David’s Blog

Looking West

Advanced Prostate Cancer, bone scan, chemotherapy, Colorado, CT scan, David Emerson, Lake of the Ozarks -

A few medical updates after Monday.

I / we were not real comfortable waiting an additional week to start chemo (until June 16th).
Tuesday, Mary did the leg work, called the doctor’s office and inquired if if there was anything we could do in the next four weeks, or if there were any alternatives/options.

Yesterday they called back with some encouraging news. I will start treatments on the 9th as originally planned! This means on the 3rd I will have to spend most of the day at the hospital getting; a chest x-ray, a C/T scan and full body bone scan. This will mark the 6th set of the latter two tests. I imagine I might begin to glow at night, as they have to inject me with low-dose radiation each time they do a bone scan.

These last three weeks have been draining. Not only are the days longer, but the weeks seem to drag on and on. I never thought I would look forward to starting chemo. It’s just this; we made a decision, let’s get on with it.

Another somewhat stressful aspect is that we can’t really plan our summer. We wanted to take Brad to Colorado, I was going to take him camping, a trip to the lake, a weekend at my brother’s property, a trip to see my dad in St. Louis, and the annual get together with my sister from Ohio. Well all of that is currently in limbo. The whole chemo process could go according to plan; very few side effects, little fatigue, white and red cell counts stay high or near normal etc. but because we don’t know, we have to be careful not to plan too far ahead.

I pray for results like I had with Ketoconizal and other medications. I consistently responded well to previous treatments. Our hope is that the chemotherapy will get the cancer under control, my PSA will decrease, we can follow it up with other meds to keep it under control and resume a somewhat normal lifestyle for years to come. We’ll see.

I thank God daily for such a loving wife and wonderful, understanding son. I know he’ll love Colorado, when we finally get there……

39…48….Whatever

Advanced Prostate Cancer, disc golf, medical port, University of Kansas Cancer Center -

So today was monthly update day, month number 39!

First of all the trial, being what I believe to be a typical trial, works like this;
– I have to be off Nilandron for 6 weeks BEFORE I can enroll. That wasn’t clear until this morning.

I did a good job of biting my lip when the trial manager explained this to us. So now I will have bone scans, CT scans and a chest x-ray on June the ninth and my first treatment in conjunction with my 40th month appointment on June 16th.

I did receive my PSA, it’s up again to 48.87. I suspected it had climbed as I have had a few twinges lately that I knew meant something. Not pain but just little things that after three plus years of this were signs.

I’m going to call Dr. Van tomorrow to make sure we are OK to wait another four weeks? I just don’t want my PSA to climb much more. My guess is that is the risk we take, I’m not sure I’m comfortable with that as I write this tonight?

I’m off to a baseball game, perhaps two hours of 11 year old baseball will take my mind off this for a while……

BTW – the port was awesome!! No needles in my arms and tomorrow I will test my ability to throw a disc again!

Historic Data:
5/19/08 48.87
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)

Another reminder that it’s not all about me….

blog -

With the risk of being repetitive, God reminded me today (once again), that it’s not all about me.

Friends of ours have been going through their own health crisis. I ask that you pray for them as they will be undergoing a major surgery tomorrow. Pray for success through surgery and comfort through the recovery process.

As I write this, I have just finished reading an email that was sent out as an update to family and friends. I have tears in my eyes as I can sense the fear and uncertainty in her words. Please send them strength through a prayer, or a silent moment, or however you choose. I would like to ask the Lord to watch over them, and have as many people as possible send some positive thoughts their way!

Hail Mary,
Full of Grace,
The Lord is with thee.
Blessed art thou among women,
and blessed is the fruit
of thy womb, Jesus.
Holy Mary,
Mother of God,
pray for us sinners now,
and at the hour of death.

Amen.

Another legend falls

Advanced Prostate Cancer, medical port, ric masten, University of Kansas Cancer Center -

On Saturday night we lost another of the true champions of the prostate cancer community.
Ric Masten, who had fought the disease for over 10 years passed on to a better place.

A link to Ric’s website is and will remain on the left side of this page.

I have written about Ric here before, we exchanged messages a few times in the last year. I wouldn’t pretend to know him but his website has been a real inspiration to me over the past three years.

I was truly saddened by this news. Ric was a poet, an artist, a minister and a friend to many.
~~~~~~~~~~~~~~~~~~~

Today I had my port installed. No complications to report. The procedure went very smoothly. My neck hurts a little, but that is to be expected. They made a small incision at the base of my neck on the right side and then about a two inch horizontal incision on the right side of my chest. I basically have a little bump on my chest. The staff at KU Medical Center were all wonderful, more details to follow.

We are the champions…..my friend!

Advanced Prostate Cancer, kansas city corporate challange, men's disc golf, PCa -

On Sunday morning my friend Gary and I represented our company in the “Kansas City Corporate Challenge”. Our event was Men’s Doubles Disc Golf [was there a doubt which sport I’d play in?].

There were 151 men’s teams. The teams are grouped into divisions by company size. We were in the A Division along with Sprint, Cerner, Farmers Insurance etc.

We went out and shot -10 to win our division and along with one other team shot the lowest score of the day! Results Page
Here’s a photo after we received our gold medals.

It was a great round, we had 7 birdies on the last 8 holes including a few REAL long putts by me and a near hole-in-one by Gary!

Another chapter in my life of irony has been written!

m’aidez

Advanced Prostate Cancer, chemotherapy, Mayday, medical port, PCa -

Mayday
The term was made official by an international telecommunications conference in 1948, and is an anglicizing of the French “m’aidez,” (help me).
~~~~~~~~~~~~~~~~~~~~~~~~
Just a little humor regarding a very serious subject.

We got a call yesterday from the hospital, seems I have to go in on the 12th to have a port inserted. What is a port? Click here to see it in action. The webpage is that of a man who was being treated for Pancreatic cancer at the time. I include it for the pictures, read the narrative at your discretion. Not only will this be used for the Chemo treatments (beginning June 9th) but also for blood draws, monthly Zometa infusions and infusions for upcoming bone and CT scans.

Mary’s a little freaked out about it. I’m not……yet.

Chopsticks

Big and Rich, Cardinals, chemotherapy, disc golf, i, Kansas City Disc Golf, PCa -

Mary, Brad and I watched the movie “Big” on Friday night. I must have seen this movie fifty times. I still love it every time. The scene that takes place in the FAO Schwarz toy story is one of my favorite parts of the movie. I’m not sure why? Perhaps it’s Robert Loggia acting like a little kid with Tom Hanks as they play ‘Chopsticks’ on the big piano.

On another note, here is yet another example of the irony of what I am going through. As I’ve mentioned my PSA continues to climb and on June 9th I will begin Chemotherapy as part of a clinical trial. So what does one do when facing events like this? How about play disc golf three days in a row!

On Friday I played nine holes and qualified (along with my friend Gary) to represent our company in the ‘Kansas City Corporate Challenge’. The event, is like a corporate Olympics and lasts for several weeks. The men’s disc golf event is next Sunday morning.

Saturday, most of the usual gang played and I got a little lesson from young Joe….I added about fifty feet to my average drive! The rest of my game needs a tune up but my drives are looking good!

Even after 5 hours working in the yard yesterday, I played again today with Pete, Joe and Steve. We played at a course I haven’t played at since last summer. This course is longer and harder than our usual course but I shot really good on the front nine but two bad holes on the back cost me a good round.

So after that lead in, one that was probably much too long, I recant – after what I am going through with Prostate Cancer, I can’t believe I played three days straight AND worked in the yard yesterday? Is this crazy or what? No fatigue, no pain…..no worries!!

And now we reach the point where I wax philosophical…..
We are on the 10th hole yesterday, Steve and I started discussing this one particularly loud sound bird. After locating a stunningly beautiful male Cardinal we further discussed the fact that unlike most birds, the male Cardinal is the more colorful bird.

Big deal right? Then yesterday afternoon, I take a break from mowing the grass and I’m sitting on the back steps and I hear the same song. No sooner do I find the Cardinal when up flies his mate. They sit there for a minute or two and off they fly together.

I wish there was more, but that’s the story, just a moment of time from a beautiful spring weekend.

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.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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)

Another Successful FLHW Event

Charity Disc Golf, disc golf, FLHW, Kansas City Disc Golf, kcfdc.org, PCF, Prostate Cancer Foundation -

Yesterday we held the first annual FLHW Disc Golf Tournament.
Pictured on the left are the winners, Dave and Arturo who shot 38 in the first round and 39 in the second for a total score of -31!

The picture on the right is of Arturo’s winning putt during the closest to the pin contest.
Click on it and in the enlarged version you can see the disc about to land in the chains.

The day started out blustery and in the mid 40’s, but by the afternoon round we were in short sleeves and the temperatures climbed well into the 60’s.

26 teams participated and helped us raise approximately $2,000 for the Prostate Cancer Foundation.

Again, the kindness of strangers as well as friends and family leaves me somewhat speechless. I owe a big thank you to Pete, Gary, the FLHW Board, the volunteers and everyone who participated in the event.

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