El Toro Marine veteran with prostate cancer left on his own after telling doctor of severe abdominal pains.
(IRVINE, CA) – Cancer is not something that anyone would volunteer for or for that matter wish on another human being. The cliché ‘avoid like the plague’ comes immediately to mind. Images of bone thin humans wasting away in a hospice bed flood the mind; unable to eat from the effects of chemotherapy; awaiting death’s call; sedated with drugs to kill the pain; all hope of recovery gone.
For me, cancer is not a vicarious experience. I had bladder cancer in 2005 (no history of bladder cancer in my family and I don’t smoke) and prostate cancer earlier this year. I’ve been through surgery, chemotherapy, and radiation.
In January 2013, I was diagnosed with prostate cancer. Cancer is not something that anyone would volunteer for or for that matter wish on another human being. The cliché ‘avoid like the plague’ comes immediately to mind.
Images of bone thin humans wasting away in a hospice bed flood the mind; unable to eat from the effects of chemotherapy; awaiting death’s call; sedated with drugs to kill the pain; all hope of recovery gone.
For me, cancer is not a vicarious experience.[i] I had bladder cancer in 2005 (no history of bladder cancer in my family and I don’t smoke) and now prostate cancer earlier this year. The VA agreed that my bladder cancer was “at least as likely as not” due to exposure to TCE/PCE at El Toro (20% disability compensation).
I’ve been through surgery, chemotherapy, and radiation. ATSDR lists prostate cancer as one of the health effects of exposure to TCE and PCE.[ii] The Center for Environmental Health, Boston, MA, reported that “evidence has been recorded of a connection between cancers of the prostate and exposure to ionizing radiation.”[iii] I was exposed to both organic solvents and radiation at El Toro. Kind of a ‘double whammy’ effect, I guess. At this point, I’m too tired to even bother to file a VA claim for the prostate cancer; the ordeal of obtaining a medical nexus opinion and going through the VA disability compensation process requires energy. I’m not up to it.
CHRONICALLY ILL SINCE 1986
As a Marine veteran who was exposed to organic solvents and radiation on active duty at El Toro in the 1960s, I’ve been seriously ill with multiple medical conditions since 1986.
I have a VA disability for the bladder cancer and have filed VA claims with medical nexus opinions for a number of other medical conditions. The VA awarded me a 30% disability for bladder cancer (20%), hyperprolactinemia (0%), and tinnitus (10%) from service at El Toro but denied all of other claims; an appeal is pending.
When my urologist told me I had prostate cancer, I wasn’t taken by surprise. In 1999, another urologist wanted to know what was causing the prostate growth and had me go for a hormone blood test. I had hyperprolactinemia with no tumor. My prolactin levels were very high. In a male, elevated prolactin will cause prostate growth. Medication reduced my prolactin levels to near zero; I see an endocrinologist every six months for a follow up examination and blood work. I need to continue to take this medication until the day I die. The VA agreed that my hyperprolactinemia was service related to exposure to organic solvents at El Toro but since it was under control with medication, the VA awarded a 0% disability rating. Later I would learn that my sterility was caused by my first prostate resection in July 1987.
My trust in medical doctors has gradually faded over the years. A primary care physician in the 1990s prescribed a dosage of 1,000 mg of Cipro to treat chronic prostatitis. My pharmacist questioned the high dosage. I didn’t have a clue. I had HMO coverage at the time and in retrospect, it’s apparent that this doctor was trying to keep the cost of medical care down. Instead of referring me to a specialist, he opted to treat my prostatitis with a strong antibiotic, Cipro. At one point, he told me that the Cipro would either cure the prostate infection or cause serious stomach problems.
I thought he wasn’t serious. That should have been my first clue to look elsewhere for medical care. Cipro (ciprofloxacin) is an effective antibiotic but a daily dosage of 1,000 mg for weeks can cause serious side effects. I don’t like to shop for doctors, but, in this case, I should have dropped this guy like a lead balloon.
After weeks on a very high dosage of Cipro, I found myself in the hospital with a severe stomach pain. The gastroenterologist who did the endoscopy told me that I had a badly inflamed stomach; a biopsy was taken. The results were negative; the medical diagnosis was gastritis. Gastritis is an inflammation of the lining of the stomach and prolonged uses of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as Advil, or ibuprofen have to be avoided. My daily intake of Cipro for many weeks was the cause of gastritis.
After the endoscopy, I’m wheeled back to my room. I’m still in the hospital with two IVs in my arm. One is for the gastritis; the other is still pumping Cipro into my system. The pain was unreal. This makes ‘water boarding’ look like child’s play.
There are not words to describe the daily pain from this condition. It took many months to get the inflammation under control. There are foods I still can eat and forget about having a social drink during the holidays.
I had no idea that I would have a flare-up of gastritis while fighting prostate cancer. Steps could have been taken to avoid the gastritis. The lesson learned is that you are your own best advocate.
THE CANCER GAME
In late December 2012, my urologist recommended that I undergo my fourth prostate biopsy. The urologist found a hard spot on my prostate during a Digital Rectal Examination (DRE). He suspected cancer. I reluctantly agreed to my fourth biopsy. The biopsy was positive. The urologist’s quick call saved my life. I had prostate cancer. It was in the early stage. But, at 70, surgery was not an option. I was given a list of facilities that used direct beam radiation to treat prostate radiation.
I contacted the Cancer Treatment Centers of America (CTCA). This was not an option. They were not accepting Medicare patients. It didn’t matter that I had good secondary health care coverage; sorry, but “We’re not taking any Medicare patients at this time.”
The CTCA website showed that, “Some CTCA providers have elected not to participate in the Medicare Program. However, if you are a beneficiary of a government health insurance program, such as Medicare, we’ll attempt to help you find a resource for the care you need.”[iv] Good luck with that one. No one at CTCA offered any help.
For elderly cancer patients (over 65 on Medicare), the road ahead is not good. According to the Medicare Newsgroup, “Medicare providers will see $11 billion in reimbursement cuts in 2013, according to preliminary OMB estimates. The CBO estimates that Medicare budgetary reductions will total $123 billion from 2013 to 2021.”[v]
The ‘joke’ is that elderly patients with cancer will be given a pill, told to say good-bye to their family, and left to commit suicide is not too far from reality.
‘PICK YOUR POISON’
Before the treatment, I met with my urological group’s cancer center’s oncologist/radiologist who told me that the outcome from direct beam radiation was comparable to surgery and for me, age 70, surgery wasn’t an option. No mention was made of proton radiation therapy; the relative advantages/disadvantages of direct beam versus proton beam radiation.
A few days later, I saw a surgeon for entirely different medical condition who told me that the University of Pennsylvania’s proton radiation therapy had fewer side effects and that once you had radiation treatments, future prostate surgery was not an option. If the prostate cancer came back, then the only option was more radiation. The doctor recommended prostate surgery and attempted to schedule an appointment with a surgeon at the University of Pennsylvania. I had to wait several more weeks for a consult. I wanted to address the prostate cancer quickly so I decided to go ahead with radiation and look into the proton radiation treatment option.
I called the University of Pennsylvania after my direct beam prostate implants had been inserted into my prostate. It was too late. My implants, which are permanent, were not compatible with the proton radiation therapy’s implants. The university’s proton radiation specialist was sorry and wished me luck with direct beam radiation. [vi]
DIRECT BEAM RADIATION
At the end of April 2013, I completed the requisite 44 radiation treatments. My urologist caught the cancer early and the outlook for cure is excellent. At the cancer center, I saw a doctor weekly. Not the same doctor each week, and the meeting lasted only several minutes. After awhile, I had the sense that this was nothing more than a check sheet item: seen patient; patient doing well; next patient. It looked something like ‘musical chairs.’ These had to be per diem medical doctors; paid to spend a few minutes each week with each patient. None of the men undergoing treatment with me thought that the weekly meetings were worthwhile.
I provided written notes to the cancer center’s nurses and doctors of my symptoms. Everyone should have known of my history of gastritis.
The center’s handout recommended the use of Advil and Aleve to control the burnings in the urinary track from radiation; my concerns about the gastritis from using these over the counter drugs were ignored. Was anyone really listening? As far as cancer center was concerned, it was okay for me to take NSAIDs during the treatment. I didn’t keep a record but I probably used the NSAIDs for several weeks until I was given a script for Phenazopyridine, 200 mg, to control the burning. The Phenazopyridine worked faster so at one point I stopped the NSAIDSs entirely.
SICK ON EASTER SUNDAY
I got sick on Easter Sunday. Our family went to a restaurant for Easter dinner, but I couldn’t eat. The cramps were so bad I asked my son to drive me to the nearest ER. Morphine drip stopped the pain; a CT scan showed no blockage; the attending physician advised me to follow-up with my family doctor and a gastroenterologist.
I followed-up with a gastroenterologist who scheduled an endoscopy of my stomach. The scope showed gastritis. Five biopsies were taken; all turned out to be negative. I was given scripts for pain medication and the need to reduce the fiber in my diet.
The endoscopy cost me a treatment day and follow-up with family doctor cost another treatment day. The center’s direct beam radiation equipment was down for two days. In total, four treatment days were lost. I told one doctor that if necessary, I would belly craw into the center to finish the radiation treatments. It almost came to that.
While walking in my housing development, I bent over in terrible pain. A cramping pain that I later learned is related to prostate radiation treatment. My doctor’s office was closed on Sunday. The pain almost knocked me off my feet. I couldn’t walk. I just stood bent over in pain in the middle of the street. The pain would last several minutes and then stop. I had my cell with me but didn’t want to alarm my wife so I made the effort to walk home. The severe cramping pain hit me every 20 or so feet. I couldn’t do anything but stand bent over until the pain passed in several minutes. It took an hour to complete a 20 minute walk. I had never experienced this intensity of pain in my life. I had pain medication at home but nothing on me.
When I got home, my family doctor’s instructions to me were to go the nearest ER, if I had pain over a weekend. I drove the 10 minutes to Kennedy Hospital and spent the next 8 hours in the ER going through a series of tests (blood, CT scan, ultra scan, etc.). The attending physician told me there was nothing wrong with my bladder, kidney, liver, spleen or any blockage in my colon. The pain was likely due to the prostate radiation. He prescribed pain medication and I would have to change my diet (already did this).
Once again, I had to go to the ER with severe cramps. I had just finished my 43rd treatment when I told the Cancer Center’s nurse and the center’s oncologist/radiologist that my stomach pain was really hurting, I was in serious pain. I have relatively high threshold for pain. When I tell you that I’m hurting, I’m not just blowing hot air. The oncologist/radiologist that spent all of 30 seconds to tell me the pain was likely constipation and offered nothing but a smile. I had to drive home.
I sat in my car for at least 10 minutes to try to ease the pain. My pain medication for gastritis was at home. Before pulling out of the parking lot, I called my primary care’s office to see, if could see one of their doctors. The receptionist promised to pass the message to one of the doctors.
I drove several blocks doubled over in pain, pulled off the road, drove back to the center, called 911 from my cell phone and was transported by a rescue unit to the nearest hospital’s ER. Morphine drip reduced the pain and the CT scan again showed no blockage. The ER’s physician thought I had diverticulitis and offered a script of Cipro. I declined the antibiotic. Later my family doctor provided a script for Augmentin (another antibiotic), which I filled and took twice a day. I followed up with my gastroenterologist who prescribed more pain medication. The good news is that my PSA is now low (0.5). So, it looks like the direct beam radiation worked. I’ll have to have repeat the PSA blood test and follow-up with a urologist. Some form of cancer may kill me in the end. But, I’m determined it will not kill my spirit or my immortal soul.
[i] For me cancer is not a vicarious experience: Robert O’Dowd’s recent experience with prostate cancer.
[ii] ATSDR lists prostate cancer as one of the health effects of exposure to TCE and PCE: “Reported health effects linked with trichloroethylene (TCE), tetrachloroethylene (PCE), benzene, and vinyl chloride (VC) exposure, ATSDR, http://www.atsdr.cdc.gov/sites/lejeune/tce_pce.html.
[iii] Prostate and exposure to ionizing radiation: “Prostate Cancer and Exposure to Ionizing Radiation,” Center for Environmental Health Studies, Boston, MA, http://www.clarku.edu/mtafund/prodlib/jsi/Prostate_Cancer_and_Exposure_to_Ionizing_Radiation.pdf
[iv] Cancer Treatment Centers of America: “ Insurance.” Cancer Centers of America, http://www.cancercenter.com/about-us/insurance.cfm.
[v] “What Does Sequestration Mean to Medicare?”, The Medicare Newsgroup, June 13, 2013, http://medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=2ec7b6bb-c68b-433e-830e-035b9d930e4d.
[vi] Proton radiation: “Proton Equal Precision,” Penn Medicine, June 13, 2013, http://www.pennmedicine.org/radiation-oncology/patient-care/treatments/proton-therapy/.
Robert O’Dowd served in the 1st, 3rd and 4th Marine Aircraft Wings during 52 months of active duty in the 1960s. While at MCAS El Toro for two years, O’Dowd worked and slept in a Radium 226 contaminated work space in Hangar 296 in MWSG-37, the most industrialized and contaminated acreage on the base.
Robert is a two time cancer survivor and disabled veteran. Robert graduated from Temple University in 1973 with a bachelor’s of business administration, majoring in accounting, and worked with a number of federal agencies, including the EPA Office of Inspector General and the Defense Logistics Agency.
After retiring from the Department of Defense, he teamed up with Tim King of Salem-News.com to write about the environmental contamination at two Marine Corps bases (MCAS El Toro and MCB Camp Lejeune), the use of El Toro to ship weapons to the Contras and cocaine into the US on CIA proprietary aircraft, and the murder of Marine Colonel James E. Sabow and others who were a threat to blow the whistle on the illegal narcotrafficking activity. O’Dowd and King co-authored BETRAYAL: Toxic Exposure of U.S. Marines, Murder and Government Cover-Up. The book is available as a soft cover copy and eBook from Amazon.com. See: http://www.amazon.com/Betrayal-Exposure-Marines-Government-Cover-Up/dp/1502340003.