Setback

A few days ago I mentioned my back situation and said I'd fill in details later. It's time to fulfill that promise. I didn't have my first treatment today after all, and the reason is directly related to the back issues.

About a week before I left Lubbock, I developed some lower back pains. Those got steadily worse and eventually shifted around to my right side, belt-level. This side pain seemed to be in the muscle, and it ranged from uncomfortable to terribly painful. I told Dr. Bush about it, and he ordered a bone scan because, if prostate cancer migrates from the gland, it likes to settle in the bones. The bone scan showed up an abnormality in the lower spine, but it was unclear enough that they ordered an MRI which I had yesterday. These two procedures—the bone scan and MRI—were exceedingly painful, because one thing that exacerbates the pain is lying on my back, and of course, in both procedures, I had to lie on my back, very still, for upwards of half an hour. Excruciating. Like a fire burning in my side.

Today, just as I was preparing to leave for my first proton treatment, Dr. Bush's resident, Dr. Kang, called with a report on the MRI. He said that the degeneration in the lower back appeared to be nothing more than arthritis, and that the muscles seemed inflamed—no doubt the cause for the pain; he said there is little or no chance the muscle pain is related to the prostate cancer. However, he said that the bone scan had also shown an abnormality higher up on the spine, about mid-back level. He said the radiologist team would study that image further and discuss it. If they decide it looks suspicious, they may order a needle biopsy to check it out. If it turns out to be malignant, my treatment plan would need to be changed to include hormone therapy. Therefore, the start of my treatments need to be delayed until this matter is settled. They're unlikely to get back to me until early next week, so for now, I should just hang out and wait. I asked if it wasn't highly unlikely that my cancer, which appears to be small, non-aggressive, and limited to the prostate, would have metastasized, and he agreed that it was unlikely but also said it is possible.

I'm deeply disturbed by this turn of events. The best-case scenario would be if the docs, getting their heads together, decided the spot in question was nothing after all. In this case, I'm guessing my proton treatments could get going a week from now; another week away from home, but still a completion date before Christmas. A worse scenario would be the needle biopsy which just sounds real unpleasant, and even if the sample turned out benign, the process would further delay my start date. The really frightening possibility would be if it turned out to be malignant. From what I understand, the prognosis for bone cancer is never good and the condition becomes very painful before the end.

I've been very hopeful about this whole process, encouraged by reports from many patients and graduates of the program who refer to it in terms such as a "proton vacation." But now, these expectations, which seemed so clear, so simple, so under control—now they give way to unpredictability. That in itself is unsettling. And the possibility of a much more severe cancer is really frightening.

I debated whether or not to include this development in the blog. But then I remembered telling someone that the blog was sort of the public invasion of my own privacy, and I also decided it would be pretty dishonest to just share the fun, warm, and fuzzy parts while hiding the terror. So here it is.

And so I'll hang out and wait. The good news in this respect is that—what with all the bone scans, MRIs, orientations, etc.—I'm just barely keeping up with my classes. Maybe I can catch up in the next few days. And if I get caught up enough, there's a lot to see and do around here. For instance, the L.A. County Fair, the great granddaddy of all county fairs, is on this week over in Pomona, ending Sunday, so maybe I can get over to take it in.

Many have offered their good thoughts and prayers. Right now, I can use them all.