Friday, January 13, 2017

Recent Result

Those who visit this page from time to time know that I've been dealing with prostate cancer since my original diagnosis in December 2004. Since then I've had surgery (it failed), radiation (it failed), and now hormone therapy (Lupron), which, though not a cure, has kept the disease at bay since I began my quarterly injections in July 2012.

But my oncologist at University Hospitals keeps close tabs on me: I have frequent PSA tests (blood draws looking for Prostate Specific Antigen--a test that should show virtually no PSA because surgeons removed my prostate gland in June 2005): If my PSA becomes measurable, it means some cancer cells have figured out a "work-around" and have begun reproducing. Reproducing and moving. The bones are a favorite spot, and that is where my cancer has been moving.

As I said, Lupron put it on "Pause," and from mid-October 2013 until September 2015 my PSA was "undetectable." This does not mean I had no PSA; it means it was below the threshold. But on September 23, 2015, I got a reading--a very, very low .01. I knew this was going to happen (as I said, Lupron is not a cure), but I was nonetheless depressed about it: It meant the cancer was active again--and that the number would slowly rise until my oncologist judged it was time to move on to the next drug in their arsenal, Casodex/bicalutamide (link to info about it), a drug that my oncologist has told me on my last couple of visits (I see him every three months) that I would soon commence.

I will remain on Lupron--for the rest of my life. Casodex mirrors Lupron's effects (a delay--temporary--of the growth) and side-effects (impotence, moodiness (especially depression; some days I just can not even get out of bed), weariness (I have nothing like the energy I used to have), periodic infusions of heat/sweating heavily, and well, overall crappiness, to be blunt).

My oncologist has also frequently ordered other tests--bone scans (which show the location of the cancer cells; mine, for now, are in my ribs, my breastbone) and PET scans. I'm due for another of the latter in February.

Anyway, as I said, I've had frequent PSA tests--sometimes monthly, sometimes every six weeks or so. And since that initial "return" score of .01, my PSA has risen steadily, if not dramatically. The chart below shows the "progress."

And, of course, you see the score in red--the result of my most recent test, just a couple of days ago. A sudden, dramatic spike--from 8.6 in early December to 19.5 just this week.

To say the least, I was/am alarmed. My oncologist sent me the score when I emailed him (as is my custom), but he didn't really say anything about it. I'm due for another test in a month--then a visit with him. So, perhaps, he's waiting.

But what I know is this: My cancer has come roaring back. And I'm steeling myself for yet another therapy, which, we hope, will delay things again. But, of course, it's the "things" that worry me. No, terrify me.

Joyce, of course, is in my corner, and no one could hope for a greater ally--a greater heart. And it is she--and the bright eyes of my grandsons--that (on most days anyway) get me out of bed, that get me working at something--anything--to keep my mind occupied. And so I read, I write, I exercise, I fuss around on Facebook, I bake bread, I love Joyce fiercely. I hope.

11 November 2015
0.18
16 December 2015
0.25
1 February 2016
0.56
9 March 2016
0.80
5 April 2016
1.1
5 May 2016
1.57
8 June 2016
2.1
14 July 2016
2.9
6 September 2016
5.7
24 October 2016
7.6
2 December 2016
8.6
11 January 2017
19.5

1 comment:

  1. Thank you Dan for posting this. From my experience, working with cancer patients for seven years (in the lab) I learned some important basics, not so much about cancer but about those with the disease. As I worked with these patients (who became friends) it seemed to me that their most important need was to connect with family and friends. And as their disease (some gave it a name-Evil Eugene, Horrible Hanna) progressed their family and friends did not know how to best support them. Being afraid of saying something wrong or being forced to talk about end of life issues family and friends would start to avoid their loved one. One of my favorite patients, a charming older lady, had only one son she was close to. He travelled from "out East" to be with her. He refused to talk about what was happening to her so the only real emotional support she had were those of us who saw her every week. She was trying to protect her son from the reality of what was happening to her instead of getting his loving support.
    There are other patients who helped me understand how we humans handle the evil disease. One was combative and difficult-not because of her disease but because (as her friend reported) she had always been anti-social and only had become more so.
    Another fellow made us laugh every week and could have gone on stage as a standup comedian. We looked forward to his visits.
    My other favorite was a woman who came for her six month checkup and was pronounced cancer free after five years. The lab ladies-all three of us- took her out for a drink after work and this became a tradition for the seven years I was there.
    You (with Joyce's help) have control over the rest of your life. This is true of all of us but most don't realize it until many years have passed. Please share your journey as it bonds all of us as friends.

    ReplyDelete