When my PSA first went above the 4.0 upper limit of “normal,” starting this journey through cancer, I began a process of finding out its significance which was characterized by long delays between the steps of the process. First, I had to be evaluated by urology for them to decide whether a biopsy was warranted. After the biopsy, I had to wait for its results. After those results, I had to wait to set up a treatment plan. After the treatment had been planned, I had to wait for the treatments to actually begin. Those 45 radiation treatments took more than nine weeks to complete. Even after those treatments, it took a long time for me to recover from their aftereffects.
At this point I had thought I would be expecting soon to hear that I was free of cancer. Instead, I have begun a new cycle of interminable delay and agonizing waiting. It has been a month since I got the unwelcome lab results of a PSA which had more than doubled from the previous reading. While I know that it has been long enough that it would be appropriate to order a new PSA test to confirm that increase, I found out that no such test has been ordered until September and then I would not get those results until December or January. I don't consider that an acceptable delay!!
I decided that it was now time to be my own patient advocate. A little assertiveness would be required. First I could contact the urology oncology clinic to have them order a PSA test before my upcoming appointment. If that didn't work, I could call my primary care physician to do the same. I was fairly sure that he would order it if the urology oncology clinic didn't, because he had ordered it before the appointment I was to have had which I changed to see him sooner.
In the end the nurse manager of my primary care clinic told me to simply go to the outpatient lab and ask them to go ahead and draw blood for the tests ordered for September. When I did, there was no problem. Now I not only had the PSA test, but also the rest of the fasting labs for my appointment with my primary care doctor.
With the test results in the computer, I went to my urology oncology appointment where I found out that my PSA had gone back down to 1.3, a very acceptable level. It seems that the 2.6 was just a “bounce.” I had read about the phenomenon whereby some patients who had had radiation therapy would have a high PSA some time in their second year after treatment. Therefore, I was not facing a return of my cancer at this time, but rather could still consider myself cancer-free even without that “official” designation.
However, I have to realize that the most unpleasant aspects of this experience came from losing sight of the most basic principles of mindfulness. I was not dealing with what was here and now, but rather with what might be. At any moment there are infinite possibilities for “what might be,” but there is only one set of phenomena in my experience which are actually here and now. It is only that with which I may interact. Furthermore, I had narrowed my focus to think only of myself, even then forgetting that, whatever the course of this particular journey, it originated in the fruition of karmic seeds that I had myself planted.
How much have I gone through during the two plus years of this “Journey through Cancer” that has been transformed from the mere endurance of what was required to burn up the negative karma into something positive that could benefit others? Such a transformation was only possible because of the tiny bit of Dharma active in my life. Now that I am a novice monk, devoted to the Dharma, I forgot all of that for these weeks?
While I am ashamed of such a lapse, I remember that I am not a fully realized being, but merely one who is on the path occasionally falling into the ditch. The wisdom of the abbot leaving my name unchanged again manifests in the reminder that it contains. Our goal is enlightenment, buddhahood, for the benefit of all sentient beings, but I am not there yet!
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