Ferrari Mailing List: Bad news about Sergio Marchionne

[Doug & Terri (dnt]

Peters note about his father caused me to look back and heft out an old note – here it is.  From 2004.

 

Next week I’ll be a young 75.  Onward.

 

10/24/2004

 

Denial is not just a river

 

Yeah, denial is not just a real long river in Africa.  So at age 61, it's Why Me? And how did this happen?  And, what now?

 

So, what is it I am harping about?  Well, a diagnosis of prostate cancer.  The final answer being a radical prostatectomy two weeks ago.  And that was good thing too as all is well - clear margins and a statistically longer life span.

 

So why write this?  Terri suggested that I stop hiding behind my self-defined "manhood failure" - and as the docs will say - it's really not - and felt I should share my experience with my close friends and hope that we all remain friends for a very, very long time.

 

As fellows, we just don't see enough warnings about prostate cancer.  Oh, aside from going from a fire hose to plant mister (as James said) we just don't seem to pay too much attention to ourselves - well, as compared to societies concern over breast cancer, cervical cancer and colon cancers.  And of course the statistical fact that if we live long enough and croak off from a worn out ticker - and if an autopsy were done, the old prostate would show signs of cancer anyway - not that that croaked us - but that's just what happens down there.  The cells change over 70, 80 or 90 years - or maybe even 40 or 50.

 

The gist of this message is cancer doesn't just happen to us when we are old.  Mine, at age 61, was caused by, according to my urologist, my family DNA and, unbeknownst to me - being a Swede.  That's just what the numbers say, I dunno why and neither does he.  Just numbers.

 

So what was I was doing?  Over the last 2 or 3 years I was watching a creeping PSA, by a 1/10 point or so, reading.  Now there is no doubt PSA levels are affected by bike riding, other diseases, and to the last sex time(s).

 

But it is important to note that if I had not been getting these PSA tests along with some other 6 month blood tests I would have never known.  Hey, I wasn't in any discomfort and there were no signs during my routine physicals.

 

So two years ago the creeping PSAs elicit a "do you have an Urologist?" question from one of my docs.  Nope - well, you might want to look into it.  I put that off.  A couple of years go by and the old PSA, while not ringing any fire alarms -is now at 3.8 and no sign of going down.  #^%#$&$

 

I discuss this with my GP.  Well, this stuff, if there is a problem, grows so slowly, probably nothing to worry about - but do you have a Urologist?  Ok, ok, who do you recommend?  "Here are two - both very good, but different bedside manners.  I sent my aging father to this one."  I see both just to kick tires and settle on one.  We do a biopsy.

 

Now let's consider the anatomy of this prostate thing - and this is my take on the anatomy of the thing but even after a lot of research, if it is anatomically incorrect - sorry.

 

The prostate is a walnut sized gland built similar to an orange with segments and a tough shell.  There is a straw that runs through it and the whole mess is suspended in the lower abdominal cavity between the bladder and the colon on a hair net of nerves and blood sources separating the colon and prostate.  Generally, the cancer grows in the soft segments of the orange and if advanced, can crack into the shell and lymph nodes.  Unchecked, this type of cancer has an affinity for nerves and so may eventually wind up in the spine. 

 

The straw is the bladders urethra and a swollen prostate cuts off our stream, so to speak.  However, it is nice to know there are other benign causes for a dwindling stream.  The hair net is the blood and nerve supply to the penis.  No main highways here - just a labyrinth of vessels and unseen nerve branches.  Complicated system, eh guys?

 

So the biopsy gizmo goes in thru the anus and the target prostate is subdivided into six segments and two samples per segment are taken, or a total of 12 samples.  Three segments came back clear - tho some cell atrophy is seen - nothing bad.  Two segments show 1 mm spots and one has a 3 mm spot.  So what's this mean?  We can watch it and do this again in 6 months - remember, it is slow growing or we can treat by removal or maybe nuclear seeds - but nuclear seeds are not recommended in a young (that is a reassuring word - young) candidate.  At this time, nuclear seeds may be one shot deal and if that doesn't do the trick - the scar tissue makes removal very hazardous if it can be done at all.

 

So - here are six or seven other docs, surgeons and nuclear medicine guys to go visit - take your results and make a decision.  We discard the famous Russian urologist, Dr. Kutchercokov, and visit some of the others.  We learn there are downsides to surgery to include incontinence, loss of feelings, non-erectile dysfunction and a host of minor complications.  It "Depends" how things turn out.

 

Terri and I revisit several docs and, drawing on my years of concoursing Porsches and Porsche restoration, decide to cut the rust out and butt weld everything back together again.  We opted for the first surgeon, the biopsy doc, and now two weeks post op, I am doing reasonably well.  We also opted for the "nerve sparing" surgery, which is a bit more complicated - read - longer.  Jury is out on that but I do have feelings.  There are other hurdles but most are behind us.

 

As I stated in the beginning, my purpose was to share my pre op activity over the last two or three years and stress - be careful and get tested.  Just as in mammography's - where the docs compare year after year looking for changes in breast tissue - as do astronomers do when they are finding new planets or stars or solar systems by comparing years of photo after photo from the same spot - that's about all the PSA is good for -comparisons.

 

I don't know about any of you, but I have lost two good, and young car guys.  Bill Neighbor was a mid-fifties Iowan and a collector with a barn of mid-fifties Buicks and Packard convertibles with many calendar cars and the other was Tony Cottier, a mid-forties Aussie F1 tech who owned his own Ferrari garage and helped us when we bought the 308 GTS.  When they "finally" went to the doc – their doc’s  final disposition for them was "to get your affairs in order."  And THAT my friends, is a gyp.

 

Oh, in closing - the path report subsequent to the surgery on my rotten orange - it had to come out.  It was a tad worse than the 12 shot biopsy showed, it was not a candidate for nuclear medicine, and there was no invasion into the shell or lymph nodes.  My question was - what If I hadn't done anything?  Oh, it would be about 5 years before the house was totally engulfed in flames and life expectancy maybe another 3 or 4 years after that.  Yikes.

 

Onward, my friends - I am sure that all of you are aware of routine tests, but frankly, we just don't see a lot wagging about this - so I thot I would share.  I want to know all of you for a very, very long time - after all, we are all young.

 

Your pal Doug