chemotherapy

Two, two, two posts in One!

chemotherapy, disc golf, FLHW, Kansas City Disc Golf, Nilandron -

First and foremost, here is a treatment update. After researching the proposed clinical trial, Mary and I decided it is worth the potential upside and we are going to participate in the trial. I spoke further with Dr. V only to discover I have to be off Nilandron for at least six weeks. I will stop taking it on Sunday, which will make my first treatment date Monday, June 9th. Treatments will continue once every three weeks for up to twelve treatments (or thirty six weeks). If I am able to stay on schedule, dependent on blood counts maintaining normal range, I will have my final treatment on January 26, 2009 [the day before my 46 birthday!!]

This is going to be a long six weeks leading up to a long nine months. Like everything else we have faced over the past three years, nothing moves fast. The first week of June I’ll have a port surgically implanted and will also have follow-up CT and bone scans. Yippee, more radioactive fluid!!!

The anticipated side effects are somewhat standard for chemotherapy; hair loss, neuropathy, loss of appetite, weight gain (from the steroids), fatigue 4-5 days after treatment, nausea and a few more.
None of this concerns me if the outcome is positive. I have my faith, your love, and the hope God instilled in us all. I truly believe we can win this battle before moving on to the next stage.

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The next update is in regards to the FLHW Disc Golf Tournament. On the upper left side of this page you will find a picture slide show like the one that I created for the Fall ’07 golf tournament. The day was fantastic and thanks to everyone, we were able to raise approximately $2,200 dollars for advanced prostate cancer research.

I especially owe thanks to my friend Gary who crafted this idea and acted as Tournament Director. I also would be remiss if I left out the FLHW Board and my dear friend Pete for his on-going support of FLHW.

At this point, our focus turns to our 4th Annual Golf Tournament to be held Friday, September 26th at Ironhorse Golf Course. We still have a few details to work out. The formal announcement will be coming out in the next week or so…..

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!!

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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)

up, up and away….

Advanced Prostate Cancer, chemotherapy, PCa, PSA, University of Kansas Medical Center -

Last night, after a VERY long day at work and after attending our home owner’s association meeting, I sat down and wrote a blog entry. It was verbose and eloquent and right to the heart of the matter. It got lost in cyber space…..

My PSA: now 36.2

Another rise. Although not drastic, certainly headed in the wrong direction.

Tomorrow we are meeting with an oncologist at the University of Kansas Medical Center to discuss some options and clinical trials involving chemotherapy. As far as Advanced Prostate Cancer goes, there are not many options and none of them offer the potential for a cure. What they do offer is hope, and time.

I also have an appointment for new CT and bone scans next Tuesday. Additionally, we are attempting to get an appointment with a doctor in Virginia. He is one of the national experts on Prostate Cancer, however, he is in such demand that it may be late March before we can get in to see him.

I find myself remarkably calm about what is happening at this point in time.

Historical Numbers
Date – PSA
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)

28 Days

Advanced Prostate Cancer, chemotherapy, disc golf, texas Hold 'em, University of Kansas Medical Center -

Over the next four weeks, a lot of things in my life are set to transpire. There will be a number of milestones, appointments and decisions that will be strategically important in our battle against advanced prostate cancer.

– This weekend I will turn 45. Some say when you get older birthdays don’t seem to matter that much anymore. For me, they have taken on a whole new meaning, each one more and more important.

– Monday the 28th I have an appointment with my Oncologist. The results of that PSA test will tell us a lot about what’s going on now and what direction we take going forward.


– On Friday the 1st we are meeting with a doctor at the University of Kansas Cancer Center. Depending on the available clinical trials, this might be one option. Regardless of my PSA number we have reached a point were we almost have to make changes. A nerve racking, highly stressful decision, but one that we will make with a lot of medical and spiritual guidance.


– On February 3rd, this blog will be three years old. Over three hundred entries posted, many new friendships created, the documentation of my PC journey, as well as personal journeys shared from all over the United States and the world. The other day I received a personal note regarding the impact of this blog that touched me deeply. It affirmed for me that the original purpose for this blog is sending the message that I had hoped.

– On February 5th the FLHW Foundation is hosting the next Texas Hold ’em Poker Tournament. Details are available at the website (www.flhw.org)

– At some point early in the month I will have another bone and CT scan. There is nothing more pleasurable than having radioactive fluids injected into your veins. I guess chemo might be better but I’ll report my experience when that day arrives! The results of these tests, along with my PSA and Testosterone levels will help guide us in the next step.

– February 18th is the third anniversary of my “official” diagnosis. I typed “Yee Haaa – a day to celebrate!!!”, deleted it, then wondered, “is it really a yee haa moment”?

– There is another appointment we may try to setup with a Prostate Cancer specialist. He is hard to get in to see, and would require a few days away from work, plane rides, rental car and hotel stay. He has a fantastic track record, but we are just considering this as an option at this point, no decisions have been made.

So, that is a peak into the next four weeks. In between all of this is family life, work and of course, just a few rounds of disc golf…..that is, if it ever warms up around here!