On Your Mark, Get Set....

I have decided to eradicate my prostate cancer via radiotherapy.

I visited my urologist for a detailed report on my prostate cancer diagnosis. He felt that since I was a (relatively) young man, treating the cancer now was the way to go. Treatment options were as benign as “watchful waiting,” which is quite popular in some circles today. The downside to this approach is the yearly horror and expense that is a prostate biopsy. With a $6,500 out-of-pocket max and a $2,500 deductible on our health insurance (which is already costing us over $15,000 per year just for the privilege of having it), the approximately $3,700 cost of an annual biopsy and pathology would be detrimental to our bank account.

Fortunately, while I was teaching I opted for a cancer insurance policy, which I kept after retiring. It will turn out to pay for our out-of-pocket costs for radiation therapy, plus an extra $500 which will help with gas.

In an attempt to get everything done this year, I decided to go with the prostate cancer center affiliated with my urologist. It turns out that with all of the preliminary exams and tests prior to getting that first of 45 zaps, it is impossible to get all of my treatments this calendar year. Next year, a new $6,500 out-of-pocket max kicks in. Fortunately, the radiation benefit on our cancer insurance also resets in a new calendar year.

You might have noticed the crux of my blog entry so far has been the financial aspects of treating prostate cancer with radiation. That is because the total cost of treatment is $76,890. When folks complain about the high cost of medical care in this country, here is a prime example. If I did not have the cancer insurance to cover my out-of-pocket costs, I would have been on the hook for $13,000 over the course of two calendar years. This does not factor in the health care premiums my wife and I pay.

My first appointment at the cancer center began with 20 minutes of filling out paperwork. Much of this information was already on file with the main office in the other building, but I was told I needed to fill it out anyway. Next came a very lengthy meeting with a nurse who explained everything I would be experiencing, possible and likely side effects, and of course, the cost. Actually, the cost was the first thing she mentioned. They took the liberty of running my proposed treatment through my insurance to ensure I was covered. They also had my cost for the year figured out. She took her time to answer all of my questions, and she helped me feel at ease.

Next I met with the radiation oncologist. This gentleman is on a five-year contract with the cancer center in Fort Wayne, and is originally from Texas. He explained more about the treatment, problems patients often experience, and the like. He then gave me a very thorough examination. Actually, it was much more thorough than I expected. It seems like every time I go to a medical appointment in Fort Wayne, my rectum will end up being the real destination. In this instance, the good doctor was trying to determine my individual prostate location as part of his pre-treatment assessment.

The doctor gave me a lot of literature to go over, including articles that he had authored that were published in medical journals. Things like that instill confidence. 

I go back for the next procedure in two days. Fiducial markers will be implanted in my prostate via a procedure much like my biopsy. The only difference is that instead of taking tissue samples out, gold markers will be implanted in my prostate. These provide a target for the radiation beam, sort of like William Tell’s apple. They will dwell in my prostate for eternity.

The CT scan sounds innocuous enough. However, it will be the true chamber of horrors, and is scheduled for a week after the markers are implanted. For this procedure, I must show up with a full bladder. A full bladder is also a requirement for each radiation session. This lifts the bladder a bit and helps avoid collateral radiation.

In the CT scan portion, dye is forced into the urethral opening and a plug is inserted in the rectum. GAH! Anyhow, these provide reference points during the imaging. I’ve got to say, this sounds like a modern form of torture. I would be lying if I said that I was looking forward to this visit. I fear this procedure more than anything, like the Ghost of Prostate Procedures Yet to Come.

Tattoos are then placed on my lower torso to help line up the radiation gun and table for the coming radiation sessions. I will also have a cast made of my legs that will be used as an alignment tool for each session, plus to help me stay still during the approximately seven minute sessions.

I will update my progress in future blog entries. Right now, I just want to get through the next week and a half! Yikes!