January 27th, 2009:

God does speak to us directly through His Word. It’s our duty to believe it and trust in it. I had lots of yard work to do and was about to start it. But the Spirit told me to sit down first and read a couple of my daily devotional readings. I chose Today in the Word from the Moody Bible Institute. The Bible readings are always long but I chose it anyway. I also prayed plainly but sincerely that if God had anything to communicate to me that He do it through His Word. The text was from Exodus 33:1-23 which describes the Israelites as they were preparing to enter their promised land, Canaan. God told Moses that He was angry at the Jews for being so two-faced. One day they trust Him when they see God’s deliverance then the next day their unbelief gets the better of them. God calls them “stiff-necked”. God instructs Moses to tell the Jews to enter the land but that God would not go with them as a cloud as He had been leading them. This was because of their unbelief. He eventually relented and accompanied them. But this spoke volumes to me. When God called the Jews “stiff-necked”, it was because despite God’s revelation of Himself and His Word, they refused to believe Him and submit to Him. Their greatest sin was that of unbelief (see Hebrews 4). Relating it to me, what is it that God has revealed to me about Himself and His plans that I continue to doubt? What is it that God has promised to me that I cannot bring myself to believe? It is the fact that through His Word He has promised to either heal my prostate cancer or keep me chronic till I die of some other cause. This word today was very directed toward myself. I had sat down to read with no hidden or otherwise conscious agenda, e.g. I wasn’t looking for a healing message only asking God that He speak to me if He had anything to say to me directly. And He did!!!!!!!

February 7th. 2009:

God answers us in His time. The Rev. George Mueller (1805-98, Plymouth Brethren preacher, author and founder of Christian orphanages) recorded an excellent prayer for us to pray in childlike simplicity about our disease states. “I do not deserve that You should hear me and answer my requests, but for the sake of my precious Lord Jesus, for His sake, answer my prayer. And give me grace to wait patiently until it pleases You to grant my petition. For I believe You will do it in Your own time and way.”

February 17th, 2009:

God speaks through His Word. From Streams in the Desert, “true faith relies on God and believes before seeing.” Our natural mind wants to see evidence of what we are praying for before we believe but to live by faith as in 2 Corinthians 5:7 (we walk by faith not by sight), we need no evidence other than God’s word. We can say with the Psalmist in Ps. 27:13, “I am confident of this, I will see the goodness of the Lord in the land of the living.” David the author had not seen God’s answers yet but in faith, he believed that he would see. What am I putting my faith in that God will deliver me from this cancer? The answer is His Word. And what is it that He has spoken to me that I am holding fast? 1) James 5 verses on anointing with oil. 2) When Jesus said :”reach out and touch the hem of My garment.” 3) When he said to go and show myself to the physicians at Hopkins (not necessarily the priests). 4) When He whispered the words in “tis so sweet to trust in Jesus.” 5) When He told Marie that He had sent His Word and healed me. 6) When He told me that now was the time to “take up my bed and walk.” What do all the above have in common with the possible exception of (4)? They are from His Word, the Bible; not words I have conjured up but His Word alone. That is how God speaks, through His Word. “They have Moses and the prophets let them hear them.”

February 20th, 2009:

God is merciful in every situation. Marie’s brother, Ray, passed away today. Ray had a personal relationship with God through Jesus. He was reunited with his mother and younger brother, Bob. Ray had stomach cancer which had metastasized to his lungs. He had been diagnosed for about two years but seemed not to suffer much pain. He had developed breathing problems which led him to be admitted to Johns Hopkins where they also found evidence of MRSA infection. He had been kept asleep for three days and then died. My birth-mother Thora also had stomach cancer in 1957. The time from her diagnosis to her home-going was 10 months.  In each case however, God demonstrated His mercy and took each one home with a minimum of pain and suffering. Ray was 70 (threescore and ten as assigned in the Bible) and my mother, Thora was 45. But age is meaningless when we think of living eternally which is where they are now. I thank God for being merciful to both of them. As my former family doctor said, “we all have to die of something unless Jesus returns and takes us while we are still alive.” God showed His mercy even in this home-going of Ray Gray and my birth-mother, Thora.

March 1st, 2009:

Consider what God has done and feed on His faithfulness. I am due to have my PSA evaluated in two days. I am somewhat apprehensive. I still have the faith to believe that by His Word, Jesus will either heal me, has healed me or will keep me chronic. But I am reminded (in Our Daily Bread devotional) that in any circumstance, I am to pray the same prayer to God the Father that Jesus prayed in the Garden of Gethsemane, i.e. “not my will but Thine be done.” In such circumstances where we are apprehensive, we are to focus on God’s faithfulness as expressed in Psalm 37:3. “Trust in the Lord, and do good. Dwell in the land and feed on His faithfulness.” This will provide “strength for today and bright hope for tomorrow” as stated in the hymn “Great is Thy Faithfulness”. Another devotional book (Streams in the Desert) for the same day, cited Ecclesiastes 7:13, which says “consider what God has done. Who can straighten what He has made crooked?” God places us in precarious situations to allow Him to guide us to the other side. He will deliver me and in the process will impart a lesson I will never forget. I will be unable to ever thank God enough for doing exactly what He has done.

March 5th-6th, 2009:

Devastating days. My faith is shaken. My poor response. The following e mail was sent to several close friends.“I just now received my latest PSA result. For the previous year, it had been undetectable (less than 0.1) but it is now 1.9. I had been on a Lupron “holiday” meaning there was no medication in my body to “starve” the cancer cells. But now, the cancer has returned and in an aggressive manner. The aggressiveness is measured by the time it takes PSA to double. Just 2-3 years ago mine was doubling every 2-3 months which puts my disease in the aggressive category. So now they will put me back on hormonal therapy until the cancer becomes resistant. This may take a year or two. Then there is some chemotherapy (taxotere) with serious side effects and then nothing after that. My own prediction is that I have 2-3 years of “quality” time. But the worst of all is that what faith I had is shattered. I had sworn that God had spoken to me through His Word on several occasions. I was counting on what He said through His Word. It is now obvious that I no longer can decipher God’s speaking to me versus my own sub-conscious. So any thought of healing or sharing my testimony on a website which I thought God wanted me to do (Godandprostate.net) is now permanently closed. I really have little to share of any value. Thank you for your prayers and considerations. My “faith experiences” of the last 6 years are figments of my imagination.”

I am most disappointed in the fact that I cannot any longer decipher God when He speaks to me. In spite of “messages” I perceive to receive from the Bible or related texts, I see no change in my medical condition. I have come to the realization of having to “number my days.” I am prepared for 2-3 years followed by the end. I don’t necessarily fear death but instead it is the fear of the manner of dying. I also don’t want to leave this life just now. I am enjoying retirement with a wonderful wife, Marie. And the worst of all, is that I cannot perceive what God wants to say to me in any way. I don’t trust myself to hear anything from God. According to Acts 2, Jesus/God performs miracles primarily to demonstrate that Jesus is truly God’s Son and deity. He obviously has chosen not to perform a miracle in my case. But then why should I be any different than the thousands of others in my position. Upon reading my e mail above, Marie and I did get an immediate visit from two close friends from our church. They are truly God’s servants. One friend encouraged me to continue the journal. It could help others who likewise receive unwelcome news. I may or may not.

In short, I believed God when I thought He told me to “take up my bed and walk”. But there is no healing only more aggressive prostate cancer. How can I believe God again??? Either that or I am not able to hear Him!!! Either way, bad news.

March 8-9th, 2009: Responses to my disappointment and cynicism. I had been praying that God would help me to be able to honestly pray “not my will but Thine be done.” Could the latest developments be God’s way of conforming me to this prayer or testing me? In any event, in response to my e mail and cynicism regarding God speaking to me, I received the following immediate responses.

1) Devotional books from March 6th; In Touch, Anchor, and Streams in Desert. I had been reading daily devotionals from 4-5 different sources. Many times in the past years, I had received scriptural messages which were extremely pertinent to the situation I was facing that day. But on March 6th, a recurring theme appeared.

a) Streams in the Desert cited the theme “we had hoped” from Luke 24:21, “But we were hoping that it was He who was going to redeem Israel. Indeed, besides all this, it is the third day since these things happened.” In the minds of the two disciples walking on the road to Emmaus, their expectations about Jesus’ earthly mission were over just as mine were for deliverance. The devotional writer states that he wishes the disciples had said “everything has come against our hope and it looks as if our trust were in vain. Yet we will not give up because we believe we will see Him again.” Instead the discouraged disciples simply declared their shattered faith just as I am doing. Jesus had to say to them “How foolish you are and how slow of heart to believe” (v. 25). Am I not hearing these same words? May I not express my faith in the past tense (“I had hoped”) but in the current tense, “I have hope.”

b) Anchor (from Haven Ministries) cites Romans 8:32-39 where “we are more than conquerors through Him who loved us.” The devotional asked if I were despondent about God allowing a specific event or circumstance, or if I were overwhelmed and asking if God had deserted me? The answer was for me to stop trying to fix things on my own initiative and according to my own plan and simply rest in God’s  arms to enable Him to lift me up to be more than a conqueror.

c) From In Touch (Charles Stanley) for March 6th. The devotional cites the episode of a resurrected Jesus revealing Himself to a doubting Thomas. Again it is stated in v. 31, that these miraculous signs were given so that they would believe that Jesus is indeed the Christ, the true Son of God. Thomas felt that God had let him down. Had Thomas believed a lie? Why had the Lord not done what the Biblical prophecies said He would do? Thomas hesitated to believe Jesus again without the proof of putting his own hands into Jesus wounds. What are we to do when our own faith takes a nosedive? When we believed Jesus would do something and then He didn’t? Answer: Keep believing!!! Jesus said “Blessed are they who did not see and yet believed.” (John 20:29).

d) Finally, Charles Stanley’s In Touch e mail for the week cited Job 23:16-17. “God has made my heart faint, the Almighty has terrified me. Yet I am not silenced by the darkness by the thick darkness that covers my face.” Dr. Stanley writes “Far too many times, I have heard people say they quit praying about a need because there was no answer. Matthew 17:20  says that faith the size of a mustard seed is able to move mountains—then imagine how tiny our trust must be when we give up on the Lord! Believers cannot treat prayers like quarters fed into a vending machine, which gives an instant response. Talking to God is a long-term investment in the intimate friendship we have with Him. Though God may be silent for a time, He never ceases working on our behalf. When the time is right, He provides an outcome that aligns with His perfect plan. Giving up before the Lord responds to your call is a grave mistake. So pray on, friends. Pray on!”

2) The following e mail response was received from my Pastor Jim.

Dear B.J., Thank you for being so honest and forthright about your feelings in the matter.  However, you are now being deceived.  Many of us are fully convinced that you DID hear from God.  Perhaps there were some wrong details about the timeline, but the truth is, you have been amazingly healed.  Just look at God’s grace and how the Holy Spirit flows through you. You are living a full and meaningful life, prospering and bearing much fruit, being an inspiration to everyone who knows you! Try and determine how your life could be more fruitful than it is right now!!! Okay, you received some medical news, but God still has the final word in all matters.  I am not sure why God has allowed this, but we do know He is sovereignly in control of your life, and you will not cross the finish line one minute too early or later than He has planned. You will need to sift through your feelings, and I have full confidence that you will. Furthermore, I have great hopes that you will rise from this stronger and more resolutely walking in Father’s perfect will for your life.  I believe you will continue to bear much fruit as long as He has you here. We will all surround you with prayer, and stand with you and Marie.  No matter what, we journey together and we will walk this road side by side. With the deepest of love AND respect, Pastor Jim & Shirley.

3) A former pastor’s phone call. I received a phone call from my former pastor and dear friend, Bob Forseth. He is a conservative Assembly of God pastor. He proceeded to give me a 15 minute mini-sermon highlighting the following points. Consider Joseph. God had spoken to him clearly outlining future events in his life and how he was to be used by God. But God did not provide the specific details of how this was all to come about. Remember Joseph was thrown into a pit by his brothers, sold into slavery, thrown in jail in Egypt and forgotten there.  But had God spoken to Joseph? Absolutely!!! But God had not specified the detailed game plan. I am to hang onto what God has said!!! Pastor Bob quoted Hebrews 10:35-6 which states “So do not throw away your confidence; it will be richly rewarded. You need to persevere so that when you have done the will of God, you will receive what He has promised.” I know one of the things God wants me to do is to prepare this on-line journal. Pastor Forseth also cited Abraham who waited many years before the fulfillment of God’s promise to him. He went on to say that when I pray a prayer such as “not my will but Thine be done”, it can be a dangerous prayer to pray. Its answers may not be exactly what we expect. It is also OK to ask God “why?’ Jesus did on the cross when He asked “My God why have You forsaken me?” God is always good and faithful especially in this messed-up world. I need to say with Job, “though He slay me, yet will I trust Him”. And in Job 19:25, “I know that my Redeemer lives”.

4) A friend’s (Ron) e mail. I received the following. Dear Bjarne, My wife and I read your report and also Pastor Jim’s reply to you. We agree wholeheartedly with what he said. Keep the faith!!! You are a bright and shinning light to us as well as many, many others. Your witness has been important to all of us. I can imagine that this is a real disappointment but never give up that God is in control and something great is going to happen to where you will be praising Him again. Do not let Satan cause you to put your light under a basket. (Your light is so bright it can burn the basket down)
Your Friend Always,

5) Dr. Michael’s e mail. My former family physician in Maryland had doctored me over the last 20 years. He states that the “faith” I had expressed over the last 6 years or so was based on evidences seen, such as PSA readings. This type of faith is experience-based and may be counterfeit. Michael encourages me to continue my webpage. He continues “Life is what you make of it. How long you live is immaterial for the most part.  I believe God has kept you alive so you can finally learn how small you are and how great He is; how, though you have everything, you have nothing without Him.  And if you have Him, though you have nothing, you have everything. Sometimes these lessons come at a great price. It will be that way for you as hard-headed as you are.” I agree with this section and I agree that faith based on sight is incorrectly placed.

March 9th, 2009:

Can I question God or express my despair to Him? Yes! Pastor Jim sent me an e mail regarding an upcoming sermon on bitterness. Do I have the right to be bitter toward God?  Job exclaimed his bitterness in Job 10. Yet Job did not sin. Am I going through a similar experience?  Job 10:8-9 state “Your hand shaped me and made me, will you now turn and destroy me? Remember that You molded me like clay, will you now turn me to dust again?”  So if I am to continue this journal, what is its purpose? People read and share to be encouraged yet what can I share to encourage them? My faith in an eternal life is one thing but what can I possibly share about God’s communication process (or my listening and understanding)? I don’t know. I am confused about whether I am hearing from God or not or whether I am listening incorrectly or just hearing my own wishful thoughts. Am I going through a Job experience as in Job 10?

March 12th, 2009:

My death of a vision and crisis of faith. I met with Pastor Jim last night. My hope always was that God was going to deliver me from this prostate cancer in a way that the doctors to whom I had been ministering would sit up and take notice that it was Jesus who delivered me. I had been careful to always acknowledge Jesus as the healer. Now that I realize that this dramatic healing seems not to be taking place, I am still perplexed regarding what I perceived to be God speaking to me in the past years. I am still convinced that He did speak. If it wasn’t Him, then I have no way of ever deciphering His voice as compared to my own subconscious. Then I might as well give up asking for direction and just “float along” life’s path. In reality, why should God heal me and not so many more deserving and spiritual individuals. Pastor Jim likened my situation to the “death of a vision” principle that I heard about from Bill Gothard seminars and Campus Crusade. Basically stated, this principle states that God often allows a vision to die before it can be resurrected again in the form He desires as compared to my own original version. There may be truth in this. I am now in a grieving process, in a crisis of unbelief. Steve Green, the famous Christian singer, was kind enough to call me while I was waiting for my car to be serviced at a dealership. He basically told me to hold onto the truths I know to be secure, namely God’s nature, His love, His ultimate plan, His provisions, His promises etc. Steve mentioned that these “crises of faith” seem to be occurring in epidemic proportions these latter days. Pastor Jim reminded me of Matthew 6:33, “Seek ye first the kingdom of God and His righteousness and all these things will be added unto you.” I asked simply, “what is the Kingdom of God” and “how in practical terms do I seek it?” I am to relinquish my own claims to my life. The big question for me is “how do I deal with the fact that I probably won’t be healed in spite of what I have perceived God to tell me????????”

I came across several pertinent articles in Decision Magazine (published by the Billy Graham Evangelistic Association), March, 2009. One article was called “The Earth is Not Our Home”, by Ruth Bell Graham. She talks about a plant which grows to 10 ft. in their home environment but in its native soil, it grows to 40 ft. She likens this to us as Christians. This earth is not our native soil hence we can expect rough times. But “Blessed is the man who perseveres under trial because when he has stood the test, he will receive the crown of life that God has promised to those who love him,” (James 1:12). In still another article, Steve Saint comments on the premature death of his daughter. He states that “sometimes Christians have an idea that if we do what God wants us to do, then God owes it to us to take suffering away. I (he) doesn’t believe that anymore.” (ibid. p.23). Finally, Greg Laurie (ibid. p. 16) comments on the death of his own son. He says that God wants us to cry out to him. There is nothing wrong with our questions and broken hearts. Psalm 62:8 says “Trust in him at all times, pour out your hearts to him for God is our refuge.”  When I am angry with God and don’t want to talk to Him, that is exactly when I need Him the most. When I cry out to Him, He will wait patiently and lovingly and set my crooked thinking straight as I seek Him. Thus, Job cried out to the Lord in Job 1:21, “He gave and taketh away etc.” God can handle the question “why” but the article says that God doesn’t owe us an answer. I sometimes disagree with that. What kind of Father will not answer his son????? He states further that we are never to trade what we don’t know for what we do know (see Steve Green’s comment above.) I should focus on what I do know about God instead of what I don’t know!!! God will be with me. As Corrie Ten Boom stated, “There is no pit so deep that God is not deeper still”. Remember John 11:25-6, “I am the resurrection and the life. He who believes in me, though he may die, he shall live. And whoever lives and believes in Me shall never die.”

March 17th, 2009:

I re-focus. My internal tension, withdrawal and suppressed anger have calmed down. I go to my Florida urologist  tomorrow. I have also been thinking about a good friend, Jim, who has a worsening case of multiple sclerosis which will ultimately lead to his death. How does he handle this? Personally, I really do not want to die right now. Life is actually pretty good although there is great earthly turmoil both economically and morally. We re living in end times and awaiting Christ’s return anytime. But deep down I really don’t want to go to heaven at this moment or maybe I just don’t want to undergo the process of going to heaven? I need to pray for the desire to go to my permanent, heavenly home and see God and Jesus. Meanwhile, as Pastor Jim recommended, I need to focus on Matthew 6:33 (seeking God’s kingdom and His righteousness) and focus on what I do know about God. I still am convinced that Jesus did speak to me on several occasions. I cannot seem to let go of that thought especially in light of Pastor Bob Forseth’s admonition to me about Joseph. I will hold onto what I believe Jesus said to me, i.e. that He will use this disease to glorify Himself, and keep me chronic, or heal me or take me home in a way that does not involve prostate cancer. Meanwhile, Pastor Jim gave me a commentary on Matthew 6:33 and its meaning from John McArthur. It states that if I think like the world, and crave the things of the world, I will be anxious like the world. A mind not centered on God has reason to worry. I should “be anxious for nothing but in all things, by prayer and supplication with thanksgiving make my requests known to God” as Phil. 4:6 states. Matthew 6:33 tells me that the cause of worry is seeking the things of this world, and the cause of contentment is seeking the things of God and His kingdom and righteousness. I am to focus my hope and attention on the things of the Lord and He will take care of my needs. God’s kingdom is His sovereign rule, His will and His authority. I should lose myself in obedience to the Lord and pour out my life in my Father’s work. I should seek to share my faith in Christ with others, and to have God’s love, truth and righteousness manifested in my life with the resulting peace and joy. I am also to hunger and thirst for the world to come. As mentioned above, I need more of this. Being anxious for tomorrow is sinful, foolish and unfaithful. God is the same now and for all of eternity. His loving kindness never ceases and His compassions never fail. Tomorrow will take care of itself because it is in my Father’s hands. God’s grace is given in the correct amount on a daily basis forever, not in one lump sum.

March 19th, 2009:

My vision resuscitated; God must have a bigger plan. I went to my urologist yesterday. He deferred putting me back on hormonal therapy (Lupron) until June, 2009 opting instead to wait to see the rate of the rise in my PSA. He also commented that I have many more years ahead of me but I suspect this is part of his “positive pep talk”. One fact did hit home however. He cited a series of parameters which were developed by a physician at Johns Hopkins which when taken together, could be used as indicators of a person’s potential life span when dealing with prostate cancer. These parameters were: a) the change in PSA when the cancer was first diagnosed (mine was basically constant between 3.5-4.5); b) the Gleason score at the time of surgery (mine was 6); and, c) current PSA velocity or doubling time (mine was very fast at 2-3 months). So I basically score optimistically in parts (a,b) and poorly in (c). My urologist stated that it was puzzling to him why the cancer came back in me. I would have been a most attractive candidate for a total cure since my cancer was discovered so early. He said the cancer would return in less than 10% of the cases like mine whereas Hopkins physicians cited 10%. It dawned on me that God must have allowed it to return for a good reason since most physicians would not have expected it. And if God so allowed it, He must have a divine plan for my circumstances. Only time will unveil what such a plan would encompass. However, I have again begun to see God’s hand in all of this. I plan to continue my website.

March 24th, 2009:

God often speaks when we least expect it. I had been disregarding reading my Bible and prayer for over 2 weeks and it was time to get back into it. I had been coasting in neutral. I had decided that I have to hold on to God’s promises and simply trust that He had indeed spoken to me and it was not my imagination. If He hadn’t then I would have no way of ever hearing from the Lord through His Word. I began reading today’s Daily Bread whose devotional came from the Christmas story in Luke 2. The devotional’s theme was that Jesus or God speaks at times when we are not expecting it, or at times when we are pre-occupied with our daily tasks. For example, the angel predicting the Messiah’s birth came to Zacharias when he was performing his priestly duties. The angel appeared to the shepherds while they were tending their sheep and several other examples. This is exactly how God spoke to me on all the occasions. I was not expecting to hear Him at all. Oswald Chambers is quoted as follows: “Jesus rarely comes where we expect Him; He appears where we least expect Him and always in the most illogical situations.” We have to always be on the lookout for Christ’s surprise visits. In all three occasions when God spoke to me, the situations were always non-expectant. God speaks to those who are quiet before Him. Likewise Jacob in Genesis 32:9,11, reminded God of what He had said. I must also stand firmly on the promise of God to take care of my prostate cancer in a way that brings glory to Himself. I don’t know the plan nor can I comprehend it nor do I dare to imagine it. But I will simply trust that God will exercise His care over my health. I will take Him at His Word, believing He means exactly what He says and accepting His words that reveal His goodness and His grace.

April 1st, 2009:

“Though He slay me, yet will I trust Him.” I have to redirect my thinking to some extent. I remain firmly convinced that God/Jesus spoke to me when he said, “reach out and touch the hem of my garment”, “go and show yourself to the physicians especially at Hopkins”, and “now is the time to take up your bed and walk”. Up to this time, I have interpreted everything in the context of an immediate physical healing. As I understand the three messages above, I still believe that God will touch me physically either by a direct immediate healing or by keeping me chronic until I die of something else. But my prayers and faith needs to be re-directed to the point where I can say with Job, “though He slay me yet will I trust Him.” Today I read in a daily devotional written by a woman who in the past 15 months, had battled breast cancer, lost her only brother to gall bladder cancer and saw her husband through bladder cancer. She herself died of her breast cancer while the devotional booklet was in press. Her simple and final message which she had come to realize fully was from Isaiah 26:3-4. “You (God) will keep in perfect peace him whose mind is steadfast, because he trusts in you. Trust in the Lord forever, for the Lord, the Lord, is the Rock eternal.”

April 4th, 2009:

Don’t try to predict God, just trust Him. I am learning a very important lesson. I cannot / should not anticipate what God is going to do. His plan, mind and thoughts are way above mine. What I should do is simply trust His Word, either written or spoken and then allow His plan to play out. This also serves to relieve me of a lot of pressure when I trust God / Jesus and lay my burden on Him.

April 11th, 2009:

The Easter message diminishes fear. Looking at my PSA data and the time it took for the PSA to return after my “holiday”, it seems that there have been no “divine” interventions in the progression of my disease so far. It has progressed as expected naturally. After stopping any Lupron injections, the PSA returned after 10 months. The total time of my “holiday” would be about 12 months, whereas the average is 16-18 months. On another matter, a Chicago Tribune reporter, Barbara Brotman, has written concerning the fear of death and that it is so widespread that death anxiety is the subject of academic research.  Researchers have divided these fears into four types: fear of pain, fear of the unknown, fear of non-existence and fear of eternal punishment. Even those with faith may be terrified to face death. At this Easter season, where we celebrate the gift of eternal life through faith in a resurrected Jesus Christ, three of the above types of fear can be viewed by the Christian as groundless. Only the fear of pain remains. As a Christian, we do not have to fear any of the above because of our hope and promise of eternal life in a new body in a new heaven and earth. It makes Easter especially relevant.

April 23rd, 2009:

Information from my oncologist and a sincere prayer. I wish to write a portion of today’s entry as a prayer since through it, I try to express my thoughts to God. Today Marie and I had an appointment with my oncologist at the Moffitt Cancer Center in Tampa. “God, I am very grateful that You have provided such expert physicians for my treatment.” My oncologist was very pleasant and communicative today which was not always the case depending on his daily schedule. But today we spent at least 30 quality minutes discussing family issues and then issues related to my prostate cancer. I asked him specifically how long people remained on hormonal therapy until they became resistant (refractory). I also asked him, given my condition, how much longer does he think I would live. He checked various recent studies on the PubMed website but in reality, did not give any time limits to either of my questions. However, I seem to remember the figure of five years as being mentioned. There seems to be such variability among patients that it is probably wise not to predict times. One negative aspect was pointed out namely how fast did my PSA drop when I started hormonal therapy? Did it drop gradually or almost instantaneously? Mine was more gradual which seems to be an indication of the moderate sensitivity of the cells to the depletion of testosterone. We also discussed several new drugs in the pipeline to be used in place of taxotere-prednisolone when/if I become hormone-refractory. New treatments such as Provenge and abiraterone seem to be efficacious in clinical trials according to the oncologist and may soon be approved for use. So there does seem to be some chemotherapeutic and immunologic treatments for hormone-refractory patients on the horizon. But I pray I never get to that stage. He did mention that I would be a candidate for a Phase 1-2 study involving antibodies to PSA and another prostate protein coupled with an immune system stimulant, poly ICLC. Details would be sent to me. Since the side effects would be minimal, I would consider this. Continuing my prayer, “But God, there seems to be no healing or intervention on your part that I can detect. I am left with the question of how can I reconcile my status with what you have spoken to me? What does ‘take up your bed and walk’ mean? How should I act ‘normal’ when I know I have a rising PSA? God/Jesus, I know You spoke to me and I treasure those words. But I see no difference in the course of my disease than in the case of someone who You did not speak to. What am I to believe? How am I to live?” I simply must try to live my life in such a way that allows Jesus/God to be glorified in my condition. I cannot presuppose anything or anticipate God. I dare not. “God, I plead with you to give me the inherent faith to believe that You will somehow not let me die of this disease and instead be glorified through my treatment.” I seem to have good rapport with my urologist and oncologist who are both Jewish. Hopefully, God would use me in any way to point them to Jesus. And help me to live my life in a normal fashion, not going through life anticipating a soon-to-be painful death. “God, please also speak to me somehow, letting me know that I am in the center of your will (or am I?) and that You are still right on course in this entire situation. I need the re-assurance and have not received any lately.” Maybe it’s because I haven’t given God the quiet time necessary for Him to speak to me?????

May 14th-16th,  2009:

Thoughts of healing are evaporating. It has been some time since I have written anything pertaining to my cancer. It has not been a particularly good period. While I feel fine, and remain asymptomatic, I await my PSA test in early June and fully anticipate that it will show a rapidly escalating value from the 1.9 in early March. The only uncertainty is whether or not my urologist will put me back on Lupron or wait till the PSA reaches 10 as my Hopkins urologist had mentioned earlier. Spiritually, I feel very cold and distant from God. It seems He has not done anything to intervene in my disease even though I had sensed He was present during the past seven years. I see no difference in my own clinical progression to allow me to say that God has intervened to either slow the disease progression or keep it chronic. The thoughts of being healed or even kept from having the cancer metastasize to lymph nodes or worse, to my bones have all but disappeared. I basically now only await clinical progression. The main focus of my prayers is that God would spare me from dying of prostate cancer. If it is indeed my time to die, I plead with Him to take me home some other way. I have heard too many horror stories of the painful, lingering states which result from bone metastases. Meanwhile my Moffitt oncologist has asked me if I had any interest in participating in a Phase 1 trial of a cancer vaccine formulated from two peptides expressed by prostate cells. I am not personally enthusiastic about a Phase 1 study since it is only a toxicity study but the side effects do not seem too drastic. I will probably decline but I plan to send the scientific background of the vaccine to several former National Cancer Institute physician colleagues for their opinion. Meanwhile, my interest in pursuing this website is decreasing. What’s the purpose? Since 2004 my focus has been on God potentially healing me. But it seems that is not happening at least from my own human perspective. Perhaps God wants me to express some other aspects of my relationship with Him as it relates to my prostate cancer???? I don’t know. But I know deep down I should. I need to get back to an intimate relationship with God and Jesus through prayer and Bible reading but I find it difficult to discipline myself to do this. I am anticipating only 2-3 good years left. I may not see my 70th birthday, (threescore and ten as promised in the Bible). I am asking God to speak to me again through His Word and let me know where I stand and what to share. To be continued.

May 19th, 2009;

Eternal issues as related to family, friends. Researchers at the Duke Comprehensive Cancer Center have identified four risk factors which could play a role in predicting how long men survive with metastatic prostate cancer. This type of information would assist doctors in individualizing treatments. Researchers studied the medical records of more than 1,000 men who took part in a docetaxel (taxotere) study on the drug’s effect on metastatic prostate cancer. (Note this chemotherapy is used when patients become resistant or refractory to hormone treatment.) They found the following four predictive factors: the presence of cancer-related pain; anemia; how extensively the cancer has spread to the organs; and the progression of cancer in bone. “Using these predictors, we were able to assign patients to risk groups of good — indicating an average survival of about two years; intermediate — with survival of about 1.5 years; and poor — with survival of less than a year,” said lead investigator Andrew Armstrong, a medical oncologist at Duke. “By knowing a patient’s prognosis and expected responses to chemotherapy, we are better able to discuss and determine whether a more- or less-aggressive treatment plan might be advisable.” Reading about such end-of-life issues made me stop and think. Knowing that our days are truly numbered, and that we are all going to die of something, how then should we live?  We should live each day to the fullest but with eternity in focus. The important things in life should be those with eternal value. My pastor recommends that we all write a legacy letter as a written record of the most important issues in our lives for our loved ones, family and friends to read and remember. I have written to several of my family members and some of my professional colleagues who played significant roles in my career. It is important to thank them now for their roles in our lives while we still have the time and faculties to do so. I also explain my faith in God through Jesus and the fact that I possess eternal life and strongly desire the same for them. My long range plan is to write such an individualized letter to each of my family members and close friends expressing my specific thanks to them and my desire that we all share eternity together through a mutual faith in Christ.

Up to this point, my thinking has been on my healing, or keeping me chronic until I die from something else. But what if it is God’s plan for me to die of prostate cancer at an age barely below 70, how do I handle this? I am pleading that this would not be the case and praying for God’s peace and His presence once again in my life. This represents a shift in my spiritual focus. Given my depressed attitude of recent weeks and my thoughts and prayer as expressed above, I sat down to read a devotional today. The first words from Anchor (Haven Ministries) for today were from Psalm 119:169-176. As I read the following words, it was as if I was receiving a direct infusion of encouragement and strength into my heart. It was a clear answer to me directly from God’s Word. “May my cry come before you O Lord; give me understanding according to your Word. May my supplication come before you, deliver me according to your promise. May my lips overflow with praise for you teach me your decrees. May my tongue sing of your word, for all your commands are righteous. May your hand be ready to help me, for I have chosen your precepts. I long for your salvation O Lord and your law is my delight. Let me live that I may praise you and may your laws sustain me. I have strayed like a lost sheep” (considering my attitude of the last 3-4 weeks). “Seek your servant for I have not forgotten your commands.” God’s word was like a direct infusion into my heart. Praise the name of Jesus.

May 28th, 2009:

What is the “prayer of faith”? In James 5:14-15, we are told that the “prayer of faith” will restore the one who is sick. But what exactly is this type of prayer? The answer is in two distinct parts as modeled in Jesus’ prayer to God His Father in the garden of Gethsemane. a) We must acknowledge that God is capable and able to heal. Many people including me have wrestled with God for years knowing full well that He is capable and hoping that He would heal. Jacob wrestled with this in Genesis 32:26, 29 when Jacob said “I will not let you go until you bless me.” But the results of this prayer were not physically evident. On the positive side, there are numerous incidents even today that illustrate that God can and does heal even in this day and time. So we have to come to that agreement that God is able to do “exceedingly more than we ask or think”. b) The second part of the prayer of faith is the total surrender of the situation to God to carry out His divine plan for us. Just as Jesus prayed “not my will but Thine be done”, we have to lay our own life’s plan down. There are numerous examples illustrating that when this process of surrender occurred initially, then God was able to mold and mature us; then the physical healing or manifestation thereof occurred. Now I have to be careful of only partial surrender, namely laying my condition down verbally only to hope to achieve the healing. It has to be a literal surrender to God’s plan no matter what it may be, even death. These two steps when taken together constitute “the prayer of faith”. Then we can stand back and see the manifestation of God’s divine plan whatever it is. All the wrestling would be in vain unless one has surrendered the issue totally to God’s plan. (From Streams in the Desert, May 28th).

June 1st, 2009:

Less anxiety about an upcoming PSA test. My PSA gets tested tomorrow. Previously I had been depressed for several days prior to such a blood test anticipating the worst case scenario. For the first time, I had not experienced this deep, dark mood but instead was quite ambivalent about the upcoming test. I did however have my moments where I anticipated the worst. The PSA had been 1.9 in early March. Now it could have doubled or tripled but somehow I don’t care as much. Am I learning to trust God more for the overall outcome no matter what the PSA reveals? In any event, last night I wanted to spend some quality time in prayer and Bible reading. I took 3-4 of the devotional books I usually read only to discover that I had the May versions and this was June 1st. So I was forced to read the only devotional which pertained to June 1. The Streams in the Desert devotional focused on Isaiah 28:12, “This is the resting place, let the weary rest’ and, “This is the place of repose”. The devotional asked “why do I worry? Is the anxiety of my life evidence that God has left His throne?” Never!!! God holds the reins of the chariots and bridles of the horses. I am not to fear, in fact I am to continue to “be still and know that I am God.” Hopelessness withers the heart rendering it insensitive to God’s grace and blessings. It also makes my burdens too heavy for me to bear. Yet God’s plans for me and His ways of bringing them about are infinitely wise. I will wait until I see the doctor to get my results.

June 4th, 2009:

Hopes, expectations and feelings. I have not yet received my latest PSA test result but the last two days have seen me angry and depressed again. Old patterns die hard. I am truly fighting a spiritual battle. God is trying hard to get me to the point where I am truly willing to say “not my will but Thine be done.” Can I truly pray that God conforms my desires in life to His? Psalm 42:5 and 11 are very similar. The author asks “why are you in despair O’ my soul? And why have you become disturbed within me? Hope in God for I shall again praise Him for the help of his presence.” The disappointment of unrealized hope is inevitable in this fallen world. Where am I to place my hope and how do I respond if it is not fulfilled the way I envision it? Hope is secure when it is aligned properly with the Lord’s desires as revealed in the Bible. I should not base my expectation on my feelings. Disappointment with God can occur whenever our expectations do not coincide with His plan. Even when hope is based on a scriptural promise, God may not fulfill it exactly in the way we expect. God may seem to be inactive but He is moving beneath the surface preparing us for the future. The key to contentment and joy lies in placing all our hope in the Lord who always wants what is best for us and never makes a mistake. His ways are often beyond human comprehension. Sometimes God has to dash our hopes in order to give us what is best. I must ask Him to clarify and direct my desires to coincide with His ways. Then rest in His goodness and keep my hope in Him. (From In Touch, June 2, 2009, p.33.)

June 9th, 2009:

PSA doubling but I put it in perspective. An e mail to my male friends. I sent the following e mail widely to mostly men friends / colleagues.
Since to some degree we are all in this together as men, I wanted to share my current status. I got my latest PSA test today and it was 3.8; it had been 1.9 three months ago, hence it is doubling rapidly. That puts me in the “highly active” or “aggressive” category according to my former National Cancer Institute colleagues. However I have absolutely no physical symptoms of disease and I feel great. I had been treated with hormonal therapy until a year ago, when they took me off all medications having an undetectable PSA. The PSA has now returned and I am sure that I will be back on therapy at the end of this month. This therapy can be effective for months-years ahead; it is variable but eventually the cancer cells become resistant. I received the latest results with less fear and anxiety than I had previously. God has spoken to me through His Word very clearly in the past years and I must continue to trust Him. I pray that He may heal me or keep me chronic until either I die of an alternative cause or Jesus returns to take us to heaven. Given the current world situation, the latter may occur at any time. Mercy is one of God’s attributes. I am slowly learning to pray the prayer that Jesus prayed in Gethsemane, when He asked the Father if He could be spared the crucifixion, but nevertheless Jesus said “not my will but Thine be done.” I know that God can heal me or keep me chronic but I have to learn to pray that His perfect will be accomplished. This is the hardest prayer I have ever had to learn to pray sincerely. But this condition is not without precedent. The apostle Paul asked God to remove his physical problem three times in 2 Corinthians 12:7-10 and when God refused, God told him “my grace is sufficient for you, for power is perfected in weakness”. Therefore, I’ll keep boasting about my weakness for “when I am weak (in myself), then I am strong (in the Lord).” Thanks for your prayers for me. Keep them coming.
Keep looking up,

P.S. My website Godandprostate.net is under construction. Meanwhile the red snapper are biting in the Gulf of Mexico and I need to stock our freezer. Marie and I will be in Maryland in mid-July.

June 14th, 2009:

Honesty and peace with God. I have been somewhat troubled of late as I have heard little from God in the past months about deliverance, i.e. healing or keeping me chronic so I don’t die of prostate cancer which is my worst fear. The problem is never with God it is always with me. God doesn’t change. I have had difficulty disciplining myself to spend the time with Him and His Word that I need to do. But yesterday, two passages spoke to me. The first, John 14:27 was a direct gift from God. It states “Peace I leave with you. My peace I give to you; not as the world gives give I unto you. Let not your heart be troubled nor let it be afraid.” This verse represents a quality of peace provided solely by God to me. But the last part of the verse (and also John 14:1) remind me of my own responsibility, when it states “Let not your heart be troubled.” How do I not let my heart be troubled? I am not sure except by asking for God’s peace which He has promised to provide. Secondly, can we claim intimacy and respect with God while we pour out our hearts before Him even when we have fears, doubts and mistrust? Yes, we can! Job did it in Job 3:11, and David did it in Psalms 13:1-2, where David asks God how long He would forget him and hide his face from him? It is a real comfort to know that perhaps our closest family members and friends may not understand us, but we can have this amazing intimacy with God through Jesus that we can communicate our most innermost thoughts and concerns without fear of rejection. Remember, when it comes to times of affliction, God’s ultimate purpose is to refine and perfect our faith before Him and before the world, see Job 23:10, “But He (God) knows the way that I take; and when He has tested me I will come forth as gold.”

June 18th, 2009:

A “bad news” prediction for 2010. Make the most of my time. A research paper was just published  (Cooperberg et al, Journal of the National Cancer Institute, JNCI, 101, 878-887, June 9th, 2009) that attempted to describe the prospects for cancer metastasis, mortality etc. using five criteria as its basis for a “CAPRA score.” These criteria are: age at diagnosis, PSA level at diagnosis, Gleason score, clinical tumor stage and % biopsy cores positive for cancer. Based on these, my CAPRA score would have been only 1 on a scale of 10, the lowest, indicating a better outcome. Unfortunately, my cancer recurred and this paradigm probably is not applicable to me. It is more useful for someone newly diagnosed with prostate cancer and initially treated. Meanwhile, I had found in my files a letter written by my Hopkins urologist-surgeon in 2005 in which he predicts I would have clinical symptoms (bone metastases, pain etc.) by 2010, next year. This depressed me greatly. It basically made me resolve to do everything now while there was still time. I had also received an e mail from a former research colleague at Arizona State University in which he basically told me to take a proposed trip to Arizona-Utah ASAP while there was still time. I must admit though, my friend is not a clinician and is being more negative than necessary, but I know his intentions are good. I am using the opportunity to hopefully allow Jesus to be seen through me by him who rarely if ever acknowledges God. In all this sea of negativity, I sought the Lord in a quiet time today (which I know is absolutely mandatory if I am to have any peace and communication with God). The Streams in the Desert devotional came from Hebrews 12:12-13, “Lift up the hands that hang down and the feeble knees; and make straight paths for your feet, lest that which is lame be turned out of the way; but rather let it be healed.” The message I received was to maintain my focus on Jesus (God), and seek His will (Matthew 6:23), remember what He has said to me in the past and keep my eyes on Him alone. God will keep me and deliver me through this process however He chooses to do so. There are things God wants me to do right now, such as writing this website. I am not to “let my feet be turned out of the way” but let my body “be healed” and my faith strengthened. I am to go straight ahead and not allow Satan or my anxieties and discouragement to overwhelm me.

June 29th-30th, 2009:

What happens when hormonal therapy fails? A sobering analysis. I went to my Florida urologist today fully expecting him to administer a 4-month Lupron shot thereby putting me back on hormonal therapy. He was of course sympathetic. He dwelt on the fact that my PSA doubling rate was extremely high (2-3 months) and that looking back over my initial pathology, I should have been a prime candidate for a complete cure in 1995. He was perplexed at the return of my cancer in 2002 and its aggressiveness as was my urologist at Hopkins. Both doctors concluded that intermittent hormonal therapy was the only course of action. My urologist also had the look of someone who was truly helpless and felt sorry for me. I had the opportunity to share with him (who is Jewish) that I still trusted God for deliverance and that God did not deliver the Jews at the Red Sea before they had inserted their feet into the water. He gave that look that said “I hope you are right.” I asked about possible therapies after I become resistant to the hormonal treatment. I knew of chemotherapy possibilities but he shook his head indicating their side effects were worse than the benefits gained. (Fortunately my Moffitt oncologist has additional therapeutic options.) It reminded me of a man at a nearby church who chose to let the cancer take its natural course rather than enduring the chemotherapy for an additional 6 months of life. We also discussed end of life issues. I assured my urologist of my confidence in going to heaven but feared the dying process. He agreed that dying of prostate cancer can be agonizingly painful and slow. I asked if he could keep me as pain-free and ‘semi-comatose’ as possible, stating that I did not need to be fully cognizant at that stage of my life. He simply said he would do all he could and went on to mildly suggest the euthanasia principles espoused by Jack Kevorkian. All this talk of death and dying left me very depressed and devastated. I started to see that God seemed to be putting together end-of-life issues for me. For example, we are instituting a long term care policy for my wife Marie. We had also contemplated building a new home but were short-circuited. It would be disastrous if I were to live only a short time. It seems the trips we are planning constitute a ‘farewell tour’. Enjoy it now because next year, I might be experiencing clinical symptoms (bone pain) as my Hopkins physician had predicted for 2010. Where is God in all of this????  Seemingly distant. Why had He spoken to me on so many occasions? Why had He given me such hope in the people I met and in His Word? Why had He spoken to Marie about healing me or at least keeping me chronic? Can I believe any of this? Who/what can I trust? My daily existence is engulfed by a cloud. And worst of all, June 30th is Marie’s birthday, a day for levity, celebration and looking forward. I look forward only to an agonizing death. I absolutely do not want this for Marie as well. I know that God is faithful, but faithful to perform what? Take me home to heaven??? I’d rather not leave right now even though the earth is getting worse in every way. I can pray and have faith but have faith in what?? I have been assured that God is on the case for years and I see no physical evidence. I am totally alone in this although Marie tries hard to be supportive and encouraging.

July 1st, 2009:

An unexpected and surprising perspective from my pastor. As I have often done, I sought the advice and counsel of my pastor and friend, Jim M. I have known him since the early 1980’s. He also has a gift of discernment which I need at this time. I spent some time with him re-hashing the events of June 29th and expressed my intense fear and anxiety at the prospect of dying painfully sometime during 2010 or beyond. Pastor Jim was also aware of my previous questions regarding whether or not I had heard from God or not. Pastor Jim came prepared with a word from the Bible and from the Lord. When we prayed before starting our conversation, I was particularly moved to tears, a sign that rarely happens with me. Pastor Jim’s first answer to me was that I had definitely heard directly from God when He had told me to “touch the hem of His garment”, “take up my bed and walk”, “go and show myself to the physicians especially at Hopkins”, and “’tis so sweet to trust in Jesus, just to take Him at His word.” My wife, Marie, had also heard from the Lord when she was told that “I have sent my word and healed him”. So the consequence of all this is that God had healed me in 1995 when my cancer was initially detected and treated. In his prayer preparation for our meeting, God had also directed Pastor Jim to the story of King Hezekiah in 2 Kings 20. The king was at the point of death but the Lord sent Isaiah the prophet to him to tell him to put his house in order. Hezekiah began to plead with the Lord who heard his petitions and fifteen years of additional life was granted to Hezekiah. Pastor Jim maintained that I was “healed” of prostate cancer in 1995 when my initial radical prostatectomy took place and that the ensuing “healing” messages referred to this period of 1995-present. I also had agreed that I was healed of my cancer until 2002 when it recurred. It was only after this time (2002), that I started to worry and question God. Pastor Jim concluded that I was healed in 1995, and given fifteen years but God kept the knowledge of a timetable from me as my lack of faith would have produced worry and fret on my part thereby making me less useful in God’s plans. This is somewhat substantiated by the fact that a friend and former colleague recently wrote me the same conclusion viz. that healing had already occurred. In addition, in 2004, the Lord told Marie that “I have sent my word and healed him”. So it seems there may be corroborating evidence here.  As an aside, it is curious that if one argues that God gave me an additional 15 years from 1995, that leads me to 2010, the year that the Hopkins physicians tell me I should expect clinical symptoms (bone problems) of metastatic prostate cancer. Only time will tell if this is circumstantial or truly prophetic. Turning to the more positive forward-looking elements of Pastor Jim’s “advice”, I should at this time rejoice in what I have been given over the last 15 years instead of looking (with dread) at what lies ahead. I do this quite often since the Bible asks us to be reminded constantly of what God has done for us in the past and use that as a strength and support for relying on Him in the future. “I still have time, making the most of every day” just as we are told to live. Pastor Jim suggests that I prepare a series of “Last Lectures” and discuss presenting them in written form as a legacy. I however feel more motivated to preparing this website as a legacy, as well as writing individual family members, friends and professional colleagues sharing my life and its eternal significance in relation to their own lives. I am truly grateful for a friend and brother in Jesus like Pastor Jim. He has always seemed to have the right word for me since the 1980’s always based upon God’s Word, on which we stand. Now the issue for me is as follows: Live like I have only a year left but anticipate more pursuant to God’s continued faithfulness and healing. Share my legacy in as many venues as possible.

July 2nd, 2009:

Positives and negatives in my pastor’s viewpoint. After processing Pastor Jim’s comments of July 1, I responded as follows.

Dear Pastor Jim:

I have been “processing” your “prophetic” message to me Wednesday. There are positives and some very disturbing negatives for me.

1. Your citing of Hezekiah reinforced in me the fact that God can indeed extend life if He so chooses. This is a positive. Your assertion that my life was to “end” in 1995 when prostate cancer was first discovered and treated, and that the “15 additional years” have been given to me subsequently, is very disturbing. It means that I may die in 2010.

2. Your suggestion that I prepare a series of “Last Lectures” is also disturbing in suggesting that I prepare for a fairly imminent death. But I do agree that it is a sound idea to prepare legacy items such as my website and letters to friends, colleagues and family. These are underway.

3. Your affirmation that I have been hearing from God is very positive for me. I know what He has said and I stand on it, holding Him to His word. What am I to do with Jesus’ words to me in January 2004 to “reach out and touch the hem of my garment”? And in June 2008, when He said “now is the time to take up your bed and walk.”? etc. etc.

4. If any healing occurred, it was not in 1995 although the surgeons “healed me” at that time. The “healing” only lasted 7-8 years until the cancer recurrence in 2002. I don’t read that Jesus healed the lame only to have it re-occur some years later (although we all die of something). I tend to believe that if any “healing” occurred, it was in January, 2004 when they anointed me with oil and when the Lord told Marie, “I have sent my word and healed him.”

In any event, I am confused about timelines but I am very grateful that you sought the Lord on my behalf and He indeed gave you and me several messages; God can extend life as he chooses; He has heard my prayers and answered them; I have heard from the Lord; I am to prepare a legacy; I am to make the most of every day; I am to look back and see how God has delivered me in the past.

July 4th, 2009:

God can delay responses until His timing is perfect. A coincidence? I started my day somewhat despondently with the reality that I had a prostate cancer that would eventually take my life unless God decided to intervene and heal me or otherwise keep me chronic. That realization is slowly beginning to sink in. My hope of “beating this” with medication in some way is virtually gone. I am using my last good “bullet” namely androgen deprivation therapy (ADT) or hormonal therapy. As I sat and began to “unload’ a little on God, I simply told him that my case was hopeless without Him and I acknowledged again my total need and dependence upon His care. I also asked to hear His voice speaking to me again (to my spirit) as He had done so many times previously. I opened Streams in the Desert to July 4th. The devotional cited Habakkuk 2:3, “the revelation awaits an appointed time…. Though it linger, wait for it. It will certainly come and will not delay.” Was this coincidence or was this a message to me from God’s Word through which He speaks? The devotional described God’s “Delayed Blessing Office”, where God stores answers to prayers until it is wise and His time to send them. Delays of answers are not denials. We tend to pick our blessings from the tree while they are still green instead of waiting for them to fully ripen. God uses the “refining fire” to burn away our impurities before coming to our rescue. I should instead rejoice and praise Him for the deliverance that is on its way to me. I will. Then be rewarded for the delay that has tried my faith. As Isaiah 30:18 states,” The Lord longs to be gracious to you….Blessed are all who wait for Him.” Was all this just a coincidence or was it just what I needed to hear today?

Here is a selected poem from Streams in the Desert, July 4th devotional, pp. 260-1 as follows.

“O you of little faith, God has not failed you yet!

When all looks dark and gloomy, you do so soon forget—–

Forget that He has led you and gently cleared your way;

On clouds has poured His sunshine and turned your night to day.

And if He’s helped you to this point, He will not fail you now;

How it must wound His loving heart to see your anxious brow!

Oh! Doubt not any longer, to Him commit your way,

Whom in the past you trusted and is just the same today.”

July 5th -27th, 2009:

I’m grateful for having few side effects of hormonal therapy. (See also December 6th, 2009). Marie and I took a three-week vacation to Maryland, Long Island and upstate New York to see family and friends. I feel absolutely fine. I have no pain, and few side effects from the Lupron except that my libido has decreased which is the expected result. General side effects of hormonal or androgen deprivation therapy (ADT) include weight gain, breast enlargement, depression, hot flashes, cardiovascular issues and osteoporosis-like changes in bone producing an elevated risk of fractures. I have virtually no hot flashes but have gained 15 pounds which I am trying to lose. I have my bone density checked every two years, maintain a fairly high level of Vitamin D and serum calcium and exercise regularly at a gym. I also am not generally depressed. I remember the book concerning spiritual aspects of prostate cancer which I had been asked to review by my Hopkins urologist. The book’s author had experienced a number of mental, physical and emotional side effects which at times were debilitating to him. I am so thankful I have been spared most of these side effects except for possible weight gain. I also have a wife who is very understanding. When one experiences a decrease in libido, couples have to find new ways in which to express mutual love for one another. Marie has been especially understanding and our love is stronger than ever in all its aspects.

A Maryland trip. During our enjoyable trip, I kept thinking if this would be my last such trip. I cannot help but remember my urologist’s letter wherein he predicted that I will experience clinical manifestations in 2010. Could this be my last trip in which I feel so good physically? My hope and prayer is that it is not so. During this 3-week trip, Marie and I had daily devotionals and several of them really spoke to our hearts. These will be summarized below. During this period however, two of our most admired church leaders and friends died. First, one of our Florida church deacons died rather quickly. He was an especially godly man who had received a heart transplant ten years earlier. He died suddenly of lung cancer and God took him home quickly and mercifully. His attitude as he was dying led our pastor to say that this deacon had served as the best example for how a Christian man should die, namely with the peace and confidence that only comes from knowing God and Jesus personally. I also saw God’s mercy in taking him home so quickly. Secondly, while we were en route to Maryland on July 6th, we received word that a pastor friend in Maryland had just died. Pastor Tom had suffered from colon cancer which had spread to his lungs, liver and lymph nodes 3-4 years earlier. During the ensuing 3 years of treatment, Pastor Tom had actively led a church in Sharpsburg, MD with God-given strength which amazed his physicians who had expected him to die much earlier with such metastatic disease. But God had other duties for Pastor Tom to carry out. He led his church family with love, strong leadership and compassion. Tom and I had met on numerous occasions for mutual prayer, encouragement and cancer discussions. Marie and I were able to attend Tom’s funeral. The funeral program contained his picture with a caption that read, “Don’t grieve, be comforted. By the time you read this I will have been in heaven for several days.” I will never forget this confident exclamation. I fully intend to use it one day.

July 13th, 2009;

God always fulfills His Word. Romans 4:17, says “God….calls things that are not as though they were.” If God has spoken to me, I must believe what He has said and act in accordance with it even though it has not yet come to pass. For example, Abraham in the Old Testament was told he was to be a father at an advanced age. While he had some doubts, he acted as a potential father should act. We must believe and declare what God has said. Therefore, in my case, I must be very certain what God has specifically said to me and not extrapolate to something with a different meaning. So I pray that God will make His words clear to me and not be enigmatic. Has God truly spoken to me through His word? Yes, He has! I do not want to suggest that He lies and will not fulfill His Word. I have more than the promise; through my personal relationship Christ, I actually have Him who has spoken it confidently. I must exhibit genuine faith and trust Him with my entire being. (From Streams in the Desert).

July 21st, 2009;

Consider God’s character. When I become fearful, I need to stop and consider God’s character and motives. (This is what Steve Green told me by phone.) God is holy, sinless, has infinite wisdom, perfect knowledge and an eternal perspective. He sees all things in my life from His perspective and in doing so fulfills Romans 8:28. He loves me and has the power to work all things for His (and therefore my) good.

August 31st, 2009;

A consistent principle: Trust God’s Word. John 20:29 states “Blessed are those who have not seen, and yet have believed”. The key is to be absolutely certain about what God has said to us (me). Make sure his Word is taken in the correct context not lifted out of its meaning. Then trust in what God has said (in His Word) unequivocally, without reservation. This is a principle I keep learning and hearing. What has God specifically said to you or me from His Word? God may have to keep encouraging results away from our sight until we learn to completely trust Him without seeing the results. “I do not ask that He must prove His Word is true to me, and that before I can believe, He first must let me see. It is enough for me to know it’s true because He said it’s so; on His unchanging Word I’ll stand and trust till I can understand.” (by E.M. Winter, From Streams in the Desert.)

September 7th, 2009;

Upcoming trips to anticipate. It is Labor Day. I woke up in a dark mood even after a good night’s sleep. There was nothing special that triggered my mood. I am starting to wonder if Lupron therapy is at least partly responsible for some periods of depression. I believe it is one of the side effects although mine has been minimal. I actually ended up taking a valium which did help but made me drowsy. I tried reading God’s Word which strengthens us when we face difficulty. Marie and I are leaving shortly for a 9-day Arizona-Grand Canyon-Utah-Bryce Canyon trip. I cannot help but wonder if it will be one of my last opportunities to enjoy such trips without any cancer symptoms. I also found out that I can get a free flight to Norway next July, 2010 using my United Airlines frequent flyer miles but I cannot help but wonder if I will be in any physical shape to make the trip. We must book it now since frequent flyer seats to Europe in peak summer season sell out fast. If I cannot make it, I can always cancel and get a doctor’s note to cancel Marie’s flight as well. In any event, through these concerns, by spending time processing what God says in His word, I can rest assured that He loves me, cares about my situation and can handle whatever I am facing. Worry and pain dissipate into peace, hope and confidence. Psalm 119:28 states “My soul is weary with sorrow; strengthen me according to your Word.” Psalm 116: 1-2, 5-6 state “I love the Lord for He heard my voice; He heard my cry for mercy. Because He turned His ear to me, I will call on Him as long as I live…..The Lord is gracious and righteous; our God is full of compassion. The Lord protects the simple-hearted; when I was in great need, He saved me.”

Then in a totally different context, I was reading in Luke 7 about the faith exercised by the centurion who asked Jesus to heal his servant. Jesus commented that the centurion’s faith was very strong. The commentary in Our Daily Bread for September 7th, 2009 stated as follows. “Faith has been described as ‘trusting God’s heart and trusting God’s power.’ Some prayers that seem to go unanswered are simply instances in which God has lovingly overruled our wishes. He knows what we have asked for is not best. Or it may be that our timing is not His timing or He has some far greater purpose in mind.  Let us remember that even Jesus prayed to His heavenly Father, ‘Nevertheless, not my will but yours.’”. We also often ask why did not God answer our prayers sooner? It is not His will to act on our schedule. He desires to change us through our trouble and cause us to learn a lesson from it. He will eventually take us out of it but not until I have stopped being restless and worried over it and become calm and quiet. Difficulties are intended to educate us and when their good work is done, a glorious reward will be ours through them.  “God is our refuge and strength; a very present help in trouble.” (Psalm, 46:1, from Streams in the Desert, Sept. 7th.)

September 20th, 2009;

Confronting fears and replacing them with peace. Marie and I had returned the night before from a wonderful 10-day vacation to the south and north rims of the Grand Canyon in Arizona, and Bryce Canyon in Utah. We had a wonderful time but on occasions, the thought had occurred to me that this might be one of the last trips I would be able to take physically due to any anticipated advances in my prostate cancer even though I am currently without any physical symptoms. I was to have my 3-4 month PSA blood test on the Tuesday following our arrival at home. I had always anticipated my PSA tests with some fear and trepidation. But for the most part, this time I dismissed those thoughts. On our trip, Marie and I began to read an excellent book by Dr. Erwin Lutzer, Pastor of the Moody Church in Chicago entitled “One Minute After You Die” (published by Moody Press, Chicago). The author describes clearly and scripturally what a believer in Jesus can expect at the moment of and after death as compared to a person who had not put their faith in Christ. It is a very readable short (180 pages) book and both Marie and I recommend it highly as a source of hopeful anticipation for the believing Christian and thought-provoking things-to-come from the Bible for those who are not sure if they actually will be going to heaven. In any event, we returned home late on Saturday night the 19th.  On the way to church on Sunday morning the 20th, Marie remarked that Dr. Lutzer’s book mentioned that God has our days numbered and that our lifetime seems to be irreversible. I do not entirely agree with this. But we continued to church. Pastor Jim gave a superb message entitled “The Father of Compassion and the God of All Comfort” from 2 Corinthians 1:1-11. As he began to speak, a cloud of intense fear began to envelope me. He talked about the inevitability of life’s crises, suffering and death for all of us. He said that life is ultimately about God, His salvation for us and His will for our lives. We should not expect life to be a series of answers to generic and unrealistic prayers such as “bless me this entire day”, “remove all sickness and other obstacles from my life”, and/or “protect me and all my family so that nothing bad ever happens to any of us.” God has the final plan and our days are truly numbered. As Christians, we should replace complaining with praise and confidently request God’s compassion and comfort for our souls according to Hebrews 4:16 which states “let us therefore draw near with confidence to the throne of grace, that we may receive mercy and may find grace to help in time of need.” All through the sermon I was very uncomfortable and fearful. I whispered to my wife Marie that “God was setting me up for some very bad news this week as I was to take my PSA test. This was for me the beginning of the end.” A couple in church testified powerfully during the service when they described the untimely death of their only son, a police officer who had been killed by a convicted felon in a motorcycle accident. I left the service convinced that I was to receive bad news this coming week and that the clinical manifestations of my disease would soon appear just as my Hopkins urologist had predicted would occur in 2010. I just wanted to get out of church, go home and take a tranquilizer. These fears covered me like a blanket. As we left church, I shared my thoughts briefly with Pastor Jim who after some thought, stated that such thoughts as I was having do not come from God but from Satan or evil spirits. Satan wants me to lose all hope, trust, faith, peace and joy while God wants to provide a gift of inner peace. God’s voice always speaks peace and with clarity and not confusion. He gives such inner peace even during life-and-death crises as the afore-mentionned couple who lost their son had experienced. Whose voice was I hearing? The fact that I was not receiving peace at all but only gloom, turmoil and insecurity told me that what I was hearing was not from God. Words I had heard earlier that God is not a God of confusion came back to me. We are not spared hard times in this life but through it all God provides His unique, intense peace. I knew that what I feared was false. Whatever the result of my upcoming PSA was to be, God’s grace and peace was to be abundantly sufficient. I was also reminded of a devotional that I had read during our Arizona trip wherein Peter and his fishermen had toiled all night and caught nothing. But Jesus told them to go out and try again and cast their nets from the other side of the boat. This was a thought that was ridiculous to the trained fishermen. But they did it anyway because Jesus had said it and they trusted Him. The idea of trusting Jesus’ words even if they make no sense to me had spoken to me during the trip. I had concluded to simply continue to put my faith not in my own intellect, feelings or medical prognostications, but in what God had spoken to me through His Word. The purpose of this entire scenario of today is to help me to learn to deal with all those negative thoughts and fears which I am so prone to believe. I rest my case on Christ and His care and the fact that all things do work together for good to those who love God even if we do not see the “big picture” as God does. As a postscript, we attended a monthly evening praise and prayer service at our church. One of the songs we sang was an updated version of Amazing Grace. A 5-word phrase from this song leaped out at me. It said “and grace our fears relieved.” I simply have to ask for and rely on the grace that God so amply provides when I am engulfed with fears. Amen!!!

September 22nd, 2009:

Good health news and issues that can hinder us from hearing God’s voice. I went for my PSA test today with results promised the next day. I do not know what to expect but am quite calm. I did have a clear opportunity to share my faith and trust in Jesus with my new Florida family physician. He seemed genuinely interested to hear my brief “confessions of faith” although he made no comments in return. So I keep sowing seeds. Meanwhile, my screening results from cholesterol, triglycerides, high-density and low-density lipoproteins (HDL and LDL, respectively) were the best in years. I am praying that when my time comes to be taken home, God would be merciful and not allow me to die of prostate cancer but perhaps a quick heart attack might be less painful and more merciful. From these test results, that prospect doesn’t look too promising (smile). I thank God for my current health where I have no pain and can enjoy the sunshine of retirement in Florida with my wonderful wife, Marie.

As I came home today from the doctor’s, I sat down to read my devotional from the Bible. Charles Stanley’s In Touch monthly magazine, talked about comprehending God’s truth. One of the issues I have been wrestling with is how to know for sure when God is speaking to me through the Holy Spirit and what specifically He is saying. Is it my own sub-conscious speaking or is it God? Dr. Stanley says (using 2 Corinthians 2:10-16 as his text), that God speaks so that we might fully comprehend. It is God’s intent that His message be clearly understood. I relate this to what God has been saying to me these past years through His Word. I do not always understand the context of what He is saying and find it often hard to interpret His message. The words themselves are clear but there may be something in my own life that is getting in the way blocking my ears from fully understanding or comprehending God’s truth. Such interfering issues, including unforgiveness, fear, anxiety, doubt or lack of prayer, may create this spiritual “static that clogs my ears.” But the biggest distraction may be my own mind trying to figure things out or rationalize God’s plan for myself which can create a wall between me and God. God always sees the clearer and bigger picture and I must simply trust Him. Non-believers who do not have a relationship with God do not therefore have the Holy Spirit to interpret God’s words but to those who have a personal relationship with God through Christ, the Holy Spirit will interpret God’s intent clearly. I must therefore watch for any of those interfering issues as stated above, especially fear, anxiety, doubt and especially prayerlessness. I should slow down, be still (and know that I am God as the Psalmist says), and surrender my anxious thoughts to God, letting His wisdom and words fill my spirit and my mind. God’s intent is always peace, clarity and not confusion though He is not required to share the bigger picture with me. His ways are above our ways but He can be trusted 100%.

September 23rd, 2009:

Hormonal therapy working. I entered the day in relative peace but as the day progressed, a dark spirit of fear began to overwhelm me much like the sky preceding an approaching storm. I tried reading some Bible passages in my devotional books but the words were meaningless and the mood persisted. I honestly do not know how to dispel this spirit of fear when it envelopes me. The phone rang around noon and the kind voice on the other end stated that all my blood work looked great and my PSA was 0.92. I was initially depressed upon hearing the news. It had been 3.8 in June, 2009 and I was praying that it would be totally undetectable, i.e. <0.1. It is obvious that God has not healed me after all the prayer and anointing with oil. It took some time for me to calmly rationalize this result. After many hours, I realized it was not as bad as I thought. The Lupron injections were performing their function. Earlier injections of Lupron had lowered my PSA between factors of 3-4; and this followed the same pattern, from 3.8 to 0.92. So the androgen deprivation therapy (ADT) is doing its job. I have 3-4 additional months to “live” before my next PSA test. Peace began to settle in after a day or so. I am getting accustomed to the fact that God (Jesus) is not obviously instantaneously healing me. So now the big question becomes, what did Jesus mean when He told me to: a) “reach out and touch the hem of His garment”; b) “go and show yourself to the physicians especially at Johns Hopkins”; c) simply trust His Word; and d) “take up your bed and walk”????? What about the verses in James about anointing with oil, restoring the sick? What about the words Jesus had spoken to Marie when He said “I have sent my word and healed him (me)”. I just don’t know!!!! I do not see the big picture. I do not have the ability to “fast forward” to the next years of my life. God doesn’t promise that. I can only rest and trust in the knowledge that God (Jesus) is still very active in my case. God’s words above to me are very clear statements. They are unambiguous. I simply have to follow them and trust in the outcome.

September 26th, 2009:

Rely on facts not feelings. Live by faith, not by sight. Paul writing in 2 Corinthians 5:7 says “We live by faith, not by sight.”  This has to be my credo. God does not want us to live by our feelings. God wants us to face facts, not feelings. He wants us to face the facts about who Jesus is, His character, His promises, and the perfect work He performed in bringing us into a personal relationship with God. If we believe God’s facts, then He will take care of our feelings. God doesn’t give us feelings to enable or encourage us to trust Him; He expects us to trust Him as an act of our will based on facts we know. God only gives us feelings when He sees that we trust Him apart from our feelings, but based entirely on His Word and His faithfulness to His promise. The feelings that come from God will be given at such a time and to such a degree as His love sees best for each individual situation. Therefore, we must chose between facing our feelings or facing the facts we know about God and Jesus. Our feelings change with the weather, moods and circumstances but God’s facts are as certain as the “Rock of Ages” himself, Jesus Christ who is the same, yesterday, today and forever (Hebrews 13:8, from Streams in the Desert, 9/26).

September 27th, 2009:

Good advice from my pastor about the value of life. In an e mail from my Pastor Jim, I had surmised incorrectly that he had suggested that my death may be closer than I would hope or anticipate. Jim wrote that “it is spiritually and emotionally healthy to accept that one could go home to heaven any day; otherwise, we begin to ‘worship life’ and make living an idol. We should be able to say with the apostle Paul, ‘for to me, to live is Christ and to die is gain.’” (Philippians  1:21).  Pastor Jim continued, “I’m not there, but I’m getting there. And so are you. I do believe that for you, there is a measure that you are not ready to die, and a measure of fearing the pain that might be involved in the death process. Those are your faith challenges.  I have mine—we all do. So I pray for your faith to increase. And my statements are not intended to project a timetable for you, but rather a longing that you are abandoned to Father’s perfect timing, whatever that may be.  I do not believe it is a sin to have some preferences in these matters. So like Jesus in the Garden, we state our preferences, and then rest and trust.  Since God DID give you those promises, I DO urge you to cling to them!” I plan to!!!!!

September 29th, 2009:

Heart disease risks associated with hormonal therapy. While it is not my intent to provide in depth scientific articles in this portion of the website, the reader is urged to read relevant medical and scientific references found in the link entitled Cancer Information Resources which accompanies this website. However since cardiac issues can be side effects of hormonal therapy, the following article published in 2009 is excerpted here. There have since been many other articles describing cardiac and other risks associated with hormonal therapy and these appear in the Cancer Information Resources link.

Prostate Cancer Therapies Raise Heart Risk: But Study Shows Some Anti-Hormone Treatments Are Less Risky Than Others.by Charlene Laino | WebMD Health News | 09.23.2009. The anti-hormone therapies used to treat prostate cancer can raise the risk of heart disease, but some drugs appear to be safer for the heart than others, researchers report. The study, the largest to date to look at the issue, suggests that overall, anti-hormone therapies were associated with about a 25% increased risk of heart disease. But in a more detailed analysis by type of hormone therapy, agents known as gonadotropin-releasing hormone agonists proved more risky than anti-androgen drugs.

Anti-Hormone Treatments for Prostate Cancer
Prostate cancer is the most common type of cancer in men, accounting for about one in four of all new cancer cases diagnosed in men each year. Prostate tumors “grow in an environment of the hormone, testosterone, so a common treatment is to block testosterone, either by interrupting its production or by making sure testosterone can’t get into the prostate.” That can be achieved in one of three ways. Some men undergo surgical removal of the testicles to eliminate the body’s main source of testosterone production. Others receive injections of gonadotropin-releasing hormone agonists. They actually block testosterone production by the testicles, so there is almost no circulating testosterone in the body. Examples include Lupron, Viadur, Eligard, Zoladex, Trelstar, and Vantas. Anti-androgen pills, on the other hand, block testosterone from attaching to prostate cells. “This means there is still testosterone in the body; it just can’t get to the prostate.” These agents include Eulexin, Casodex, and Nilandron.

Measuring Risk of Prostate Cancer Treatments
“The new study involved more than 30,000 men in Sweden with advanced prostate cancer who received anti-hormone treatments between 1997 and 2006. The researchers compared their rates of heart problems to those in the general Swedish population. Most of the patients received one treatment, but 38% received both gonadotropin-releasing hormone agonists and anti-androgen pills. The men were followed for about three years. Overall, anti-hormone therapies were associated with a 24% increased risk of heart attack, a 19% increased risk of irregular heartbeats known as arrhythmias, a 31% increased risk of ischemic heart disease, and a 26% increased risk of heart failure. The risks began to climb within a few months of starting hormone therapy.

Prostate cancer patients treated with anti-hormone therapies also had a 22% to 41% higher chance of dying of a heart attack or other type of heart disease, compared with the general population.

But further analysis showed that while all three forms of anti-hormone therapy were associated with an increased risk for heart disease, anti-androgens were associated with the lowest risk. Patients on gonadotropin-releasing hormone agonist therapy had the highest risk of these problems.”  For example, men given anti-androgen pills had a 15% increased chance of developing ischemic heart disease vs. a 33% increased risk in the men who received gonadotropin-releasing hormone agonists. Since men given anti-androgens still have circulating testosterone in the body, the findings “support the hypothesis that testosterone is protective for the heart.”

Risks vs. Benefits
While the study does not prove that anti-hormone drugs cause heart ills, “they show the importance of taking heart disease into account when considering anti-hormone therapy, especially since it is now being given to men with earlier-stage disease.” While increased, the risks are still low in absolute terms. For example, the researchers estimated that anti-hormone therapies cause an extra one heart problem per year for every 100 prostate cancer patients treated.

“Untreated, advanced prostate cancer is a lethal condition. For most men, the benefits of anti-hormone therapy ultimately outweigh the increased risk of heart problems.” It is recommended that men at risk for heart disease should talk to their doctor and undergo a thorough heart health exam before starting anti-hormone treatment.

October 3rd, 2009:

Future therapies? Rest on the power of God not just on the wisdom of man. Yesterday I spoke by phone to the clinical director for prostate cancer of a large, nationally-known cancer center. I was able to explain my situation to him as well as to mention my website dealing with spiritual issues. He seemed quite interested in my website. He also listened intently as I described my current Lupron therapy and asked him about the sequence of treatments available after one becomes resistant to the Lupron. He listed that after Lupron fails, treatment with anti-androgen agents such as Casodex and Flutamide is begun. They both inhibit the production of testosterone by a different mechanism than does Lupron. Next in the sequence would be treatment with ketoconazole (an anti-fungal aromatase inhibitor) and hydrocortisone. Following that would be chemotherapy with taxotere (docetaxel®) and possibly prednisone. When asked about potential treatments involving immune system modulators, he said they seemed to not be very effective against established disease. I would be able to maintain my communication with this clinical director in the future. It seems that there are some distinct differences of opinion regarding treatments between physicians when comparing this clinician with others at Tampa, Florida’s Moffitt Cancer Center for example. So in this context, I sat down to read today’s devotional from Our Daily Bread.  The scripture text quoted was from 1 Corinthians 2:5. Here Paul describes his advice to the Corinthian church as not using Paul’s persuasive words but with the demonstration of God’s power through the Holy Spirit. In verse 6, he cites the phrase which has become one of my hallmark verses, “so that your (my) faith might not rest on men’s wisdom but on God’s power.” It is a verse Marie and I recite most mornings. Physicians (for which I am extremely grateful) may be expert and well-intentioned, but they may differ. I rest my case and prognosis on the power of God.

October 5th, 2009:

My case is “troubling.” I saw my local Florida urologist today. He is a compassionate physician who truly seems to take an active interest in his many patients with prostate issues. We often discuss the latest medical and scientific findings. When he saw that my PSA was 0.94, he appeared pensive and a bit worried. He commented that considering my initial diagnosis in 1995 and subsequent treatments, I should have been cured. He labeled my current situation of rapid doubling times as “troubling”. His overall demeanor is not one of confidence in my case. He again lamented why I hadn’t been cured when my initial situation was so benign and treatable. He thinks that the cancer must have mutated somewhere along the way to become aggressive. My next PSA test is not for 5 months in March 2010. I keep coming back to the question “why me Lord?” I can only trust in the fact that God sees the bigger picture and Romans 8:28 is true in that “God works all things for good to those who love Him.” Somehow good things will evolve from my current situation. Maybe my situation will result in more people, especially from the medical profession, coming to know Jesus and thereby gaining eternal life? My faith doesn’t rest in the wisdom of men, it rests in the power of God.

October 7th, 2009:

Positive outcomes from negative experiences. I have often seen Charles Stanley preach on TV as the senior pastor of the 1st Baptist Church of Atlanta and I also receive his monthly devotional In Touch magazine. Today I received a mass-mailed letter from him but it really struck a note with me. Dr. Stanley writes that “some of the most inspiring people in Scripture went through incredibly difficult circumstances and situations. And because they did, each one demonstrated pure, genuine trust in the Lord that can encourage us in our walk with Him.” His example was Joseph, an example Pastor Bob Forseth has also cited for me to follow. It is through difficulty that we determine whether or not our faith is truly genuine. Adversity can lead to a deeper relationship with the Lord if we submit to Him. Joseph’s aspirations in life were based on dreams that God had given him. He would one day be a powerful ruler. But before he could realize any of this, he was thrown into a pit by his brothers, sold into slavery, was thrown in jail in Egypt, and was falsely accused of sexual impropriety. But through it all, Joseph maintained his trust and focus on the Lord. He did not become bitter or arrogant. Finally Joseph ended up with a very high position in Pharaoh’s government in Egypt and he ended up saving Egypt and his own family. But it took all the difficulties Joseph experienced to position him for maximum impact in God’s plan. He could say that God meant it for good in order to bring about the present results. Can this be said of me and my cancer?  The key is to always keep my focus on God. If I obey Him and leave the consequences to Him (“not my will but Thine be done”), He will take care of the rest.

October 9th, 2009;

There’s a message in our diseases. Using Paul’s conversion story in Acts 9:1-19 as a text, Charles Stanley writes in In Touch a column entitled “Speaking Through Sickness”. He writes “God’s primary goal is our ultimate good, not our comfort or short-term happiness. He wants what is best for us in light of eternity. At times this means He’ll lay us flat on our backs for a season. If you experience such hardship, do pray for healing but also pray for His message to you in your sickness.”

October 15th, 2009;

Finding humor in cancer. I received the following from a former colleague at the National Institutes of Health, National Cancer Institute. The author, Dana Jennings has an aggressive prostate cancer and writes a blog in the N.Y. Times entitled “Prostate Cancer Journal: One Man’s Story.” They can be found at http://well.blogs.nytmes.com./2009/09/08/. His topics include:

Here is an example of his blog.

A Funny Thing Happened on the Way to the Cancer Clinic. By Dana Jennings.

Funny stuff happens when you have cancer. Seriously.

Take last winter, when I was in the middle of hormone therapy and radiation for an aggressive case of prostate cancer. One of my relatives came by the house and said: “You know, if you need any weed to get you through this, I know where to get it.”

After politely declining — I was truly and deeply touched — I just cracked up. The laughter and the tears made me feel better than any amount of marijuana would have. All I could imagine was this relative getting busted and then pleading, “But, officer, I’m getting this for a guy who has cancer.”

As I’ve recovered from cancer surgery, treatment and its aftermath, it has been important to me to try to see the absurd plaid lining in a difficult situation. Just because the stakes with cancer are dark and mortal, that doesn’t mean there aren’t moments of high hilarity.

The classic family one-liner that stems from me having cancer is this one: “You take the dog out. I have cancer.” That soon morphed into infinite variations, along the lines of: “Can I sit in that chair? I have cancer,” or “Do you mind switching from HGTV to the Patriots game? I have cancer.”

So, please, read this post and e-mail it to a friend. I had cancer.

Being able to laugh in the face of cancer lets you continue to own yourself, as hard as that might be, rather than ceding ownership to the disease. A good laugh reminds you that you are not your cancer.

After surgery, I was swollen, urinating blood and had drains hanging from my body that the nurses called “grenades” (because of their shape), and it hurt to laugh.

But I laughed, anyway, because there was a certain earthy humor to all these bodily insults. And in telling these stories to my friends with a grin after the fact, I could let the listener know that I’d journeyed to a narrow place of darkness, but had come back.

There’s a part of me that would like nothing better than to do cancer stand-up comedy — please cue up a neurotic, put-upon Rodney Dangerfield voice:

So, there I am, half-naked in a dimly-lit room, my feet are bound, and cool female hands are manipulating my body. Yeah, it was great. I was getting prepped for the radiation machine.

Or there was this moment.

You know, a funny thing happened on the way to the cancer institute this morning. Just a quarter-mile from the institute, my wife and I got stuck in traffic behind a truck … a casket truck from the “Batesville Casket Company.” At least it wasn’t following me … with vultures on top.

I know that sometimes laughter seems impossible. After my cancer diagnosis I plunged into a bleak funk. And these days I’m struggling with a post-treatment depression that leaves my days swaddled in wearying grays.

But no matter how remorseless the gloom, we humans tend to have our antennae for humor out. We’re the animal that wants to laugh, wants to unlock itself through a chuckle and a chortle. And laughter lets us cope, even in awkward moments.

There was the time last winter when a colleague gave me the get-well gift of a book. Being a wise guy (maybe I should blame it on the hormone therapy), I cracked, “Oh, great, it’s probably ‘1,000 Places to See Before You Die.’”

My colleague gasped, then blushed as she handed me a copy of “1,000 Recordings to Hear Before You Die.” We both laughed (and I apologized for wising off). But she only laughed after I laughed first.

In my laughter, I’ve been able to nudge my family and friends into laughing, into letting them thaw their tight and frozen faces. And that’s important, too, because when you’re seriously ill, you’re not the only one who needs to heal.


October 18th, 2009;

To get “more” of whatever we seek gives us less time in life. So make the maximum use of the time we all have allotted to us. (From James Robison Words of Life weekly devotional. Written as a blog from a man who has colon cancer.

“Lord, make me to know my end,
And what is the extent of my days,
Let me know how transient I am.
Behold, You have made my days as handbreadths,
And my lifetime as nothing in Your sight,
Surely every man at his best is a mere breath. Selah.
Surely every man walks about as a phantom;
Surely they make an uproar for nothing;
He amasses riches, and does not know who will gather them.
And now, Lord, for what do I wait? My hope is in You.
Deliver me from all my transgressions;
Make me not the reproach of the foolish.”
(Psalm 39:4-8)

“I received a note the other day from another dear friend of mine. Dr. Bill Lawrence taught and mentored me in seminary and has been one of my big brothers in the ministry through all my years since then. The occasion of Bill’s note was his rumination upon turning seventy and thus fulfilling his Biblically proscribed “threescore and ten.” He’d been meditating on the very verses above and was wondering how much longer God would wait before taking him home to Heaven.” There are numerous ways God (Jesus) can use to take us to Heaven. Cancer will get you in. So will old age. Jesus can get you there lots of different ways, but you’ll probably arrive without your luggage. In any case, Bill voiced an insight from Psalm 39 above.

“More always means less. There’s always more out there somewhere. More opportunity, more recognition, more power, more control, more success, more money, more everything. But more always means less. You see, to get more of whatever we seek, we always end up with less time. That’s what we do in life-we trade our time for whatever we gain. Now everything in life is finite, but nothing is more finite or more final than time. There’s more of everything else, but there’s never more of time. We kid ourselves into thinking we have more time. We say, ‘I think I’ll put more time into sales or management or golf,’ but we don’t really have more time, we just manage ourselves differently in the time we have. We’ll never have more time. In fact we have no idea how much time we do have. We look at the game clock and think, ‘I have years to go before the game ends,’ but only the Timekeeper actually knows how much time we have. And He’s not telling. So here’s the deal. More means less. No matter how much more you get, in the end you always have less time. Now all of us need to go after more because that’s the way life works. It’s just that you need to make sure the more you’re going after is worth the less time you’ll have once you get it…so what ‘more’ are you going after? At this point in your life what makes the ‘more’ you’re seeking worth the less time you will have once you get it? In light of God’s purpose for you, what are the wisest ways you can invest your time to give the most glory to Him?”

October 19th, 2009:

What to think about the next time someone you know dies. (This is not morbid). When I am told that a person I know has died, I automatically visualize that person as I remember them and I think “too bad, he/she will be missed.” But is that all???? Perhaps we should think more as follows. That person was born to a mother and a father who had dreams and aspirations for that child. Did the child fulfill his parent’s dream??? When that person was 7 years old and later into their teen years, they had dreams and aspirations of what they wanted their life to be like. Were these dreams fulfilled or did they just vaporize over time?  Even more important, God the Father created that person with an individualized plan for their life. Was God’s plan carried out? Did that person experience the good works for which they had been destined? One of my favorite verses is Ephesians 2:10, “for we are His workmanship created in Christ Jesus for good works which God prepared beforehand that we should walk in them.” Fortunately, for those who know God through Christ Jesus, the “good works” are not ended at death but are only begun. The Bible says we are to eventually live in a new Heaven and a new earth in a new body forever. We will also have positions and responsibilities just as we had during our lifetime. We’ve only just begun!!!! So the next time we attend a funeral or read an obituary, let’s consider these thoughts.

October 20th, 2009;

Hormone therapy, fractures, calcium and Vitamin D. Prostate cancer patients who are receiving hormonal treatments with e.g. Lupron are significantly at risk of bone fractures. Bone density testing is therefore initially recommended as are blood tests for calcium and 25-hydroxyvitamin D. To minimize the risk of bone fractures, calcium citrate or calcium carbonate-containing vitamin D supplements are recommended. When taking these calcium-Vitamin D supplements, it is important to read the labels and know how much actual or “free” calcium is present. Pills of calcium carbonate and calcium citrate contain differing amounts of elemental or free calcium. Regarding vitamin D, it is now believed that previously-recommended daily requirements for vitamin D have been underestimated. My endocrinologist recommends 1200-2000 IU (units) daily of vitamin D3 providing a blood level of 50-80 ng/mL. Two Citracal tablets contain 500 units of vitamin D or 250 units per capsule in addition to the calcium citrate. When I had my PSA tested, I also had my 25-hydroxyvitamin D blood levels also checked. Even though I took 3-4 calcium-vitamin D supplements daily, my vitamin D levels were still too low (about 30). I was prescribed one capsule of 50,000 IU (units) of vitamin D3 per week for three months, after which my vitamin D levels increased to 65 ng/mL (desirable is 50-80). I was told by my endocrinologist that taking 2 grams (or 2000 mg) of free calcium with 2000 IU (units) of vitamin D3 daily is desirable. I now maintain a desirable vitamin D level (50 ng/mL) by taking approximately 5000 units of vitamin D3 daily. For me, three calcium-vitamin D tablets (two in the morning and one at evening) and 2000 units of vitamin D3 (with the fattest meal of the day usually evening) seem to work well.

October 21st, 2009:

A Phase III clinical trial and my heartfelt plea to God. My 68th birthday is tomorrow. Today I received the latest issue of the National Cancer Institute (NCI) Bulletin which described a current Phase III clinical trial enrolling patients who had failed hormonal therapy, and therefore were hormone refractory. The next course of treatment for them would be taxotere and prednisone. The clinical leader, Dr. William Dahut, was a former colleague of mine. He cited in his introduction that when a prostate patient becomes hormone refractory, there are few options left. His clinical trial consisted of administering a specific platin drug  with prednisone in place of taxotere. He cited that this combination had demonstrated better pain relief and quality of life but not an extension of life when compared to taxotere/prednisone. Since I am still on hormonal therapy and not yet ready for this trial, I paused this evening and wanted to express my thoughts to God and Jesus. I decided to put them in writing. “Dear God, I come to you in the name of your Son, Jesus. You allowed me to develop prostate cancer in 1995 and seemingly ‘cured me’. But in your wisdom and plan, You allowed the cancer to return in 2002. I don’t know why and the doctors do not know either. But for this totally unexpected event to happen, You must have a good reason and purpose. My desire is that Your purpose be revealed as I travel this path of cancer treatment. I pray most sincerely that physicians, clinicians and everyone I encounter see You, God and Jesus and Your attributes in my case. I am weak but You are strong. I pray almost selfishly that You allow me to live into my 80’s so as not to leave my wife Marie alone. We have had nearly ten wonderful and belated years as husband and wife and look forward to an eternity together with her. Please let me grow old with her. I am also thankful that I have a disease such as cancer since it allows me to actually plan out the last phase of my life as opposed to just dropping dead unexpectedly and leaving my family with loose ends. It will not take me by surprise but allow me to share my most important thoughts with those family, friends and colleagues who have meant so much to me. I would not want to be in eternity, in a new heaven and a new earth without them. So I submit my steps to You and humbly ask for time. You have spoken to me in the past. I know this beyond a shadow of doubt. You have told me to trust You and have indicated that You are well aware of my situation and are in control of it. Help me to continue to hear You speak to me. It has been a while since our last memorable spiritual encounter. You speak through Your Word so help me to stay therein and be available. When the time comes for me to ‘come home’, please be merciful. But in the meantime, I believe there is much for me to do so I humbly ask that You guide my thoughts, words and deeds and replace any anxiety with Your peace. In Jesus’ name, Amen.”

October 23rd, 2009:

I finally realize I am angry at God. The day after my birthday dawned as a typical sunny Florida day. But I suddenly realized this morning that the source of my anger and outbursts of the last few years especially has been that I am harboring anger toward God for allowing me to get prostate cancer at a young age (54) and then allowing its return in 2002. So in my state of suppressed hostility, I read some of the devotionals that I read daily. The messages I received were that I am to trust God even when I cannot understand the circumstances; that I must walk in the steps of Jesus’ heels as if I am following someone very closely; and, that I have to learn how to deal with this anger and “forgive God”. Just as the Lord’s Prayer states, “forgive me my sins as I forgive those who have sinned against me”. So how do I learn to forgive God?  I have to confess it God first, admitting my resentment and acknowledging it as sin. In the words of Charles Stanley, “I have to lay my anger and hurt before the Lord and let Him begin to heal my broken heart.” I am at the very first steps of this process. To be continued hopefully.

November 2nd, 2009:

God makes all things new and delivers us from all fear. Steve Green has had a multi-year career as a Christian singer and Marie and I have had the privilege of getting to know him personally. We recently attended his concert in St. Petersburg, Florida. In past years in Maryland, I would always get an excellent word from the Lord when I attended one of his concerts but that has not happened of late. So en route, I asked God if He would give me a good message this evening. God and Steve did not disappoint. One of Steve’s themes for the night was that God makes “all things new” in His time. God can renew our bodies and spirits now as well as promising to create a new heaven and new earth eventually and provide new bodies to His children. I hoped that the “all things new” message did not necessarily refer to the fact that I was to die very prematurely and would experience these “new entities” shortly. But it is a comforting thought to know that God’s plan is to make us anew now through our faith in Jesus and being empowered by the Holy Spirit. It also has a long term component in that we can look forward to serving God in a new heaven and earth with new non-failing bodies for eternity.

On another issue, I have mentioned previously that at times unsubstantiated fears enter my mind and depress me. Psalm 34:4 can be used to address these fears. I plan to claim this verse where David simply writes “I sought the Lord and He answered me and delivered me from all my fears.” Remember the acronym S.A.D., which stands for “sought, answered and delivered”.

November 3rd, 2009:

Can (does) God extend life? It is amazing that whenever I discipline myself to daily read God’s word, the Bible, the words of that book speak volumes. Today’s devotional from Our Daily Bread cited Proverbs 9:10-11, where Solomon (the wisest man of all time) writes that “the fear of the Lord is the beginning of wisdom and the knowledge of the Holy One is understanding. For by me (the Lord), your days will be multiplied and years of life will be added to you.”  These verses tell me that I must learn to “fear the Lord.” The word “fear” does not mean “to be afraid of” (although we should be in awe of His power), but it means to “highly respect above all things.” I personally need to focus daily on “fearing the Lord” and its implications. Secondly, the verse states that days could be added to my life. This sounds good at first since days might be added to those already the Lord has numbered for us. But I think it means that foolish living (not fearing God) can decrease the days of our lives so that fearing God will mean that we will be able to thoroughly enjoy the days He has already numbered for us. A second pearl of wisdom came from today’s Streams in the Desert which simply stated that “our capacity for knowing God is enlarged when we are brought by Him into circumstances that cause us to exercise our faith.” Thirdly, the In Touch devotional focused on knowing God and cited 2 Peter 1:12-21 as its text. As I read verses 13-15, Peter is exhorting the believers to keep focused on the things of God that they have learned because “it is right to refresh your memory as long as I live in the tent of this body because I know that I will soon put it aside as our Lord Jesus Christ has made clear to me. And I will make every effort to see that after my departure you will always be able to remember these things.” This hit home. Is God telling me that the day of my departure is near and that I am writing this diary so others will remember it after I am gone? Time will tell.

November 13th, 2009:

Be totally honest with God; He can handle it; but trust Him. From RBC Ministries (December 2009), Mart De Haan writes an article called “What Trust Looks Like.” In 2 Samuel 12:16-17, King David wouldn’t eat or be comforted as he pleaded with God for the life of his dying child. Even though he was a man after God’s own heart, the songs and groans of his life reflect recurring fear and despair (Psalm 6:1-7). Job’s experience was similar. In the dark nights of his loss, his first expressions of trust turned to bitter anguish in Job 2. Therefore “trust can cry and groan and even doubt.” We should therefore not be afraid to be honest with God. “Abraham laughed at the absurdity of God’s promise to make him the father of many nations. Jacob wrestled with his Lord over the uncertainty of what lay ahead. David openly expressed his despair and helplessness in circumstances beyond his control. Job accused God of being unfair. When heaven seemed to be ignoring them, they expressed it. They learned to trust God in the dark valleys of their doubts.” Likewise we should not underestimate God. When we are helpless, God is not. “If God doesn’t answer our prayers in the time and manner that we’ve asked, it’s because He can see what we cannot. Joseph learned to trust God after being sold into slavery by his older brothers. When he was reunited with them later in life, he was able to say ‘As for you, you meant evil against me; but God meant it for good.’” (Genesis 50:20). A good prayer for us to pray when we doubt is as follows: “Father in heaven, I want to trust You. But sometimes I get so confused. Please forgive me for wanting answers so that I don’t have to trust You. Thank you for being so patient with me. Please help me to have the same patience with You as I wait to see that Your plans and timing are better than my own.”

November 24th, 2009:

The key is understanding God’s intentions. “We must realize that thankfulness is not based on emotions or a situation’s outcome. We can be grateful, even during trials, because the Lord has promised to work everything for our good in Romans 8:28. That means He has a purpose for every experience, pleasant or difficult.” When we encounter a big problem and compare it against our small resources, our situation sends us running to Him, thankful that He has committed to work it to our benefit. Adversity is a tool God is using for our benefit; we should not see it as something He is doing to us. The believer’s part is to trust that God will bring good from trials and to discover His plan, which gives further reason for thanking Him. Understanding His intentions renews our strength for facing difficult trials. Expressing gratefulness changes our attitude about God, ourselves, and our situations. Most people allow hurt and stress to form a pessimistic mindset, which negatively impacts every facet of their life. But believers have God’s Spirit working within to provide courage and a flow of thanksgiving. (From In Touch Magazine by Charles Stanley, 11/24/2009).

November 25th, 2009:

My 6-month visit to Moffitt Cancer Center with my oncologist. An update on new therapeutic agents under development. Marie and I had a 30 minute conversation / visit with my oncologist at Moffitt Cancer Center, on the campus of the University of South Florida, in Tampa. Moffitt is a designated National Cancer Institute (NCI/NIH, my former employer) Comprehensive Cancer Center which is a highly-sought distinction. My oncologist had been highly recommended to me by former program directors at the National Cancer Institute. He and I spoke at length about several scientific areas; he is very bright and up-to-date regarding new therapies and areas of research. Several issues of specific interest were discussed; I’ll try to highlight a few.

Since I have been on hormonal therapy with Lupron since August, 2006, I asked my oncologist how long one could expect to be on hormonal therapy before the cells become resistant (i.e. hormone refractory). He said it varies quite a bit from 12-18 months up to many years. I have been on this therapy now for over three years. I counted this as a blessing from God. We discussed whether I should be on intermittent or continuous Lupron therapy. His answer was basically that it did not matter as far as the cancer outcome is concerned. But since hormonal therapy poses increased risks of heart attacks and bone fractures, intermittent therapy might be seen as minimizing these potential negative side effects.

Regarding potential drugs to protect against fractures, virtually all the drugs being used today with few exceptions are bisphosphonates and pose similar risks and basically act the same in our bodies. My oncologist did however speak favorably of a new drug under development called Denosumab. It is a monoclonal antibody which counters bone breakdown by targeting RANKL; the latter spurs the activity of certain bone cells (osteoclasts) that break down bone. My own bone density is good so I would not necessarily require such treatment at this time. But periodic monitoring of bone density while undergoing hormonal therapy is recommended.

I had often feared the day if/when my cancer becomes resistant to hormonal therapy (refractory) since the only real option following that would be chemotherapy with taxotere / prednisone which pose severe side effects. But we discussed several new treatments under late stage development for hormone-refractory patients which would be useful before any taxotere/prednisone chemotherapy. These therapeutic agents include:

a) Provenge, a new  immunotherapeutic agent from Dendreon, which was approved in 2010 by the Food and Drug Administration (FDA).

b) MDV3100 is a drug under development by Medivation, Inc. which offers a radically different way of attacking prostate cancer. It showed promising initial results and is set for larger-scale human testing. A study report in the journal Science looked at MDV3100 and its ability to block the receptors for androgens which drive tumor growth on cells. After treatment with the drug, there were “sustained declines” in PSA levels in 43% of the participants, which the report called a “promising” result. The researchers now have data on 114 men given the drug. It showed not only declines in PSA but also regression of the tumor on scans. In addition, “circulating tumor cell counts, another measure of treatment, converted from unfavorable to favorable in a considerable percentage of patients,” said Dr. Howard I. Scher, chief of the genitourinary oncology service at Memorial Sloan-Kettering Cancer Center in New York City and co-author of the study. Based on those results, an application for a large-scale trial has been submitted to the U.S. Food and Drug Administration.

c) My Moffitt oncologist was also optimistic about abiraterone acetate, a drug that blocks the production of testosterone by blocking the activity of CYP17, a key enzyme that helps cells produce androgen and estrogen. It is currently in Phase II and III development in men with hormone-refractory prostate cancer. Earlier Phase I studies had shown that it was safe and led to reductions in prostate-specific antigen (PSA) levels by as much as 90 percent in some patients. A majority of patients given the drug also had reductions in tumor size, both in the primary tumor and in metastatic tumors.

Overall, it seems that God is truly keeping me free of any symptoms and is sustaining me well on hormonal therapy. I sense that God may be using this prostate cancer as my “thorn in the flesh” (as He did with the apostle Paul) to keep my totally dependent on God’s grace. In any event, I cling to God’s promise in 2 Corinthians 12:9 that “My grace is sufficient for you for power is perfected in weakness.” If I ever fail hormonal therapy, it seems there would be several good options before having to resort to chemotherapy with taxotere / prednisone, which I might even decline due to its side effects. I am grateful to God that I am able to see my knowledgeable Moffitt oncologist every six months as needed. My goal remains that God’s and Jesus’ role in controlling my disease be evident to all the physicians from whom I receive excellent care and that they see the Lord through my treatment outcomes and attitudes.

December 6th, 2009:

Naturally-occurring prostate cancer inhibitors under investigation:

a) Pomegranate: In a Phase II clinical study at UCLA involving 46 men with rising PSA after prostate cancer treatment (surgery or radiation) who consumed 8 ounces of POM Wonderful 100% Pomegranate Juice daily over two years, PSA doubling time (a measure of prostate cancer progression) increased from 15 to 54 months. A longer term (6-year) continued evaluation of an active sub-group of patients showed a further increase in PSA doubling time to 88 months. [Ref. Pantuck, A.J., et al, Clinical Cancer Research, 2006; 12(13), 4018; July 1, 2006.]  Personally, I take pomegranate extract pills and drink a concentrated pomegranate juice daily. While there are a number of sources of pomegranate, I found that the POM Wonderful website was useful. Also I strongly suggest an e mail subscription the newsletter entitled Zero, the Project to End Prostate Cancer. Its November 10th, 2009 e mail included an article from NaturalNews.com, 11/9/09, entitled “Protect the Prostate with Pomegranates.”  Zero’s Newsletter gives a lot of recent research findings and should be must-reading for anyone with prostate cancer.

b) Fish oil: Omega-3 fatty acids found in many fish such as salmon, mackerel and bluefish, may help prevent aggressive prostate cancer according to a recent article summarized in Johns Hopkins Newsletter (January, 2010). A recent study (published in Clinical Cancer Research, vol. 15, p.2559,) analyzed the diets of 466 men with aggressive prostate cancer and compared them with the eating habits of similar healthy men. They found that men who ate the most dark fish were 57% less likely to develop aggressive prostate cancer than those who never ate fish. The protective benefits of the fish were greatest in men genetically predisposed to the cancer.

c) Flaxseed: Plants such as the Norway spruce produce chemicals called lignans to protect against disease. When humans ingest lignans, bacteria in our colon convert the plant lignans to a different chemical form called enterolactones, which have been shown in laboratories to suppress hormone-dependent cancers such as prostate and breast cancer. These enterolactones produce cell death (apoptosis) in cultured prostate cells. In the clinic, flaxseed-supplemented diets generated favorable reduction in tumor proliferation in men with pre-surgical prostate cancer in as little as 30 days [reference: Demark-Wahnefried, W. et al, Cancer Epidemiol. Biomarkers Prev. 2008,  Dec. 17(12), 3577-87.] Personally I also take a flaxseed oil pill and a portion of flaxseed with my morning cereal. The flaxseed is available at most food stores.

There are numerous other naturally-found extracts (e.g. saw palmetto, nettle root, and  boswellia)  as well as specific drugs [e.g. finasteride (Proscar) and dutasteride (Avodart)] that may be useful in prostate cancer prevention or other prostate conditions such as benign prostatic hyperplasia (BPH). But I will not address them here since my focus is prostate cancer.

d) Curcumin: This is the chemical found in the Indian spice turmeric used to make curry. Curcumin has been shown to possibly play a role in prostate cancer prevention. Curcumin also may interfere with prostate cancer proliferation and metastasis by its action inducing apoptosis (cell death). It is currently being studied in numerous major laboratories and clinics as a non-toxic alternative for prostate cancer prevention, treatment or co-treatment. Personally, I take one curcumin pill daily with food.

e) Pectasol-Modified Citrus Pectin (MCP): This is a modified citrus pectin derived from the rind and peel of citrus fruit. It may inhibit the spread of cancer by binding to galectin molecules and blocking them. Galectins are adhesion and blood vessel-attracting surface molecules that are thought to be involved in the spread of cancer. A small study in 2003 revealed a significant reduction in PSA rise in men where primary conventional treatment was initially successful but in whom serum PSA’s began to climb again. [Ref. Guess, B.W. et al, Prostate Cancer Prostatic Dis., 2003; 6(4); 301-304.]

Therapeutics under development (as of early 2010).

In addition to the FDA-approved drug, taxotere, used for treating prostate cancer which has become resistant to hormonal therapy, there are a number of new treatments under development. Much more information can be obtained by reading the references in the website section on Cancer Information Resources especially from AWARE, the Newsletter of Zero-The Project to End Prostate Cancer, the Prostate Cancer Research Institute (PCRI) and from the National Cancer Institute Bulletin. Some examples of new treatments include the following.

Provenge® (developed by Dendreon) was approved by the FDA in 2010 for use in men with advanced prostate cancer. The drug has been shown to improve overall survival in men with metastatic androgen-independent prostate cancer. Provenge may be the first in a new class of active cellular immunotherapies which engage the patient’s own immune system to fight cancer.

Johnson & Johnson’s experimental drug abiraterone can help men with advanced prostate cancer who have run out of standard treatments options. The latest Phase III study tested it in patients after treatment with both hormone therapy and taxotere, the only currently approved chemotherapy to show benefit in late-stage prostate cancer. Abiraterone produced strong decreases in PSA levels and shrank or stabilized men’s cancers for an average of almost six months.

A new drug (MDV3100) by Medivation, Inc. offers a radically different way of attacking prostate cancer. It showed promising results in an initial trial and is set for larger-scale testing. A study report in the journal Science looked at this drug’s ability to block the receptors for androgens which drive tumor growth on cells.

Serious potential side effects related to androgen deprivation (hormonal) therapy (ADT). Vitamin D. Many articles have recently been published describing the side effects of ADT or hormonal therapy. In the USA today, perhaps 700,000 prostate cancer survivors are receiving ADT and are therefore vulnerable to loss of libido, hot flashes, anemia, fatigue, accelerated bone loss, increased fat mass, increased cholesterol and triglyceride levels, decreased insulin sensitivity and loss of cognition. These adverse metabolic effects are associated with greater risks for fractures, diabetes and cardiovascular disease. It is emphasized that primary care physicians and patients should be aware of the potential benefits and harms of ADT. Guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors should be incorporated into the management of all patients on long-term ADT. A new drug called denosumab is currently under development by Amgen specifically for the treatment of bone loss in men with non-metastatic prostate cancer undergoing ADT. To avoid fractures, it is also recommended that men undergoing ADT have  bone density measurements every two years or so. Bisphosphonates such as Fosamax or newer drugs such as Reclast or Zometa may also be recommended to prevent osteoporosis. Zometa is used for patients with bone metastases. Calcium supplements (two with every meal) are also recommended. It is also thought that vitamin D deficiency plays a role in cancer development. Many scientists and physicians now state that the minimum daily requirement of vitamin D has been grossly underestimated. Recent studies have shown that as many as 85% of subjects tested showed a vitamin D deficiency. It is advised that prostate cancer patients especially those undergoing hormonal therapy be tested for vitamin D levels in their blood (using the assay for 25-hydroxy-vitamin D). Optimal serum levels have not been clearly defined but most researchers state that at least 50 ng/mL may be ideal. While large doses of vitamin D can be toxic, many researchers including my own physician recommend a minimum of  2000 IU’s of vitamin D daily. [Ref. Espinosa, G., Integrative Medicine and Prostate Cancer, in Prostate Cancer Research Institute (PCRI) Insights, November, 2009, Vol. 12, No. 4, pp.2-7]. This can be found in individual supplements or associated with calcium supplements such as Citracal. Maintaining proper calcium and vitamin D levels, checking one’s bone density and maintaining a disciplined exercise program can help to minimize potential side effects such as bone fractures in ADT. Your own physician should be consulted first to ascertain your personal treatment regimen.

December 22nd, 2009:

Why does a loving God allow sickness? Why has God forsaken me? Why does God allow me to experience this sickness or condition? In the Old Testament (Judges 6:13), an angel had just appeared to Gideon and assured him what a valiant warrior he was. But Gideon asked “if the Lord is with us, why has all this happened to us?” Gideon went on to ask “where are the miracles that we (Israel) saw God perform in delivering them in the past?” One answer is that God allows difficulties to come upon us in order to bring us closer to Himself. Sicknesses don’t come to separate us from Jesus but instead cause us to cling to Him more faithfully, firmly and simply.

There’s more to it than that. There are times when God permits pain to enter our lives, not just as a consequence of our own actions, but because He can see the big picture, and He knows that in the long run these painful experiences will help us. With our limited perspective, this is so often hard for us to grasp. But God is so much wiser than we are that we cannot always understand His idea of goodness; it is not opposed to ours, but greater than ours. God wants something more for us; C.S. Lewis writes: “We are a divine work of art…something with which He will not be satisfied until it has a certain character.” God has paid us “the intolerable compliment”: He takes us and our moral development seriously and is working to make us holy.