Bladder Cancer : With Cancer, You Can"t Hurry Recovery

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One year ago today I had surgery to remove my cancerous prostate. Then came radiation and hormone therapy because my cancer was more aggressive than expected - Gleason 9, Stage T3B - and had breached the prostate.

In a culture where the micro-second has become a viable unit of time, one year seems to be an eternity nowadays. We are addicted to the idea of instant closure, have knuckled under to the myth that media time is real time. But biological time, that unerring clock whirring at the cellular level, still has plenty to teach us.

My body, that once-sturdy vessel, sustained a lot of damage in the past year to be rid of its cancer. Incontinence and impotence, deep fatigue and weight gain were among my most constant physical companions.

As spring blossomed, though, so did my spirits. My energy surged, I started running again and even talked about doing a marathon this fall. But in my vernal cheer I forgot one of the most important realities of recovering from serious illness. Complete recovery rarely arrives as a wide and smooth ascent. More often it's a pinched and bumpy road full of ups and downs, with no shortage of switchbacks and dead ends - even one year later.

Most noticeably, in the last month, my energy level has plummeted. (Don't worry, my doctors are on the case.) Typically, my energy falls off the table by mid-afternoon, then dwindles from there, kind of like how the Wicked Witch of the West fizzes and shrivels at the end of "The Wizard of Oz." Sometimes I need a nap right after work. On weekends, I sometimes need a nap at noon, then another at five, leading me to wonder whether I'm turning into a cat.

Even though I haven't received any treatment since February - and there's a good chance I might be cancer-free - I understand that I'm still a cancer patient. I try to embrace the "patience" part of being a patient.

But physical fluctuation brings with it mental frustration. I just want my body and the treatment for my cancer to kiss and make up, already. I'm not complaining, but trying to explain how I feel in this particular ongoing biology experiment of one. These issues aren't about vanity - well, maybe a little - but about wholeness.

As far as the fatigue, one of the culprits could be low testosterone. In April my testosterone level was 364, within the normal range of 241 to 827. But late last month it had tumbled to 202, prompting me to come up with a new medical rule of thumb: It's not good when your testosterone is lower than your weight.

The fatigue also didn't help my running. Neither did the hamstring pull.

My runs were going well. I was pleased to have progressed from baby-stepping to shuffling to walking to running since last July. Six miles felt comfortable, and the goal of a fall marathon seemed reasonable. Now it seems unlikely. The hamstring injury has been stubborn, and with my energy AWOL I'm back to taking long walks.

And walking does put less stress on my bladder than running does. My bladder control keeps improving, and I'm still man-pad free. But if I stand for a long time, or if I bend in an odd way... well, let's just say that I needed to modify the position in which I clip my toenails.

I probably shouldn't be, but I guess I'm surprised and disappointed that erectile function is still a work in progress. My penis is simply a mutt that doesn't come running when it's called, even when it's given a little blue Viagra treat. In addition, when your testosterone level is nomadic, your libido seesaws, too. And when your sex drive is hibernating or absorbed in rereading "The Lord of the Rings" for the sixth time, the idea of the actual sexual act sometimes seems faintly silly.

Despite my current trough, there's good news, too. My weight has dropped from a hormone-induced high of 226 to 209, and my PSA, the number that signals whether my cancer is gone, is still less than 0.1.

I'll fully admit, though, that before my surgery last summer, I didn't expect that I would feel physically diminished one year later. Even so, I still suffer from chronic optimism. But today it's also tempered by cancer-induced realism.
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