-5 blogs, is what you’re most likely to face if you have prostate cancer and it’s detected relatively early: A biopsy, followed by either “watchful waiting”, if the tumor is benign, or androgen suppression and then daily radiation beams (except weekends) for 6-8 weeks.

Radiation Beams seem to be the commonest prostate cancer treatment, with androgen suppression “before and after” in a supporting role. This is the treatment pattern i’m in as of Movember 28, with the radiation about 90% complete. After the last radiation session next week, i can expect some follow-up examinations, and to remain a pharmacological eunuch through 2016 and partway into 2017. I don’t have a real prognosis yet, and probably won’t until the first or second follow-up.

I did not get “chemotherapy”: which is probably the kind of cancer treatment that has most visibly increased in variety and hopefulness over the past few decades, and yet remains quite scary. The scans and chest X-ray found no indication that the cancer had spread. Chemotherapy is rare for prostate cancer that has not spread; usually a tumor local to the prostate is treated by radiation, perhaps combined with or preceded by androgen suppression, or else by surgery. If i hadn’t changed general practitioners last year, and my cancer had been detected only after spreading, i might likely have got chemotherapy—which from all i’ve heard, is a much harsher kind of treatment than radiation, with poorer average results, at least in the case of prostate cancer.

The scuttlebutt i’ve heard, says that when people get chemotherapy, they nearly always vomit and are nauseous for days. Even the American Cancer Society website seems vague about chemotherapy, probably because there are so many different chemicals used, each with a different profile of effects and risks. I’m glad not to be in it.

Radiation by Surgery is called brachytherapy. It’s a half-day procedure, from what i’ve read, and if radiation leaves you fatigued, the restrictions demanded after brachytherapy imply weakness well beyond mere fatigue: One rule i’ve heard said, lift nothing heavier than a 10 kg sack of flour or sugar, for 8 weeks after surgery.. maybe 25 pounds [11 kg] might be allowed.

There are two varieties of brachytherapy, and if you are considered for either, you’ll probably read and hear about both. Not having been through either, i’ll just say that they don’t seem as drastic as chemotherapy; but how the oncologists decide who gets one or the other of them, is beyond what i know.

Direct prostate surgery didn’t seem to be available to me; and most of the men i’ve talked with didn’t seem to have it as an option, either. One man had had it, and suffered incontinence [inability to hold the urine in his bladder] until a second surgery installed—this is not a joke, he told me—a valve he can turn on and off. When he goes to piss, he reaches down into his underwear and opens the valve; when he’s done, he shuts it again. I have no information on how common such secondary surgery is, but it is impressive that it exists. In my father’s friend Bill’s day, that would have been either impossibly precise or impossibly expensive.

The Canadian and American Cancer Societies have websites which can give you some further information about those treatments and what to expect—but neither told me the sort of detail that i described about the radiation beam experience. It would be good to find writers who can tell their stories of “Chemo”, brachytherapy, and direct surgery ,… but i’m not one of them; androgen suppression and radiation beams are what i’ve been prescribed, what i’ve been through, and so, what i can write about from experience.

Movember’s near its end for 2015, and radiation treatment is near its end for me. Next Movember, i’ll probably have a good idea how well my treatment succeeded, and roughly how long my remaining lifespan will be if i don’t get killed in a road accident.

It does seem clear that changing physicians in 2014, got my prostate cancer diagnosed and into treatment before it spread; and men over 55 should insist on PSA and those uncomfortable finger examinations. Without them, my father’s friend Bill died not that long after diagnosis; without them, i might not know yet that i have prostate cancer. I might have found out too late, like Bill did; while with those diagnostic tools, i might be cured of cancer by the time i would have known of it, without.


* I label this blog “draft” at first posting, to allow for possible technical improvements and corrections by readers. .


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About Davd

Davd (PhD, 1966) has been a professor, a single father keeping a small commercial herb garden so as to have flexible time for his sons, and editor of _Ecoforestry_. He is a practicing Christian, and in particular an advocate of ecoforestry, self-sufficiency horticulture, and men of all faiths living together "in peace and brotherhood" for the fellowship, the efficiency, and the goodwill that sharing work so often brings.
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