Last time I wrote about this topic, I had some questions asking if everything was ok. At the time, it was. If you read the earlier post, you know that almost 4 years ago my dad was diagnosed with prostate cancer. At the time he was diagnosed (June 2009), they already called it Stage IV, which is the worst it gets.
If you're like me, you've probably heard "stage IV cancer" in a negative context and just assumed it was bad. What it really means is that the cancer has spread. Stage I is a minor occurrence of cancer in a specific part of the body. For prostate cancer it's in the prostate, for breast cancer it's in the breast, etc. Stage II is when it starts to advance within the localized area, and there's some distinction in the type of advancement that moves it into stage III.
By the time you get to stage IV, the cancer has spread outside of the original spot. You'll hear these called "mets," because the cancer has "metastasized" to other parts of the body. The bad part about this is you can't contain the disease anymore. With stage I-III, you may have the option of surgically removing the affected part of the body, or directing radiation toward the small section of cancerous cells, but with stage IV those treatments almost entirely lose their effectiveness.
Once the cancer spreads, there's nothing holding it to one spot anymore. With my dad (and I assume with most prostate cancer patients), the mets went to the bones. CT scans (or bone scans) would find mets that showed up as dark spots on the bones, and the number and size of these spots would help the doctors gauge how well the treatments are working.
The treatments are the most difficult part, as I discussed in the earlier post. With the cancer not contained, the strongest treatment option is some form of chemo. In the first year they tried a hormone therapy, because prostate cancer is known to feed on testosterone. Limit the testosterone, limit the amount of fuel the disease can build from. It was great in that it had minimal side effects (at least compared to other cancer treatments), but it didn't work for long.
After about a year and a half of taking it slow, the chemo started. First every 3 weeks for about 8 months. Things got much better, and stayed that way for a good, long time. We got to stop worrying as much about the disease, and the treatments turned to trying things like short bouts of radiation on the most symptomatic areas. But this also came to an end.
In the fall, he went back to chemo. Again, it was every 3 weeks. This was a different formula that they hoped would make a more long-term impact on the disease, but after 8 treatments it had basically stopped working.
And this has been the last month of our lives. The chemo has stopped working. Radiation might give some symptom relief, but the likely side effects are just as bad as the symptoms they're trying to relieve. There are other kinds of chemo, but after 2 long tries with chemo they need to try something else. And that something else just isn't out there yet. Last week, the tests came back that the cancer hasn't just stopped shrinking, it's still progressing. Just weeks after ending chemo, it's hitting harder than ever.
Because of all of this, last weekend was one of the toughest my family has experienced. What started with a trip back home to hear the full story quickly progressed into discussions to prepare for end-of-life care and making sure my mom will be taken care of when he's gone. Our usual Sunday tradition of going to my parents' church (where I grew up) was filled with weepy hugs as the news spread. Even a piece of amazing news on the adoption account (to be detailed in a later post) was tear-filled in light of the emotions of the weekend.
Now, I hardly know what to do with myself. My brother and I agreed to do everything we can to help our mom be as ready as possible, and we both want to spend as much time with dad as we can. But every discussion gets harder, not easier. Even in sharing the news with a close friend, I could hardly get the words out. When I talk to anyone about this I have this overwhelming urge to tell them how great a man he is, and how much I've appreciated the life he has lived. Yet, every time those thoughts come out, I feel like I'm already attending his funeral.
The one thing I want to say about my dad today is how amazing he is through this process. Since the diagnosis, he has always absorbed as much of the negative stuff as he can, and just showed love and respect to the family and friends who care about him. Even now, he talks down his symptoms as if they're no big deal, all the while chatting with family and letting his grandkids play in his lap. I know many people tend to shut down in his position, but I don't think he's ever going to stop treating us all with the love and respect that he has always shown. That's the kind of strength I will always admire.
So, with regard to my work and day-to-day life in the next few weeks or months, I might be a little unavailable. I'm going to try not to be, but I already find myself drifting and losing focus, and I'm sorry about that. Don't feel bad for talking to me about the responsibilities I'm ignoring, because I probably just need the reminder to get going again. And if you don't know what to say to me, a hand on the shoulder says more than enough.
I know it's going to get harder before it gets easier, but maybe someday it won't hurt so much.
Always moving forward,