Cancer and Fear - 032

There is one common thing associated with cancer, and that is fear. Even the word "cancer" scares some people. I've had many experiences along this journey where I've experienced various types of fear. Fear is a continuum from mild anxiousness to full-blown terror.

It's been about seven years since I first experienced fear regarding prostate cancer when the urologist suggested I undergo a prostate biopsy to rule out cancer. The intensity of the fear has waxed and waned since then, depending on my state of mind and circumstances at each point in time.

Thankfully, it seems that the maximum amount of fear surrounding this cancer diagnosis has generally declined over time. After a while, I learned not to let the fear amplify to the point of terror like it used to. I've succeeded in that through mindfulness and using nature as a distraction.

I've learned to be more mindful about not letting the fear amplify, focusing on my breathing, and distracting myself by walking in the woods, going to the beach, and shooting photography. My favorite place is the Jacksonville Arboretum & Botanical Gardens, a beautiful garden and lake surrounded by forest and hiking trails. And I always bring my camera.

So that's where I recently went when I began feeling the fear ramp up to a high level. It all started about three weeks ago with low back pain associated with numbness and tingling down my left leg. I've had intermittent low back pain since about ten years ago when I injured my back while lifting weights in the gym.

About eight years ago, I had an MRI of my lumbar spine, which showed multiple herniated discs from L3 through S1. I started doing core exercises and getting regular chiropractic therapy and acupuncture, which helped immensely. So, I was used to intermittent back pain but had never experienced numbness or tingling in my legs.

I figured I had tweaked my back in the gym because I noticed it had started the day after a leg workout. So, I was okay when it first started, but when it persisted, I started thinking I needed another MRI, and that's what triggered the fear - what the MRI might show.

When I first thought of the possibility of a metastatic lesion in my spine, a part of my mind wanted to escalate those fearful thoughts, but I was able to reign it in. But I knew it was a possibility since my last PSA was 117, and prostate cancer usually metastasizes to bone.

I told my radiation oncology nurse practitioner, Katrina, what happened, and she immediately ordered an MRI. That afternoon on a Friday, I got a phone call from the imaging center and made an appointment for the following Monday morning. I had difficulty sleeping that night because of "worst-case scenario" thoughts that kept popping into my mind.

I was supposed to attend the wedding of some close friends the next day, but I was too stressed to go. I felt terrible about not going, but my head was not in a space to attend and be sociable. I did what I often do when stressed: I isolated myself. It's an old habit and hard to break.

Monday morning, I drove to the imaging center and checked in. A technician led me to the back, and another vaguely familiar technician led me to the dressing room. He called me "Dr. Holden" and reminded me who he was. He is a friend of a friend, and we follow each other on Instagram. We said our hellos, and he instructed me how to prepare for the scan.

A few minutes later, he led me into the MRI room and helped me get arranged on the table. It was over before I knew it, but when he brought me back to the changing room, he said, " It will be marked as urgent and sent to the neuroradiologist to be read within 2 hours."

That's all it took to trigger me back into a high-fear state. Of all the scans I've had during this cancer journey, no technician has ever said, "It will be marked as urgent." He might as well have said, "Your scan looks very concerning, and I'm going to expedite a read by the radiologist.”

I came home and emailed Katrina, letting her know I'd had the scan, and told her what the technician said. She responded, "Definitely will be impressed if that is the turnaround time!"

Two hours passed, then three hours. I was pacing the floor. That's when I headed to the Arboretum with my camera. I felt relief as soon as I got there and started taking pictures. I walked one of the long trails and visited two of my favorite trees. I have a thing for trees, especially ancient ones. They comfort me in a way I can't explain.

I didn't want to leave, but I was getting hungry. I took the long way home, and when I got home, I drew a hot bath with Epsom salt and lavender essential oil and tried to meditate.

A couple of hours later, Katrina called, and my heart skipped a beat. She sounded calm and kind, as usual. I said, "Thank God you called. I've been stressing about the results." She said, "There's nothing to stress about because the MRI doesn't show anything that looks like cancer. You've got some bone marrow changes from the radiation you've had but nothing to suggest metastases."

At levels L3 through S1, there was mild spinal stenosis (narrowing of the spinal cord) due to disc bulges and degenerative changes. At L4/L5, there was also narrowing where the right nerve exits, and at L5/S1, there was narrowing where the left nerve exists.

Spinal stenosis, even though mild, could account for the numbness I'd been having in my left leg.

The MRI showed that the red marrow in my lumbar spine, which creates red blood cells, white blood cells, and platelets, has been mostly replaced by fat. Fatty bone marrow replacement is part of the aging process, but the radiation I'd received had expedited the fatty replacement.

In retrospect, the technician, an acquaintance, thought he was doing me a favor by labeling my scan urgent so I’d get the results faster. He had no idea that would trigger an escalation of my fear, which, primed by previous fearful thoughts, had created a low threshold for worsening.

Before Katrina hung up, she told me Dr. Stround asked when I was returning with a PSA level. I reminded her that our plan was for me to return in December with another PSA level. She said she knew that but had told Dr. Stroud she'd remind me.

Will I let my mind go down a dark rabbit hole while waiting for the next PSA results? I doubt it because I'm currently in a state of gratitude for no evidence of cancer on my MRI scan.

Whatever the results, I'll keep moving forward with a positive attitude, which I always seem to return to. Thankfully.

Until then, stay well.

Much Love,

Keith