Radiation

My 6-week radiation adventure began mid-march of 2017 in Northfield, Minnesota. Five days per week we drove south to Northfield from the cities for my daily treatment. Getting to each session was an adventure. This kind of radiation must be done when the bladder is full. So each day I would try and drink just enough water, at the right time, to make sure my bladder was full for the session.  This could be challenging if there were any delays with the machine. Several days there were mechanical problems with the machine...you can imagine the dancing that occurred.

 

The radiation treatments were very easy. Lie down, get positioned (the technicians create a couple of small tattoos that are used to repeat positioning each day), and wait for the bazillon dollar machine to do it's thing. From walking into the radiation room to exit was about 15 minutes but almost all of that time was positioning. The actual radiation time was probably less than 30 seconds each day.

My wonderful wife drove me down each day (Northfield is about 45 minutes from the cities) so I would not lose any work time. I created a custom desk for my car so I could code while we drove.

It is common for radiation patients to have some side-effects from the radiation. For the most part I was quite lucky. I was even able to ride my bike back from Northfield to Saint Paul in the 4th week. I did have some butt pain (made bathroom visits difficult) for about 2 weeks near the end.

As in most of my cancer journey I was thoroughly impressed with the medical team. The oncologist, nurses, and technicians were all wonderful.  We had, amazingly, a lot of laughs.

Of course I also met some great guys and their wives. So much kindness.  :-)

After 36 sessions I hugged the machine, rang the bell, said goodbye and left, looking forward to a long vacation from cancer.

Cycling and Prostate Cancer

This post is for cyclists.

Being a rabid road-cyclist raises a lot of questions in the context of prostate cancer.  It is hard not to worry about the potential for prostate problems when riding a narrow bike seat (not much more than a pole).  Does road biking contribute to prostate cancer?  What about PSA testing and biking?  I've been treated for prostate cancer...are my days of riding over?

Here are my thoughts...

 

Causality

Like most men who are avid cyclists I wondered if there was any correlation between my prostate cancer and my riding.  Did I do this to myself?  There have been many studies done, some of which have found correlation but the studies are not conclusive.

 

PSA testing

Every man who has a PSA test wants to ensure that the test is as accurate as possible.  Inaccurate results can lead to anxiety and unnecessary biopsies.  Can cycling change the PSA level?  There have been a number of studies in this area as well.  Some of which have concluded that PSA levels are sometimes higher when there has been recent (within a few days) cycling activity.  In my own case this seems to be true.   During my first two worrisome PSA testing episodes I did the PSA the day after cycling and repeated the test after staying off the bike for a week.  In both cases my PSA level dropped ~1.5 ng/ml (5->3.5 and 12->10.5).

Post-treatment riding

Given my passion for cycling I was anxious to get back on the bike after surgery (robotic prostatectomy). Cycling has many benefits for me and one of the most important is the emotional value: cycling gets my endorphins going. When I discussed with my urologist post-surgery he was very supportive of resuming cycling.  He wanted to make sure I was healed before starting but after that it was simply a matter of "you can ride if it doesn't hurt".  My doctor asked that I wait 8 weeks. I had an unusually painful recovery period (see Recovery) so I was careful about my re-entry.  I decided to try one of several "prostate friendly" seats first. This worked but the ride was awful.  I found forums that suggested you can get "use to it" but I seriously doubt that.  In addition to the very awkward position they can really throw off your balance since there is nothing between your legs.

                  

I then tried one of the many more conventional "ergo" seats. Selle SMP (not to be confused with Selle Italia) offers a full line of these. This was much better. These saddles take a lot weight off the perineum and distribute it to the sitz bones. The effect is, as expected, a lot of weight on the sitz bones.

               

In the end I found a seat that I loved that was pretty close to my old seat...just a bit more ergo [read: a slit down the middle to offer some relief to my perineum].

It took a couple more months for my prostate to feel 100% but eventually biking felt the same as pre-surgery. All good.

UPDATE [August 2018]: Professional riders adopting new seats