Monday, December 2, 2013


   This was supposed to be the cystoscopy that should have told me if the treatment did work or not.
   I did not want to see any tumors or any other irregularities in my bladder. Because if there is cancer – all bets are off, I will have lost and I will have to figure out how to retreat gracefully.
   The procedure was done in the office of my urologist Dr. Ramin, where, without anesthesia, I can watch the inside of my bladder, and since we did this already numerous times, I'm fairly familiar the environment. I was not happy with what I saw. There were two distinctive bumps under the mucosa.
   Not very big, but one looked like it was going to burst any second. Dr. Ramin scratched his head and said that it looked strange, not like cancer – maybe a benign cyst from the radiation? A biopsy needed to be done, but since one of the bumps looked so explosive that a lot of blood could be expected. I had biopsies done before – without anesthesia – it does hurt, but a cystoscopy is not much fun to begin with. So, to deal with the blood, and the pain a second cystoscopy had to be arranged.
   This was not a YES or a NO – it was a MAYBE! Which is a bummer anyway...
   Then the next day my radiologist Dr. Kamrava called, and he had a different take on this. Before the Brachy-radiation they had placed “Markers” in my abdomen, to more precisely target the suspect tissue. I thought these were little pieces of gold leaf or something similar, which can be placed in the body, and are always visible on x-rays etc... Working with markers has the advantage that you are aware of any movement or displacement of the marked tissue within the body, so, if necessary, the treatment can be adjusted.
   Now I found out that these markers were not what I thought they were. I was injected with something like a saline gel, that is commonly used in plastic surgery to inject under wrinkles or scar tissue. In my case it served to distance the bladder from other organs, to reduce the collateral damage of stray radiation. The use of the saline gel is not experimental – the particular procedure – the HDR Brachy-therapy for the bladder – on the other hand is! Dr. Kamrava was sure that what we saw were the markers, and since the method is so new – my urologist would not be able to recognize this.
   So, there is hope, and tomorrow after the MRI, I should know more.
   And the cysto next Thursday should provide a final result about the effectiveness of the procedure.
   Then I can, or cannot make plans for the next three month.
   In the meantime I am learning how to wait! Not very successful, I'm afraid -- because with all the training in my life – I should be world champion in the “patiently waiting” discipline.
   I'm not.