Yesterday we saw the urologist who explained the results of all the tests and gave us a game plan.  Jim's biopsy showed that the cancer is aggressive.  The CT scan was okay but the bone scan showed that it has progressed to the bones.  He has a MRI on Monday to determine if what the scan is showing in the vertebrae is cancer or arthritis.  That determination will help decide which route of treatment to take.
     

    As of right now, it is 8 weeks of radiation going 4 days at a time.  Surgery doesn't seem to be an option as of right now.  Hormone therapy was also discussed.  If any of you are familiar with the grading system of Prostate cancer called Gleason's, his number is 4 + 3 for a total of 7.  The scale is 2-10 so 7 is on the high side.  The Dr. was clear to say that al though there is no cure, there is treatment.
    

    Jim's PTSD has been a struggle the last several months and the added diagnosis has been a tough one for both of us.  We both think he is getting good care at the VA and are very thankful for that.  Because Jim was exposed to Agent Orange while serving his country there is a possibility that he has prostate cancer from that.  The studies have shown high statistics of this.  However, there are many men in their 60's who have prostate cancer and don't even know it and die from something else so who knows. The government will reimburse patients with prostate cancer from Agent Orange exposure so there must be something to the statistics.  His doctor at the PTSD clinic are very supportive and will continue to help Jim have a better quality of life.  Jim tends to shut down and that is not going to help him fight this new adventure.
   

     I share all of this as we will need your phone calls, good wishes and prayers.  Most of you know that Jim isn't much of a socialite (lol), but I will relay email messages and hand him the phone.  I know some of you have even gone through this yourselves so you will be a information source to both of us.  He is on several prayer lists and any of you that want to add us to one, it would be much appreciated.
    

    I am walking in the American Cancer Relay for Life on Fri/Sat.  I signed up with Jim's daughter last winter when she asked if I would walk with her.  I am fortunate to have cancer survivors in my inner circle and was honored to walk with them and honor those that lost their fight.  Our son-in-law is a 2 year  tonsil cancer survivor and doing quite well.  This walk takes on a whole new meaning to me now and will breathe in all the resources and information I can get.  For those wanting more info on prostate cancer, this site is fairly good. www.cancer.gov/cancer_information/ cancer_type/prostate
    

    Next week he has his MRI on Monday and appointments in the PTSD clinics on Tuesday and Thursday and then his results of his MRI on Friday.  I'll send updates.

 Thank you for your prayers and love,

Karen

Response from Roger Schwintosky on July 24th, 2008:

Karen and Jim,

    You will be in our prayers. Sounds like the bone scan indicated possible progression, like you say hopefully it is arthritis. My Gleason was 7 as well and of course I had the surgery. I am presently just monitoring with the urologist and radiation doctor. It's a big shock to the system, psychologically, even though we know anything can happen.
    

    As far as VA, Prostate cancer is one of the things attributed to Agent Orange so put in a claim today if you haven't already. The day they receive the claim is the day any compensation goes back to. It doesn't have to be complete you can do it at one of the service organization or on the computer. I just downloaded a form filled it out and mailed it. Being on the ship they will probably required statements from some of us that can testify that you were on the ground in Viet Nam. There are plenty of sources there. Just do step one first, apply.
    

    Helen is off today and we were out driving around on errands and I said I needed to call today because I knew you had an appointment on the 23rd. When we got home I checked and got the message. Any help I can supply with the VA claim let me know if there are questions. The medical stuff I will leave to the doctors. Sounds like we have been doing the same tests though. Just said to Helen I have had 3 cat scans and 2 bone scans in the last year. Among other things. You guys hang in there. Talk to you soon.

 LOVE and PEACE from TN.

Response form Karen Dare on July 24th, 2008:

Roger,

    Thanks for your quick response and kind words.  We are very fortunate and have a service representative from our county that has helped us every step of the way.  He put in a claim for the Agent Orange exposure the day the doctor gave us the diagnosis.  He has always been one step ahead for us.  I will let him know that Jim has someone that can verify his whereabouts during the exposure if need be. I will read Jim your email after supper.

Thanks again,

Karen 

Update from Karen Dare on August 1st, 2008:  

Family and friends,

    First of all, thank you for all the responses to the last email.  Your notes, calls, emails and most importantly your thoughts and prayers have been a great source of comfort and relief for both Jim and I. As much as I would like to call everyone or personalize the email to each one of you I hope you understand that by sending out one informative email I remember to tell you everything and I also find that if you have something to refer to you can look back at it and try to take it all in.  The doctor has commented that it is good I always bring my notepad and pen with me.
    

    The results of the MRI show that the cancer has spread to his spine.  Radiation at this time would not benefit Jim.  The decision was made to start Hormone therapy.  He was injected today with an implant that is injected under the skin.  They put it in his abdomen.  The implant gradually dissolves and releases the drug over the time between injections.  He gets his next one in 90 days. The name of the drug is called Zoladex.  It is used for patients with advanced prostate cancer.  It is hoped that it will help reduce the size of the cancer and reduce symptoms.  Because he will no longer produce testosterone the cancer shouldn't be able to grow.  One of the side affects of this implant is hot flashes, oh boy!  I told him he'll probably have urges to go shopping more, lol.  Because one of the side effects is bone pain and it has spread to the bones they put him on a drug called Bicalutamide. He is on it for 30 days.  This should help counteract any joint or muscle pain.  It is used with the Zoladex and helps to block the effects of certain chemicals that are necessary for the cancer cells to live.
    

    The doctor told Jim that even though his cancer is too advanced for surgery or radiation it doesn't mean that the hormone therapy won't work.  The goal is to shrink it and get his PSA down from 75 to zero.  If the hormone therapy does this then we can revisit radiation.  We were both quite on the ride home.  I took good notes and asked questions but it is so much to absorb.  His nurse today was very kind and put her ext. # on one of the handout sheets so we can call her if we have questions.  The hard part is all the side effects and precautions that are involved.  Some would wonder why take these drugs if they can cause so many harmful side effects.
 

    The good news is that there is no more tests for awhile.  No more waiting for results.  Now, we need to learn to live with the results and move forward.  If Jim and I were on a tandem bike, I would be in front peddling forward and Jim in the back peddling backwards so we would be going no where fast.  The key is going to be working together to move ahead.  That would be the prayer requests that we need.  The PTSD doctors are aware of Jim's new diagnosis and are switching some of his med.'s and are willing to meet with him once a week if need be.  Hopefully, this will help. Once again, thanks for your thoughts and prayers and keep them coming. 

Love,

 Karen

Good Evening,

    Jim has been home for a week or so and is continuing to heal and mend.  He has physical therapy twice a week at the VA.  He has mastered the stairs in our split level entryway home and has a walker on each floor to make it easier.  He received from the VA last Fri. a walker that has brakes, a seat and a basket.  Our granddaughter wanted to add streamers and a bike horn but advised against it, lol.  I attached a few pictures of Jim and Ashley at a local park the other day. 

    Thank goodness all three of our kids live in town.  Between putting up safety bars, tighten screws in the railing, and frequent trips to the VA, they have been a godsend.  His prostate acted up while in the nursing home but a new medicine has helped shrink it.  His potassium and sodium levels were off and when one would level off the other would go low.  He is eating much better and has gained 13 lbs in the last 3 weeks.  Drinking a V8 and eating an occasional hot dog seems to be helping his sodium levels. 

    The cards, e-mails , well wishes and prayers have been such a source of encouragement and very much appreciated.  Jim isn't much for the computer but I had him sitting in front of it the other day looking at all the well wishes and he asked if I would help him "figure the puter out" which I will. 

Love,

Karen