I’m a little late with this news.
I find that when I’m feeling particularly good or bad, it’s easy to compose posts. Otherwise, it’s often hard to generate the energy to write something. Monday and Tuesday provided mixed news and the rest of the week provided little motivation to write. It’s either a sense of guilt or a desire for completeness that drove me to finally write this post. My apologies.
On Monday I saw the oncologist for our bi-monthly meeting. I gave him a copy of my medical directive info, including an addendum that describes in more detail when I want a Do Not Resuscitate, or DNR, applied. Apparently, I want a DNR applied earlier than most, as he commented I seemed very pessimistic. I have to admit I was surprised. When it’s clear the end is near and no more than pain/heavy sedation is in my future, a DNR makes sense to me.
We then started talking about bone pain and when I might likely start to experience it. He said it can’t be predicted, but the good news is it might not happen at all. This was much appreciated – I’ll keep hoping I remain bone pain free.
I told him another of the potential side effects of Casodex had surfaced, very tender breasts. Any moderate pressure on my breasts produces a sharp pain. About 30% of the men who take Caosdex experience this and/or breast enlargement. (So far I haven’t had any enlargement issues.) I asked if there was anything we could do to reduce the side effect, which right now is yet another inconvenience, but tolerable. The short answer was no. The longer answer was it might get much worse, so that it’s intolerable, and then surgery is the only generally accepted option, but the surgery might not fix the problem. Great. A hot flash hit me right when he said “surgery” and then built until he finished with “might not fix the problem”. The prospect of this growing into intolerable, incurable pain scares the hell out of me.
My distress must have been very obvious, because after that he became more positive about my future than he’s ever been. Suddenly, he was hopeful that the Casodex might continue to work for 50 or even 100% longer than on average. I felt better at the time, but later realized there were no tests or any other new data since the last visit to warrant any change in opinion. It was nice he noticed and reached out, though.
We briefly discussed Zytiga, an existing prostate cancer drug now being used earlier in treatment than originally proposed. It sounds as if I would go on it after Casodex fails and before chemo. Preliminary results show up to an 18 month life extension. Very good news.
On Tuesday I called to get the results of my latest PSA test – 0.45. Good news, the Casodex continues to work.
A couple hours later my wife returned from the vet. It turns out our one remaining french bulldog, Julia, is having trouble absorbing proteins from her food. She’s an old girl, and the bottom line is we’ll be lucky if she makes it through the end of the year. At least she’s alert, eats well, is happy, and not in pain. Still, it hurts my heart.