Life Goes On

Since I started  phase 2 of my Androgen Deprivation Treatment things have have moved fairly quickly.  Helen flew up to visit me for a brief visit and she accompanied to see my oncologist for the six week PSA review to see if Casodex was working.

This the my latest report on Fred, my cancer, as posted on a Prostate Cancer forum:

"
Well it is now November 2018 and things have progressed.

In July my baby daughter, 56 this year, accompanied to see my urologist to review my latest PSA test. It was 0.98; my lowest ever was 0.3 and highest 1.03. My urologist saw this as a positive sign and I laughed out loud. My reading of published papers showed that the PSA test is very accurate but the readings can vary due to the patient's condition. My previous reading of 1.00 and the the new reading varied by only 2.0% which was insignificant which, in my opinion, showed that the Casodex had not worked. I was persuaded to give it three months.

I also complained about soreness in my right groin. It felt like the hernia I had fixed a few years back. I was sent for a CT scan with tracer of the lower abdomen which started a chain of events which highlights the differences in the medical profession.
After the scan I was called back as the "Doctor" wanted to have an ultrasound of the groin carried out. I, of course, went back to the radiologist and the ultrasound showed an enlarged lymph node which had shown up in CT scan. Incidentally the CT scan also showed that my hip mets extended right across my pelvis. I was advised to have a needle guided biopsy in a couple of days. This conflicted with my next appointment with my urologist so I phoned up to move the appointment. To my amazement I was told that the urologist had not authorized the ultrasound and did not support the new biopsy and I was to attend my next appointment. I was very upset and went to see my GP and friend of over 20 years to sort out what to do. He advised me to visit the urologist as the biopsy could be done later. Later I found out that he phoned both the urologist and radiologist to sort things out. The "Doctor" was a radiologist who failed to notify the urologist of the ultrasound but used the urologist's original authorization to conduct the test. My urologist took offense and started a flurry of communications.

I attended the follow up meeting with my urologist who didn't think that the biopsy was necessary as the lymph node was almost certainty cancerous. This with the dubious PSA result and, as I was still having blood in my urine which was still causing concern and as I was on blood thinners for Atrial Fibrillation , I was asked to consider stopping blood thinners taking aspirin instead.

I went to see my cardiologist who said it unlikely that aspirin would be any use but the use of aggressive blood thinners was not advised with bleeding tumors so an alternative treatment was advised. I am now off blood thinners as I await a Left Atrium Appendage Occlusion scheduled for December 20. I now have to worry about having a stroke as well.

This Monday, November 12, I got the results of my latest PSA. It was 3.7 a nearly quadrupling in three months. It has been decided to stop Casodex and take Androcur instead until after the heart procedure before reviewing follow on treatment n January. I have reached the Castration Resistance Phase of Prostate Cancer.

Overnight my waterworks packed in. I was having bladder spasms every 15 minutes before passing blood. It was extremely painful and at 3.30am Tuesday morning I called an ambulance. The Paramedic gave me a Penthrox inhaler to minimize the pain but I still had spasms and passed blood on the way to the ER. We pulled over to let me stand and use a travel john three times on the journey. The ER nurse measured my urine retention as over 750ml and tried to insert a catheter without success. The ER doctor used more force and succeeded. I ended lying in a puddle of blood and urine as my bladder emptied.

I was fitted with a leg bag and, after the ER doctor phoned my urologist to advise of this development, was picked up by a friend and was home by 10.00. I received a phone call from my urologist and given an appointment for Wednesday November 14. I am now scheduled for surgery on Tuesday November 20 where they will either carry out a TURP to clear the urethra blockage or insert a supra-pubic catheter and block off the bladder above the prostate. My tumor will continue to bleed. It has extended to the the outer sphincter muscle.

Now I am having spasms every hour or so and passing blood around the catheter which appears to be cause by pressure in the bowel.

I have typed this lying on a recliner chair which my most comfortable position during the day apologize for the numerous typos!"

Helen is going to fly up on Tuesday Morning ans will take me hospital at 2.00pm for the surgery. I will probably spend 3 nights in hospital.

Update For 2018 - Life Goes On

Towards  the end of 2017 Helen had driven her ancient Toyota Camry from South Australia with Ann, and Logie her dog to visit me as I recovered from surgery.  The car is nearly 30 years old and was loaded to the gills.  I was amazed that it got home again.  The round trip was 4.800 Km.

She wanted to make regular trips to visit so before Christmas I bought a 2016 Holden Trax mini SUV for her to use and tow my little camper trailer which I could no longer use.  In January she flew up to visit for three weeks and we both drove the Trax with the CT attached back to Adelaide.  The Trax towed the CT beautifully but after two nights camping, with Helen sleeping in the CT and me in my old large tent, we had had enough.  The temperature during the day was 40C plus and over 30C at night. I was two weak to drive and Helen was doing all the driving and setting up camp. We decided to stay in air conditioned cabins for the next two nights until we reached Helen ad Ann's house Charleston in the Adelaide hills.

The Trax and CT outside our cabin at Hay NSW

 

 

Their old house (150 years plus) is not set up for old men so I stayed at the hotel in the next little town, Woodside.  The hotel is over 100 years old and is not air conditioned.   I only stayed two nights before flying back to Queenslandto  my air conditioned home.  We did have a great lunch in the hotel's dining room with some of Helen and Anne' friends.

My huge room at Woodside Hotel

Back home Meals on Wheels needed a driver to help another volunteer to deliver meals so I am back to driving Kath two or three times a month..  I also got back into a routine of shopping, walking Louis and light housework,  I have cleaner to do the heavy stuff.

In April Helen and Anne plus Logie towed the CT back to Tewantin to visit for month.  They had had difficulty setting up the CT as they are both height challenged so they decided to give it back.  We put a roof rack and luggage basket on the Trax for the trip home.

The all had a great visit but Logie didn't take to swimming in the local creek.

Louis showed him the way

Helen gave him encouragement while Ann watched on.

 

As far as he go

Helen an Ann visited all the Op shops in Noosa while Logie waited at home.

When are the coming home?

We dined at the floating restaurant on the Noosa river

But soon it was time to go back to SA and away from the river.

Let''s go

No! not more bags

Full to the gills!

I will paste in my latest medical update to my Prostate cancer forum:

"I have just had my fourth Zoladex implant and this is a summary my progress since I posted my profile.
After three months my PSA had dropped to 0.5 from its previous 1.0. I was having occasional blood in my urine but was told this should settle down.
At six months my PSA was 0.4. I had begun to experience pain in my left hip and my right ankle was very sensitive to warm (in the shower) water. I was still having blood in my urine. I was told that things were "still holding on".
At seven months (May 2018) I had a stumble and jarred my left hip which caused me extreme pain. I was taken to the ER given morphine and x-rayed . There was no break but a bone scan was advised.
The bone scan showed that the metastases had grown. My GP referred me to a Radiation Oncologist. I was given five treatments of IMTR (Intensity-modulated radiotherapy)and I am now free of pain in my hip and can shower without wincing. It is a pity that they can't fix fatigue as easily.
Last week my PSA was reviewed. It was back at 1.0 and I was told that Zoledex had failed. I would now have Casodex added to Zoladex and my PSA checked in two months. I asked about Zytega ot Xtandi but was told that these required special approval on the Australian Pharmaceutical Benefits Scheme as they were Chemotherapy. I didn't think they were. I will wait to see how things progress and see my my Medical Oncologist who had advised me previously.
I now will have two month wait to see how I get on. At least Louis still gets his walks down by the creek .
Brian

This these are PBS requirement to receive Zytiga for $39.00 instead of $3,900.00
Castration resistant metastatic carcinoma of the prostate
Clinical criteria:
The treatment must be used in combination with a corticosteroid,
AND
The treatment must not be used in combination with chemotherapy,
AND
Patient must have failed treatment with docetaxel due to resistance or intolerance; OR
Patient must be unsuitable for docetaxel treatment on the basis of predicted intolerance to docetaxel,
AND
Patient must have a WHO performance status of 2 or less,
AND
Patient must not receive PBS-subsidised abiraterone if progressive disease develops while on abiraterone,
AND
Patient must not have received prior treatment with enzalutamide; OR
Patient must have developed intolerance to enzalutamide of a severity necessitating permanent treatment withdrawal."

This is all for now.

Brian