Prostate Cancer Journal: My Friend Peter


I made a new friend last week. You don’t always get to pick your friends ahead of time, and such is the case with Peter. He showed up during the course of my prostate surgery. I was totally unaware of his arrival, but he was greeted by everybody in attendance as one uniquely qualified for his task. By the time I regained my senses after the surgery, Peter had obviously become a fast friend. He cared for me deeply and touched me in ways I had never experienced before. And I found I couldn’t leave him behind. Upon my release from the hospital, my wife and I made a place for this new friend in my life.

bestest buds

Peter has been faithful; despite my outbursts and even wishing him harm, he as stuck by me without question or recrimination. Peter is giving; he retains nothing for himself but passes on all that he has every minute of every day.

These hot, fast friendships have their challenges. We found that Peter was a bit demanding and a bit clingy. And while his friendship tapped an inner well I rarely thought about, having him around each minute of each day is wearisome. Peter is an “up front” sort of friend, but admittedly very private. So, getting ready to leave the house with Peter is stressful and frankly exhausting.

My friendship with Peter is as close a relationship as I have ever experienced. It is also an ill-fated relationship, for today Peter and I must be parted. The reality is that I must move on in my recovery, and I have to go, alone. Peter cannot go for me. The absence of his indwelling presence will be a void in my life.

Farewell, my friend, Peter.

[During a radical prostatectomy, a foley catheter is inserted into the urethra. The catheter assists the surgeon during the transection and resection of the urethra and then supports the urethra as it heals. The patient keeps the foley catheter in place from 7 days to 3 weeks depending on the procedure and the surgeon involved. I named my catheter “Peter.”]

Other  posts in the Prostate Cancer Journal can be found under Categories in the sidebar of this blog.

Prostate Cancer Journal: The Choices We Make


With treatment, I am not very likely going to die as a result of my prostate cancer, as my father before me did. The scoring and grading complete, I am among those with a 90%  chance of being prostate-cancer-free through at least the next ten years (10 years is pretty much the extent of the data), and can look forward to being a cancer survivor. Thanks be to God that such mercy has been given to me.

While my prognosis is just about the best that one could hope for, I am at somewhat of a loss before a buffet of good treatment options. Advancements in medicine offer those with prostate cancer a plethora of choices of excellent treatments:  da Vince, brachytherapy, IMRT, IGRT, clinical trials, active surveillance, proton beams, HIFU, laparoscopic robotic radical prostatectomy, cryotherapy. While the biopsy was certainly uncomfortable and nerve-wracking, and the news that I had cancer invoked rage and fear, having to pick my own treatment may yet be the most agonizing part of this journey through prostate cancer so far. Continue reading

Prostate Cancer Journal: Positive for Cancer


Ever since hearing that my elevated PSA might be a cause for concern, I had been preparing myself for the news, preparing myself to hear that I had prostate cancer. Dad had it, why shouldn’t I? I’ve been steeling myself so that I wouldn’t scream, or yell, or, God forbid, cry when I heard the news.

“Mr. Kinnaman, your results came back positive…” That really is the only thing I heard in our brief conversation. As Dr. de la Paz continued to speak I looked at the pictures on my desk, pictures of my wife and I on a cruise, pictures of our four grandchildren. I ask a few questions, write a couple of notes that mostly make sense later, but while hearing, I really am not listening. I have cancer.

The Roller coaster of Rage and Fear

boulder-dashRage is what fuels all the reading, it is the cranking up of the roller coaster, “clack, clack, clack,” as I am taken higher, the rage that this should happen to me “clack, clack, clack,” higher and higher; rage, being pushed on by the idea that if I read enough I can find a solution, rage that compels me to exhaustion to find the next website, the next procedure, the next presentation on YouTube. And then just as I reach the pinnacle and seemingly have nowhere else to go, I overtop and begin the free fall into fear: fear of loosing my health, fear of the surgery, fear of radiation therapy, fear of incontinence, fear of impotence, fear that I’ve let you down, fear that dying will hurt, fear of leaving my wife alone. While on the way up it felt like rage would leave me with no place to go, fear seems like it could go on forever. And along the way fear throws me into switchbacks of loathing and pity and ultimately into the 360° of doubt: did I do enough, should I’ve been more vigilant, can I make a treatment decision that will make a difference? Continue reading

Prostate Cancer Journal: The Waiting is the Hardest Part


universal-no-symbolThis will be an intensely personal post. If you came to this blog expecting something else, you might want to take a break from reading this now, head over to the archives, and wait until the more characteristic posts make a comeback.

This week I have been doing a lot of waiting. I no longer know what to do with myself.

Carly Simon’s lyrics are so overdone that they have become trite (except for Heinz, I guess), but they are running around in my head abreast with Psalm 130:

We can never know about the days to come
But we think about them anyway….

Anticipation, anticipation
Is making me late
Is keeping me waiting.

-Anticipation, Carly Simon

Out of the depths I cry to you, O Lord!
O Lord, hear my voice!
Let your ears be attentive
to the voice of my pleas for mercy!

If you, O Lord, should mark iniquities,
O Lord, who could stand?
But with you there is forgiveness,
that you may be feared.

I wait for the Lord, my soul waits,
and in his word I hope;
my soul waits for the Lord
more than watchmen for the morning,
more than watchmen for the morning.

O Israel, hope in the Lord!
For with the Lord there is steadfast love,
and with him is plentiful redemption.

And he will redeem Israel
from all his iniquities.

-Psalm 130

cubs_fan

I'm a Cubs fan. I know about waiting.

In Spring 2002 suddenly appearing “liver spots” (actually petechiae bruising) had been met with curiosity on Thursday. I rarely show bruises, much to my wife’s dismay as she seems to share a genetic link with bananas when it comes to bruising; so I didn’t make much of them. Dad had liver spots, so probably would I. On Saturday a couple bruises, startling purple and red explosions, appeared over a very short period of time. I called my GP’s exchange. Interrupting his golf game, he likely saved my life. Instead of saying “come and see me on Monday,” instead he said “hang up the phone and go to the emergency room. Now.” He said he would meet me there. That didn’t sink in.

When I got to the emergency room they were expecting me. That didn’t sink in either. After exchanging my clothes for theirs, a blood sample was taken, and a physical exam was conducted. I became a bit of a curiosity as seemingly random medical personnel would knock on the door and ask if they could examine me. By now I knew the “liver spots” were actually petechiae, that is pinpoint bruises, and they were showing up everywhere. If you are old enough to remember the water-color books for children that had the pictures filled with dots—a child paints with a dampened brush that releases the color in each dot—well, that is what I had come to resemble, especially on my arms and legs. But they didn’t hurt. No one said any different. And it didn’t really sink in. Continue reading

Prostate Cancer Journal: You’re Going to Do What?


universal-no-symbolThis will be an intensely personal post. There is no delicate way to describe what took place during the prostate biopsy. If you came to this blog expecting something else, you might want to take a break from reading this now, head over to the archives, and wait until the more characteristic posts make a comeback.

A Bit More Waiting

waiting-roomYou can read a lot about the procedure that is technically known as transrectal ultrasound-guided prostate biopsy on WebMD and the many good sites that have written about men’s health and prostate cancer. Most of them will say that it “doesn’t hurt much,” that it’s “not so bad.” But, “doesn’t hurt much” and “not so bad” only seemed to mock me. Despite the vast amount of information I had accumulated over the previous ten days, I am wading deep into the unknown, nearly drowning in a mix of fear and anxiety. As I drove the thirty minutes to the office I’m thinking about the needles. Upon checking in I am shown into a standard exam room by an efficient but very kind nurse who checks my vital signs and goes over a list of questions about my medical history. Then she explains everything that is going to happen from that point forward. Her calm, deliberate, two-minute speech drains away some of the fear that has been washing over me in waves. The nurse leaves, and following her directions I get naked. I put on a hospital gown so it opens in the back and have a seat on the exam table as I wait for the doctor. I’ve been told it will be about ten minutes. This exam room has two carts set up with monitors and keyboards. The nurse has one powered up and sitting next to the exam table. I recognize the image on the screen as the pie-wedge that will display an ultrasound image. But it is the wand clipped in readiness on the side of of the cart that gets my attention. The business end is about eight inches long and about the diameter of a roll of nickles. The doctor is obviously an advocate of safe sex as the wand is sheathed in a form-fitting condom. From my reading, and the nurses’ explanation, the wand will be used to get an ultrasound image of my prostate gland and map where the doctor will take his biopsy. That’s okay. What sets off alarms is the very slim metal tube that runs down the length of the wand. I start to go into meltdown as my forced-calm exterior gives way to the anxiety within. The metal tube indicates the ultrasound wand’s second use: to guide the placement of the biopsy needles. One at a time, a dozen needles will be shot down that metal tube by a spring-loaded biopsy gun, through the wall of my rectum to snatch and bits of tissue I wasn’t all so sure I wanted to surrender. Continue reading

Prostate Cancer Journal: Today I take the test


Or maybe it is more accurate to say that today the test takes me.

universal-no-symbolThis will be an intensely personal post. If you came to this blog expecting something else, you might want to take a break from reading this now, head over to the archives, and wait until the more characteristic posts make a comeback.

This afternoon I will be heading over to my doctor’s office, a urological specialist, and have a transrectal ultrasound-guided prostate biopsy. This test will be used to determine whether my elevated PSA blood test results are indicative of prostate cancer or infection or something else altogether.

picture-3Since getting the report of my PSA (prostate specific antigen) levels ten days ago, I have only talked about this with my wife, pastor, and three trusted friends. Those who know me may be surprised that I told that many others about the impending biopsy. When it comes to such personal details, I tend to be intensely uncommunicative, a New Englandish “It’s my business, and only my business” attitude–although I have never lived in New England. I have decided to leave my comfort zone and journal about this experience for two main reasons. First, as a coping mechanism to help give the swirl of emotions some expression and a place to “live” besides in my gut. And second, the majority of my male friends are in their forties and fifties (the women are never older than twenty nine), and if the sharing of my journey–wherever it may lead–gets even one of them into the doctor to begin getting an annual PSA, than this breech in my personal space will be very much worth it. Well, maybe a third reason: wives and mothers get your forty-year-old husband or son to the doctor annually–the years of health and life you will give them is worth the nagging! Continue reading