Results and Followup of Treatment

Entry 72

This was a pivotal week with regards the change in status of my prostate cancer. To say I was nervous would be an understatement.

Appointments with the doctors at Cancer Care Prostate Centre and Cancer Care Radiology on Tuesday and Thursday respectively, assessed the results of the change in medication and the radiation therapy. 

The news is good.

The new medication Abiraterone has not only stopped the rise in the PSA number but in fact dropped it by a full point in the space of 1 month. The key take away here is that it’s working. If it did not at least stop the rise in that number we would be looking at Plan B.

Additionally, l am experiencing no significant change in side effects. 

With regards the second part to this equation, the radiation therapy, the news is equally positive. It has been 2 weeks since the application of a single dose of radiation to address a relatively small and localized occurrence of cancer. 

The pain normally associated with it has been minimal. When needed one Advil tablet per day has sufficed. As in the case of the medication, any side effects from the radiation have been minimal.

This was the first assessment since the diagnosis and treatment in July. It is very encouraging. I will see Dr Saranchuk of the Prostate Centre every month for the foreseeable future to continue to monitor the efficacy of the Arbitrarone on my PSA. Radiology will do the same according to a slightly different schedule. 

Radiation

Entry 71

Just to bring you up to date I have had my appointments with Health Science Centre Radiology and am already finished. It was accomplished in 2 days. The first day's appointment was about 1 1/2 hours long and was mainly consultations and marking the spot on my hip to be radiated. Very thorough. 

The following day was the actual treatment which took about 20 minutes and was done in one session.  I'm happy to report they think they got a relatively small and localized spot on my hip with one strong radiation application. I am having little or no side effects that one extra strength Advil tablet per day can’t handle. 

I have also been taking new medications, Abiraterone and Prednisone for 3 weeks and am equally free of significant side effects from that combination. So all in all I appear to be doing quite well. 

Cancer Care Prostate Center and Radiology are all over me like a tent. They will continue to monitor me closely for the next 6-8 weeks at which time they should know if the 2 treatments are successful. We will see.

A Major Change

Entry 70

There has been a change in my health status as it applies to the prostate cancer. I have been aware of it for over a year but things firmed up over the past few weeks. Below is a relatively brief explanation of how things arrived at their current status.

So, first things first....

A little over a year ago at one of my quarterly appointments, my Urologist/Oncologist Dr Jeff Saranchuk told me he was concerned that my primary line of defence against the spread of the prostate cancer was losing its efficacy. That line of defence was Androgen Deprivation Therapy (ADT). ADT is a hormone therapy that blocks the transmission of testosterone which prostate cancer uses to enable its transmission elsewhere in the body. It is not chemotherapy. 

Ten years ago, back in 2010 when  Dr Saranchuk surgically removed my prostate gland he also removed 12 pelvic lymph nodes & found 2 tumours. I was instantly metastatic. The cancer had already escaped the prostate capsule. Not good news.

To put this into perspective, the only line of defence available at that time was ADT & on average it’s efficacy lasted 2-3 years. So I took it. As Dr Saranchuk pointed out, if I hadn’t I would have shortly been in palliative care with a likelihood of pushing up daisies in the not too distant future.

But wait ! Here it is 10 years down the road & I just told you that very same ADT regimen is just now losing its efficacy. Instead of a couple of years I got 10! The how & why of that statement would legitimately be another full entry, so in the interests of simplicity let’s just say it is not lost on me that I am a very fortunate man.

What the above explanation is in aid of is that when I went into the appointment with Dr Saranchuk on Tuesday, June 29th I knew what was coming. Truth be told, I have been expecting to hear it 4x a year for the past 10 years. 

At that same appointment he ordered additional blood analysis, a CT scan & a bone scan. 

What I could not predict was the second shoe to drop, that being what the outcome of the CT scan & the bone scan would be. Once again in the interests of brevity, the CT scan (thoracic & abdominal) showed no signs of the cancer in the soft tissue & internal organs. Whew! The bone scan, which was head to toe however spotted bone metastasis in my left hip. Not good.

So in summary, my primary line of defence, the ADT treatments, had finally lost its ability to keep the cancer at bay. The bone scan having detected cancer in my hip was proof the ADT had lost its efficacy.

So, where does that leave us?

Well, perhaps not so bad actually. 

In the 10 years that have passed since my surgery there have been several new treatments & medications that specifically address my circumstances. The ADT will remain & a new drug, Abiraterone (aka Zytiga) will reinforce it along with Prednisone to mitigate any side effects. Assuming this new regimen works it should control the aggressiveness of the cancer.

The second part to this equation is of course the bone metastasis. That will be addressed with radiation. My understanding is the bone metastasis is localized & the treatment of short duration with a good chance of success. 

I await a call from Health Sciences Centre Radiology with an appointment schedule.