reality check with Dr. Swift

(black dots are tumors; click picture to enlarge)

I had a bracing talk this morning with Dr. Swift, my radiation oncologist (I'm not getting any radiation, but he's the resident prostate cancer expert at Alta Bates).

When I got a copy of the film at the bone scan last Tuesday, I knew it was bad...but I could only stand looking at it for a little while and I filed it away. My coping mechanism was to immediately dive into researching what my next treatment would be (a process I actually enjoy -- it gives me hope, a sense that possibilities actually do exist out there, and it's something over which I exercise partial control).

Talking to Dr. Swift today reminded me in stark terms exactly what I'm facing. The worst metastases are in the pelvis, which have developed dramatically since my last scan six months ago. I also have many, many new metastases -- mostly on vertebrae, but also a few on my ribs and scapula.

So where do things go from here if the cancer keeps progressing? The bones where the metastases are will become weaker and weaker, and eventually break. A break in my pelvis means pain, six months of being bedridden, and a big, big hit to my mental state. A break in one of my vertebrae might mean partial or complete paralysis.

Needless to say, this is a HUGE motivator for me to find a more effective treatment than what I've been on. It's also a giant challenge not to think about dreadful possibilities all the time. This is the strongest challenge to my cheerfulness and equilibrium that I think I have ever encountered. Fortunately I'm still upbeat most days -- going to the ashram for chanting or meditation really helps, and Liz is being a peach!