Next Steps

After my biopsy indicated that I clearly had an aggressive form of prostate cancer, the next step was to develop an initial treatment plan. My doctor wanted to do start with two things; an injection to lower my testosterone (the "food" for this type of cancer) and a more high-tech radiologic scan to determine how far the cancer had spread in my body. We discussed all this at the biopsy follow-up appointment on March 12, but couldn't schedule the injection until March 21. The scan had to be pushed even further out to March 27. I didn't like the idea of waiting so long for treatments to start but little did I realize how torturous the waiting was going to be.

In the days following March 12, many of my maladies (fatigue, hip and back pain, etc.) got worse, making me feel (justifiably so) that the cancer was indeed spreading during all these in-between times. Then, with the injection formally scheduled, my insurance would not approve it. The urologist's office called me on March 20 to tell me this and to say that they were working on a more acceptable alternative. They'd get back to me within 24 hours. March 21 came and went, as did March 22, with no word. I think we even called them on March 22 (a Friday) but got no reply. It was already very frustrating to do all this waiting but now, because of my insurance company, we needed to wait some more.

Fortunately, the scan, which was hideously expensive, had been approved and could happen as planned.

We got a call from the urologist's office on Monday, March 25, indicating that we had an appointment for an injection (presumably an insurance-acceptable one this time) the next afternoon. That more or less went without a hitch. Apparently, though, unlike the original injection that was submitted, this new shot would first raise my testosterone and then lower it. Not sure why but maybe what made the other one more expensive was that it went straight to lowering. A physician's assistant gave me the shot in my left arm and warned me about the potential hot flashes to come. My first actual treatment toward taming this cancer.

The scan, called PET-PSMA, was the next afternoon. The acronym is short for Positron Emission Tomography - Prostate Specific Membrane Antigen. Beloit Memorial Hospital only does these on certain days of the week (hence the scheduling delay) from a big, high-tech trailer parked just outside one of the hospital's doors. My assumption is that the equipment used here is too expensive for the hospital to own their own and keep it on site. I was told to allow at least two hours for it, but what I didn't realize is that the first hour involved being injected with something radioactive that would "light up" on the scan, then sitting in a chair while it coursed through my veins. When it was time for the scan, I was led to the other end of the trailer to what looked like a giant MRI tube. The tech was very pleasant, the scan itself was painless, and took no more than a half hour.

All that was left of this process was the follow-up appointment to go over the scan the next day, Thursday, March 28. This was the part I was dreading, though... The part where we find out just how far through my body this cancer has spread.