Met with my oncologist today. The results of my last PSA test came in – a little over 50. Bad news. At this point I’m likely to start a on a new drug, either Zytiga or Xtandi. First, I go off Casodex, and we see if I’m in the 20% of men whose PSA drops (for unknown reasons) after coming off Casodex. If so, we’ll wait until it rises again.
Note there’s nothing magic about 50. The accepted standard of care is that Lupron/Casodex are in failure after the PSA rises for three straight months. By that measure, I have already entered failure. My treatment plan has been different from the norm, because I’ve had so much trouble with depression.
Due to side effects, I’m leaning towards the Xtandi when the time comes.
I’m not sure what I thought I’d feel like when I reached this point. Maybe relief, because I no longer had to deal with the anticipation. Instead I feel mostly nothing. It seems like just another step on the path to death. I don’t mean that in a morose way. Death seems more and more like a natural part of life to me.
Went in for the oncologist appointment today. Surprising news. My PSA was flat from two months ago. Very good news. Everyone was expecting an increase. I may yet qualify as an outlier and live substantially longer than the median survival length.
I was really sure my PSA was going to be higher, maybe a lot higher. This was a real shocker. It gives me new hope.
I’ve been on black cohosh, an OTC supplement, for some time time now to relieve hot flashes from the lupron I have to take. It’s worked fairly well for a year or so, but recently it’s been failing. I’ve had 2-3 killer hot flashes and about a half dozen mini-hot flashes every day. I discussed this with my oncologist at the last visit and he suggested I switch to Evening Primrose Oil.
I wish he had suggested this as my first option. Black cohosh had hot flash breakouts from time to time. The Promrose Oil has shut down even the mini-hot flashes.
If you’re having hot flash problems, I highly recommend you try evening primrose oil, 1000 mg. they say to take it three times a day, but twice a day works for me.
Yesterday, I met with my oncologist. My PSA has risen to the mid 30’s from the mid 20’s two months ago. Not terrible, but not good. The disease continues to make advances.
We talked about when I should go on Zytiga and he admitted that he’s kept me off of it due to concerns that the side effects, especially depression, would be a problem. After thinking about it, I don’t really see that I have much of a choice but to try it out. With Lupron and Casodex alone, my cancer will continue to make headway. If I can’t tolerate the Zytiga, there’s an alternative Xtandi. If they work, they’ll at least significantly slow the advance, until they too fail. If I can’t handle either of them, I’m really screwed.
He volunteered to look into clinical trials for me, which I quickly accepted. I’m hoping for something that’s DNA based and targeted.
All in all a sad day for me. I wish there was some drug or treatment, even chemotherapy, that held out the hope for remission, but that’s not the case with stage IV prostate cancer. The disease just keeps advancing.
I’ll probably get a Provenge treatment before long. They take your blood and build up antibodies within it and then reinject it into the patient. It’s supposed to extend life by 2-3 months. There’s also Xifigo, which is a radiation injection that targets prostate cancer cells. It’s usually administered after bone pain starts appearing. It also has been shown to extend life 2-3 months.
On the subject of bone pain, I go in for an MRI on July7 to look at my lower back and right hip. I think it’s arthritis, but my oncologist wants to be sure it’s not bone pain. Who knows I may be in for an Xifigo treatment shortly.
Just found out another side effect of prostate cancer is loss of taste or food starting to taste metallic. I don’t have the metallic taste issue, yet, but my sense of taste is so diminished that eating is more about sustenance than enjoyment. Still, there are times where food tastes very good. I’m really appreciative when that happens.
Healthline has named YAPCaB as one of the best 11 prostate cancer blogs in 2016. I am humbled and honored by this recognition (http://www.healthline.com/health/prostate-cancer/best-blogs-of-the-year). I think the reason the blog made it was the fact we “discuss the effects of cancer that are sometimes ignored, including those that are emotional and psychological.”
I hope you all feel it’s an accurate portrayal, as it is one of my primary goals. I decided my privacy wasn’t as important as letting other cancer suffers know that they’re not the only ones going thru all this craziness.