February 28 '04
Volume 404

Prostate Cancer From The Beginning

From questions I’ve fielded over the past few weeks, I can only assume some readers were unaware of the known problem I’ve had with my prostate for the past few years. It’s a problem I discovered in 1999, when my family doctor was unable to resolve a kidney stone issue and made arrangements for me to see Dr. Jonathan Kalish, a urologist with Urology Professional Association of Tupelo, MS.

The urologist informed me that my prostate was enlarged and contained a firmer-than-normal region on one of the hemispheres. However, a blood test indicated the PSA (Prostate Specific Antigen) level was relatively low, and a biopsy was not merited. A decision was made to monitor the PSA at six-month intervals.

Since my family history includes persons with prostate problems and prostate cancer, my urologist, by 2001, was convinced a biopsy was needed. The biopsy, which consisted of 12 or more tissue samples, showed no cancerous tissue present.

Once again, my urologist resorted to PSA monitoring as a reliable indicator of prostate cancer, and I resumed a twice-yearly schedule of office visits for a digital rectal exam and blood test. To the best of my memory, my PSA was never higher than 2.81, but because of recent medical advances in blood tests, my urologist was concerned with factors other than PSA alone.

I think it was last October that the urologist again recommended a biopsy. With his acquiescence, I begged off having the procedure until after the Holidays. I had an appointment for the middle of January, but SUPERVALU needed my services elsewhere at the same time, so I rescheduled the appointment for the following week.

"If you’ve not heard from me by next Tuesday, call me," Dr. Jonathan Kalish admonished, after completing the biopsy procedure. "We usually get the results back within a few days, sometimes a little longer."

I was in Indianola the following Monday afternoon when Dr. Kalish phoned me with the results of the biopsy.

"Wayne," he began in his normally cheerful tone, "I’ve some bad news for you. Two of your tissue samples contain cancer. I’d like for you and your wife to see me this week to discuss our options."

The preceding is not necessarily verbatim but is representative of the conversation. I remembered Dr. Kalish also saying the cancer was not advanced and was a level six on the Gleason scale.

After consulting our respective calendars, Friday, February 6th was selected as the day of consultation. Later, I phoned Barbara to give her the report and made sure she could be off work for the visit.

I don’t remember doing much more "work" that afternoon as the weight of the words, "two of your tissue samples contain cancer," seemed to push other concerns aside. I remember logging onto the Internet and searching for "prostate cancer treatment options." I found a ton of material, but one of the sites I visited had the six most common options explained in order of most radical to least invasive. After studying the possibilities, I didn’t like any.

I would discover, that which Dr. Kalish later stated, "Saying you have prostate cancer is like saying you have a pickup truck."

With prostate cancer, there is no one-size-fits-all approach for treatment. The person’s age, his general health, and the stage of the disease, all must be considered.

Since I had been told my cancer was not in an advanced stage, I had narrowed the treatment options from several to two before Barbara and I met with Dr. Kalish. I tried to keep an open mind regarding other options, but it seemed my best choices were 1) radical prostatectomy (surgical removal of the prostate) and 2) radiation.

When Barbara and I finally met with my urologist and discussed the many options, he affirmed my own thinking.

"I can do the surgery if you choose to have your prostate removed," Dr. Kalish advised. "I don’t do the radiation bead or seed implants, anymore, but some of my partners will if you choose radiation implants. Technological advances with beam radiation make it a viable option as well, but someone with the Oncology Group would be responsible for that procedure. If it were me, I’d have the prostatectomy or radiation, but there’s no rush, and you don’t need to make a decision today."

"No rush, huh?" I questioned. "So, we can wait a year?"

Dr. Kalish smiled at my absurdity, "No, more like a few months, just think over what you want to do and call me in a week or two."

On the drive back home, Barbara and I discussed the possibilities, and I shared that I was definitely leaning toward choosing the prostatectomy, though my older brother, Fred Carter, chose the bead implants five years ago and was recently told he’s now free of cancer. My cousin, Neal Huskison, chose a combination of beam radiation and bead implants more than a year ago, but I was uncertain whether or not he’d received a clean bill of health. I had read that surgical removal of a radiated prostate gland was next to impossible, and while I didn’t know the odds of such being necessary, I figured there’d be less for me to worry about if I initially chose a prostatectomy.

The following Monday, I was back in Indianola and decided to check with the insurance clerk regarding any forthcoming changes in our health care benefits. I’m glad I did, because I had not been able to attend any of the overview meetings held in January, and since our fiscal year ends at the end of February, I knew any benefit changes would be implemented on March 1, 2004.

"Amber, if I were to have surgery, is there any reason to try to have it done before the end of F04?" I asked.

"Well, it’s going to 80/20 on March 1," she stated, referring to the ratio responsibility of the insurer and the employee.

"What is it now?" I responded.

"It’s 90/10, and also the reimbursement for out of pocket expenses is being reduced the first of March."

As long as Barbara was an employee of South Delta Planning and Development District of Greenville, she carried me on her medical plan. However, when she began working for Habitat, at a greatly reduced salary, we could ill-afford the additional premium to add me to her policy. As long as I was covered under Barbara’s insurance, it didn’t really matter to me what yearly policy changes were made to the SUPERVALU plan, because I could count on her insurance picking up the difference. Suddenly, I did the math, saw that my co-payment was about to double, and figured I had better try and save myself a bundle by scheduling the surgery during February.

I phoned Barbara to let her know about the insurance change and then phoned the Doctor’s office and left a message for Dr. Kalish to call me. I was driving home later that evening when Dr. Kalish called. He understood my situation and said he could definitely work me into his schedule on either February 17th or February 24th and would let me know the next day, once he was back in the office.

Earlier, following the office consultation, I had thought the anticipated surgery would be perhaps in mid March, but now circumstances seemed to dictate a date much sooner. What was once a distant appointment was suddenly a time at hand.

Dr. Kalish phoned me the next day and confirmed February 17th as the earliest he could work me into his schedule and was told to await a call from his nurse regarding forms, Pre-Admissions Testing, and pre-surgery instructions.

Realizing I might be away from Indianola for the next four to six weeks and already having scheduled myself off for Thursday and Friday, I found it necessary to return to my office there on Wednesday to finish my workweek.

In the week prior to my surgery, word spread among family, friends, and work associates of my situation. I was a little overwhelmed by the response. Folks went out of their way to let me know they would be praying for me.

In Christian circles, prayers lifted to God on behalf of others are called intercessory prayers. And, while I’m no expert on the subject, I am a beneficiary of intercessory prayer. I confess that I do not understand how or why God chooses to provide emotional and physical healing through intercessory prayer. Neither do I understand why God does not provide healing in all instances when Christians pray earnestly for one another. However, I know what I felt in the days leading up to my surgery, and it was a sense of peace, a belief that while many uncertain days lay ahead, the future looked bright.

To be continued.

Complexions By Sarah Carter Brown

Several years ago Uncle Lamar mentioned that he was serving on the board of a dance company in New York. A few years later, he mentioned that he had moved on to other things. I never knew the name of the company or much about it until I was in Washington D. C. in October. Late one evening, he began to talk about this graceful dancer with the company for which he had been a board member. I listened as he talked about a lady named Sarita and a James Brown number that he had seen.

This January, Uncle Lamar tried to let me know that Complexions, the dance company, was going to be at Ole Miss in February. Barbara returned a call to him because it is difficult to get in touch with me while I work two jobs. Barbara told me that Uncle Lamar said he could get us tickets to the performance. Barbara, Felicia, and Denise, my friend and boss from the hospital, planned to attend, however Wayne’s post-op recuperation kept Barbara with him. Felicia brought a friend, and Denise and I met them in Oxford.

Complexions Contemporary Ballet was founded in 1994 by Dwight Rhoden and Desmond Richardson and has become well known for its performances. Sarita Allen is the company’s artist in residence. For a better understanding of the mission and members of the company, the web site, complexionsdance.org is a good place to start. The dance company has an impressive number of performances worldwide. Complexions has been invited to appear at all of the major European dance festivals. Recently the company has completed a run of performances in Italy and Russia.

Felicia had been telling me about her friend from Tupelo, Roxie Thomas, getting a part in an upcoming project. Felicia had mentioned that the choreographer was from New York and that Roxie was excited about getting to work with such a prestigious personality, but we did not put the choreographer and the visiting performers together until Uncle Lamar told us about the New York dance company’s scheduled visit to Ole Miss. Six Ole Miss dancers were chosen to participate in the performance. The performance was part of The Racial Reconciliation Choreography Project: Before Now and After Then.

Denise and I were spellbound by the performance. I noted three standing ovations. Sarita was tremendous and as graceful as Uncle Lamar had proclaimed. Denise and I were particularly taken with Desmond Richardson. Of course, we could only figure out the folks who had solo or partnered performances by the program listings.

As Denise and I perused the program, we noted that Sarita began her career with Agnes DeMille. Then she joined the Alvin Ailey American Dance Theater. She has danced on numerous television programs and in the movies, The Cotton Club, Angel Heart, and The Last Dragon. She recently appeared as Bess in the first all-dance version of Porgy and Bess at the Kennedy Center for the Gershwin Centennial and danced the role of Venus in the American premiere of Venus and Adonis at the Santa Fe Opera’s summer festival.

After the performance, the four members of our group went backstage and met Sarita. She was charming and all that we expected someone of her rank to be. It’s a small world.

Bodock Beau Best Kept Secret

What with the Editor all wound up about his medical condition, I figure the following observations might be appropriate.

Did you hear about the hospital that asked the doctors about a new building project?

The Dermatologist said the move would be rash.

The Gastroenterologist (Stomach and Intestines) had a gut feeling that it wouldn’t work.

The Otolaryngologist (Ear, Nose, Throat) said, "I hear what you are saying, but the cost would be hard to swallow and we’d pay through the nose for years."

The Neurologist thought the hospital had a lot of nerve.

The Allergist said, "Scratch it."

The Ophthalmologist said the idea was shortsighted.

The Orthopedist issued a joint resolution to prevent a knee-jerk reaction.

The Pathologist said, "Over my dead body."

The Pediatrician said, "Grow up, the notion is childish."

The Psychiatrist said, "In your dreams; you must be crazy."

The Cardiologist said the heart of the matter is cash flow.

The Obstetrician/ Gynecologist said, "Who conceived of this project? It’s premature and born to fail."

The Podiatrist just took it all in stride.

Contributed by Callie B. Young

Things For Which To Be Thankful

The spouse who complains when dinner is not on time because s/he is home with me, not with someone else.

The teenager who is complaining about doing dishes because that means she is at home and not the streets.

The mess to clean after a party because it means I have been surrounded by friends.

The taxes I pay because it means that I’m employed.

The clothes that fit a little too snug because it means I have enough to eat.

A lawn that needs mowing, windows that need cleaning and gutters that need fixing because it means I have a home.

All the complaining I hear about our government because it means we have freedom of speech.

The space I find at the far end of the parking lot because it means I am capable of walking.

My huge heating bill because it means I am warm.

The lady behind me in church who sings off key because it means I can hear.

The piles of laundry and ironing because it means I have clothes to wear.

Weariness and aching muscles at the end of the day because it means I have been productive.

The alarm that goes off in the early morning hours because it means that I’m alive.

Best Kept Secret

At a dinner party, several of the guests were arguing whether men or women were trustworthier.

"No woman, "one man said scornfully, "can keep a secret."

"I don’t know about that," huffily answered a woman guest. "I’ve kept my age a secret since I was twenty-one."

"You’ll let it out one day," the man insisted.

"I hardly think so!" responded the lady. "When a woman has kept a secret for twenty-seven years, she can keep it forever."

Selections contributed by Kim Goslin

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