PSA

There are times when you just have to pray, and hold on

Advanced Prostate Cancer, David Emerson, PCa, PSA -

If any of you have watched the recent HBO mini series, The Pacific, there was a quote I had written down from Episode 2. I’m not sure the exact context of the statement. The series, produced by the same team that produced ‘Band of Brothers’, provides a glimpse of what these wonderfully brave men went through in order to defend our country. It’s rather gut wrenching at times.




The quote, “There are times when you just have to pray, and hold on”, stuck with me.With treatment and a doctor appointment coming up once again, I find myself in the 28 day funk I have mentioned here before. These four weeks between appointments just seem to fly by some months. 


I’m feeling great and believe, as Dr. S pointed out, that the radiation continues to provide benefits. Even with his recently positive comments, I don’t know what will happen next week, next month, or next year, but then again, do any of us? 

No worries, I’m fine, it’s just one of those moments when I find myself holding on and praying.

It’s a good news, bad news thing…..

Advanced Prostate Cancer, David Emerson, hrpca, Provenge, PSA, radiation -
I’ve written here are a few times about a recently approved and very exciting new treatment for advanced prostate cancer, a drug known as Provenge. Well it seems the demand is far exceeding the company’s capacity to keep up. This is something I saw first hand back in March and something that the company has been very clear about since the FDA approval in late April.

From Bloomberg: Rationing of Provenge

It’s just kind of sad to see in writing and know that even after Dendreon expands their existing facility and opens two others by the middle of next year, it will take some time to clear the back log of patients.

By the way, the title had nothing to do with my personal situation. Yesterday I received my 14th and final radiation treatment. For the most part the whole process was easy. I had some increased pain the first week and was rather fatigued as well. I have however been completely off pain meds for a week now and the fatigue is in the past as well.

We met briefly with the radiation oncologist and I can begin to exercise again but to avoid any exercise involving my legs for the next few weeks. Walking will be fine, but I have to avoid sit-ups so there goes the six pack abs I was working on! Disc golf of course is still a non-issue for at least two months, that is a hard pill to swallow, but I am very thankful that the pain is gone.

Turn the page

Advanced Prostate Cancer, David Emerson, hrpca, MRI, PSA, radiation -

During last month’s Greenhouse fundraiser I met a great couple, the Clarks. She invited me to attend a support group they are members of and asked me to share my journey. I gladly accepted though I did so with some trepidation. Most times I can tell the story and speak of the treatments and issues we’ve experienced with ease. Other times it becomes too emotional.

Tonight was their monthly meeting and Mary and I fought our way through a massive thunderstorm to arrive about 10 minutes late. The meeting began with the members of the group sharing their names and their stories. I was by far the man with the most advanced diagnosis and based on some of their expressions and reactions, I think they were somewhat stunned by our journey.

On a daily basis I guess in some ways I forget everything we’ve been through. When I lay it out like I did this evening, and tell ‘our story’ it is sort of overwhelming. I am glad to report I completed the tale without getting emotional. There were a few points when I had to pause and take a deep breath.

I share all this as a prelude to the latest chapter in the journey. What I am about to share is certainly a new part of the journey.

First the blood test and MRI: my PSA was down almost 18% from the previous week! And the MRI expressed some stable area but others there showed noticeable increase in activity. The Radiologist was careful with his assessment, they always are, but this time he was comparing the MRI to a CAT scan from last October, eight months ago. The one area that was rather clear is my right thigh has a tumor that has nearly tripled in size. I wish there was more to report but that will come tomorrow when we meet with the Radiology Oncologist. It is all but guaranteed that My next step in dealing with the pain will be radiation treatments. The question remains how many? Will we go after the hips and the leg? How successful can we be without compromising my bone marrow in case I need future chemotherapy?

Only time will tell, fortunately, time in this case, is less than 12 hours.

The Good, the Bad and the Ugly

Advanced Prostate Cancer, David Emerson, PCa, PSA, U2 -
I could have sworn I used this title before but after searching the blog, I’m in luck, the title is available!

Let’s start off with “The Good” – I’ve been off Advil for nearly two days. After experiencing quite a bit of pain in my left hip last week and earlier, things took a turn for the better over the weekend. I still don’t have full leg motion, but being able to put the Advil aside is great. I was at the point where I was taking 800mg every 8 hours. This isn’t an issue once in a while, but long term use at this level can cause stomach issues. I walked a mile yesterday morning and worked out for about twenty minutes this morning. While at the oncologist’s office yesterday I had my left hip x-rayed. If this turns out to be arthritis then it looks like I might add Celebrex to my daily dosage of meds. Updates on this to follow. It’s strange that I am hoping that it is arthritis. The alternative is not a welcome thought at this time.

“The Bad” also has to do with yesterday’s appointment. My PSA number came back and it has once again gone up a little. Currently my PSA is 129.6, up from 118.3 last month. No panic has set in, we just hope to bend the curve next month!

“The Ugly” is the fact that I will be looking for a job as of June 30th. Though I have known about this since September, there were some indications until yesterday that the date may be extended. It’s not all that terrible, I have 36 weeks of severance. Additionally, and perhaps most importantly, I can switch to Mary’s health insurance next year when mine runs out. With twenty years of experience in telecommunications and a pretty solid resume I have faith I’ll find something in due time.

Oh but there’s more…Looks like out air conditioner just went out! When the thermostat is set at 76 and the temperature in the house is 86, you know there is problem! To top that off, the U2 tour was just postponed until 2011, so much for my first live U2 experience this summer!

In closing, I want to add this cliché ridden statement; “It’s all good people!” Seriously, we’ve been down this road before and we’ll come out better when it’s all through.

We Got To Get You A Woman

David Emerson, DES, estrogen, PSA, Todd Rundgren -

As funny as I thought I was being with the Helen Reddy post, I promised Mary to lay off the references to the whole ‘woman’ thing.

With this post I am hoping for little leniency, or forgiveness? However, come to think of it this has nothing to do with being a woman or feeling like one.

Being a Todd Rundgren fan it just came to mind and I wanted to share.

Why? When your PSA goes down 40% in 10 days you have to sing about something!

One final note, as we have in the past, we are cautiously optimistic for long term results. Yes it’s good news and without a doubt I am going to enjoy the next 28 days!


What’s going down?

Advanced Prostate Cancer, David Emerson, DES, PSA -

Tomorrow is my monthly check-up, you can probably guess I’m a little nervous.

After five years, close to 75 PSA tests, and I would guess over 100 doctors appointments, you might think I would be used to this routine. While the routine is old hat, the anticipation and lead up to the results are something I can’t ever imagine getting use to.

This subject is a topic that gets bantered about on some of the Prostate Cancer message boards. I can’t express to what extent the quality of men’s lives are impacted by this disease. With my case this might sound like a very obvious statement, but there are millions of men out there that have surgery, radiation or just choose to monitor their condition, that go through this anticipation periodically as well. Whether it be every month, quarter or year, these men go through a similar period of time leading up to their test results that mirrors the monthly anguish that I experience anticipating my PSA tests. This is one of the aspects of our experience that the general public may not be able to completely understand. It’s very taxing.

I usually do pretty well with this and probably will do so tomorrow, but I do wonder what the results will be. After starting estrogen (DES) ten days ago, this will be my first test. My last test indicated my numbers were increasing rather quickly. On March 14th my PSA was 193 and I didn’t begin the Estrogen until March 18th, so my PSA before starting DES was probably over 200. Tomorrow, well we’ll see. I don’t know how quickly we will see a response to this new treatment. I am struggling to make a clear, concise point and that IS my point.

~~~~~~~~~~~~~~~~~~~~~

I was able to get out today and play disc golf. It was good to see and play with Tim and E again. Eric, it’s been far too long! I played pretty good, nothing great, but it was a pain free round. Since starting DES, overall my body feels much better. My hips hurt less and my legs are better and I am still able to avoid the Advil.

Finally, tonight was a good, quiet family night. We caught up on a few things we had recorded and basically just enjoyed the relaxation and each others company. It’s Easter week and I look forward to the emotions of the week.

Peace be with you all.

Like Atlas

Advanced Prostate Cancer, David Emerson, hrpca, PCa, PSA -

The news of late on one hand is weighing heavily on me, but on the other, we have been here before so I face the day with a smile and try to put the fear behind me. As we revisit this ‘place’ on our journey, I was recently reminded that Faith, Love and Hope are once again those attributes that we must lean on and call on to get through this period.

I try not to speak here as some sort of self-appointed expert on cancer. I just try to share what I know, what I feel about living with advanced, metastasized, hormone refractory Prostate Cancer. Right now it is the unknown that is most concerning. Fear is a particularly distracting emotion. It’s there, right there below the surface, sometimes deeper than others. This will all be behind us once we make a decision. Next week I will either prepare to start a clinical trial or begin a new treatment. Time is of the essence.

If I start the new treatment we will know within a few weeks if it’s working. However, what we will not know is how well and for how long. Another thing that concerns us (re: more fear) is if we pursue this treatment (DES), it will require radiation to my chest to avoid gynecomastia (think man boobs or ‘moobs’). It’s only a one time shot of radiation, but it’s still radiation. We must focus on the fact that there have been a lot of good results with this treatment. That is encouraging.

If we decide to pursue a clinical trial, I’ll have three more weeks when I have to remain off one aspect of my past treatment regime. This is sure to cause my PSA to go even higher. This thought is very concerning as well, again with the fear. The clinical trial is not looking too promising. We might even have a final answer later today. It is going to require some travel, but hopefully just three trips over a month’s time.

It is my burden, but it’s also hers and his. We will get through this together. So after a brief period of self pity and being somewhat consumed by the fear, I am moving on to more positive thoughts, feeling and attitudes. It’s not the final round in this fight, more like the 10th and I just got knocked down, but not knocked out!

194 More Reasons to Hate Monday

Advanced Prostate Cancer, David Emerson, Ketokonizol, PSA -

Today we saw the oncologist to review my bone scan and the updated blood tests from Friday.
The results…worse!

My PSA climbed to 194.45 which equates to about a 20% increase within one weeks time.
The radiologist report indicated the bone scan was primarily stable. There were up ticks in existing areas, but no new tumors were identified.

The rise in PSA is very troubling and reinforces our decision that a change in treatment is required. As of tonight, I have stopped taking the Ketoconazole, in preparation for our next step. Next Monday, we will either start DES or select a trial location for Provenge. Our ability to pursue a Provenge clinical trial is dependent on us finding a location that is accepting new patients and logistically reasonable.

I’m not depressed, but just kind of bummed out at this point. I have a very busy week ahead so that will provide a lot of distraction, and leave me little time to ponder what lies ahead.

I remain pain free and even played disc golf yesterday for the first time in over a month. We’ll get through this, as we always do.

At the risk of being repetitive, please join me in a prayer to Saint Peregrine.

Prayer to Saint Peregrine ~ Patron Saint to cancer patients

O great St. Peregrine,
you have been called “The Mighty,”
“The Wonder-Worker,”
because of the numerous miracles
which you have obtained from God
for those who have had recourse to you.

For so many years
you bore in your own flesh
this cancerous disease
that destroys the very fiber of our being,
and who had recourse
to the source of all grace
when the power of man could do no more.

You were favored with the vision of Jesus
coming down from His Cross
to heal your affliction.

Ask of God and Our Lady,
the cure of the sick whom we entrust to you.
(Pause here and silently recall the names of the sick for whom you are praying)

Aided in this way by your powerful intercession,
we shall sing to God,
now and for all eternity,
a song of gratitude
for His great goodness and mercy.
Amen.

The beach is how far away?

Advanced Prostate Cancer, anna maria island, David Emerson, PSA -

I have to start by complaining a little about the weather. Wow is it cold here in KC! Sub zero temperatures and wind chills that will freeze you in minutes. Yes, we had a white Christmas, now I am ready for a little reprieve from the snow and freezing temperatures.

On Monday I had my four week appointment with Dr. V.My PSA stands at 111. That is up 3 points from December, virtually stable. If It had gone from 8 to 11, I’d be worried but with numbers that high, it’s as if it didn’t change.
Yes I’ve become a little complacent, but what we are waiting for is a big jump and/oran increased amount of pain. Right now, as I type this I am pain free. This leaves us,once again, living in a 28 day cycle.
At some point, hopefully months from now, we will have to make a decision on our next treatment. I’ve gone over what those choice are here time and time again so I’ll save that for another post. The choices are few and the long term benefits of most are negligible. However, we go on,heads up, stronger than ever.
As we grind through another frigid winter day I look forward to a few degrees of warmth that perhaps will come next week. I also look forward to a trip to the beach and the warmth and comfort of sand between my toes and Maryat my side. Perhaps it’s time to start making those plans…

Lucky Sevens

charity poker, David Emerson, FLHW, Prostate Cancer Foundation, PSA, texas Hold 'em -


Monday the 7th we held our 7th FLHW Texas Hold ’em Poker Tournament. We started these in 2006 as another way to spread the word about Prostate Cancer screening as well as to allow people that may not play golf to come out for a good time and to help support FLHW.

Over the past three years the poker tournaments have raised approximately $10,000 of the overall $132,000 we have raised for the Prostate Cancer Foundation. I was rather proud when I added this up on Monday before the tournament.
At this week’s event we had 42 players and raised slightly more than $1,500! It was really great to see a number of first timers. I hope they enjoyed themselves and will come back for future events! The room and tables were packed! In the end Brad took first and Tim second.

I really enjoyed the evening and am looking forward to our next poker event in February!

Also on Monday I had my monthly doctor visit, Lupron shot, PSA test and quarterly Zometa infusion. The meeting with Dr. V was rather quick. My PSA rose to 108.8. We decided to maintain the current regimen through the holidays. I am feeling great and the other tests were in the normal range. When I return next month, on January 4th, as long as I remain pain free and my PSA remains somewhat stable, we will just continue on. (All of the pictures are here).