Today is my one year cancerversary. Last July (2013) I had a doctor say the words that I think everyone dreads ever hearing, “You have cancer.” I was diagnosed with an aggressive, stage II prostate cancer and my wife, doctor and I immediately decided that the best option was surgery to remove the affected organ. On the morning of September 30, 2013, I reported to hospital for what was supposed to be a fairly routine robotically assisted prostatectomy.
Unfortunately, during the surgery, and unbeknownst to my surgeon, one of the robot’s arms nicked two major blood vessels and I began to bleed to death internally. Over the next six days, I had four more emergency surgeries and ‘died’ three times (my heart stopped beating, my blood pressure dropped to near zero and I stopped breathing on my own.) Luckily, my original surgeon recognized that he was in way over his head and turned my case over to the hospital’s trauma surgery team. I ended up with a team of tenacious and highly competent/experienced medical professionals who were determined to keep me alive and, as I’m here one year later to tell the story, everything worked out well…and I have a really impressive, groin to sternum scar as a souvenir.
My life, or at least the way I look at it, has changed significantly since them. It seems that there’s nothing like dying a couple of times and literally having to consciously fight for your life to help put the rest of the world in perspective. Since that ordeal I have found that I am a much calmer and empathetic person. Things that in the past would have had me grinding my teeth and dangerously elevated my blood pressure now roll off me like water off the proverbial duck’s back. I still get upset at things, but I have found that the number of those things has drastically diminished and when I do get upset, I find that a deep breath and taking a mental step back helps me to regain my perspective and allows me focus my energy on fixing the problem instead of the blame. I like this new version of me a lot more than the old one; it’s just a shame that it took dying for me to discover this new guy.
In any event, while they were rushing me down the hall to surgery number three, the original urological surgeon met me in the hall and told me that the ensuing complications aside, the prostatectomy was a complete success; the treacherous organ had been successfully removed and the biopsy indicated that while both lobes of the prostate were full of cancer, it was still contained within the wall of the organ and it didn’t appear to have had the opportunity to spread. So, ‘Gunga Galunga,’ at least I had that going for me (if you don’t get it, ask a Caddy Shack fan, they’ll explain it to you).
Now to the point of today’s essay. Complications aside, I was lucky that my cancer was discovered when it was, and that was thanks to a program of regular screenings. Advances in medicine have taken a lot of the finality out of a cancer diagnosis. Treatment options are available for nearly every type and stage of cancer and new discoveries are being made every day. However, the key to a successful outcome is early detection of the cancer. So today I would like to share some recommendations from the American Cancer Society on cancer screening:
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
- Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
- Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.
Colorectal cancer and polyps
Beginning at age 50, both men and women should follow one of these testing schedules:
Tests that find polyps and cancer
- Flexible sigmoidoscopy every 5 years, or
- Colonoscopy every 10 years, or
- Double-contrast barium enema every 5 years, or
- CT colonography (virtual colonoscopy) every 5 years
Tests that primarily find cancer
- Yearly fecal occult blood test (gFOBT), or
- Yearly fecal immunochemical test (FIT) every year, or
Some people should be screened using a different schedule because of their personal history or family history. Talk with your doctor about your history and what colorectal cancer screening schedule is best for you.
- Cervical cancer screening (testing) should begin at age 21. Women under age 21 should not be tested.
- Women between ages 21 and 29 should have a Pap test every 3 years. Now there is also a test called the HPV test. HPV testing should not be used in this age group unless it is needed after an abnormal Pap test result.
- Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
- Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
- A woman who has had her uterus removed (and also her cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
- A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
Some women – because of their health history – may need to have a different screening schedule for cervical cancer.
The American Cancer Society does not recommend tests to screen for lung cancer in people who are at average risk of this disease. However, the ACS does have screening guidelines for individuals who are at high risk of lung cancer due to cigarette smoking. If you meet all of the following criteria then you might be a candidate for screening:
- 55 to 74 years of age
- In fairly good health
- Have at least a 30 pack-year smoking history AND are either still smoking or have quit smoking within the last 15 years
Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is the right choice for them. If they are African American or have a father or brother who had prostate cancer before age 65, men should have this talk with a doctor starting at age 45. If men decide to be tested, they should have the PSA blood test with or without a rectal exam. How often they are tested will depend on their PSA level.
Take control of your health, and reduce your cancer risk.
- Stay away from tobacco.
- Stay at a healthy weight.
- Get moving with regular physical activity.
- Eat healthy with plenty of fruits and vegetables.
- Limit how much alcohol you drink (if you drink at all).
- Protect your skin.
- Know yourself, your family history, and your risks.
- Have regular check-ups and cancer screening tests.
With regular screening you can turn “You have cancer” from the death-knell it once was into an individualized treatment program that adds quality years to your life…and in many cases, such as mine, give you the opportunity to live a normal, active and healthy lifespan.
Once again, the choice is always yours.
Here’s hoping you have an intentionally great and healthy day.