Atrasentan

I want to hold your hand….not

Advanced Prostate Cancer, Atrasentan, chemotherapy, David Emerson, PCa -

It’s now been a week and things are returning to ‘normal’. Over the weekend I experienced what I was warned about… I felt like I had the flu. My body ached, I was tired and spent a lot of time on the couch watching golf.

Yesterday we went in for my monthly Lupron shot and Zometa infusion. What should have been a maximum two hour visit to the lab and treatment room turned into a series of missing lab requests and incorrect orders. We were there for nearly three and a half hours.

We did get a blood test back, no PSA test but it did show a HUGE drop in my white blood cell count. Normal is around 11, last week before treatment I was a little low at 8.9, yesterday I was at 1.9. Ouch! This is normal and the basic intent of the chemotherapy. The WBC should begin to recover before the next treatment on the 30th.

A count this low can make me very susceptible to germs, infections, etc. I am now using more hand sanitizer than I have ever used in my life! No offense intended if I don’t shake your hand!!

“C” Day + 4

Advanced Prostate Cancer, Atrasentan, chemotherapy, David Emerson, PCa -

The good news is I’m tolerating chemo very well so far. The bad news is….well there is none to report!!

It’s been four day, except for the first night, sleep has returned to my normal broken pattern.
I was able to play golf on Wednesday (worse than ever!) but have been able to work out the last three days. Only about thirty minutes each session, this morning I pushed it pretty hard.

As we were told might happen, I’m a little “flu like” today. My back is a little sore but I’m doing fine.

I picked up the study medication yesterday morning and began taking it immediately. There is no telling if I am getting the placebo or the Atrasentan? A runny nose is one side effect but because it doesn’t happen in all cases it’s going to be a guess.

I’ll take a shot at disc golf tomorrow and check in here later in the weekend.

I could use a good nap……

Advanced Prostate Cancer, Atrasentan, chemotherapy, David Emerson, Prednisone, taxotere -

It’s a day later and I feel completely fine. I did have trouble sleeping last night. I woke at 11:30 and was up until about 12:45. Then a slept for an hour, was awake for 20 or 30 minutes, would sleep for another hour, wake up etc.

I forgot to enclose this yesterday.
Historic Data:
6/9/08 52.02 (Started Chemotherapy)
Day before and day of treatment (12mg Dexamethasone)
Daily (10mg Prednisone)
With Treatment (once every three weeks); Benadryl – 25mg, Dex10mg, Zofran 24mg, Zantac 50mg, Taxotere 151mg
Waiting for trial drug (Atrasentan)/placebo to arrive.
5/19/08 48.87
4/21/08 38.31 (Stopped Nilandorn as required by clinical trial starting on June 9th)
3/24/08 34.7
2/25/08 29.4 (Started taking Nilandron on 2/4/08; Started Selenium 200 mcg on 2/26/08)
1/28/08 36.2 (Stopped taking Ketoconazole and Hydrocortisone in anticipation of next treatment)
12/31/07 30.9
12/3/07 21.9
11/5/07 23.3
10/8/07 19.30
>10/8/07 Changed Lupron from 120 day dose to monthly dose> 9-12-07 Began taking .5mg of Avodart per day. Changed Ketoconazole from 600mg twice per day to 400mg three times per day)
9/4/07 21.80
8/6/07 19.25
8/2/07 16.96
7/02/07 20.30
6/04/07 17.80
4/30/07 16.25
4/2/07 17.68
3/5/07 21.87
2/5/07 20.90
1/8/07 18.90
12/11/06 24.86
11/13/06 43.61
10/16/06 51.48 (Started “High Dose” Ketoconazole and Hydrocortisone, 10/01)[at this point and for a second time we prepared for Taxotere. First my Oncologist wanted to try High Dose Ketoconazole and Hydrocortisone.]
9/11/06 83.97 (started Zometa)
8/23/06 41.77
8/18/06 54.66(no tests in June or July)
5/19/06 11.37 (stopped Casodex)
4/3/06 4.25
3/5/06 1.45 (started Casodex again)
1/27/06 0.46
12/28/05 1.85[at this point we prepared for Taxotere, chemotherapy treatments. First I had a new PSA test and new bone and CT scans, lymph nodes clear, spine clear, ribs, femur and hips stable. The PSA dropped to 1.85 and the scans revealed marked improvement. Chemo was cancelled 72 hours before it was scheduled to begin]
12/15/05 7.18
11/03/05 4.64 (Stopped taking Casodex)
9/22/05 0.8
08/11/05 0.35 [nadir]
6/24/05 0.55
4/17/05 2.51 (taken at MD Anderson, Gleason lowered to 7/7)
4/06/05 3.51 (Six weeks after starting Lupron and Casodex)Original Gleason scores (7/8)
Pre-treatment tests:
2/18/05 Started Lupron
2/11/05 Started Casodex
2/?/05 219
12/?/04 189 (Original test)

The Inevitable

Advanced Prostate Cancer, Atrasentan, chemotherapy, David Emerson, PCa, taxotere, University of Kansas Cancer Center -

After 39 months, the inevitable is finally upon us. After meeting with my Oncologist today and receiving my updated PSA number (38.31) we had “the talk”.

I am definitely ready to take the next step and use a more aggressive treatment to try to to get the cancer under control. We have been fairly conservative during the past three years. Even so, we have had great results and I have no regrets on any decision we have made to date.

I am eligible for a clinical trial at the University of Kansas Cancer Center. We are researching it and at this point are favoring this protocol. It would be the standard chemotherapy (Docetaxel plus Prednisone) that I would receive, plus an additional oral medication (Atrasentan) that has shown benefit to other patients with advanced hormone refractory prostate cancer. It is a Phase III trial which is randomized, so I would have a 50% chance of receiving the additional medicine versus a placebo. I will receive the chemotherapy intravenously once every three weeks for 12 sessions, which means I’ll finish up in early 2009.

From the things I’ve read about this protocol it is very well tolerated. Most men continue to work or keep up with most of their daily activities. I plan on being no different. Fatigue usually sets in about 4-5 days post treatment which we plan to schedule so it would coincide with the weekend. So in other words, more movies, more couch time!

Crank up the prayer chain people…..I’m going to need a little help here!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Historic Data:
4/21/08 38.31
3/24/08 34.7
2/25/08 29.4 (Started taking Nilandron on 2/4/08; Started Selenium 200 mcg on 2/26/08)
1/28/08 36.2 (Stopped taking Ketoconazole and Hydrocortisone in anticipation of next treatment)
12/31/07 30.9
12/3/07 21.9
11/5/07 23.3
10/8/07 19.30
>10/8/07 Changed Lupron from 120 day dose to monthly dose> 9-12-07 Began taking .5mg of Avodart per day. Changed Ketoconazole from 600mg twice per day to 400mg three times per day)
9/4/07 21.80
8/6/07 19.25
8/2/07 16.96
7/02/07 20.30
6/04/07 17.80
4/30/07 16.25
4/2/07 17.68
3/5/07 21.87
2/5/07 20.90
1/8/07 18.90
12/11/06 24.86
11/13/06 43.61
10/16/06 51.48 (Started “High Dose” Ketoconazole and Hydrocortisone, 10/01)[at this point and for a second time we prepared for Taxotere. First my Oncologist wanted to try High Dose Ketoconazole and Hydrocortisone.]
9/11/06 83.97 (started Zometa)
8/23/06 41.77
8/18/06 54.66(no tests in June or July)
5/19/06 11.37 (stopped Casodex)
4/3/06 4.25
3/5/06 1.45 (started Casodex again)
1/27/06 0.46
12/28/05 1.85[at this point we prepared for Taxotere, chemotherapy treatments. First I had a new PSA test and new bone and CT scans, lymph nodes clear, spine clear, ribs, femur and hips stable. The PSA dropped to 1.85 and the scans revealed marked improvement. Chemo was cancelled 72 hours before it was scheduled to begin]
12/15/05 7.18
11/03/05 4.64 (Stopped taking Casodex)
9/22/05 0.8
08/11/05 0.35 [nadir]
6/24/05 0.55
4/17/05 2.51 (taken at MD Anderson, Gleason lowered to 7/7)
4/06/05 3.51 (Six weeks after starting Lupron and Casodex)Original Gleason scores (7/8)
Pre-treatment tests:
2/18/05 Started Lupron
2/11/05 Started Casodex
2/?/05 219
12/?/04 189 (Original test)