Two weeks since starting treatment

     Today it has been two weeks since I restarted cancer treatment for my stage IV prostate cancer. There’s really not much to say. I feel really good but I attribute all of that to the prednisone. My oncologist believes that for the last 10 months I had been  suffering from adrenal insufficiency. Zytiga shuts down the adrenal gland. Patients taking Zytiga supplement with prednisone. Often, patients who stop taking Zytiga find that their adrenal system never fully restarts. This was true in my case.  Once I resumed the prednisone my body was getting the steroid it needed to repair itself. 

     Prior to re-starting treatment I had received a referral to the local orthopedic clinic for the chronic pain I have been suffering in my shoulder. I had already received two Cortizone shots to try and relieve the pain. The first shot worked pretty good. It seemed  to relieve the pain for several months. The second shot lasted only a few weeks before pain returned. Two years ago  I was leaving work and slipped on a patch of wet moss. I fell hard and absorbed weight of a full body impact onto my left forearm driving my shoulder straight up. It has been problematic ever since. Friday last my shoulder was X-rayed. Next Monday I will have an MRI. I am no longer certain the MRI is necessary. Since restarting prednisone much of the pain has dissipated. There is still mild discomfort however I am not so sure the MRI will detect anything that can be repaired by arthroscopic surgery. Time will tell.

   I am finding it somewhat easier to urinate this week. I take that as a sign that treatment is once again putting cancer to sleep. Chronic diarrhea has returned since starting Lupron. Huge bummer. My libido is waning. Worse bummer! Oh well, Mandy and I have worked through this before and know how to keep intimacy alive.

   On a positive note, we broke down and purchased a hot tub last month. It arrived a week ago and we have been using it every day since. That may also have something to do with the absence of shoulder pain. 

   That is about all I have for this update. Life is good. If you have been diagnosed with late stage cancer and have not heard it from anyone else, I want you to know there is hope. A diagnosis of this disease does not mean you have been given a death sentence. Thee is hope. There is hope! THERE IS HOPE!!!!

Day 1 update

    Yesterday I felt fantastic. I felt better yesterday than I have in months. None of this made sense to me. Androgen deprivation therapy is not exactly quick acting. Once you receive your injection it takes a while for it to get into your system. PSA has a half-life of two weeks therefore there’s no way there was a reduction in PSA. I was trying to figure out why I felt so good. It hit me this morning. It was the prednisone. To me this is the only logical explanation. I am speculating that my adrenal gland may have started up somewhat but still has not been working the way that it should prior to Zytiga. With this in mind, it stands to reason that my body has not been producing enough of its own steroid for the last several months. This would cause my joints to ache and my muscles to ache and nothing to really work the way it supposed to. Once I started taking prednisone again my body stopped hurting and I had more energy. There is a negative side of this. I haven’t slept very well the last couple of nights. Maybe my body doesn’t need as much sleep now that it’s getting the steroid it needs to function correctly or maybe the prednisone is keeping me awake until I adjust to it again. Either way I feel better and I’m not falling asleep at work which is a bonus. Not only that I felt so good yesterday that I dug a ditch approximately a foot deep and 10 foot long, install the drain pipe off my downspout and refilled the ditch in an hour. I could not have done that two days ago.

   Last night my mind would not shut down. I spent a good portion of the hours I should’ve been sleeping thinking about prostate cancer. Imagine that! In my mind I was doing mathematics regarding PSA doubling time. I realized that with a doubling time of 4 weeks it would only take another 10 months for my PSA to reach my prediagnosis level of 3200. Try sleeping with that on your mind. As terrible as I had been feeling with a PSA of just over 3, I couldn’t stop thinking how bad I would feel with a PSA of 3200. The thought then occurred to me that if treatment ever stopped working I would probably only have a couple years left to live. It was a long night. I guess I must have nodded off around 1:00 a.m. My usual bedtime is 9:00 p.m.

   When I woke up at 5 it hit me that my discomfort was not cancer symptoms but rather a lack of steroid. I call that a gift. 

   I am not looking forward to treatment side effects. I will be sending my doctor an e-mail today suggesting that the next time I am on treatment holiday ( if there is a next time ) that prior to restarting we base that decision on imaging and not just PSA. Todd

My ADT vacation is over

Yesterday was a full day of Oncology. It started with a blood draw at nine in the morning and then Mandy and I spent the next five hours playing disc golf and going out to lunch. We had a really good day until my appointment at 2:30 with the oncologist. At the appointment I found out that over the last 20 weeks my PSA had increased from .06 to 3.03. Essentially it had been doubling approximately every four weeks. My testosterone level had went from less than 10 to 245 since going off of Zytiga last November.

    To be perfectly honest I completely expected it. There were a few tell tale signs. It had become more difficult to urinate and I would find myself straining a little to void my bladder. Overall my body seemed to be fatigued and achy all over. After my appointment yesterday I received my first Lupron injection in 14 months. This morning I restarted Zytiga.

   Mandy is doing as well as can be expected with the news we got yesterday. She and I both want to believe that by some grace of God or miracle, the cancer would not come back. This morning she was a little off. It breaks my heart what this disease does to her. Sure, we are able to retain a degree of intimacy but it’s not the same. She wants to be wanted and simply being able to make love is just not the same thing.

   For me, yesterday‘s news brings with it a lot of questions. Well maybe not a lot of questions. I just wonder, if my testosterone level had not of jumped right back up into normal range, would the cancer have stayed at bay much longer? I suppose that it’s a question that will have to go unanswered.

    For Mandy and I, it was a pretty incredible year. Having testosterone again, we both appreciated the renewed interest in intimacy. I suppose my only regret is that we didn’t utilize the interest as often as we could have. Unfortunately we both work long days and when we get home we are tired. During my ADT holiday we ventured to the big Island of Hawaii spent time in the mountains, And at various lakes. I will include some photos of our adventures in this post.

    I have no doubt that the combination of ADT and Zytiga will once again put the beast to sleep. Zytiga is a powerful weapon against advanced prostate cancer. I wish I could receive Provenge again. I firmly believe that in my case it is the reason that the Zytiga has worked so well.

    So where do we go from here? My oncologist seems to be on board with intermittent therapy. If that is the case perhaps after the beast goes to sleep I will be able to experience another vacation from treatment. I certainly hope so.