Posted 4/11/2016 8:19 AM (GMT -5)
I've mentioned in the past that rather than worrying about PC, that I've been dealing with a rare cancer called liposarcoma. Over the winter, I had four rounds of inpatient chemo and I then went to MSKCC for surgery with the top liposarcoma surgeon in the world in early March.
I had been told before chemo that it has limited effectiveness. about 1/3 of patients get a positive result and tumors shrink. Another 1/3 get stabilization but no reduction in tumors, and the last 1/3 get no effect at all. I had a CT scan on 12/31 after two rounds. On New Year's Day, my medical oncologist e-mailed me to tell me that the CT scan showed that the tumors were shrinking. I was overjoyed.
Just a couple days later, I had my 2 year post-op PSA test. It came back as 0.10, conspicuously missing the "less than" sign. I was devastated. I met with my urologist, and I was sure he was going to take me off testosterone therapy and start talking to my medical oncologist about how to possibly coordinate treatments.
Instead, he basically blew it off. He said it was just one data point. It was still at the very bottom of the detectable level, and he simply wasn't worried. It might simply be an error. Or a rounding issue. He told me that in the bigger picture, I had other more important issues (he did my original liposarcoma surgery and has twice in the past 2+ years had to tell me that I have cancer) and my testosterone levels were good (tested at the same time). So, he said to stay the course. But, instead of moving to every six months for PSA testing, he scheduled another test for April, another for July, and an appointment in July. He said if I had three detectable readings in a row, we would talk then.
So, I completed my chemo. I had my surgery. My post-op pathology was promising. The chemo completely killed one tumor on the exterior or my liver. Two tumors on my bowels that looked like they would require some resecting of the bowel turned out to have shrunk so much that they simply peeled off, and the path report showed they were the non-aggressive form of liposarcoma. The fourth lesion, on the psoas muscle, hadn't responded well to chemo, but the path report showed it was primarily the non-aggressive type of liposarcoma, which typically doesn't respond well to chemo. There was a tiny piece of the more aggressive subtype I'd started with, but great margins were obtained. All in all, the pathology report was promising for a truly deadly cancer.
So, I'm about 4 weeks post-op, and I had to get my PSA checked again last week. I went in on Thursday, so I'd have the result before I see my medical oncologist this week. I don't know why it took so long (I normally get results the same day), but it finally showed up overnight. I was undetectable again.
So, the fear of having to treat both cancers at once is gone, for now at least.
I get a CT scan for the liposarcoma in June, and another PSA test in July. I think the testosterone has been helpful in my recovery from surgery, and I'm glad I can continue to use that.
I'm still recovering from some pretty major surgery, but the list of things to worry about is a lot smaller than it was 5 weeks ago.
Bit by bit, maybe I'll get through all of this. I even got out fly fishing the past two days, although it was cold as hell here in VT and I didn't catch anything. But, there's a long fishing season ahead of me, it appears.
Damon