Friday, June 18, 2010

Treatment #1

Well, the day had finally arrived; the one I dreaded yet anxiously anticipated. The first installment of the BCG treatment was scheduled this week.

For those of you (like me) with short term memory loss, let's review. The treatment recommended for this type cancer is called Immunotherapy. BCG (Bacillus Calmette-Geurin) is a live tuberculosis bacteria that is injected into the bladder. The bacteria then stimulates my own immune system to send in troops to fight the bacteria. It's like "Shock & Awe" to all enemies of the bladder; the troops indiscriminately kill all evil cells. Cancer, bacteria, they don't care! There will be six treatments, once a week until the enemy surrenders.

At 3:30 pm, I arrived at the doctors office with my body guards, Sue and Alison. As expected, once we hit the elevator to the second floor, I tried my escape. "Maybe I should consider a holistic approach to this cancer instead, let's go home!" My argument did not convince the tough minded family soldiers so on we went.

As if the medical assistant at the office knew of my internal struggle, I was called in before I even had a chance to think. OK, this is it, no turning back now. I'm not really afraid of the treatment, I'm nervous about the insertion of the dreaded catheter. The treatment will be injected directly into the bladder through the catheter.

Once my urine sample passed muster, it was time to begin. A numbing gel is applied to the area and then pushed into the urethra. After a few minutes to allow the gel to work, they inserted the catheter. I closed my eyes, took a deep breath and 'viola' (French word inserted for Alison's enjoyment!), the worst was over  in a couple seconds. As they injected the solution, I didn't feel a thing. Before long, the whole thing was over, we were in the office for only 15 minutes or so. Boy did I feel good once this was over. It really wasn't as bad as I had anticipated. I walked back into the waiting room and greeted Sue and Alison with a smile; one might even say I had a bit of a cocky smirk on my face!

Now at home, I would need to keep the solution in the bladder for 2 hours, then I was free to urinate normally. For the first hour, I needed to lay on my back, then on my stomach, and on each side, for 15 minutes each. This was to be sure the solution coated all areas of the bladder. I was a bit nervous about having to 'hold it' for 2 hours, but made it with no problem. The rest of the evening I felt just fine.

The following day, I went back to work as normal. The side effects of this treatment include fever and nausea, or basically feeling you have flu-like symptoms. None of that for me, I felt great the day after. The only thing that bothered me was some burning and bleeding while urinating and that is normal after this type procedure. A great anxiety has been lifted now that I've gone through the first session without incident.

To further boost my spirits, I went for a short run the following day after work. It's still a struggle compared to where I was 6 months ago, but it felt good to get in a couple miles. I'm feeling more and more confident every day. So, if you're a certain brother-in-law, you may want to step up your training, my next race may be sooner than I anticipated!

Saturday, June 5, 2010

The Second Opinion

This past Thursday, Sue and I met with Dr Holzbeierlein, a urological oncologist with the University of Kansas Hospital. I wanted to be sure that another specialist in this field agreed with the course of action prescribed by my initial urologist.

It was obvious that Dr Holzbeierlein was a leader in this field of medicine, as he sent in a resident doctor for the first round of questioning and the dirty work. Yes, years of experience does have it's rewards; the resident would ask all the redundant questions and have the honor of doing the digital prostate check. For those of you my age, you know what I mean, a personal space violation only a doctor could get away with! And no, it's not digital because there's an electronic device, it's digital, like one of the digits on your hand that does the work. OK, I am being a bit factitious about the doctor's roles, but there probably is a little truth to that.

Moving on, the doctors recommendation for treatment was exactly the same, however, he did want to go back in and do another scraping of tissue inside the bladder and do another biopsy. His reasoning was to be sure we removed any potentially dangerous cells before beginning treatment. I was very uneasy about having another biopsy done; this would mean another surgery and another month to recover.

So, the dilemma; should I follow the experts advice or continue straight to the treatment. Remember, regardless of whether I choose the second scraping, the long term treatment recommendation of both doctors is the same.

Here's my thought process:

* A second scraping of the bladder may slightly increase the odds that all of the cancer cells were removed. However, even if some dangerous cells were still intact, the prescribed immunotherapy treatment would likely fight those remaining abnormal cells.

* A call back to my original urologist, Dr Joseph Myers from the Olathe Medical Center, confirmed his personal observation that all suspicious cells were removed. He assured me that there would be nothing left to scrape.

* Somewhere in the back of my mind lies this feeling that since Dr Holzbeierlein did not do the original surgery, he needs to be sure in his own mind that everything inside was scraped properly, hence the recommendation to do it again. Kind of a CYA?

* Fighting cancer requires a strong mind and a strong body. I personally feel ready to begin treatment and do not want the mental setback of another surgery. I also feel comfortable with Dr Myers, his answers to my questions and his staff.

After discussing the situation with Sue, we have decided to continue down the initial path given by Dr Myers. Treatment will begin on June 16th as planned.

On a happier note, today I ran for the first time in almost two months. I was a little apprehensive at first, jogging quite slowly (uh oh, runners hate the word jogging!), but eventually became more confident and ended up laying down 3 miles of tracks. My legs felt great but the breathing was still quite labored. Overall though, I was extremely pleased with the run. I'll slowly work in more days and more miles and hopefully will feel strong again soon.

Thanks again to everybody that has wished me well, I haven't been able to respond personally to everyone, but I do appreciate the kind words.