Good news! I get to go through menopause.
Really. I met with the oncology team about my prostate cancer today and they recommended a treatment plan of hormone therapy plus radiation. The hormone in question is testosterone, which is the main feedstock of prostate cancer. So basically the idea is to suppress testosterone and starve the cancer. As a side effect I'll be getting hot flashes and fatigue for the next two years.
Do you want more details? If not, just scroll on by. But I've been oversharing about cancer for a decade and I'm not about to stop now. For starters, here's a picture of my prostate:
The bright white patch is where the PET scan lit up, and it's basically the entire prostate with a large bulge on the left (note that the image is reversed). The bulge prompted the oncology team to lean against surgery because there was about a 50-50 chance that I'd still need radiation treatment afterward. So why not just do the radiation instead?
That makes sense. However, although the PET scan showed no spread of the cancer outside the prostate, the size and aggressiveness of my cancer make it likely that there are still microscopic amounts in my bones and lymph nodes. That's what the hormone therapy is for. It (hopefully) kills off the micro cancers and makes the prostate a little more amenable to radiation.
Overall, my doctor says this combination has about a 100% chance of very significant improvement and a 70-80% chance of complete remission.
The radiation involves daily visits for six weeks. After a prep session, they program the machine and then target my prostate with beams of—something. I forgot to ask about that. It's either X-rays or protons. By the end of six weeks my prostate and all the surrounding areas (bladder, rectum, etc.) will be nice and inflamed, which promises to be unpleasant. But then it's over.
The hormone therapy is a drug called Lupron that's injected once every six months. The doctor I met with was very nice and assured me I could take some time to think about this, but why bother? I've been dealing with this crap for ten years, so I'm ready. My first injection is next Tuesday. The radiation treatment will start in July.
Anyway, testosterone suppression really is analogous to the loss of estrogen that causes menopause in women. So that's what I'll get. I wasn't really expecting that the ladies out there would have much advice for me about prostate cancer, but it turns out they might! But don't tell me. Let's make it a surprise, OK?
POSTSCRIPT: I know what you're thinking. This has all been about me me me, but how does it affect you? The answer, I think, is that I'm likelier to become crankier, and if Donald Trump wins the election I'm going to get really cranky. Bewarned.