PSA Doubling Time Calculator

 Knowing your PSA doubling time is important, in terms of treatment and survival.

Latest Salvage Radiation News

 Some recent discoveries in salvage radiation

Early salvage RT after prostatectomy improves outcomes: https://www.cancertherapyadvisor.com/home/news/conference-coverage/american-society-of-clinical-oncology-genitourinary-asco-gu/asco-gu-2022/early-salvage-radiation-after-surgery-improves-mfs-in-recurrent-prostate-cancer/  (Research continues to confirm that earlier is better if you need SRT.)

When to Add ADT to Early or Late Salvage Radiation: https://www.urotoday.com/video-lectures/prostate-cancer-genomic-classifier/video/2269-when-to-add-adt-to-early-or-late-salvage-radiation-dan-spratt.html (I didn't have ADT, otherwise known as hormone therapy, but in higher-risk cases it makes sense)

Salvage Radiotherapy versus Observation for Biochemical Recurrence: https://pubmed.ncbi.nlm.nih.gov/35159007/. (Salvage radiation was associated with better long-term survival, both in terms of being free of metastatic disease and overall survival.)

Can you get cancer insurance after you've had cancer?

In the case of prostate cancer and Mutual of Omaha, the answer is yes. Yes, you can get cancer insurance if enough time has passed. I signed up a few years ago. There was some time stipulation, a number of years without a cancer diagnosis or treatment, something like that. For me that was no problem--my prostate cancer diagnosis and treatment was far in the past.

So I signed up. It was cheap--for my whole family, $20 a month. With that, I got a rider that for a diagnosis of cancer, there is a one-time lump sum payout of $2,000. 

If you get a screening PSA once a year, you get a check for $60. So I get that, and my spouse gets $60 for her mammogram each year. Think about that for a minute. The insurance costs $240 a year, and you get $120 back (if you're a couple) for screening, so the real cost is $10 a month.

If you later get diagnosed with cancer, the benefits are generous. Besides the lump sum payment (assuming you take that rider), you get paid about $50 for labs and X-rays each time. You get $50 for each follow-up visit with your doctor, up to 3x a year. You get money for being hospitalized for treatment, for chemo and immunotherapy treatments, for surgery (including biopsies). There are benefits for radiation therapy, hospice care, blood products, skilled nursing, rehab, and ambulance transportation.  For the most part, claims are simple, and taken care of with a single phone call.

I got diagnosed with lymphoma a few years after signing up for the plan, and the payments have been extremely helpful in keeping up with copays and other incidentals. The cancer plan pays on top of other insurance you might have, and it is not taxable. It's paid directly to you, not the medical provider.

I tell all my acquaintances about this. I think it's a good deal. The odds are pretty significant that you will be diagnosed with cancer sometime in your life, and just because you've had one cancer, it doesn't mean you won't have others.

 Yesterday's PSA: less than 0.10.  Hurrah!

My oncologist does not like ultrasensitive PSA tests for men in my position (many years after apparently successful treatment). 

I'll take it. Even if my PSA is creeping up on the ultrasensitive test, the doubling time would appear to be pretty long--like a year or more--and so I'm not going to have any problem with prostate cancer for a long time, if ever.

Had a bunch of tests related to lymphoma as well, and they're all fine. That cancer is staying nice and sleepy, and not causing me any problems (i.e. it's not impacting my red or white blood cell counts, or my spleen, or causing any symptoms).

I'm now going back to trying to get my percent body fat down to a healthier level. I'm at 20% right now, and would prefer to get back to 18% or lower. I'd also like to lose a couple of inches on the waist. I used Noom before, but I didn't really like it, so I'm going to try MyFitnessPal, an app that counts calories, activity, nutrients, etc. Gotta get back into the hiking, biking, spin classes, and strength training.

Watching Reacher on Prime Video--it's really compelling!  I've read some of the novels. Well done on this one, Amazon. I think you missed the target on Wheel of Time, though. 

Heart Valve Replacement and Blood Cancer

 

I forgot to post about my mitral valve. Here's a mitral valve:

Mine wore out, basically. I had mitral valve prolapse for several years, and in the past 18 months, it got worse. In September I had it replaced at Mayo Clinic in a minimally-invasive procedure. While it's better to repair than replace, mine was just flopping all over the place (Barlow's disease) so now I have one that is part cow, part artificial--a bioprosthetic. It works great. I was out of the hospital on the 5th day and back to work a month after that. 

During the workup for surgery, the doctors found out I have stage 3 follicular lymphoma, an incurable but treatable blood cancer. Right now we're just watching it, because multiple studies have shown no benefit to treating before the cancer causes problems. In prostate cancer this is called "watchful waiting" or "active surveillance."  In lymphoma they call it "watch and wait." Some patients never need treatment, but most do within a few years. Treatment is a combination of immunotherapy and chemotherapy.

 

Oh hey, me again.

Just had a biopsy of my thyroid, waiting for the results. Maybe I have a cancer trifecta--prostate, follicular lymphoma, and thyroid. We'll see. The odds are strongly in my favor for a benign result. It's just that my a nodule on my thyroid lit up on a PET scan last year. Thyroid nodules that are FDG-avid (the technical term for taking in a lot of tracer in the PET scan) are much more likely than average to be cancer. However, my ultrasound was only "mildly suspicious" for malignancy, which improves the outlook. If it is cancer, it is most likely thyroid cancer, not lymphoma or prostate cancer.

I'm going to have a standard, non-ultrasensitive PSA next week to see where I stand there. On a couple of ultrasensitive tests over the past 2 years, it looked like my PSA might be rising, 15 years after successful treatment. So that will be interesting. I'll also have some blood tests related to follicular lymphoma, just to make sure that's staying indolent (quiet). Follicular lymphoma is not curable, but most patients live many years, even decades, with it, in the same way that people live with any chronic disease.

Anyway, more to report in the coming days and weeks.

UPDATE: the afternoon of this posting I got my thyroid biopsy results back--negative for malignancy. BTW, the biopsy wasn't bad at all, done under a local anesthetic.