Monday, January 13, 2014

Androgen deprivation . H/T

   At the time of my diagnosis the only treatment available to me was hormone therapy. A friend of mine who passed away from Pca told me it would only work for six months. That was all the longer that it worked for him. He was diagnosed 2 years prior to me and died 2 years after I received my dx. The treatment worked much better and longer in my case. I did not have to change treatment for five full years. During the course of that time my P.S.A. dropped from over 3200 to less than 0.05. The metastasis in my body was undetectable with a C.T. scan. My doctor said that these were very impressive results. I was thrilled to be doing so well and I began to sleep a little easier at night. The hormones were doing their job and beating back the cancer but with the successful treatment came all of the side effects. The purpose of this blog entry is to list the side effects I experienced and the way that I dealt with them to minimize the effect they had on my quality of life. Hormones effect different men in different ways. The broad range of side effects are not experienced by any two men the same way. With each side effect, humor played a huge role in dealing with it. Faith played an even stronger role in the big picture but learning to laugh at myself was the key component in my day to day struggle. This is not a complete list of side effects. This blog includes only those that I personally dealt with. One thing to remember in any cancer treatment is "attitude is everything". If you think you are beaten, you are!!
   Three days after my first Lupron injection, I had my first hot flash. They grew in both number and intensity over the next few months. At the peak I was having a couple dozen a day lasting 5 minutes or so. I hated them. I did however find empathy for my mom and every other woman over 50 years old. The worst of them came in he night while trying to sleep. Mandy likes to be warm when she sleeps. We learned to co-exist by having a small fan blowing air on my face and I slept covered only by a sheet. The hot flashes were pretty steady for about two years then began to wane as my body adjusted to its new normal. I rarely have hot flashes anymore. 
    Eighteen months into treatment my chest began to feel tender and swollen. I was starting to grow breasts. After several months I made the decision to have them radiated. It was bad enough that I was being pumped full of female hormones every 4 months. There was no way I was going through life with a pair of breasts. After all, what would the guys think? The treatment was easy but I didn't count on the nice little tan that encircled my nipples. Needless to say I kept my shirt on that summer. I wish I had done the radiation sooner. The growth stopped but I will always be a little puffy in that area. I am told it is not noticeable but I know it is there and remain self conscious about it. I am told that I stand a good chance of developing breast cancer in the next ten years. Maybe one day I will be wearing both pink and blue ribbons. I hope not.
   Fatigue is another promonent side effect caused by H/T. Since starting the hormones I would just as soon sit on the couch as do anything. I compare it to a dog who has been neutered and just wants to lay on the porch. Essentially it is the same thing. Hormone therapy is chemical castration. Fortunately I have a very proactive outgoing wife. Mandy was not about to watch me turn into a couch potato. She kept me moving as I worked through the fatigue. We are always doing something on a long list of activities we both enjoy. The list includes hiking, biking, kayaking, snowshoeng, fishing, hunting, skiing, water skiing, snowmobiling, boating, and much much more. We bought a camper a while back so being in the great outdoors is now a year round activity. I couldn't have done this on my own. I wouldn't have done this on my own. I could just as easily have stopped living but Mandy wouldn't let me. At first I whined about it. I told her I was tired and didn't feel like going for a walk or a bike ride but I always felt better afterward. I always felt younger. 
Sometimes I would forget all about cancer. It also helped me combat the battle of the bulge. Weight gain is inevitable on H/T. When I started I weighed in at a lean 145. Prior to starting Zytiga, I tipped the scales at a healthy 170 pounds. I have since lost 20 pounds due to a loss of appetite, but I am now beginning to gain it back again. 
   The most troublesome side effect of H/T is E.D. and the lack of libido. It was no problem for me. I didn't think about sex anymore so E.D. wasn't really an issue. It was a huge issue for my bride and rightly so.  At first my H.M.O. was pretty good about loading me up on Viagra and Cialis but they ended that program and left me on my own to solve the problem. I am not going into great detail about this subject other than to say we were diligent in our endeavors. Although our physical relationship is not as good as either of us would like it to be, we still manage to be together 1 or 2 times a week. I still lack the physical desire so it has become a mental game. I have learned to will myself to be in the mood. Sometimes we need help from E.D. Medication but just as often we don't. We are blessed to be able to continue physical love when so many cannot. 
   So this is it. I have been on hormone therapy of one kind or another for 93 months. It's not what I wanted but it is what I got. I am alive. In the time time that has passed since diagnosis there have been a plethora of new medications come online to combat this cancer. Sometimes I am still afraid. When those times come I fall back on my faith and the verse in psalms given to my on that very first day. It is the promise that I cling to when all else fails. My journey through H/T may never be over until my life is over but because of the hormones I am here to perhaps see the day when they cure this disease. Todd