Friday, October 12, 2007

Diagnosis

Wow. So it's a bit late for this, but frankly things have been busy, and I wasn't sure this was the best place/forum for posting stuff. Anyhow, here goes: I have cancer. That sounds weird. Somehow it sounds so much better to say, "Well they found a carcinosarcoma in my prostate." Okay, maybe not sooo much better, but it seems to sound better. I have cancer. It doesn't even sound like a proper sentence. It's like, "I have book" or "I have monopoly board." I suppose it can't be "I have THE cancer." No, that's not quite right either. Well, in any case, I have it, and it's there, and hopefully next Friday they'll take it out.

Lessee, do we want all the details? Why not, as this is the first post on the subject. Here's a brief run down of what happened:

June - started seeing blood in my urine, went to see the urologist. Lots of blood tests, urine tests, everything negative - no fever, no chills, no signs of infection.

July - first aspiration - dude shoves a probe up my butt and sticks a needle in the prostate - they drain out fluid, they culture it for bacteria - nada.

August - second aspiration - pretty much the same as the first, a bit of fluid,
not much to go on - but they did find... e. coli! So... antibiotics for that, but most likely it was a contamination from the needle being in the rectum and such

Sept - at some point around the 5th something got really inflamed in my left buttocks and there was this lump there. Then, it became harder and harder to urinate, until I really couldn't empty my bladder and had to go to the ER. There they put in a Foley catheter, which I took home for a couple weeks. I also had a fever going into the ER and a little afterwards, but some antibiotics and vicodin helped keep that and the pain from the butt lump in check.

Mid Sept - Finally, I went in for a third transrectal ultrasound and biopsy of actual tissue - they still didn't find much, mostly dead tissue and a little bit of cartilage - that sent up some flags. Prostate has no business with cartilage. They tested for germ cell tumors but came up negative.
End sept - I was scheduled for a TURP (transurethral resection of the prostate) to grab out more tissue and get a better reading on what this thing is. Of course a few days before the surgery I started having intermittent feelings of urgency that would make me clench up my abdominal muscles and such. Then I started having fevers, and at one point they hit 101.5, so into the hospital I went. They gave me IV antibiotics for about a day and a half and were then able to do the surgery once the fever came down. They suspect this was a side infection from having the catheter in.

Oct. 4 - Diagnosis day. It's a carcinosarcoma. It's rare, and it needs to come out.
Oct. 5 - Unceremonious call from the oncologist - they'll need to remove the prostate, and maybe the bladder. That was a tough day.
Oct. 6 - CT scan to see if it's grown or changed in anyway. Fortunately it looks about the same on the scan and doesn't seem to have spread anywhere. Two lymph nodes on the right side are enlarged, but this could be from the infection/prostate inflammation after surgery.

Oct. 10 - Second opinion appt. at UCSF. The doctor lays out some of the possibilities given the pathology, we schedule a follow up for next week on Wed.

Oct. 11 - The urologic oncologist lays out the plan, and it's not terribly specific. They'll have to remove the prostate, and then they'll see when they're doing the surgery whether or not they'll have to remove the bladder. They can't see the distinction, but they can do real-time biopsies. If they do have to remove it, they can reconstruct a pouch from part of the bowel, but then I have to empty that with a catheter through a stoma (port) in the skin every 4-6 hours. If they take just the prostate, they can reattach the bladder to the urethra, I go home with a catheter for two weeks and eventually I should be able to pee normally. I'm hoping to wake up with a catheter strapped to my leg. Chemo and radiation therapy will be dependent on what the prostate tissue looks like. Surgery is scheduled for Friday the 19th. If that's too soon, we'd have to wait until the 31st...

Oct. 12 - Schistosomia-what? So, at some point throughout all this, the infectious disease doctors found antibodies for the schistosoma worms (freshwater worms found in exotic locales) in my blood. They checked urine and stool and found no eggs, and the pathologists found nothing either. I went in for a follow up appointment with ID and they said, well let's treat it anyway. The treatment? Two sets of pills twice a day for one day. Would that were the whole problem...

Well, that brings us mostly up to date. . .

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