Yesterday Margaret and I spent nearly four hours at the Cancer Centre in the Burr Wing of Kingston General hospital, talking with both a radiation oncologist and a surgeon, regarding treatment for my prostate cancer The bone scan last Friday showed that there was no metastasis; if today’s CT scan of my lymph nodes similarly shows no problems, I’ll be having surgery, likely in early June.
The lack of urgency compared with my 1990 surgery (3 days after diagnosis then as opposed to 3 months now) is mostly because prostate cancer grows very slowly and testicular cancer is very aggressive.
Of the four hours, about 45 minutes was with the oncologist and 20 with the surgeon (who also performed the biopsy on February 8), plus medically-related interviews with nurses and students (all of the Kingston hospitals are administratively joined and associated with the Queen’s medical school). Most of the rest was paperwork, plus about an hour total of travelling or waiting.
The oncologist gave me a long rundown of my medical condition and the clinical evidence relevant to making a decision about treatment. My tumour stage was T1c (detected via biopsy after PSA tests), four of ten biopsy samples had cancer (thus it probably hasn’t grown a lot yet); most recent PSA 8.7; no signs of bone metastasis; lymph node spread unlikely. He described the radiation-related treatment options. The usual method is 38 days of daily (weekdays) treatments of External Beam Radiation therapy. The alternative is brachytherapy (insertion of radioactive material directly into the prostate, of which there are two methods both of which require trips to Ottawa or Toronto at the moment), followed by fewer EBRT sessions. He reassured me that if cancer had breached the prostate capsule or spread to the seminal vesicles, both surgery and radiation would take care of the problem.