A word about my father.
In June 1974, when he was 50 years old, my father retired. He had seen four of his five children through college. The fifth, my younger sister, graduated from high school that same month. She had a full scholarship to the University of Dayton. His child rearing responsibilities were over. He decided that thirty-two and a half of working for the Federal Government in one capacity or another was too stressful.
Dad had a variety of ailments and he had some sort of premonition that he didn’t have all that many years left on the planet. He suffered from hypertension since he was a teenager and had been medicated ever since. In 1951, the year I was born, he had one of his legs crushed in an industrial accident. He was off work for a year and he never walked straight again. When I was sixteen years old (when I was learning to drive a car), he was off work for six weeks with high blood pressure issues. He had kidney stones and a heart attack when he was 48 years old. The same year (1972) my parents were in a serious automobile accident that left both of them hospitalized for a good part of the summer. He deserved a break.
In 1977, my parents moved to Cape Coral Florida. (We found them a year later!!) He worked a little bit, but mostly he enjoyed things, like travel, gardening, and just tinkering around the house. Fast forward to 2000. Dad was now 75 and was diagnosed with prostate cancer. I didn’t know it until after he started treatments. He didn’t tell me about things (or I didn’t listen) until treatments were initiated. At this point in time, the Swedes hadn’t come out with their study that recommended no treatment for old men. Treatment, as mentioned before, was guaranteed to bring nasty side effects. The older you get, the more probable and the worse they are. This is why “watchful waiting” is a standard treatment modality for older men in Europe. But, his health insurance being as great as what it was, the docs in Florida were anxious to treat. He opted for hormonal treatment in conjunction with brachytherapy. This is where small radioactive “seeds” are injected into the prostate next to the cancerous places in order to kill the cancer. It is supposed to be less invasive. You get to keep your prostate and hopefully resume you life relatively uninterrupted. Brachytherapy is preceded by hormone therapy, whereby they inject you with a drug or drugs that halt the production of testosterone. This is supposed to stop the growth of the cancer, which is associated with being stimulated by testosterone. However, it didn’t work out that way for him. It didn’t stop the cancer’s growth and it left him both impotent and incontinent. I never knew how much the potency issue bothered him, but the incontinence was a seriously depressing problem for him. He was in full-fledged adult Depends all the time. Also, the hormone therapy results in other negative side effects. Dad experienced emotional problems, hot flashes, decreased sexual desire, erectile dysfunction, fatigue, weight gain, decreased muscle mass, and memory loss. Most men who are on hormone therapy experience at least some of these effects.
In April 2002, Dad developed head and neck cancer. He underwent removal of the tumor and several moths of external beam radiation. He lost is teeth and his sense of taste. In July of 2002, we moved Mom and Dad into an assisted living facility in Cincinnati, the city of their birth. In December 2002, at the age of 78 and pretty worn out, he underwent an operation to install an artificial bladder sphincter to control the incontinence. During the recovery period in mid-January 2003, he went downhill again. He was admitted to the hospital with a diagnosis that he had squamous cell carcinoma that had spread to his lungs and the rest of his body. He spent his 79th birthday on January 25 in Hospice of Cincinnati. He had a cupcake and beer. It was not a celebration. He died on February 3rd.
His prostate cancer period was hard on him. His quality of life sunk pretty low during the two years before he came down with the head and neck cancer. If we knew then what we know now, I would have advised him to take his chances by foregoing treatment and living without the Depends. What I mean by that is not so much that we could possibly second guess the future course of his cancer or treatment, but that the Swedish study hadn’t come out yet. In all likelihood, as much as we don’t like to think of dying, his odds of dying of something else was greater than dying of the prostate cancer.
This was the source of my greatest anxiety. I could see what it did to him and it was horrible. If what happened to him was going to happen to me, then my life, at least as I knew it, truly was over. There were several possible treatment interventions and I didn’t like any of them. Unfortunately, non-treatment wasn’t a very good alternative either.
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