Archive for Healing the Mind
“I Know I’m Dying, Children, But I Ain’t Dead Yet…”
Posted by: | CommentsI want to give a shout-out to a remarkable blog I came across while reading about the Blagojevich scandals in the Chicago Sun Times a few weeks ago. It is called:
“ Conquering cancer and heart failure…with Jesus, doctors and common sense”
http://blogs.suntimes.com/banks/2009/02/i_know_im_dying_children_but_i.html.
This blog is written by a man named Lacy Banks, 65, who has been a columnist and sports writer for the Sun Times for 36 years. He was their first African-American reporter. Banks has also been a Baptist preacher since he was 10 years old and served in Vietnam for three years as a naval officer. It’s definitely worth reading Rev. Banks’ bio in its entirety.
This past March, Rev. Banks went to the doctor and was simultaneously diagnosed with congestive heart failure, prostate cancer and brain cancer. He needed a heart transplant, but because of his other illnesses, that was ruled out. Fortunately, the brain tumor is benign. Rev. Banks received brachytherapy (seed implants) for the PC, and fortunately, his PSA is down and holding steady.
Rev. Banks’ blog is the first I’ve seen that speaks earnestly of dying. It is thoughtful, beautifully written and covers a lot of territory. There are a lot of scriptures and hymns, but you don’t have to be religious to enjoy reading it.
Rev. Banks is fighting for his life, and so it would be really nice if you could say a prayer for him or stop by his blog and leave a nice comment.
Here are some excerpts from Rev. Banks’ most recent post (Feb. 8). He emphasizes the importance of work in his life — and death.
“I am exercising regularly and I am pacing myself in my return to work as a Sun-Times reporter and I thank God that I have an understanding and kind boss in sports editor Stu Courtney and an outstanding employer in the Sun-Times. It has put me on the honor system and is allowing me to do the work that I feel I am capable of doing. The paper is not trying to play God or doctor. And I am not trying to play martyr or hero.
“I will share this painful memory with you, however. Three years ago, a superior of mine, perhaps in a fit of anger, told me I should retire because he felt I had slowed down physically and he knew I had undergone a triple-bypass in 2001 and still had a weak heart. ”Why don’t you retire and enjoy life?’, ‘ he said. ‘You ought to be able to do so.’
“Obviously, he knew nothing about my financial obligations, my need for the best health insurance and medical care available and what I could financially afford to do.
”When other people dare to speculate and count your money, they always end up with a whole lot more than you KNOW YOU HAVE.
“Those words hurt me more than anything I had ever heard in my 36 years of working for the paper. It is true that I am no longer young. At 65, I am the oldest writer in the Sun-Times sports department and also the second longest in tenure. But I am still healthy enough to do my job. I’ve never had a heart attack. Dick Cheney has had several, as well as bypass surgery, and he was the vice president of the United States for eight years!
“Millions of Americans with congestive heart failure still work and live productive and enjoyable lives. Yes, I’m 65 years old and now officially drawing social security and I’m proud of my age. I thank God that I have lived this long.
“But even before I had a talk with the Lord and my lawyers, I knew that as long as I was healthy enough to work and, even more important, was doing my job properly, I could achieve something no black writer has yet achieved at this paper: and that is a normal retirement, not a forced one.”
Gleason Grade 7 or Above: Why You Should Consider Open Surgery
Posted by: | CommentsI want to pass on some information that newly diagnosed men absolutely should consider. It is from the excellent blog “Palpable Prostate” by A. Black. The gist of this is that for intermediate- and higher-grade PC pts (GL 7+, PSA 10+), *open* surgery for PC is considered preferable to laparascopic (which includes robotic) surgery by a number of notable surgeons. One reason is that it allows for more extensive dissection of the lymph nodes, which is very important in this situation.
I am NOT saying that if you are in an intermediate or high-risk category you should not have minimally invasive RP. What I am strongly suggesting is that you consult at least one open (traditional) surgeon to get a different point of view. Do some research and find the most qualified doctor in your area. Don’t settle for just anybody.
Dr. Alan Partin (of the famous “Partin Tables”), head of Urology at Johns Hopkins (top-rated urology faculty and top-ranked hospital in US by usnews.com), will not do a laparascopic RP on any patient with a Gleason grade over 7. This is also what I was told by Dr. Bertrand Guilloneau when I called about making an appointmentt for my husband a few years ago. Dr. Guilloneau pioneered the use of laparoscopic RP in France and was practicing it long before it was approved in the U.S. He is also head of minimally invasive PC surgery at Sloan-Kettering, the #2-ranked cancer hospital in the US . (I understand that Dr. G. has since changed the rules, but I’m not sure why.)
The website I referred to, Palpable Prostate, has a 4-part survey of the relative merits ot the different kinds of PC surgery. http://palpable-prostate.blogspot.com/2007/03/rp-vs-lrp-vs-rlrp-part-1-open-surgery.html. Then there is a wrap-up of “what surgeons and others say”. The information here is comprehensive and well-sourced, with links to all cited references. Here is a pertinent excerpt of doctors’ opinions:
Dr. Kevin Slawin of Baylor College of Medicine:
“Dr. Slawin recommends that [patients with] Gleason 6 and less extensive Gleason 7 [3 + 4] can have laparascopic surgery, while patients with more extensive Gleason 7 [4+3] disease and Gleason 8-10 patients have open surgery and are most effectively treated when a careful, extended lymph node dissection, that includes the removal of all lymph nodes situated in the iliac, hypogastric, and obturator regions, is performed as part of the prostatectomy procedure. This type of lymph node dissection can only be best performed using an open, rather than robotic-assisted, approach.”
“Patients with larger Gleason 7 – 10 tumors, situated primarily at the base of the prostate, who have a high risk of seminal vesicle invasion, can achieve a lower positive margin rate and higher cure rates than those with similar tumors treated with standard techniques, either open or robotic, when treated with “en bloc” resection of the prostate, SVs and bladder neck.”
David F. Penson
“An Evidence-Based Analysis (Feb 7, 2007) concludes that for low risk patients (all of: GS 6, PSA < 10, cT1 or cT2a) either open or robotic is reasonable, but for high risk patients (any one of: GS 8 or higher, PSA > 10, cT2b or higher) open surgery is preferred. For intermediate risk patients (GS 7) the proper approach is unclear.”
BTW, the results achieved of by minimally invasive surgeons (such as short recovery time), can often be equalled by an experienced open surgeon. Also, there is no evidence that the rate of ED is lower in patients who’ve had laparascopic PC surgery. Finally, I believe there are fewer urinary problems with open surgerey.
In any case, read the information for yourself. Always remember that the most important thing in choosing a treatment is saving your life, i.e., *cancer control*.