Cancer Living Cancer Talk #1

My first informal cancer talk from my home office. I discuss my diagnosis, my treatments, a little bit on chemotherapy terminology, and a few cancer related books and I’m currently reading. 

Hope is grief’s best music

Strength is born in the deep silence of long-suffering hearts

Participating in a Clinical Trial – Part 2

After a writing hiatus due to chemo side effects, I’ve finally started writing again. Today my latest article for prostatecancer.net was published. I’m still struggling some getting in my writing mode, but it’s getting there. And I hope to be writing more here as well. Until then, please check out my latest piece:

Participating in a Clinical Trial – Part 2

Oh, the pain!

Dr. Smith said it best: "Oh, the pain!" (Or "Oh, the pain...the pain!!") Well, I could probably put it another way, but I won't for now for fear of offending myself.

So anyone who knows me on Twitter knows that the previous two days I've dealt with a lot of pain. More than usual. Since my diagnosis the pain has slowly been increasing. Some of it is sciatica, but a lot of it isn't. Sometimes the pain is around the L5 spinal segment, and that's the one that practically keeps me from walking. 

I initially rejected the idea of pain killers. I felt that admitting I needed pain killers was like I had one foot in the grave. But then I started feeling the pain in of sciatica. Not only did it hurt, but it gave me this claustrophobic feeling like belts were strapped around my legs and I couldn't get out. This led to a panic attack, which just made the thing a whole lot worse. 

So at that time I asked my oncologist, (who also specializes in palliative care and hospice care) if there was something stronger than aspirin that I could take. Pain is one thing she will not let patients endure unnecessarily. Since my pain was acute, I was given a prescription for Oxycodone. (Note: the second opioid crisis is lack of pain medication for those who really need it, like people with metastatic cancer.)

I found this worked really well. I'm generally never painless, but the Oxy will take it down to where it's bearable. Fortunately, I can usually tell when weird claustrophobic sciatica will happen, so if I can take pain meds early, I don't get panic attack.

Yesterday and the day before I could barely walk when I got up in the morning. This morning at 6:00 am, I got up and took my pain medication as I could feel it coming on. Then I went back to bed, slept a couple of hours, and woke up at 8:00 am with barely any pain at all. So seems that if I can stay ahead of the pain, it'll be a whole lot better for me later on.

Ok, I never get to talk about the Lost in Space TV show. Ever. Enjoy...

Giant carrot

Smith turned into a celery stalk

Debbie the Bloop

The Green Lady

Danger Will Robinson

Stay tuned for scenes from next week's exciting adventure!

Song for a Friend (Music)

A picture is worth a thousand words…and so is a melody. I’ve written music since I was five or six years old. I studied composition at university, but eventually dropped out of music school. But one thing I’ve found is that I can somehow express my deepest feelings with music where words would just fail me.

 Here's an instrumental track I wrote and recorded in my kitchen in 2009. This tune was written for my dear old friend, Kirk, who I’ve known for over 20 years. Kirk and I live less than an hour apart, but I swear it’s been ten years since we’ve seen each other in person, which just ain’t right…

Kirk and I usually send each other silly emails each Christmas. But I hadn't sent one the last two holidays because I was going through chemo each time. I finally decided to send that silly email, and like always, we were reconnected. Before I could tell him I had been diagnosed with incurable cancer, he told me his wife of many years had just died of cancer in the last year. Kirk is a curmudgeon and a grump old fart who is funny and a pleasure to be around. Even though it was an email, I could hear his heartbreak through the wires.

Listen 

When Goodbye Really Means Goodbye

Goodbye. It’s a word we use all the time. We may also say something like: see ya later, so long, farewell, bye-bye, and others, but goodbye has a more formal ring to it. But despite that, our intended meaning is often something like "until we meet again.”

I had a couple of cancer friends who died last year. In both cases, the last time I saw them we hugged and said goodbye to one another. I had no reason to believe that we would never see each other again.

Cancer is a cruel and unmerciful taskmaster. Alas, another lesson learned that bites like the bitter winter wind and knocked me off my feet like a right hook would from a champion boxer.

Always say goodbye like it may be the last. Sometimes goodbye really means goodbye.

I'm alive, I'm alive

I'm one month out from my last and final chemo. My PSA last week on the three-week checkup was 0.97. That's pretty amazing considering I started at 5,306 a mere 16 months ago. My first line-treatment (docetaxel and Lupron) only lasted about six months before my PSA started going back up, but we did get it from 5,306 down to 22, and that's a hell of a decrease. I started with such a high PSA that an improvement was almost a given during my first round of chemo. When my PSA started going up, I finally learned what cancer treatment disappointment is. I'm stage 4, so my cancer is incurable, but I had hoped the first-line treatment would have kept my PSA in the normal range for months, if not years. It was like the first time you nick a precious porcelain tea cup and you know it will never be the same even though the whole time you knew it was inevitable. But no matter how much time you have to prepare, you're never quite ready for it.

Today I read a post from a guy in a metastatic prostate cancer support group who said that his PSA had started going up after 20 months of being on abiraterone acetate (Zytiga), the same medicine I started a few months ago. This made me think of the stage 4 cancer as a chronic disease debate. Truthfully, as long as my medicine works, I can actually think of it that way. But once my medication quits working, and the medication after that quits working, and then when I'm all out of options, well there you have it, end of story.

Don't get me wrong, I'm absolutely grateful that there are medications (even the chemo) and options that can keep me a alive a wee bit longer. But the fact is, in the end I will run out of options. I play this over and over in my head, imaging how I'll feel the day my "chronic condition" goes terminal. I'm in this odd position of uncertainty and shaky middle ground, feeling somehow that despite have incurable cancer, I'm not sick enough to be in the "cancer club" (imposter syndrome) yet knowing the day will come when I most definitely will be.

I mostly focus on the present, enjoying life moment to moment. I still feel that I have so much to give before I go and that somehow I'm helping others. So the time spent feeling helpless is relatively small, which leaves me plenty of time to feel fearless. I have my bad days, don't ever think that I don't. But I do have really good days, days where all the little pieces of life seem to fit together. It's at those times when I want to scream, "I'm alive, I'm alive!" and know that I really am. 

Chemo - Round 2, Cycle 6

At last the day for the final treatment has arrived. Pretty much a standard treatment day. Labs, meet with my oncologist, and head to the chemo room for treatment. I thought that I might be asked to ring the bell again for my last treatment like I was last year, but that didn't happen. Could be because I didn't mention it, or maybe because I slept through most of my treatment due to the Benadryl once again. Just in case I had written my own bit to read before the ringing of the bell. I had originally decided I was definitely not gong to ring the bell because my cancer is incurable. I talked to several of my online cancer friends and I got a few good things to think about. First, do what ever makes sense to me. No right or wrong answer. For the most part I also got the suggestion that I do it for all those going through cancer. I couldn't argue that. So I wrote a quick piece to read if I were asked to ring the bell. Since I wasn't, I sent a scan of my handwritten words to the cancer center via Twitter. With no further commentary from, a copy of it follows:

The Smallest Gestures

It's a shame we fail to realize the smallest gestures often produce the largest returns. A smile when someone is feeling sad. A hand when someone is feeling down. A word when someone is feeling discouraged. An ear when someone needs to talk. That's all it takes. -Harry Petsanis

Chemo - Round 2, Cycle 5

Cycle 5, the penultimate treatment. I wish I could say I was going to miss it, but I'm not. I will miss the awesome nurses that work the treatment room. They make it so much better. So no matter where you are in treatment, better is always good.

The usual labs, nothing special there. Well, my PSA was down to 2.08, which is incredible. And pretty special. Just a little more than a year ago my PSA was at a monumental 5,306. Not bad at all buddy boy, not bad at all. (I love Henry on the TV show Oswald, and that's one of his classic lines.) Ok, where was I? My oncologist thinks I'm doing really well. The clinical trial coordinator things I'm doing pretty well. And I think I'm doing pretty well. So we have a unanimous consensus on that.

Scan results were good as well. The morning PET scan was cancelled due to the tracer not passing quality control. That worked out for the better as the schedule was really tight, if not impossible. CT and bone scans showed that things were still holding ground. At stage 4, that's really the best you can hope for, so I felt really good about that.

Treatment was just another day in the chair. I wish I could tell you more, but the cumulative effect of the chemo is catching up with me. I'm still going to work, but really when I get home it's hard to do much of anything. Fatigue is the main thing. I took it real easy during my nadir week, as I don't dare get sick again like last time. The nurse I had this time explained to me that the machine could be set to take 13 minutes to deliver the Benadryl, which has been the real bane of this round of chemos.

Cycle 4 Recap

As I had predicted, my previous treatment (cycle 4) started hitting my harder. This was the first time I had ever gotten sick durning the nadir period. Other than that, nothing unpredictable. All the normal throbbing aches and pains in the ankles and legs. The peripheral neuropathy more pronounced. Week 1 was typical in that I felt fine after chemo on Monday, as well as all of Tuesday and Wednesday. The aches kicked in on Thursday, which is also typical. Metal mouth started on Friday. Week 2, nadir week, I definitely felt the fatigue. And on Tuesday I felt something was not right. I was having hot flashes followed by the chills. I was constantly taking my shirt on and off. Or I should say shirts. It's winter here and cold, so I have a t-shirt and a flannel. So it was the flannel that saw the action. And on Monday and Tuesday I had terrible brain fog. On Friday I felt so bad that I went in for a checkup at the cancer center.

I was at the cancer center around noon. First was labs and about an hour wait to see the PA. (Physician's Assistant) I was just out of it, so I feel like I really didn't answer her questions very well. But she was patient and very kind, and just let me ramble as I needed. My white blood cell count was low, which was to be expected. 1 point something. She also determined that I was dehydrated, which no doubt I was. So she sent my upstairs for a saline drip.

I was there by myself, and even though I still felt pretty miserable, I had the greatest nurse. I think she was a little bit of everything I needed to feel better and have faith in humanity restored. I think she was yet another guardian angel. Can you have ore than none? Anyway, that's another blog post.After six hours at the cancer center, I was ready to go home. It took a day or so to feel better, but by Sunday, I was feeling back to normal.Week 3 was pretty standard. The white blood cells are building up and the immune system is getting stronger. Generally during week 3 I feel human again. I try to eat well and exercise a lot more so I'm all ready for the next cycle.

Chemo - Round 2, Cycle 4

So we start the back half of treatment in the first week of the new year. And back to what I consider the normal schedule: 9:00 a.m. labs, 9:40 a.m. appointment with my oncologist, and chemo at 10:30 a.m.

Well, not quite normal. The cancer center was incredibly busy, I imagine partly due to the holidays and things were running behind.

My wife met me in the “small” exam room and we had a bit of a wait. I never mind as my oncologist is very attentive to all her patients. Anyway, it was probably about 10:15 or so before we met with my oncologist.

Fortunately my labs looked good and I didn’t have a lot of questions. My scans also came back good. Or really as good as they could be. No progression for the most part, and some mets have gotten smaller. But there are a LOT of mets. I asked how many there were and she really couldn’t quantify it as pretty much my whole spine was black in the scan, which means there are lots and lots of mets.

My previously swollen lymph nodes (only one or two) had shrunk and my prostate has been getting smaller too. That I can tell because peeing is a lot easier. Yeah, the Flowmax helps, but I can tell the difference with my prostate. One thing I didn’t get at my appointment was my PSA, as it wasn’t ready yet.

We made it to the third floor for chemo just a few minutes late. The waiting room was packed. I did have a longer wait than usual, but nothing outlandish. It was nice to just sit. I did some 4-7-8 breathing exercises and then just enjoyed the wait. Not too long and the pager buzzed and I was on my way in.

This time I got a room with a window. Normally that’s a good thing, but it was cold outside and the windows were drafty. Reminds of a time when I got a rental car that was a convertible, which I suppose is a good thing (despite being terrified of them), but it was December, bitter cold, and it was snowing.

I got my warm blanket and I was happy. The good news is the nurse who would be administering my chemo was this really nice (and very thorough) lady from Ethiopia who I’ve had before, I think during my first round. This is my 10th chemo and I didn’t start blogging about them until this time around so I’m not really sure.

There was some delay in getting the medicine from the pharmacy, so we didn’t get started until about 11:30, an hour later than scheduled. Not a big deal, I enjoyed just sitting. I asked for a sack lunch, but apparently there weren’t any. The Ethiopian nurse brought me some snacks, which was very kind of her. Some peanut butter crackers and a little pack of shortbread. And later she found a frozen peanut butter and jelly sandwich that I saved for later. And my wife brought some Tippins pumpkin pie. Not sure what it is about pumpkin pie and chemo, but for me, the two go hand in hand. My oncologist’s nurse called and let me know my PSA had gone down to 2.8! I can’t remember the last time it was under 3.

Another nurse came in to do the pre-chemo drip. When I mentioned the Benadryl just wiping me out, she said she would administer it to me in one-minute intervals over the course of five minutes. Ok, this nurse deserves an award of some kind. This made a huge difference. It took five or ten minutes before I even felt it. And I simply felt groggy, which is way better than falling asleep in a matter of seconds. I nodded of here and there, but I was with the world for the duration. And when we left I was cognizant and could walk out on my own two legs. Still, it’s 7:00 p.m. and I’m going to bed.

Cycle 3, Week 1

I’m finding cabazitaxel to be less predictable as I go through treatments, and certainly not like docetaxel where side effects kicked in like clockwork. Tuesday and Wednesday were side effect free, which is one thing that hasn’t changed. Normally the jabbing pains in my legs and ankles start on Thursday. This time is was barely noticeable, with the pain being less frequent and less intense. Thursday I had brain fog for the first time this round. When I say brain fog, I don’t mean chemo brain where it’s hard to think of a word or forgetting things. This is more like an out of body experience where I feel like I’m floating and my brain feels like I took way too much Benadryl. This only lasted a couple of days, done by Saturday. If it’s like docetaxel, it will last more days the farther along I go in treatment. Fortunately I’m on vacation, so I pretty much stayed in bed for a couple of days. On Friday I started experiencing metal mouth. I’ve noticed that peripheral neuropathy has increased. Now both my feet are tingly. Up to now, it’s just been in my left foot, primarily my big toe.

Chemo - Round 2, Cycle 3

Today is my halfway mark through this round of chemo and the good news is that PSA is down to 3.8. So for the first time since this whole thing started I'm in the "normal" range.

Things started a little earlier than usual, with labs at 8:00 a.m. Then downstairs (floor 1) for an 8:40 appointment with my oncologist. My favorite receptionist was holding down the fort, and *blushes*, I heard her tell someone I was one of her favorites. We're both interested in history of local architecture, but she also experiences some of the same Sensory Processing Disorder that I do. Anyway, almost no wait and I was taken to the "little" exam room. (Eventually I'll remember the room number. It's either 2 or 4. But that's less descriptive.) Had my blood pressure taken, and it was actually 102/68! How I  managed that, I'll never know. A few minutes later my oncologist entered the room and we got down to business. My white blood cell counts and platelets and all that were fine, so I was good to go for chemo. I had a few quick questions for her and then we were done. I love that I basically get all the time I need for questions. I won't say today was rote, but just didn't have much today. The clinical trial coordinator came in next and we went over how I was doing (find) and I gave her my cycle 2 medication diary.

Last, but not least, headed up to floor 3 for chemo. I got in the chair, got a warm blanket, and then had my per-chemo drip pumpkin pie. Speaking of pre-chemo drip, once again I was totally wiped out by the pre-chemo IV Benadryl. First up was the dexamethasone. Then the Benadryl. And then, zzzz.

Happy

Occasionally I have someone who knows I have stage 4 cancer ask, “How can you always be so happy?” My response is simple - “How can I not be?” #LifeIsWhatYouMakeIt

Chemo - Round 2, Cycle 2

Before I get to the details, the main news is my PSA went down to 7! Holy crap, I did not expect that...it was 55 when we last checked it.

So today I had treatment later in the day than I usually do. I almost always do a Monday morning, but due to scheduling, I had to have treatment in the afternoon today. Labs at 3:00, meet with oncologist at 3:40, chemo at 4:30. Things were running a bit late as we had a blizzard the day before, and the weather and roads were still bad. No complaints from me, though. Just bring me that warm blanket. Oddly enough, I still enjoy going to the cancer center. Well, I guess enjoy may not be the best word, but I do like the attention and care. Even better when results are good.

One thing - the Benadryl in the pre-chemo drip...wow. I joked with the nurse in the chemo room about how sleepy the Benadryl had made me last time. So she let me know when the Benadryl was going in. A few minutes later I thought, this isn't so bad. And then a few minutes after that it hit me. I nodded in and out for a while, and then finally fell asleep before she even switched me over to the chemo. I got a nice hour and half nap.

One down side to the afternoon treatment - no sack lunch! But they did have peanut butter crackers and cranberry juice. I ate the crackers pronto, I was starving, but I fell asleep before getting to the juice, though. Speaking of eating, I think all the Thanksgiving pumpkin and apple (most pumpkin) pies must have fattened me up a bit. I was down to 157 lbs last time I was in, and today I was back up to 163.

I ended the day leaving the cancer center completely incoherent. Good thing I had my wife pick me up. When I got home around 7:30 p.m. I had a quick dinner and went straight to bed. Out go the lights, zzzzz.

Chemo - Round 2, Cycle 1, Week 1

It's been nine months since the last cycle of my first round of chemo. Ringing the bell back in February seems so long ago. And just as it was a year ago, the first week of chemo really wasn't too bad. Just like clockwork, it's chemo on Monday and shooting pains in my legs, ankles, and hands on Thursday. The pain is a little more intense than it was a year ago. By Saturday the pain began to subside. I experienced a little of the metal mouth today. If it's like the first time, hat usually gets worse the farther along I get in treatment.

Chemo - Round 2, Cycle 1

Well here we go. I get to go through chemo again. Like last year (round 1 - docetaxel), I go in every three weeks for an IV infusion for six cycles total. I've already grown used to the familiar bump in my upper right chest like a port was just a natural part of my body that I was born with.

An interesting coincidence, the dates of my second round of chemos are exactly one year to the week day from last year. I tend to like things to go the same way, so I guess someone was looking after me in the scheduling department. If I can get any comfort out of all this, I reckon this is it.

First up is the nurse lab visit. Today that's at 9:00 a.m., so I need to be there by 8:45. Generally this is pretty quick and simple. Check at the front desk, repeat my name and birth date a few times, get the patient wrist band, and then I'm handed a pager and head to the waiting area. After a short wait, the pager goes off and I head over to they do the blood draws. This is the first time we get to use the new port, and it's good to go. First the nurse draws blood through my port, and then sets me up with the tubing for chemo. The jab of the needle is almost nothing. You get used to needles pretty quickly. I wish I could say it's a bonus. Actually, I guess it is.

The lady at the front desk is the same lady who was at the front desk when I started my first chemo last year. I still don't know her name, but she reminds me a lot of the actress Mary Steenburgen. In another interesting twist of fate, she started working in another area for a while and this is the first time I've seen her at the front desk since she had moved elsewhere. Oh.And that other area was my oncologist's office, so I still got to see her when I was coming in every six weeks for a checkup. But still, first day of chemo and there she was at the front desk, just like she was when I started this whole thing. So far I kind of feel I'm being dropped back a year ago, but with the knowledge of a year of treatment.

After the lab I head downstairs to my oncologist's office. The appointment is scheduled for 9:40 a.m., arrive by 9:25. The wait is normally pretty short. Again, I check in at the desk, repeat my name and birth date again, and then head back to the office. I guess not everything was going to line up. The same girl has taken me back to my onncologist's office since I started. Today it's somebody different. But he's just a nice as everyone else in this place, so the small change doesn't throw me off. Fist we check my weight on the scale outside the office. This time I weigh 157 pounds, so I'm down five from last time. Not a big worry, though, I'm still well within normal BMI range, and truthfully, I prefer to be around 155. Then we head into the office to check my vitals. I tend to get really anxious when I visit a doctor, though really I'm so used to the cancer center, and everyone here is so nice, I'm not sure if I really get the same anxiety. Blood pressure a little on the high side, as is my heart rate, but it's never been enough to worry about.After that I'm left in the room alone to wait for the oncologist.

Quick side note - my oncologist is amazing. Every quality you'd want in an oncologist, she has it. I sometimes think she's my guardian angel. I hear so many horror stories from other cancer patients about their doctors, their treatments, their medications, I can't believe what I'm hearing because it sounds nothing like what I've experienced. It's not just my oncologist, either. The entire staff at the cancer center are incredible.

While I'm waiting for my oncologist to come in, I get a notification on my phone that I have a new test result in MyChart. I look and my PSA has gone up again. This time it's up to 54.76, up nearly 20 points from the last time, so the decision to go on the trial and do chemo again was a good one.

My oncologist will let me ask as many questions I want, and is never in a hurry to leave. She's very attentive and knows my case well. She allows me to work with her when it comes to decisions. I do a lot of research (I'm her "enlightened patient.") and that makes it easier to discuss options with her. I get the feeling that most patients just want to come in and get the magic pill. I've become nearly (but not quite) obsessive about cancer. A good part of my reading is cancer related and I listen to several cancer related podcasts. I don't let cancer define my, but it is part of my identify. Working together with my oncologist gives me some feeling of control over my treatment, and she gives me every opportunity to do so. That's a really good thing mentally.

After brief discussion about the PSA results, which was really no more than confirming that the trial was the right decision, I get the green light for chemo. My white blood cell count generally does't get very low, so I've never had to miss a chemo due to white blood cell count being too low. I  love talking with my oncologist, but I don't really have many questions, so we keep it pretty short. The clinical trial coordinator is there as well, and she gives me so forms so I can track when I take my medications each day, specifically what I'm taking for the trial, which is prednisone and abiraterone. (Zytiga) She wants me to start today, same day I start chemo.

Next is the actual treatment. We go up to the third floor where the chemo rooms are. Once again I check in at the desk and repeat my name and birth date. (You get used to it.) This time I get a bed as whoever was scheduled for that room wanted a chair instead. I have no preference, actually, so bed it is. Now one thing I learned about mid-day chemo is to ask for a sack lunch. I don't know if other cancer cernter's have them, but they do here. Bed, warm blanket, sack lunch, it's almost like a mini-vacation! I know someday I won't feel that way, but I'm making the best of the situation.

So this time I'm on a different chemo, cabazitaxel. It's another Taxtane like docetaxel, so I'm assuming the side effects will be similar. One big difference, though, is that there's Benadryl in the pre-drip. I ended up sleeping through most of my chemo, and it was really kind of nice. Other than that, chemo was rather uneventful. My wife drove me howand within a few hours I was in bed and out for the rest of the day.

Cycle 1 done, so lets see what the next three weeks will bring me. I also forgot to take my meds, so I'll start that tomorrow.

Labs Follow Up and the Clinical Trial

Well, my PSA has risen again, this time up to 37. This is the third consecutive rise of my PSA and three times is enough to consider my prostate cancer as castrate resistant and time start looking at second-line medication. But first an explanation of what's likely going on.

Castrate resistant cancer means your PSA is rising despite being at a castrate level of testosterone. The chemo I went through killed cancer cells. Not all of them, but a good number. The Lupron (which I receive as a shot every three months) signals my pituitary gland to tells my testes to produce any testosterone. Prostate cancer thrives on testosterone and Lupron is a first-line hormone treatment to prevent your body from producing it. However, my prostate cancer will eventually begin producing its own testosterone, which is known as castrate resistant prostate cancer, and that's where I am..

Last year I started first line standard of care treatment for for high volume stage 4 prostate cancer. Thanks to the CHAARTED clinical trial it was found that chemo (docetaxel/Taxotere) combined with Lupron had more efficacy than either alone. So that's the treatment I had the first time around and it was quite effective. Though my PSA is 37, I feel reality good considering. The Oxycodone works well with the pain I do have and I don't need to take it every day.

So on to the next step. Second-line treatment in my case would be abiraterone (Zytiga). There's a clinical trial currently open that I qualify for, the CHAARTED2 trial. It's very simiarl to the CHAARTED trial I mentioned previsously. CHAARTED2 is testing the efficay or abiraterone alone vs abiraterone compared to abiraterone with chemo, which would be cabazitaxel (Jevtana). It's a non-blind, randomized trial, so if I join the trial, I'll be randomized into one of two study groups.

A quick note: abiraterone will prevent the testes from producing testosterone, but it also prevents the adrenal glands, which also produces testosterone, about 10%, from producing testosterone. And abiratereone also stop the cancer itself from producing its own testosterone.

All clinical trials have fairly stringent inclusion and exclusion criteria, and generally some preliminary tests. So after talking to my oncologist we decided to  move forward with trial. She brought in a clinical trial coordinator and we went through the 21-page consent form (this process is called "informed consent") and since I was ready to start and I had no issues the consent, I signed the form and the wheels started rolling. I would have three scans before I got randomized: a PET scan, a bone scan, and a CT scan. Those would be scheduled within the next few days and we scheduled a follow up for two weeks from today, Monday October 22.

Year Two, Here We Go

I haven't been very good about writing here on this blog. If I want to document year one any more than I have, I'll have to go from memory. That said, this weekend is the one-year "cancerversary" from when it all began. A year ago today (I'm going by weekday, not date), October 6, 2017, I had my PSA checked because I was having some obvious symptoms, which I documented in an early blog post.

So today (one year from when my GP called me with  my initial PSA results), I'm going in for my six-week lab work. My PSA started at 5,306 last year and went down steadily during chemo and with Lupron shots every three months. Sometimes my PSA would go down by consistently by 30 or 40 percent each checkup while during treatment and for a few months after. We got all the way down to 22, which is still a pretty elevated level, but compared to where I started it was nearly miracles. As it stands, 22 is my nadir.

Twelve weeks ago my PSA rose to 24. Then six weeks ago it went up to 27. Depending on today's labs, we'll probably start talking about second line treatment. My oncologist and I have discussed various options, but we wanted to wait to see if the PSA would go up again. There's a clinical trial I might join. It's the CHAARTED2 trial that is a phase 2 trial testing the efficacy of Zytiga by itself as comapared to Zytiga and cabazitaxel (Javatana) together.

So I'm going to try and document year two more in real time. Chemo brain or not, my memory isn't what it used to be. And it didn't used to be much...