Sunday, January 22, 2012

PSA's, Gleason Scores and Other Things We Didn't Know



So much to tell and it's just plain hard to start.  The things I'm about to share are deeply personal and not very pretty.  I'm sharing because Gregg asked me.  He wants his story known, so others can benefit.  Try not to be judgmental if at times my sense of humor seems odd or my faith seems weak or I have a little pity party.  Lastly, this is our story.  I'm not speaking for others fighting cancer, just us. 

The 1st week of December, Gregg had a physical.  Thinking it was a good time to meet our new doctor and nurse practitioner and get his prescriptions from his Milwaukee docs refilled.  He had some microscopic blood in his urine so his NP wanted to get a PSA (prostate specific antigen).  He always has blood in his urine, because he's had kidney stones forever (or so it seems).  We weren't worried at all.  He gets a call a couple of days later to let him know his PSA was elevated to 5.2.  If you're like me, you'd have to look that up on the internet.  Yes, it was elevated but not that much and I also read that having sex 24 hours prior to this test can give a falsely high result.  ok...guilty.  Again, very reassured and really didn't even think about it anymore.  The NP encouraged Gregg to see a urologist and he thought it a good idea because of his history of kidney stones and to check out this PSA.

Dr Banks, the urologist, talked with Gregg and was concerned with the PSA.  He wanted to repeat the test but he also wanted to do a prostate biopsy.  This PSA was 4.6.  Barely elevated!  Gregg went ahead with the biopsy anyway.  At the office, they refer to this as the "torture chamber".  The PA that did this was compassionate, funny and thorough.  He informed Gregg that he had done about 1000 of these. 

Here's the procedure...A prostate biopsy uses transrectal ultrasound imaging to guide several small needles through the rectum wall into areas of the prostate where abnormalities are detected. The needles remove a tiny amount of tissue. Usually, 12 biopsies are taken to test various areas of the prostate. The tissue samples are then analyzed in a laboratory by a pathologist.  

No anesthesia...none. 

Gregg said it was more painful than anything he could imagine.  He came home with bloody urine and bloody BM's for about a week.  He was not happy!

On December 15th, Dr Banks called and told Gregg, while he was on his way home, that he did have cancer and wanted to see him the next week to talk about treatment options.  We swallowed hard but proceeded.  Again, I go to the internet seeking trustworthy information and once again, I'm relieved.  Clark Howard, an Atlanta talk show host, has prostate cancer and he's not doing anything.  His is so new, so slow growing, he has decided for watchful waiting. Gregg has no symptoms, no family history, slightly elevated PSA, this is where we would be.  FOR SURE

We called our daughters and told them, reassured them, and answered their questions the best we knew how.  We had Kati Beth that week, so there was no time for lots of pondering or even talking.  She kept us happy and focused...on her.  We went into NC the following weekend and had Christmas with our family.  We were upbeat and yes, a little worried. 

December 21st, we met with Dr Banks.  He gave us the reports, laid out charts, drew us pictures.  Gregg was told he had 10 of 12 cores positive for cancer.  His Gleason score was 8 on a scale of 2-10.  Not what we were expecting.  We were told this was a very aggressive form and needed immediate treatment.  He informed us of options but told us we needed to see an oncologist the following week for a real plan of care. 

This was Wednesday.  Thursday morning I was calling and scheduling appts with Atlanta Oncology.  Wow, my head was spinning.  Before they would see us they wanted CT scans and bone scans, which means insurance authorizations and all that nonsense.

We were scheduled to meet with Dr McCord, December 29th.  It was the longest week of our life.  We researched more than I thought humanly possible.  We developed our questions.  We were in full attack mode.  Our daughters shared their research and their questions and we copied and pasted those onto ours.  I didn't know how they were doing.  They were quiet, which was scary.  As the mom, I need to take care of everyone.  If they're hurting, I need to be there.  This particular week, I could only think about Gregg.







We're ready to fight!

Come back in a couple of days for the rest of the story, as Paul Harvey would say.


We sang this song in church a few weeks ago.  It's become my motto for now.


I Am Determined

by Jennifer LaMountain


I Am Determined 
Darkness around me, sorrow surrounds me; 
Though there be trials, still I can sing. 
For I have this treasure – my God reigns within me, 
And I am determined to live for the King. 

CHORUS:
I am determined to be invincible 
‘Til He has finished His purpose in me. 
And nothing shall shake me 
For He’ll never forsake me 
And I am determined to live for the King. 

Hell’s gates are trembling from our prayers ascending 
Darkness is crumbling from praises we sing. 
Our Sovereign, Victorious is marching before us, 
And we are determined to live for the King. 

CHORUS

When I am weary – I’ll look to His face; 
And when I am tempted, 
I’ll trust in His grace --- 
Yes, I’ll trust in His grace ----- 

CHORUS:
I am determined to be invincible 
‘Til He has finished His purpose in me. 
And nothing shall shake me 
For He’ll never forsake me 
And I am determined – 
I am determined --- 
I am determined to live for My King.
 
  

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