How to cope with stress/anxiety, waiting for PSA blood test

@northoftheborder do you mind if I ask what your treatment was? Congrats on 4 years!!!!

@bkandrew

1. 10+ hours of emergency debulking surgery to decompress my spine (I suddenly lost use of my legs four days after I was admitted to hospital with balance problems), and spinal fusion from T1–T5: that's not a standard treatment because of the risks of spinal surgery, but I needed it *immediately* to have a hope of walking again, as a side-effect, it significantly reduced my secondary tumour burden.

2. About a week after the surgery, I started on Apalutamide (Erleada) and ADT (initially Firmagon, now Orgovyx). That's the "doublet" therapy.

4. Four weeks after surgery, I received 20 gy of radiation in 5 fractions to my spine to destroy any remnants of the secondary tumour that the surgery might have left behind. After that, my PSA rapidly fell from over 67 to undetectable. That's the practice of "zapping" individual metastases for oligometastatic cancer.

5. About six months after surgery, 60 gy of radiation in 20 fractions to treat the primary tumour in my prostate (which was still too small to detect with an MRI or digital exam). That's what Dr Scholz describes in his book as "attacking the mothership".

The debulking surgery was unusual, but it probably did help; the rest is latest best practice for castrate-sensitive oligometastatic prostate cancer, based on major studies like STAMPEDE and TITAN.

@northoftheborder Wow! You’ve had quite the journey. PC doesn’t have a chance against you! So glad to hear you’ve been undetectable!!! Was the metastasis covering T1-T5?

@bkandrew Thanks for the kind words.

The metastasis was at T3 and starting to spread to T2 and T4, so they added screws from T1 to T5 to ensure that my spine didn't collapse in the future, in addition to the cement to fill in all the gaps.

The fortunate (?) part is that I didn't have much time to worry. I was wheeled to the operating room just a few hours after I realised I couldn't move my legs — they called their star orthopedic surgeon in from home in the middle of the night — then I was unconscious for about half a day, so I didn't have to sweat it out like my family did waiting for news.

I know now that there was a non-trivial chance I could have died on the operating table, but there just wasn't time to think when it was happening. They would have operated immediately, but there was someone in even worse shape than me (a car crash victim, I'd guess), so I was bumped to second in the triage line for ortho surgery.

This is a timely topic - I have an appointment in a couple of hours to go over my first post-op PSA test. My post-RARP pathology was less encouraging in several aspects (EPE, SVI, large cribriform) than my original biopsy, so the PSA test has perhaps loomed larger than it otherwise would have.

Here is what has helped me not be crushed by PSAnxiety: my Christian faith, including prayer and daily Bible reading, active church membership and fellowship, exercise (primarily running), parenting a middle schooler (!), focusing on and finishing a few side projects at work, encouragement and wisdom from this message board

Here are some things that haven't helped: fixating on this one aspect of my life (i.e., PSA, PCa), spending too much time on this message board trying to predict the future and figure out the optimal way to eat, sleep, take vitamins, etc. etc. etc., and a less-disciplined post-op diet.

I tend to be all-or-nothing so striking a balance between harmful internalizing (whistling in the dark) and constantly researching, talking, thinking, worrying about the dreaded 0.2 ng/mL is not as easy as the two lists above imply, but in general, life seems better when I spend less time thinking about myself. There are numerous ways to do this, some probably more healthy than others. Is it better to serve in my church food pantry than to watch several hours of funny pet videos on YouTube? I don't know - there seems to be a season for everything.

My next PSA test is Monday. I get quite anxious as well. I just look for distractions, my main one being exercise. I’m with you. Hoping and prayer for the best! Good luck.

This is a timely topic - I have an appointment in a couple of hours to go over my first post-op PSA test. My post-RARP pathology was less encouraging in several aspects (EPE, SVI, large cribriform) than my original biopsy, so the PSA test has perhaps loomed larger than it otherwise would have.

Here is what has helped me not be crushed by PSAnxiety: my Christian faith, including prayer and daily Bible reading, active church membership and fellowship, exercise (primarily running), parenting a middle schooler (!), focusing on and finishing a few side projects at work, encouragement and wisdom from this message board

Here are some things that haven't helped: fixating on this one aspect of my life (i.e., PSA, PCa), spending too much time on this message board trying to predict the future and figure out the optimal way to eat, sleep, take vitamins, etc. etc. etc., and a less-disciplined post-op diet.

I tend to be all-or-nothing so striking a balance between harmful internalizing (whistling in the dark) and constantly researching, talking, thinking, worrying about the dreaded 0.2 ng/mL is not as easy as the two lists above imply, but in general, life seems better when I spend less time thinking about myself. There are numerous ways to do this, some probably more healthy than others. Is it better to serve in my church food pantry than to watch several hours of funny pet videos on YouTube? I don't know - there seems to be a season for everything.