We all suspended our disbelief for as long as we could. I made a point of ignoring the PSA numbers in Dad’s latest blood tests during the short interim between the results and our next oncology appointment, but the appointment eventually arrived and we could no longer bathe in denial.

No-one, of course, is willing to say exactly what is going on, because they will say that they don’t know exactly what is going on. But here’s where we stand, in layman’s terms: The cancer is back and it’s pissed.

The hormone therapy seems to have lost its efficacy, which we suspected as soon as we heard that Dad’s PSA numbers were on the ascent again. So the doctors have put him on the one-two punch of hormone therapy plus Casodex, the only tablet I’ve ever seen that costs 350 dollars for twenty pills, a net cost of $17.50 per dose. Ouch.

Aside from putting together this Dynamic Duo, the doctors have ordered up an MRI, a CT scan and a bone scan, putting us back into the medical circus in earnest. They’ve ordered this battery of tests to take a peek into his bones and see if the cancer is crawling into his spine, which we all agree is a pretty crummy place to house a resident alien. And the reason that this is such a crummy place to house anything except spinal fluid is that he can experience spinal cord compression and potentially paralysis as a result.

If I had my way, which apparently I don’t, I would hang Dad in gravity boots from his ceiling like a Prosciutto di Parma to decompress anything spiny, and perhaps store him there until we could get the results from the scans back. Alas, people are telling me this isn’t practical, and may actually be considered “abuse” in certain states. So instead I’ve insisted that he not do anything hasty, like jog, or skip, or maybe even shiver in anticipation lest he shake something loose in the preciously fragile spine.

He seems okay with my demands, but that’s because he’s on painkillers now.

Thank god for opioids is all I’ve got to say. Yesterday, just sitting in the doctor’s office Dad was constantly rolling his shoulders and crinking his back, trying to find the sweet spot where he was comfortable. There was no sweet spot, and he was paying for his discomfort in sleepless nights and uncomfortable days trying to distract himself with craptastic television.

Now he’s got the painkillers in his arsenal and at least he’s been able to get one decent night’s sleep. I don’t know if the dose is high enough because he’s still feeling a little creaky, but I’ll call the office soon to see how much of his discomfort is expected to be alleviated.

So here we are. Back on the merry-go-round. Soon we’ll discover whether or not the uninvited guest has started squatting too near his spine, and then we’ll have to go in for radiation therapy. More tests to see if the Casodex is stomping his testosterone back to girly levels, and if it’s not, probably chemo.

With all this, I think we’re just going to have to admit that there are no more decisions that don’t involve whether or not, or how much, medical intervention we’re dealing with. The hormone therapy provided an excellent respite, although too short. But we must hop back onto the wagon and follow it whereever it leads.

I hope it’s somewhere nice, like the Nile.

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