1994-2003, Life’s Bubble Bursts

I had lived quite a normal life from 1941 to the mid-1990’s. I was a reasonably healthy, well-adjusted, bachelor (until I was 58 when I married for the first time in June, 2000 to my wife, Marie, a true gift from God). My main interests in life were my scientific career in chemistry and my musical hobby playing keyboards and arranging music. God had protected me from many dangers during those years, especially in my teens and 20’s. Physically I was fine until one major attention-getting accident in 1989 and a worse, life-threatening accident in February, 1990. At that time, in a remote section of farmland near my home, I hit a tree at 50 mph without a seat belt in the very early morning. I suffered life-threatening head injuries, and broke a finger, my right wrist, 7 ribs, my right hip and my right ankle. All have been healed in a miraculous fashion and my right hip was replaced at Johns Hopkins Hospital in Baltimore by a masterful surgeon, the late Dr. Lee Riley, who was Chief of Orthopedics at the time. Even when I had this accident, God’s protective hand was evident as He had positioned a policeman in such close proximity to my accident site that he witnessed the ordeal and was able to reach me within two minutes. His immediate action saved me from dying from my head trauma. I am often reminded of God’s protection and have raised many prayers of thanksgiving. God’s plan for my life was still unfolding and there were many more roads to travel. Thoughts of life-threatening illnesses and accidents had never really entered my mind by 1990. Like so many of us, these tragedies usually happen only to other people. But I was now about to embark on an era of life-changing experiences with prostate cancer.

My Initial Diagnosis and Treatment: In the early 1990’s when I had passed the age of 50, I began to experience the common male symptoms of frequent and slightly-difficult urination. I had annual check-ups and began screening for prostate-specific antigen (PSA) in 1992. During the period of 1992-1995, my PSA always remained in the range of 3.9 to 5.0, never increasing in any given pattern. In 1994, I had an ultrasound of my prostate and a biopsy which were revealing. The biopsies (6 cores at that time, I think they take 12 now) were all negative but the ultrasound revealed that my prostate gland itself was not extremely enlarged. This fact gnawed at me for some time. I reasoned that if my prostate gland itself were not that large, why would it be producing a significant and slightly elevated amount of PSA? I am not a urologist but I assumed that the larger the gland, the more PSA would be produced. This naïve conclusion seemed to have some basis in medical fact because I learned that a measurement called PSA density was being used as a criterion for choosing to undergo a biopsy or not. PSA density was roughly defined as one’s PSA concentration (e.g. 3.0) divided by the volume of the prostate gland; my PSA density value was 0.23. This made sense to me since it gave credence to my naïve observation that my smaller prostate gland was actually producing more PSA than one would expect. So for the period of 1994-5, I was a little on edge even though I had a negative biopsy in 1994. In October 1995, I went to Johns Hopkins in Baltimore, MD for a urology checkup. I was very fortunate to be working and living within driving distance of Johns Hopkins since their Urology Clinic was acknowledged to be the country’s best. In August, 1995 my PSA was 4.8; in December, 1995 it was 4.0 and over the period of 1992-5, my PSA stayed relatively constant in the range of 4.2 plus or minus 0.7. A biopsy was performed at Hopkins in October, 1995.

My career at the National Cancer Institute (NCI), the largest of the institutes comprising the National Institutes of Health (NIH), was progressing beyond my expectations. God had given me a position at the Frederick, Maryland campus which suited my interests, skills and temperament perfectly. It was also close to home and I was spared a traffic-laden commute to the main NCI/NIH campuses in Bethesda and Rockville, Maryland. I was sitting in my bright, comfortable office one October day in 1995 when the phone rang. A voice on the other end from the outpatient clinic at Johns Hopkins simply announced that the results of the biopsy revealed that I had prostate cancer. Never had I experienced the numbing shock that accompanied that message. I am sure that my specific brain chemicals were providing their “comfort” to me as I sat contemplating what I had just heard. The best word I can use to describe this feeling is a complete “numbness” and lack of specific emotion.

Though I was unmarried much of my life, I always had good male and female friends. Upon receiving the news of my biopsy, I drove immediately to the home of my girlfriend at the time. I told her the news as we stood in her driveway face-to-face on this sunny late morning in October, 1995. I was 54 years old at the time and I knew I wanted to be married one day. I knew the potential side effects of prostate cancer treatment were impotence and incontinence. I had made up my mind instinctively to go to Johns Hopkins and have the prostate gland removed (radical prostatectomy) since I knew that the foremost surgeon in the world at the time was at Johns Hopkins. He had pioneered a technique called the nerve-sparing technique wherein he could avoid permanently severing nerve bundles which controlled erections and incontinence. I had even witnessed this surgeon’s graphic presentation of the operation when he was awarded the General Motors Prize at a ceremony at the NIH campus in Bethesda. My mind was made up. I would get this most-renowned surgeon to remove my prostate gland, and I would be as good as new and ready for the mate which God was later to deliver for me. I plotted my course of action or so I thought. As I was explaining all of this to my girlfriend, we both noticed a small sparrow wandering so close to us seemingly totally un-afraid. This sparrow wandered no more than 1-2 feet from us, ignoring our human presence entirely. This “odd” experience was the first of many which I will chronicle. I am not sure exactly when the verses from Matthew 10:29-31 (see Spiritual Medicines) and Luke 12:6-7 came to the forefront of my mind. It was either at the moment I saw the sparrow or shortly thereafter. [Luke 12:6-7: “Are not five sparrows sold for two pennies? Yet not one of them is forgotten by God. Indeed, the very hairs of your head are all numbered. Don’t be afraid; you are worth more than many sparrows.”]. [Matthew 10:29-31: “Are not two sparrows sold for a cent? And yet not one of them will fall to the ground apart from (the will of) your Father. But the very hairs of your head are all numbered. Therefore do not fear; you are of more value than many sparrows.” (“So don’t be afraid; you are worth more than many sparrows.”)].

This was the first of many such experiences to come wherein God (Jesus) was telling and showing me that He was fully aware and in control of the situation, and that I was not to worry. These words and others have comforted me and continue to serve as “spiritual medicines” (see the link).  So armed with God’s assuring word and presence, the support of close friends and colleagues and the anticipation of a successful resolution of my prostate cancer by the world-renowned  surgeon from Johns Hopkins Hospital, I rested my case and prepared for surgery in December, 1995. Happy October Birthday, Happy Thanksgiving and Merry Christmas to me!

I resumed my work, reading everything I could on prostate cancer and receiving numerous valuable insights from my colleagues at the National Cancer Institute and other research institutions. During the following week, that “still small voice” which I have learned belongs to God (actually the Holy Spirit), began to repeatedly ask me, “Whom are you counting on to cure you, Me (God) or the famous Hopkins surgeon?”  I could not shake this lingering question. Finally after a week of debate within myself, I prayerfully but decisively told God that I was counting on Him and that I would trust the surgeon that He was to supply. When I called Johns Hopkins to schedule my post-diagnosis urology appointment, I was told in October 1995 that the first open appointment with this surgeon was not until March, 1996. So I gratefully accepted God’s choice of an alternative surgeon, which has proven to be the best choice possible. In the interim, two of my NCI colleagues had offered independent recommendations citing this surgeon specifically. So the choice was made and a radical prostatectomy was performed in December, 1995.

One lesson I had learned during my previous accident hospitalizations is that I always became especially aware of God’s (or Jesus’) intense and close presence during such medical crises. My sensitivity levels to Jesus’ words from the Bible were keenly high. His presence is especially close and realistic during such critical times. The night after my surgery, my doctor visited me in my room. I happened to be reading my Bible at the time of his unexpected visit and I remember we had a brief but meaningful conversation about how we can believe and trust the words written in the Bible. As I look back on this incident, the theme of the relevancy of God’s Word was to become a dominant one in future years. An interesting sidelight was that Marion Barry, who at that time was the mayor of Washington D.C. underwent a prostatectomy at the same time as I had my surgery. We shared adjoining rooms at the hospital and Mayor Barry and I walked the hospital corridors together. To this day, I wish him well.

 My surgery was as positive as could be expected. My cancer was totally confined to my prostate, my lymph nodes proved negative for cancer, my Gleason score was 3+3 or 6 (a moderate value). Most urologists would classify Gleason scores of 5 and 6 as low-grade tumors, a Gleason score of 7 as intermediate, and Gleason scores of 8, 9, and 10 as high grade, with the least favorable outlook.  I was specifically told by my physicians that my cancer was diagnosed at such an early stage that “if we can’t cure you, we can’t cure anybody.”  Comforting words!!  I and my catheter went home for Christmas. I recovered well and after a few weeks, I was no longer incontinent. Once the incontinence recovery started, it progressed fairly quickly. I also noticed at a later time, that impotence was also not going to be a major issue. Essential spared nerve bundles had retained their potency. But a major lesson that I learned from this radical prostatectomy procedure is that one is never the same after such surgery. I may not be incontinent nor impotent, but my physical responses were never going to be the same as they were before surgery. There are benefits, risks and after-effects with any medical treatment be they surgery, radiation or less invasive treatments. While side effects can be minimal, a person is never quite the same after treatment as before. I try to tell this to every man who asks me about my treatments.

My first-time marriage and post-treatment adjustments: I was 54 years old at the time of my cancer surgery. The next several years of my life I spent trusting I would be cured as defined by no recurrence within 15 years. I was still hoping to get married one day (which finally happened on June 17th, 2000). I had met Marie in November, 1986 and we dated for one year. At that time, I was still not ready for a permanent relationship which resulted in Marie breaking up with me. We maintained occasional contacts for the next twelve (12) years. Each of us experienced serious relationships during that period. In November, 1999, Marie and I had a rare dinner date. That evening, the still-small voice I know to be that of God (actually the Holy Spirit) told me that Marie was God’s choice to be my wife. In January, 2000, Marie received a similar direct assurance from the Lord. We were immediately engaged and married in June, 2000. The ensuing years have borne evidence that it truly is a “marriage made in heaven.” Through my experience with cancer, Marie continues to be my most important source of support after God Himself.

Meanwhile, I was also hoping and trusting that I would live to see retirement at age 65 (in 2006) and that God would give me an indefinite period of healthy retirement. I think this is true of most cancer patients in their early stages. We tend to initially think that eventually all will be well with us; we’ll beat the disease one way or the other. In the years from 1996-2002, I became a regular at the urology clinic at Johns Hopkins. My PSA was checked every 3-6 months. I learned to live my life in these monthly intervals. As the time approached for a PSA test, I would get anxious. Once it was over, there would be a huge relief of a burden until the next time. Every time I would receive a PSA result of <0.1 ng/mL, I would thank God for another 3-6 months of life. My life became one of ebb and flow of emotions. Little did I know that God had many more important lessons for me to learn.  Once we come to enter into a relationship with God through Jesus, God’s plan for our lives becomes the maturing of our faith. As James 1:2-4 state, “Consider it pure joy my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance” (patience in the King James version). “Perseverance” (patience) “must finish its work so that you may be mature”(perfect in King James) “and complete, not lacking anything.” All things work toward that goal. The next years would be one big “maturing / perfecting project.” In the earlier part of my life, God had delivered me fairly quickly from my problems. I could “see” the solutions coming on the horizon. Now for the next years and continuing to this day, I am being taught to walk “not by sight”, meaning not by only trusting visible signs of deliverance, but by faith when positive signs are not visibly seen. Cancer also makes us very much aware of our mortality. I now began to think much more seriously about the issues in life which have eternal significance, such as God’s specific plan for the next years of my life, and the nature and reality of “eternal life” which God promises to us in John 3:16 through placing our faith in Jesus. My earthly life had been reduced to 3-month portions with hopefully-anticipated extensions for many years. The concept of possessing eternal life was slowly but surely coming into better focus as time went by.

 December, 2002 – January 11th, 2004. The cancer recurs. What do I do now? In December, 2002, my PSA reappeared increasing from an undetectable level (<0.1) to 0.3. This was to be life-changing. The cancer had recurred even though I had received medical and spiritual assurances that I was in the highest “cure” category. To this day, the physicians at Johns Hopkins tell me that such cancer recurrences are seen in less than 10% of patients like myself who have extremely favorable initial prognoses. Experts say they have no idea why this occurs. This is easy to say now (in 2009) but God obviously had other additional plans for me which I could not have tolerated learning about earlier. This cancer recurrence made me very apprehensive and nervous even though my long-time family physician and friend did not immediately admit that prostate cancer had returned. He was probably sparing my emotions. I buried my feelings after a period of weeks until November, 2003, when my PSA had doubled to a value of 0.6. I was told to schedule an appointment with my urologist-surgeon at Johns Hopkins and with Johns Hopkins oncology.  Two months later in January, 2004, my PSA had risen from 0.6 to 0.9. I eagerly sought and received encouragement and advice from the many excellent sources available to me through my position at the National Cancer Institute. I even received a supportive e mail from the NCI Director who later went on to head the Food and Drug Administration under President George Bush.

During this period, like so many other cancer victims, my first thought was that God could and hopefully would heal me. Every time I would hear a Christian song or hymn containing a reference to healing, I would appropriate those words for my case. More importantly however, the scriptures from James 5:14-16 were brought to mind: “Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer offered in faith will restore the one who is sick, and the Lord will raise him up, and if he has committed sins, they will be forgiven him. Therefore confess your sins one to another, and pray for one another so that you may be healed. The effective prayer of a righteous man can accomplish much.” During this period, I had a lot of skepticism and anger at God. Why had He allowed my cancer to be diagnosed so early? Why had my excellent surgeon assured me that “if we can’t cure you, we can’t cure anybody?” What was the purpose of this recurrence?  Remember that it re-occurs for reasons unknown in 10% or less of patients with such an early diagnosis.  Had I started to get comfortable and not pray about things as much as I did during crises? Would God ‘heal’ me if I followed the words in the book of James and was anointed with oil and prayed over by my church elders? Do the words in James 5:14-16 apply to modern times or did they only apply to the early church to whom the book of James was written?

The practice of anointing with oil and prayer by the elders had regularly been carried out in many churches I had attended, including Evangelical Lutheran Free, Baptist and Assembly of God churches. My pastor at the small country Baptist church where my wife Marie and I attended suggested that he and two elders pray for me and anoint me with oil in conformity to James 5:14-16.  I was in constant doubt, anger, frustration, and especially fear of dying of prostate cancer and its accompanying bone pain. It is not a pretty death. Then on November 10th, 2003, my Hopkins surgeon and urologist e mailed the following. “If the PSA has gone up, the most likely cause is cancer recurrence. One third of patients will progress to needing treatment at a mean time of 8 years. Two/thirds progress slowly and may never need any treatment. The best initial approach is to follow the rate of rise of PSA and look to see if there is any local recurrence.” One week later on November 17th, 2003, the physician wrote, “My expectation is that you will do well for many years to come, with no immediate or even intermediate compromise of health or quality of life. Only periodic PSA surveillance needed. I will be happy to continue to follow you.” I am scared and frustrated. I see only pain and an early death. I may not even make it to retirement. I am reminded of a fairly young chemist from Kansas State University who had recently spent some time with us at the National Cancer Institute as a visiting scholar. He had gone back to Kansas State where he developed severe hip pain and died painfully of prostate cancer within two years. One of my major problems is that when I am faced with a potential obstacle such as this, I tend to think the worst, rationalizing that any other outcome would be more positive than the one I imagine. My father had the same thought processes. I asked God how much faith is needed to heal according to James 5? Where do I get such faith? Why doesn’t Jesus still heal most people who come to Him like He did in the New Testament? I am looking for answers.