The immunotherapy option, Keytruda, had me all excited. Even if the odds were very low that it would score. Unfortunately, one of the preconditions for trying the therapy is that one’s prostate cancer has certain mutations. That’s where the rub comes in.
The most common way to check for the mutations is to sample the biopsy material from way back when the biopsy was performed. Regrettably, M D Anderson lost my biopsy samples.
Second is to capture some of the tumor cells floating in the bloodstream. It appears I have very few as our attempt at this was a total failure.
Third is to sample a soft tumor where the cancer has spread. The good news/bad news for me is my cancer has not spread into any soft tissues.
Fourth isn’t really an option at all. There are prostate cancer cells in my bones, but they’re calcified as I understand it. The process of decalcifying them destroys the ability to detect the mutations.
In sum I’m screwed. Until I have the cancer spread into the soft tissue and get a hit, or I pay for the treatments out of pocket Keytruda is not for me.
I wasn’t sure how things would play out after I got my 1-2 year prognosis. At the very beginning I was in disbelief, a little shell shocked, but this wasn’t a total surprise. My PSA was starting to rise suggesting the Xtandi was beginning to fail and from research I’d done 1-2 years seemed about right.
Once that initial disbelief passed, I was ready to go. I decided this was going to be one helluva last 1-2 years. I started thinking about what would be first.
Then a new morning came. I woke up sobbing and in a full blown panic attack. Fortunately, I had some Xanax on hand and got control of the situation. A few hours later, as the Xanax wore off, the panic returned and I had to take more Xanax. This repeated again at bedtime.
And it continues to repeat to this day. Every morning I wake up crying, take Xanax, feel like a zombie, wait until it starts to wear off and the panic returns and take some more. Repeat one more time.
I have lost all interest in doing anything. I don’t want to get dressed or go out. I have to force myself to brush my teeth and shave. All I want is for God to come and take me. Don’t get me wrong, I’m not suicidal, I just feel God should be willing to end this torture.
My wife and I set up several dinner engagements over the past couple weeks. I didn’t make any of them.
I know this can’t go on indefinitely, so I’m pursuing three paths. First, meeting with a psychologist. Second, meeting with a psychiatrist. Third, trying to get a ketamine infusion. Ketamine has proven to be very effective at lifting most people out of depression. It works very quickly. There’s a clinic that administers it about 5 hours away from where we are. How it plays with panic attacks is an unknown at this point. I have to do something. This is worse than no life at all.
At my last meeting with the oncologist there were a couple topics that came up that I thought would be of interest to folks with prostate cancer. We spend much of our time obsessing over PSA, but it has to be tempered.
On chemotherapy and PSA. Chemotherapy will reduce PSA, but that reduction doesn’t carry over to much improvement in survivability. The median extension in life for chemotherapy is around 2.5 months.
On Provenge and Xofigo treatments. Both produce a median extension of life of about 3 months and have minimal side effects. However, both can produce an increase in PSA.
While PSA is very important, it’s not the last word. It’s possible to get too caught up in treating the number.
I had my four month oncologist visit yesterday. The PSA result wasn’t good. It’s up to 40 from about 18. What this means is the Xtandi is now failing. It was my last major defense against the cancer. According to the oncologist, I now have one to two years to live. Time to start prioritizing…
We had to put down our little French Bulldog, Nancy, today. It was a gut wrenching experience. Fortunately, my wife found a vet who would come to the house, so it was a little less traumatic. Here are a couple shots of her taken last night.
We’re not really sure what happened. Last week she was fine and then suddenly went into a terrible tailspin. She was only 8 and should have outlived me. I can’t understand why these things happen. I guess I’m not supposed to.