The ambiguity of remission

May 8, 2017

Hi Tracy.
This is an update from my follow-up consult of May 4, illustrating that there's always something else to think about.

The small print on my "report card"

After the exit interview I took time to read the paperwork they provided me on the way out the door. At the bottom, there was this phrase:

"Cancer of prostate w/high recur risk (T3a or Gleason 8-10 or PSA>20)

That got my attention, and I sent off an e-mail to my  physician's assistant. My question was:

I remember (that) once before my numbers indicated I was stage 3, but you told me that this was likely due to my high PSA, which was likely distorted by my enlarged prostate.
So my question is, do I fall into a catetgory with a high recur risk, or is this a result of a computer algorithm that doesn't really apply in my case? How should I interpret that phrase?

And here is the clarification:

You are still considered to be high risk based purely on the numbers; however we suspect you are more likely a favorable candidate and that is why we only did a short course of hormones instead of two years of shots.
For diagnosis purposes we have to put in the high risk. It is difficult to squeeze you into a specific category because of the low risk Gleason and the high risk PSA.
Your report card is that you have an A.
You responded well to the hormone blocking injections, hormone blocking pills and the radiation as evidenced by your dramatic drop in your PSA.
I would recommend you interpret this as you were in a high risk category, but did not quite fit into that full bell curve of that, so we believe you will likely fare better than other gentleman with a high risk prostate cancer (for example Gleason 8).
Hope this helps.
Take care.

Making ends meet

Many years ago you gave me a present -- a small wooden desk sign with a brass inset that said, "Just about the time you think you can make ends meet, SOMEBODY MOVES THE ENDS.

It's still sitting on the roll-top in the apartment -- a reminder that the only certainty in life is its uncertainty.

But I'm feeling good.
Love,
Dad