When it rains, it pours. Last night, in the hotel, I reached for my suitcase and WHAM... my back went out big time. I am in pretty severe pain. Not the way one wants to feel on a very important day.
Despite the severe pain, the important events of the day went well.
Best news was that neither the surgeon or radiologist felt more tests were needed. The surgeon pointed out that all a bone scan would show in a 63 year old male would be plenty of hot spots that might need to be investigated and they would all turn out to be arthritis or healed broken bones or whatever. The risk/reward isn't there as the probability of cancer being so advanced to show up is real but very small. (I know some of you disagree strongly with this).
Actually, I had said that earlier but figured they would want to do the tests as part of defensive medicine. I am in such bad back pain that I am VERY grateful for that reason alone not to do it. In fact, I really learned nothing new, but my own ideas were reinforced. With surgery, if PC occurs again, radiation (salvage) is often possible and curative. Radiation can cause bowel problems and rectal bleeding and other stuff. For someone like me who has had bowel problems and lots of hemmies, it can cause problems. Also, radiation side effects can kick in a year later too.
My choice will be surgery. Tomorrow, after I try to somehow teach through this back pain, we will head for Detroit and I see Dr. Menon on Wednesday. He is my first choice at this juncture. The Umich surgeon, top-notch, was interesting. He is a man of few words but straight to the point, with honest answers. Ditto with the radiation guy. Oh, we ended up not seeing the urological oncologist. She indicated that if we had all our questions answered and were satisfied from the first two experts, we didn't need a third appointment. Also, I got the impression that she is the go-to person if surgery and then radiation fails (HT, etc.).
I didn't really learn anything new. I was well-versed in this darn disease. Oh, the surgeon did say that he does robotic and non-robotic surgeries. The tumor I have on the apex is better to handle via robotic surgery. The other stuff: 5 out of 12 cores is a concern as is the Gleeson 4+3. The 5% volume is a positive. The low PSAs are positive. The high PCA-3 is a concern but they are still finding out about the PCA-3 test, so it is more of an indicator as to whether or not to biopsy. These days, all Gleason scores are at least 6, so a positive spin is that there is also an 8, 9, 10, which I don't have. It's a mixed bag and we won't know more until after the surgery.
Mel