On the other hand, my PSA was up, way up. It now stands at 97.04 up from 66.14 last month.
While we did agree to pay less attention to my PSA when we left MD Anderson in April, this climb has me a bit concerned. This is my highest level since September 2006.I did leave with two new prescriptions for Ketoconozale and Hydrocortizone (HDK). This combination is what I took in 2006 when my initial treatment stopped working. It worked for 16 months, then I tried Nilandron, then I did chemo. Going back to Keto + HDK is somewhat of a risk. There is a chance that it might not work at all. We decided to give it one more try before moving on to something more serious and more toxic. We can try DES (very low amounts of estrogen) but want to keep that in reserve and may end up trying that next. Until some of the newer drugs (Provenge and Abiraterone) are either approved or open new trials, my next choice is another round of chemo in combination with some sort of clinical trial.I knew my PSA was going to be higher, I just did not expect it to be such a dramatic increase.
Main Entry: stable
Function: adjective
Inflected Form(s): sta·bler l “”
Etymology: Middle English, from Anglo-French estable, stable, from Latin stabilis, from stare to stand Date: 13th century
1 a: firmly established : fixed, steadfast b: not changing or fluctuating : unvarying c: permanent, enduring 2 a: steady in purpose : firm in resolution b: not subject to insecurity or emotional illness : sane, rational 3 a (1): placed so as to resist forces tending to cause motion or change of motion (2): designed so as to develop forces that restore the original condition when disturbed from a condition of equilibrium or steady motion b (1): not readily altering in chemical makeup or physical state (2): not spontaneously radioactive
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Are you scratching your head yet wondering what the heck I am getting at?
Well I picked up my copy of the scans and the Radiologist’s report and within the seven page report lies the bottom line, the conclusion the good news!
CT Scan: Impression
Abdomen:
1) Stable sclerotic foci within L2 vertebral body consistent with blastic metastatic disease from the patient’s known prostate cancer. No new sclerotic metastses are identified.
2) No evidence of hepatic metastatic disease or abdominal lymphadenopathy.
Pelvis:
1) Stable sclerotic lesions within the hips and bones of the pelvis consistent with metastatic disease from the patient’s known prostate cancer. No new osseous lesions are indentified.
Full Body Bone Scan
Stable bone scan with uptake in multiple pelvic osseous metastases. There is no scintigraphic evidence of new osseous metastatic disease since February 23, 2009
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All this means is that the overall disease appears to be stable. On Monday we will find out what the blood and other markers (PSA, CTC, BAP etc) are indicating and we’ll go from there.
Not sure what the options are, but we’ll be sure to let you know once we discuss with Dr. V, and perhaps Dr. L in Houston
In this case I broke out in hives!
Today I had a follow up bone scan and C/T Scan. Like everything else with this disease, it all takes time.
At 1:00pm I was injected with a radioactive isotope in preparation for the 4:00pm bone scan. Not much to the prep other than accessing my port and injecting me with a syringe they take out of a lead container that contains a warning symbol for radioactive material. It’s kind of ominous.
Immediately after the injection I spent the next hour drinking a “creamy vanilla” mixture in preparation for the C/T scan. This scan was approximately my 4th or 5th in the last four and a half years. It’s a relatively easy process that seems to have gotten easier over the years. My memory isn’t the greatest but I do remember that the first few times the liquid was dreadful and it seemed to take a lot longer to consume, or perhaps it’s just that the wait used to be longer after consuming the liquid. Anyway, after I finished drinking the required dose I was immediately escorted to the scan room. The C/T device is not like the scanner you see on TV or in the movies. It’s like a gigantic donut. I lie on a table that slides me in and out of the donut hole. Before the scan starts however they injected me with some type of iodine that reacts
with the “Creamy vanilla” liquid in order to make ‘areas of concern” light up on the scan. I can tell when they begin the injection, as I feel a weird warming sensation in my lower abdomen and bowels…lovely!
Today, shortly after the injection I started feeling a little itchy but thought it was the chigger bites from recent rounds of disc golf. As it turns out, I was was having an allergic reaction to the iodine and started breaking out in hives. I didn’t put two and two together until they were done and I was back in the waiting room with Mary. I told her I was itchy, she pulled up my shirt and discovered a few hives on my stomach. I returned back to the procedure area and the doc, the nurses and techs knew right away what it was and 50mg of Bendryl took care of everything. The only problem was the Benadryl wiped me out and I needed a 45 minute nap when I got home. Also, now anytime I need a C/T I’ll have to take Prednisone (steroids) the day before. Hopefully, it’s low dose and at least my knees will feel good for a day! We were surprised that I had an allergic reaction, as I’ve had numerous scans previously, and I never had a problem. The doctor explained that one’s immune system can be altered after going through chemotherapy, so we will assume that’s the case.
Mary and I had 90 minutes to kill before the bone scan so we ran out to one of our favorite places to eat, the Blue Koi. Ever since chemo my favorite dish at the Blue Koi has never tasted quite the same. I am glad to report that today it was great once again! We both enjoyed the meal and our time together mid-afternoon.
The bone scan was routine: lie on the table and 45 minutes later, you’re on your way. After receiving the Benadryl, I think I might have dosed off for most of the procedure and my ride home as well!
I’ll pick up the CD’s tomorrow and we’ll review with Dr. V on Monday.
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I’m not sure where this thought came from today, it may have been the murder/mystery I was reading or the article on Elizabeth Edwards from an old dog eared People Magazine, but I was thinking two things; I think Mary and I are doing a pretty good job of living a “normal” life. I’m not sure what normal looks like anymore, but my guess is there is some semblance of it in our day to day lives. That makes we happy.
The other thing I was thinking is I am grateful. Grateful for what you may ask? I am grateful for all the time God has blessed me with since this happened. So many people in this world die quickly, unexpectedly and without any warning. I was just reflecting on how lucky I actually am!
Once again a week has passed and I have failed to post an update.
I do have a slight excuse, we spent the holiday weekend in Minneapolis with a dear friend.
The weather up there was ideal, low 80’s and no humidity and not a hint of rain. We had not been there in years, literally it was before Brad was born, so we’re talking 1995? For that I would like to apologize. Good friends are hard to come by and we should have visited long, long ago.
The four days were a whirlwind of activity; Mall of America, a Twins game, Lake Minnetonka, Excelsior, Lord Fletcher’s, Wayzata, a visit by Mary’s old house, Lake Reilly, an afternoon cruise on the Lake, spending the evening sitting around the fire pit twice, way too many toasted marshmallows, smores and almost 14 hours of driving.
On another note. work is becoming more and more stressful as we get closer to the offer of a job or you’re out of a job stage. Many people I really enjoyed working with are leaving. It’s going to be a much different place, if I am extended an offer to stay.
Next week I have appointments for an updated MRI and bone scans followed the next week by my monthly Oncologist appointment. More on that in a later post.
Time is flying, but I hope it’s clear, I am taking time to enjoy a little of it!
Today was my monthly doctor appointment. I am not sure where the time went…June is nearly over.
For the past weeks I have felt the same, no new aches and pains, no need for Advil or the like. As reported, my knees hurt but Glucosamine is helping a little. I think chemo pretty much trashed my cartilage. As for cancer related pain, I really have none.
So, on to the test results. A little history; after leaving MD Anderson we agreed to pay more attention to everything going on instead of focusing primarily on PSA.
My PSA today was: 66.14
This is up from 55.13 last month. I was not at all surprised considering I am only taking Lupron at this time.
The three new tests came back looking like this:
Alkaline Phosphate (bone portion) – 6 [very low!]
Circulating Tumor Cells – 0 [excellent!!]
This was all followed by the fact they once again screwed up the forth test (the urine test). I could only ask, “Seriously?”. Doc tried to lessen the blow by saying the other markers are indicating good things. I had to just bite my tongue and move on. He promised to write out very, very specific instructions for my appointment on the 14th. I’m not holding my breath.
So then we were off to the treatment center for a shot of Lupron and Zometa [a 25 minute infusion to strengthen my bones]. Turns out someone wrote the orders for next week, so it took 45 minutes to get that straightened out and then another hour to wait for the pharmacy. I’m really finding it hard to be patient in regards to the the service at the cancer center, but I will.
In the end, the plan is this; on the 14th I will have a bone and CT scan. The following week will be my usual four week appointment on the 20th. If at that time, my PSA has continued to climb we might start High Dose Ketoconazole once again. By then it will have been 17 months since I last took Keto and it MAY work again? Like a broken record, I guess we’ll just wait and see.
* Every man has the right to know whether he is at risk for clinically significant prostate cancer that might lead to his death.