Wednesday, January 7, 2015

Prostate Problem

After my annual physical this past summer, the doctor ordered the usual blood work. Everything was fine except this year he noticed a slight increase in my PSA. I’m not sure what PSA means but it is used, in addition to the rectal examination, to evaluate the condition of the prostate gland, a common source of cancer in men. Although some question the validity of PSA results, this year my reading moved above 4, a kind of benchmark.

The doctor ordered another blood test and this time it read 5, still not a dangerous level but enough to make him suggest I see a specialist. An appointment was quickly arranged with my urologist whose practiced finger detected a slight lump in my prostate. This finding made him recommend a biopsy of the prostate. He explained what the biopsy entailed and scheduled the test for the week before Christmas.

In the examination room I had to get up on a table and assume a position much like a woman about to give birth. Next to the table was a probe that looked over a foot long. The probe contained a tiny camera so the doctor could look around. Of course, I had to take an enema a couple of hours before. The probe also contained a needle that would actually take about 14 cell samples from the prostate.

Just as the doctor was about to insert the probe, I asked if I could ask a question. He agreed and I asked why he ever decided to take up such a specialty. Even the attending nurse had to laugh but he took time to give an answer I will never forget.

He explained that when he went to medical school, he had no idea of what specialty to pursue. However, his best professor turned out to be a urologist and showed him and his other students how important that work was in healing people, many in great agony. If you can open up or clear a blockage, the patient experiences almost immediate relief from incredible pain. To paraphrase his words, the doctor who can achieve such a result will have a friend for life.

His words immediately brought to mind a college professor of my own. His name was Ross J.S. Hoffman and I took his eighteenth century English history class in my senior year at Fordham University in NY. Although nearing the end of his teaching career, he was kind of a legend at Fordham. At the time though, I had no idea of the extent of his scholarship or his position in the historical community.

To me he was just an imposing and awesome teacher who could take you back into the past and make you believe you were actually in it. More than anyone else he made me realize that history was serious business, and not just a record of names and dates. It was his class that made me decide to concentrate in British history in graduate school at Columbia. Later I returned to the doctoral program at Fordham and Dr. Hoffman agreed to supervise my dissertation. It took me awhile but he stayed with me even after he retired into Professor Emeritus status. I still recall visiting him at his home where he would go over each chapter line by line. He was a tough critic but I remember those sessions with great fondness. He spoke with authority mixed with real concern for me and my growing family.

I suppose many people have had the kind of experience that my urologist and I had with an older role model. It is unfortunate that many college students today who take their courses online or in large lecture halls will never have this life changing experience.

This blog post is a kind of tribute to my urologist. He went into medicine for the right reason and today he is one of the leading practitioners in his field. He and many other doctors I have encountered are the real heart of the American medical system. But let’s conclude with the biopsy.

It was a painless procedure and shortly after Christmas my urologist called with the results that indicated that I had some cancer cells in my 75-year-old prostate. He immediately ordered some follow up tests to see if the cancer had spread elsewhere. In short order I had a chest x-ray, a bone scan, and two MRIs. 

Just yesterday he informed me that there were no signs that the cancer had spread. I will see him tomorrow to discuss the treatment for the prostate cancer. Apparently, if you get cancer, prostate cancer is the best kind since the treatment success rate is very high.

So, after a hectic holiday season I would like to wish my readers a very happy New Year. I will be taking some time off in the next two months but will keep looking for material for the Weekly Bystander. It’s amazing that you can find material even while someone is about to shove a probe up your ass.


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