16-32-64 fourteen-point-five

Delayed post from 17th July 2015:

So my dad received a diagnosis of prostate cancer today. This entry won't be going live until the news is public, but I feel like writing so it can live in my drafts for the time being.

A whole new world of learning ahead of us - and starting over with telling people bad news. The worst part for him - having been surprisingly prepared for bad news - is going to be telling my brother and uncle. Prostate cancer is hormonal and therefore genetic links are very possible. My brother at 36 won't need to worry yet, but uncle T at 57 will need to get the PSA blood test and be closely monitored from now onward. As if our lives aren't full of enough worries.

In the last couple of weeks following a elevated PSA test (blood test that simply says "prostate needs further investigation"), Pops been through multiple tests and a horrific sounding biopsy procedure with one more to follow - a CT scan to check the abdomen. I'd convinced myself there were too many other things this could be and when there was only one person in the room calling us in - I thought we were home-free. Not so much.

The level of cancer is showing at a middle-seriousness; with quite an aggressive character. It showed up in all twelve of the biopsies (on an organ the size of two walnuts - I was surprised there was enough tissue!) and is currently showing in one lymph node, meaning it has started to spread but not yet made it to bones and organs yet. The CT next week should confirm this - he's had a bone scan but they need to double check. If it had been in less biopsies and not the lymph node they may have chosen to operate (he has COPD as well which increases risk, so this may not have been an option anyway). If the cancer was further advanced and spread, chemotherapy would have been suggested and - from what I can tell from his opinion of it - declined. That leaves us with the middle ground of hormonal treatments - which starts with a month of tablets once the CT scan is done - and radiotherapy.

Radiotherapy has been the easiest part of my experience so far, but the way they apply it to secondary breast cancer bone mets is completely different from the way my dad's experience will be. For bones, you get a blast, or two (or in the case of my vertebrae which were positively crumbling, eight sessions) on a very specific spot. They take about fifteen minutes each and are painless. For my brain the sessions were even faster - I think four minutes each - and the worst part for me has always been lying perfectly still on my back, as the beds are metal and flat which isn't good for anyone with bone mets in their back!

For prostate cancer we've been told he'll be facing 7-12 weeks of five days a week visits. This should - with the hormonal treatments - shrink the cancer right back down to a minimum and stop it from spreading and becoming secondary. However, it's already considered incurable, because they can't do surgery which I guess is the only way of removing all the effected tissue. So we're using the term 'incurable, not terminal' because it may yet not be the thing most likely to kill him. Damn it's lucky we both have a sense of humour about this - we've already joked about being in the race 'to go first'. Dark dark dark humour.

So, the next stages are CT scan, GP appointment to start the hormonal meds and then meeting the Oncologist at the Marsden who will be in charge of his care. There was some discussion of having his care transferred to GSTT where I am treated, but once we heard about the radiotherapy planning, it makes no sense to drag him into town daily for months when he could get public transport and - as the fatigue and side effects kick in - get cabs from home in much better time. He also identified that he likes the idea of the dividing line between his appointments and mine being at different locations, which I really understand and support. Hopefully his regular Oncology clinic appointments won't clash with mine on a Monday morning - anything else can be moved if necessary.

That feels like everything for the time being - I'm in a bit of shock and denial still at the moment but the news will settle in over the next few days and I'll feel better once the news is known to others - knowing something so big that my siblings - particularly my brother - don't know yet is very odd. The next few days have intermittent plans, so we'll see how I get on with energy levels after a decent night sleep.