fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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The Return

 
Catherine and I had been through my symptoms, diagnosis, staging, treatment and hormone-deprivation therapy. “It’ll be like a menopause,” the consultant had said, and it certainly was. Through flushes, mood swings, emotional fragility and a whole host of side effects from the drugs, she was there, supporting me all the way. Then the treatment was done, a fading memory that had strangely enriched our lives, bringing insights otherwise unobtainable. As I said, half-jokingly, I got in touch with my feminine side. 

It came back quietly. There was no fanfare, no crashing through the door, not even a soft knock, no word to say, “I’m back.” And yet there it was, five years after we had thought it was gone. Catherine could no longer say “David has had prostate cancer.” Instead she had to say, “David has prostate cancer.”

In fact, it had never really gone away. We had lived with the side effects of the treatment, the radiation-induced proctitis in my sigmoid colon (with its occasional–and sometimes spectacular–bleeding), the arthritic pain in my hip, the urinary issues and so on, all part of the wallpaper of our life, the new normal we had assumed was a small price to pay for having survived locally advanced, high-risk prostate cancer, with a Gleason score of 4+3. And now, here we are, me no longer having had but now having prostate cancer, once again.

We knew the two main criteria for biochemical failure and we knew that I fitted them both. We knew the possible outcomes and treatment protocols that could follow. We also knew there might be other reasons for the consistent rises in my PSA. Or that there might be no other reasons. After five years of hiding in the shadows, my prostate cancer was back. 

The PET/CT scan was quiet and claustrophobic. I did as I had done in MRI scanners, in CT scanners, in the gamma camera. I fell asleep–and awoke to wonder and hope.

The outcome: one minor intrusion in a pelvic lymph node, a doubling rate of around ten months, a recommendation of PSA testing every couple of months and active surveillance.

Meanwhile, the wallpaper of our life has a new normal, now less certain and less secure than it was.

David Matheson
Northampton, Northants, United Kingdom

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