Tuesday, November 15, 2016

Memento mori

Gustave Dore - Death on the Pale Horse (WikiCommon)

This week I saw the movie "Dr. Strange". If you haven't seen it, there are rather deep questions (for an action movie) about mortality. For example, the Ancient One tells Stephen Strange, "Death is what gives life meaning. To know your days are numbered and your time is short."

I'm 54. It seems to be about this age that the Reaper really starts mowing. Two weeks ago a childhood friend died after battling heart failure for 15 years. He was born just a few weeks before me. Last week my sister-in-law died of cancer. This week I learned that one of my favorite teachers (young at the time) from elementary school had died of Alzheimer's. 

I feel my age. This wasn't always the case. In my 40's I felt younger. In my 30's I could pass for 21--and I felt like it. At 21 I looked like 16--and acted like it. No longer.
I think I've beaten prostate cancer. I'm so happy that I got on top of it when I did, especially the salvage radiation after surgery failed to cure me.
But that means that something else will be my demise. Another cancer, maybe, or heart disease. Or maybe dementia. Right now I think I'd opt for door number 2.

I sometimes get an unpleasant squeeze in my chest. Nothing serious, the cardiologist says. A little valve leakage, a little rhythm disturbance. But just the fact that I'm seeing a cardiologist says a lot. Right now I'm the youngest person in the waiting room. But I know that, in a flash, that will change. In a heartbeat.

Anyway, just a reminder that death is a part of life, essential to the natural order of things, and that I will kick from something at some point, and I have far fewer days ahead of me than behind. So I should stop and smell the coffee, enjoy the pizza, the bike ride, the rising of the full moon.  And I should shift my focus to serving others.
As the Ancient One teaches Doctor Strange, the "simplest and most significant lesson of all": 

It's not about you.

Thursday, November 10, 2016

Salvage Radiation Nomogram Updated

This is exciting stuff for people contemplating salvage radiation after prostatectomy.


"A contemporary update of a 2007 predictive nomogram for salvage radiotherapy after radical prostatectomy offers a modernized forecast of cure compared to its predecessor."

"The updated 2016 nomogram takes into account the more recent trend of treating patients at lower PSA levels than in the past (“early SRT”). Randomized trials published since the original nomogram was created have demonstrated the benefit of early SRT in high-risk patients."