We had the first follow-up appointment with the surgeon on Monday. He was pleased with my progress. My first post-op PSA came in at either “0.1” or “<0.1” depending on who (and when) you ask. The secretary on the phone said it was “less than 0.1”, which is exactly what I wanted. Unfortunately it’s entered into the records as just “0.1”, which is not as good. Remember in elementary school when you said that the difference between “=” and “<” and “>” didn’t matter, and your teacher said it did? She was right. In my case “=” means I have a low amount of cancer in me, and “<” means much less or maybe none at all. Nobody seems to have the original value so I’ll just have to wonder until the next test, which scheduled for July.
It doesn’t matter that much to the surgeon because can add me to his “successful surgery” stats on his Excel sheet either way. As with baseball players, salespeople, and bookies, statistics are very important to surgeons. They keep track of how many surgeries they’ve done, how many removed prostates had “clean margins”, and how many patients had side effects. Given my clean margins and my progress on side effects (i.e. effectively none) my surgeon called me a “poster boy” for this type of surgery. With humility (which I’m learning is uncharacteristic for surgeons) he suggested that my age probably has as much to do with my recovery as his skill. Still, I’m very sure I picked the right guy.
There could still be microscopic tumors in me somewhere that just aren’t big enough to produce significant amounts of PSA. Thats called micrometastases, and the chances of it are in the “worrisome” rather than the “terrifying” range. Due to the fact that my higher-grade cells had an opportunity to enter my bloodstream, it appears my risk of the cancer having spread is in the range of 5-10%.
So I can go about my life acting as if I’ve been cured. Maybe for forty years or more. If my PSA starts climbing again then I’ve got stage four cancer and my time is much more limited. There are no sure things but it feels much better to know my remaining lifespan — however long or short it turns out to be — will most likely be measured in years rather than months. That feels like an incredible gift. Whatever I have to thank — prayer, medical science, luck, or maybe all three – I am very thankful.
But then it’s not Thanksgiving now, is it? By the calendars of many Christian churches it’s Lent, which is a time I hear many friends and relatives talking about things they are giving up. Some actually fast during Lent, although I recently learned that in some churches people can eat a full meatless meal plus breakfast and lunch as long as they don’t add up to a meal. By that standard I fast on most days. Other people give up things other than food, even intangible things. That’s how I feel now. Although I have been given back at least part of my life, some things will be gone for good.
So what am I giving up? Namely:
- My remaining delusions of immortality. Those delusions were damaged 15 years ago with the Guillain-Barre Syndrome. There’s nothing like telling your leg to move, and having it respond with “No thanks, I’m good right here,” to shock a twenty-five year-old guy into understanding that his body is fragile. But cancer drove that point home once and for all.
- The feeling that I have plenty of time to help my kids become happy, healthy adults. I’ve got to get moving on that, cancer or no cancer. I’m not sure how to communicate much wisdom to a boy who is always distracted by video games and T.V., a girl who mostly wants to talk about horses, and twins who are very focused on the here and now, but I’m going to take every opportunity I can to teach. They need to be completely prepared to make all the right decisions in their lives by the time they turn 18, or by the time I die, whichever comes first.
- The expectation that I’ll get to enjoy retirement with my wife. I sure hope so, but I truly understand now that will be a gift, not an entitlement. I may not last that long, and/or Sarah may never retire. We’ll see.
- The belief that my kids will be young and healthy forever. Both Harrison and Shepard are at risk for prostate cancer. All the kids appear to be at increased risk for various kinds of cancer. I don’t want them to live in fear, but I want them to be on the lookout and get all the tests they can. I want them to do all the right things, which leads to . . .
- The confidence that if I just do everything right, everything will be okay. Life makes absolutely no guarantee of fairness and people aren’t given credit for effort. Eating right, exercising right, and living right helps but not always. Regular checkups can miss things. Sometimes both belt and suspenders may fail.
The difference between all of these things and the things that most people give up for Lent, of course, is that self-denial for Lent is voluntary. That’s the point, I think. The losses I’ve described here were forced on me so I can’t claim a pure motive to seek enlightenment. But whatever the motive, I’m enlightened. And I won’t be getting those things back next month. They’re gone for good.
As is that test result, apparently.