Imagine if you will, I guy out in the wilderness on a hike or what have you. Maybe he is out bird hunting. He has a shotgun and a small caliber side arm and nothing more. On his hunt he encounters a wounded grizzly bear who is hungry and unable to feed himself in the usual way. The bear sees the guy and charges determined to make the guy a meal. The guy knows he is toast but survival instincts tell him to throw everything he can at the bear. He starts shooting and although he hits the bear 5 times with his pistol the bear keeps coming. He has one bullet left and his shotgun.
The bear in this story is Prostate cancer and I am the guy. The bullets are treatments that will not kill the bear but will slow it down. Sooner or later the bear is going to eat me and I am running out of bullets. Maybe there is more ammo in my backpack but I don't know that.
I started this journey on Lupron and Casodex. They were my first two bullets and they slowed down the bear considerably. After some time, (18 months ) the Casodex simply quit working and actually enraged the bear. Lupron in and of itself kept the bear at bay for three more years. My next shot was D.E.S. and it stunned the bear momentarily but the bear kept coming. Time for another shot. Provenge stopped the bear for a year and it was an arterial wound. Although the bear is still bleeding, it keeps on charging only now he is not charging so fast. My next shot is Zytiga and it is another good shot. The bear has stopped but for how long. He has backed off a bit and seems to want to rest but he is still standing. He is still there. He is waiting. I have one more bullet in my gun. Xtandi is advertized to be a wonderful drug. My shotgun sits at the ready. It is loaded with Taxotere and Jevtana. Will it stop the bear or simply make it angry. I need more bullets. There are some in my pack but they are unproven. Damn!!!
I know that I am going to be a meal. I know that with the weapons at hand I cannot kill the bear. It's going to hurt to be eaten alive. It is going to be slow and painful. I am not afraid. I am going to go down fighting. Why did I have to go on this stupid Hike? Is there anyone near me who has a bigger Gun? Damn!!!
I still have one shot left in my pistol. I don't want to use the shotgun. I am afraid it will only anger the bear and motivate it to finish the job. It will be my weapon of last resort. I must look for the unproven ammunition. Which one might work. There are so many. Each shot buys me time to find another. I must keep shooting. My wife, my children, my grandchildren need me. Stupid Bear!!!
Next Monday I must go for my monthly blood work to be approved for the next round of Zytiga. For the last 5 months the bear has been walking away from me. The more time that passes the more nervous I get that the stunned bear will once again resume it's charge. Perhaps I worry for no reason. At this point, and judging from my past experience with Androgen Deprivation, there is no reason to believe that the bear will be coming back in the short term but still, he is out there and each day brings me closer to another encounter. I hate the bear. I want him dead. I no longer want to live a month at a time. I want a big gun.