davidfcooper: (Default)

This is a follow-up to my January and February posts. In January I reported that an increase in my PSA would necessitate a prostate biopsy and in February I reported that the biopsy was inconclusive and would require another biopsy in April. In March at the suggestion of our friend [livejournal.com profile] rabjeff, who has been living with prostate cancer for several years, I had a 3-D Doppler ultrasound of my prostate taken by the only radiologist in North America who does them. The radiologist told me I had a non-active prostate cancer of insignificant size and suggested I adopt a strategy of watchful waiting/active surveillance including eliminating dairy from my current pescetarian diet, taking nutritional supplements that are beneficial to the prostate and having the 3-D Doppler ultrasound again in six months. There are treatments for small prostate cancers, however, that can target the tumor in a way that does not impair the entire gland, have fewer side effects than treatments that might be required later if the tumor grows larger, and unlike those other treatments can be repeated should other tumors develop. But to have the option of such targeted treatments required I undergo the second biopsy scheduled for April. The radiologist advised against the biopsy warning that biopsies can actually spread cancer. My urologist said that the radiologist was mistaken and probably basing his opinion on outdated research (the urologist also expressed the opinion that the reason no other radiologist uses 3-D Doppler imaging of the prostate is that it is inaccurate). My own on-line research on biopsies indicates that if the cancer is as small and inactive as the radiologist said it is then it could not survive outside the host organ. Thus having the biopsy posed little risk and would give me more options. 

 

The January prostate biopsy took 12 samples; the April biopsy took 14 samples and was more painful than the first one both during the biopsy and in the weeks since. Only one of the 14 tissue samples had cancer, cancer was found in only 5% of that one sample, and the cancer cells in question are moderate (3 on a scale of 5) and not lethal. Three other tissue samples showed pre-cancerous growths. Prostate cancers are measured on the Gleason Scale (2-10): anything under 7 is considered favorable and non-lethal, and my Gleason score is 6. By and large my April biopsy confirmed the radiologist's scan the previous month, but it also gave me additional information. My Gleason 6 makes me a candidate for what is known as a male lumpectomy (targeting part of the prostate instead of the entire gland). The method that most accurately targets the tumor with the fewest side effects, High Intensity Focused Ultrasound (HIFU), is available abroad (for about $20K in Toronto) but is not yet FDA approved. If my prostate gland were a bit smaller (25 mm or less) than it is (32mm) my urologist could get me into a local HIFU clinical trial. Another form of male lumpectomy is Partial Cryosurgery (freezing half the prostate and leaving the other half intact), but that would destroy one of the two nerves responsible for sexual function. So I decided I will adopt a strategy of active surveillance which includes PSA tests every three months, biopsies every six months, following the no animal fat diet mentioned above, and continuing to take meds and nutritional supplements that may shrink my prostate sufficiently to qualify me for a HIFU clinical trial or in a best case scenario may shrink the tumor itself so that treatment other than continuing active surveillance becomes unnecessary. Active surveillance can continue for decades and has no side effects. I prefer giving up dairy cheese and ice cream and enduring the biopsies to over-treating an as yet non-lethal condition.

Posted via web from davidfcooper's posterous

davidfcooper: (Default)

This is a follow-up to my January and February posts. In January I reported that an increase in my PSA would necessitate a prostate biopsy and in February I reported that the biopsy was inconclusive and would require another biopsy in April. In March at the suggestion of our friend [livejournal.com profile] rabjeff, who has been living with prostate cancer for several years, I had a 3-D Doppler ultrasound of my prostate taken by the only radiologist in North America who does them. The radiologist told me I had a non-active prostate cancer of insignificant size and suggested I adopt a strategy of watchful waiting/active surveillance including eliminating dairy from my current pescetarian diet, taking nutritional supplements that are beneficial to the prostate and having the 3-D Doppler ultrasound again in six months. There are treatments for small prostate cancers, however, that can target the tumor in a way that does not impair the entire gland, have fewer side effects than treatments that might be required later if the tumor grows larger, and unlike those other treatments can be repeated should other tumors develop. But to have the option of such targeted treatments required I undergo the second biopsy scheduled for April. The radiologist advised against the biopsy warning that biopsies can actually spread cancer. My urologist said that the radiologist was mistaken and probably basing his opinion on outdated research (the urologist also expressed the opinion that the reason no other radiologist uses 3-D Doppler imaging of the prostate is that it is inaccurate). My own on-line research on biopsies indicates that if the cancer is as small and inactive as the radiologist said it is then it could not survive outside the host organ. Thus having the biopsy posed little risk and would give me more options. 

 

The January prostate biopsy took 12 samples; the April biopsy took 14 samples and was more painful than the first one both during the biopsy and in the weeks since. Only one of the 14 tissue samples had cancer, cancer was found in only 5% of that one sample, and the cancer cells in question are moderate (3 on a scale of 5) and not lethal. Three other tissue samples showed pre-cancerous growths. Prostate cancers are measured on the Gleason Scale (2-10): anything under 7 is considered favorable and non-lethal, and my Gleason score is 6. By and large my April biopsy confirmed the radiologist's scan the previous month, but it also gave me additional information. My Gleason 6 makes me a candidate for what is known as a male lumpectomy (targeting part of the prostate instead of the entire gland). The method that most accurately targets the tumor with the fewest side effects, High Intensity Focused Ultrasound (HIFU), is available abroad (for about $20K in Toronto) but is not yet FDA approved. If my prostate gland were a bit smaller (25 mm or less) than it is (32mm) my urologist could get me into a local HIFU clinical trial. Another form of male lumpectomy is Partial Cryosurgery (freezing half the prostate and leaving the other half intact), but that would destroy one of the two nerves responsible for sexual function. So I decided I will adopt a strategy of active surveillance which includes PSA tests every three months, biopsies every six months, following the no animal fat diet mentioned above, and continuing to take meds and nutritional supplements that may shrink my prostate sufficiently to qualify me for a HIFU clinical trial or in a best case scenario may shrink the tumor itself so that treatment other than continuing active surveillance becomes unnecessary. Active surveillance can continue for decades and has no side effects. I prefer giving up dairy cheese and ice cream and enduring the biopsies to over-treating an as yet non-lethal condition.

Posted via web from davidfcooper's posterous

davidfcooper: (Default)

It was not fun, but was necessary. The doc must have taken seven or eight tissue samples, and I could feel each incision. Afterward I felt weak and light headed but was able to walk home; on the way I stopped at the Park Slope Sweet Melissa Patisserie on Seventh Avenue and got a chocolate chip cookie (very rich and very sweet) to raise my diminished blood sugar level. I should get the results of the biopsy in a week. The ultrasound showed calcium deposits which would be the likely explanation for my elevated PSA should the results turn out to be negative. It would also confirm my hunch that I should switch from dairy to soy milk/yogurt.

Posted via web from davidfcooper's posterous

davidfcooper: (Default)

It was not fun, but was necessary. The doc must have taken seven or eight tissue samples, and I could feel each incision. Afterward I felt weak and light headed but was able to walk home; on the way I stopped at the Park Slope Sweet Melissa Patisserie on Seventh Avenue and got a chocolate chip cookie (very rich and very sweet) to raise my diminished blood sugar level. I should get the results of the biopsy in a week. The ultrasound showed calcium deposits which would be the likely explanation for my elevated PSA should the results turn out to be negative. It would also confirm my hunch that I should switch from dairy to soy milk/yogurt.

Posted via web from davidfcooper's posterous

davidfcooper: (Default)
We had dinner at different friends' homes Friday and Sunday nights and a shul picnic Saturday afternoon; we enjoyed all three. By coincidence our respective hosts both nights are moving soon and each offered us books to help thin out their respective collections. Our Friday host is moving to Philadelphia to enroll in Gratz College to earn a Masters degree in Jewish education. Our Sunday host, [livejournal.com profile] mofic, lost her job and has to move back to the spacious co-op apartment she and her ex co-own and which her ex has refused to sell; sharing the space with [livejournal.com profile] mofic again may at long last convince her ex to sell (with the proceeds of such a sale each could buy her own apartment, and it would also help pay for their oldest child's final year of college).

Since I commenced my twice daily therapeutic regimen for lymphedema nine years ago we have mostly limited our socializing to a diurnal schedule which meant not seeing friends much. On Friday night we got home shortly after midnight and I didn't get to bed until 3:45 AM (it usually takes me close to four hours to get to bed); last night we got home about 10:45 and I went to sleep at 3:00 AM. Much as I don't like messing with my sleep schedule I dislike social isolation more.

This weekend was the 20th anniversary of Shoshana's working for the same boss (she's been with the same employer for 23 years), and to mark the occasion she spent this morning baking chocolate cakes she will bring to work tomorrow.
davidfcooper: (Default)
We had dinner at different friends' homes Friday and Sunday nights and a shul picnic Saturday afternoon; we enjoyed all three. By coincidence our respective hosts both nights are moving soon and each offered us books to help thin out their respective collections. Our Friday host is moving to Philadelphia to enroll in Gratz College to earn a Masters degree in Jewish education. Our Sunday host, [livejournal.com profile] mofic, lost her job and has to move back to the spacious co-op apartment she and her ex co-own and which her ex has refused to sell; sharing the space with [livejournal.com profile] mofic again may at long last convince her ex to sell (with the proceeds of such a sale each could buy her own apartment, and it would also help pay for their oldest child's final year of college).

Since I commenced my twice daily therapeutic regimen for lymphedema nine years ago we have mostly limited our socializing to a diurnal schedule which meant not seeing friends much. On Friday night we got home shortly after midnight and I didn't get to bed until 3:45 AM (it usually takes me close to four hours to get to bed); last night we got home about 10:45 and I went to sleep at 3:00 AM. Much as I don't like messing with my sleep schedule I dislike social isolation more.

This weekend was the 20th anniversary of Shoshana's working for the same boss (she's been with the same employer for 23 years), and to mark the occasion she spent this morning baking chocolate cakes she will bring to work tomorrow.
davidfcooper: (Default)
I've been trying to remember on which other websites I've used my old FB password and have been changing those that I do recall. I was going to write another examiner.com article but that has been preempted. I suspect most Matisyahu fans already know about his concert tomorrow anyway. Shoshana's next BWAC show opens Saturday in Red Hook; this time she's showing works on paper instead of her usual reverse paintings on clear plexiglas.

Next month we'll spend a week in Maine (after we celebrate my MIL's 75th birthday in CT). From central CT we'll drive up to Camden, ME and spend 3 nights there, and then we'll drive down to Portland and spend three more nights there after which we'll drive home to Brooklyn. We're looking forward to it.
davidfcooper: (Default)
I've been trying to remember on which other websites I've used my old FB password and have been changing those that I do recall. I was going to write another examiner.com article but that has been preempted. I suspect most Matisyahu fans already know about his concert tomorrow anyway. Shoshana's next BWAC show opens Saturday in Red Hook; this time she's showing works on paper instead of her usual reverse paintings on clear plexiglas.

Next month we'll spend a week in Maine (after we celebrate my MIL's 75th birthday in CT). From central CT we'll drive up to Camden, ME and spend 3 nights there, and then we'll drive down to Portland and spend three more nights there after which we'll drive home to Brooklyn. We're looking forward to it.
davidfcooper: (Default)
Friday Shoshana was on a Federal panel on emergency evacuation & I had lunch w/writer/blogger @vboykis. We spent Shabbat & Sunday morning with Ann Hollender Schwartz and her family including her sister Judy Hollender Tipton (childhood friends from New Rochelle; the visit felt like reconnecting w/cousins with whom we felt completely comfortable or resuming a conversation after a hiatus of several decades). Hiked Billy Goat Trail along the Potomac River and C&O Canal & saw new air/space museum at Dulles w/Ann & her husband Allan.
davidfcooper: (Default)
Friday Shoshana was on a Federal panel on emergency evacuation & I had lunch w/writer/blogger @vboykis. We spent Shabbat & Sunday morning with Ann Hollender Schwartz and her family including her sister Judy Hollender Tipton (childhood friends from New Rochelle; the visit felt like reconnecting w/cousins with whom we felt completely comfortable or resuming a conversation after a hiatus of several decades). Hiked Billy Goat Trail along the Potomac River and C&O Canal & saw new air/space museum at Dulles w/Ann & her husband Allan.

travel

Jan. 29th, 2009 08:23 pm
davidfcooper: (Default)
Parking place drove us straight to the terminal. Checked our luggage curbside. Flight was noisy but OK--excellent seats (emergency exit seat with empty space in front of me), only two and a half hours. At Jacksonville airport our luggage was on the conveyor belt when we arrived, and Alamo upgraded us to a Chrysler 300. We arrived during rush hour, and it took us an hour to reach our hotel where our suite has two bathrooms, a large bedroom, an equally large living room, two televisions, two desks with built-in surge protectors, a refrigerator, a microwave oven, and is down the hall from a fitness room with an elliptical machine, treadmill, and a stationary bike. We are around the corner from Whole Foods where we had dinner, and a two minute drive (or a twenty minute walk) from the synagogue. At the shopping center in which the Whole Foods is located we browsed a consignment shop where I bought a Harris tweed jacket for $16. Unfortunately Shoshana has a stomach bug.

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travel

Jan. 29th, 2009 08:23 pm
davidfcooper: (Default)
Parking place drove us straight to the terminal. Checked our luggage curbside. Flight was noisy but OK--excellent seats (emergency exit seat with empty space in front of me), only two and a half hours. At Jacksonville airport our luggage was on the conveyor belt when we arrived, and Alamo upgraded us to a Chrysler 300. We arrived during rush hour, and it took us an hour to reach our hotel where our suite has two bathrooms, a large bedroom, an equally large living room, two televisions, two desks with built-in surge protectors, a refrigerator, a microwave oven, and is down the hall from a fitness room with an elliptical machine, treadmill, and a stationary bike. We are around the corner from Whole Foods where we had dinner, and a two minute drive (or a twenty minute walk) from the synagogue. At the shopping center in which the Whole Foods is located we browsed a consignment shop where I bought a Harris tweed jacket for $16. Unfortunately Shoshana has a stomach bug.

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Our siblings and parents all had other plans this year, so we hosted our own vegetarian Thanksgiving dinner. Read more... )
davidfcooper: (Default)
Our siblings and parents all had other plans this year, so we hosted our own vegetarian Thanksgiving dinner. Read more... )
davidfcooper: (Default)
1) Call plumber about faulty heating zone and thermostat.

2) Shop for travel (airfare, hotel & car rental) for late January/early February trip to Jacksonville.

3) Start practicing Torah trope for 01/31/09.

4) Put candy near front door for trick or treaters.

5) Try to continue staying horizontal as much as possible for final two days on anti-biotic.

Regarding the last item, not fighting gravity has helped the antibiotic fight the infection. I've been in bed or on the couch, physically inactive (except for sex which resumed Monday--Thank God, I can be oversexed again), and I've lost weight despite feeding a voracious appetite, which must mean my body has been burning calories fighting bacteria. I've craved dairy products in general and cheese in particular, so my body probably needs extra protein. Saturday will be my final day on the anti-biotic; I'll see if I feel up to going to shul or whether I'm better off staying home and supine. On Monday I'll get a sonogram of my bladder & kidneys. I'll have to fill my bladder to the point where I'll need to pee and then hold it while they do the sonogram. What fun!
davidfcooper: (Default)
1) Call plumber about faulty heating zone and thermostat.

2) Shop for travel (airfare, hotel & car rental) for late January/early February trip to Jacksonville.

3) Start practicing Torah trope for 01/31/09.

4) Put candy near front door for trick or treaters.

5) Try to continue staying horizontal as much as possible for final two days on anti-biotic.

Regarding the last item, not fighting gravity has helped the antibiotic fight the infection. I've been in bed or on the couch, physically inactive (except for sex which resumed Monday--Thank God, I can be oversexed again), and I've lost weight despite feeding a voracious appetite, which must mean my body has been burning calories fighting bacteria. I've craved dairy products in general and cheese in particular, so my body probably needs extra protein. Saturday will be my final day on the anti-biotic; I'll see if I feel up to going to shul or whether I'm better off staying home and supine. On Monday I'll get a sonogram of my bladder & kidneys. I'll have to fill my bladder to the point where I'll need to pee and then hold it while they do the sonogram. What fun!

follow up

Jun. 4th, 2008 02:58 pm
davidfcooper: (Default)
Follow up to the earlier contraception issue post.

We met Shoshana's new gynecologist yesterday, and she is wonderful (I was there as an interested party to the issue of choosing a form of contraception). She sees no reason Shoshana should not continue taking hormonal contraceptives for the next 3-4 years, but is switching her to a lower dose pill. We are pleased.

follow up

Jun. 4th, 2008 02:58 pm
davidfcooper: (Default)
Follow up to the earlier contraception issue post.

We met Shoshana's new gynecologist yesterday, and she is wonderful (I was there as an interested party to the issue of choosing a form of contraception). She sees no reason Shoshana should not continue taking hormonal contraceptives for the next 3-4 years, but is switching her to a lower dose pill. We are pleased.
davidfcooper: (Default)
Four of Shoshana's paintings were sold on Saturday at the BWAC show in Red Hook, Brooklyn. On Sunday we brought four replacement paintings to the exhibit, and they are hanging on Shoshana's panel. The show continues on weekends through June 15.
davidfcooper: (Default)
Four of Shoshana's paintings were sold on Saturday at the BWAC show in Red Hook, Brooklyn. On Sunday we brought four replacement paintings to the exhibit, and they are hanging on Shoshana's panel. The show continues on weekends through June 15.

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