May 30, 2026
Week three is in the books: Five-plus weeks to go.
This week handed us our first real decision point, and it centered on the plumbing.
The UroLift Wrinkle
As I mentioned last week, I had some blood in the urine after finishing the antibiotic course. When I showed Dr. Greenfield the photos at our weekly check-in, he got noticeably serious. Visible bleeding at this stage, he said, is unusual. He started talking about pausing my daily treatments and sending me back to my urologist, Dr. Spencer, for a look inside the bladder.
That’s when I threw something into the conversation I hadn’t thought to mention before. Several years ago I had a procedure called a UroLift — small permanent implants inserted into the prostate to hold the tissue open and improve urine flow. I asked whether those clips might be reacting to the radiation. Dr. Greenfield paused and told me something I didn’t expect: I am the first patient he has ever treated who came in with UroLift implants already in place. He was candid — he wasn’t sure how those implants interact with the daily radiation beams.
After the appointment, my AI research partner and I did some digging. As it turns out, the combination isn’t completely uncharted territory in the medical literature. Published research has found that UroLift clips are sufficiently visible on imaging that they can actually serve as targeting markers during radiation therapy — essentially doing double duty. More importantly for my peace of mind, one study following seven patients with UroLift implants through a full course of external beam radiation reported no complications attributable to the implants whatsoever. So while Dr. Greenfield hadn’t personally encountered this situation, the published data offers some reassurance that the two can coexist without serious incident. The bleeding most likely reflects the tissue around those implants reacting to the swelling that radiation causes — irritation at the implant sites rather than anything more serious.
Neither Patty nor I were keen on hitting the brakes this far into the process over an unknown. After talking it through, Dr. Greenfield and I agreed to use this short week as a watch-and-wait window before making any drastic moves.
It was the right call. The bleeding has backed off to occasional faint coloring, and the burning sensation has settled into something completely manageable. The frequency is still significant — four to five trips an hour — and there’s an interesting pattern: flow is weak and stubborn at night but considerably better during the day. As a safety net, Dr. Greenfield wrote a prescription for Dexamethasone to reduce swelling in the event of a serious blockage. It’s sitting in the medicine cabinet and I intend to keep it there.
Everything Else
The hormone therapy side effects are holding steady at their new normal. The exhaustion is cumulative — it doesn’t hit you all at once, it just quietly adds weight over time. The hot flashes are coming more frequently. All of it remains bearable.
We’ve managed to keep our morning routines intact, avoided a treatment delay, and even got the vault video made. A good week, all things considered.
On to week four.
“And forget not that the earth delights to feel your bare feet and the winds long to play with your hair.”
Khalil Gibran