Two Steps Forward, One Step Back

This is an overdue post, and it's a long one, so be prepared.

If you want the short version, the current treatment failed, and I am just now starting IV chemo. There are also some added complications, yet to be addressed.

LONG VERSION (Bless your heart if you continue)

Three weeks ago (Nov 1, 2022), I went in for blood results. My awesome Oncologist expected the results to be in line with previous results. With most patients the drugs I am using would combat the cancer for months, perhaps years.

In ten to fifteen percent of patients using my therapy, the drugs fail to halt the growth of cancer.

I always knew I was special.

Let's face it; I'm a tough guy, and my cancer cells are tough, too.

Last week I had new blood tests, a Bone Scan and an MRI.

PSA

Those tests confirmed that my Oral Chemo is not working. In fact, I'm regressing. My PSA is soaring, from 0.2 on August 30 to 8.4 on November 1 to 13.5 on 11/16.

I didn't show the Testosterone chart, but the numbers there simply confirm that my T level is decreasing again as well.

That might explain some of the constant fatigue.

Now, on top of that, my GP convinced me that my Blood Pressure is soaring to heights that might cause a stroke, which would not kill me but simply put me in a worse place than I am now. So, I'm on BP medicine. (So much for my long talks with my brother.)

NM Bone Scan

Findings: Overall interval increase in extent and intensity of multifocal MDP avid osseous metastasis involving multilevel vertebrae, several ribs, sternum, bony pelvis and right proximal femur. The lesion in the bony pelvis and right proximal femur, with significant increase extent and intensity.

I’m not sure what all that means, but the picture showing March to November seems the bones are getting worse?

CT Abdomen Pelvis with Contrast

It is amazing that we can actually look inside someone’s body and see organs. I’ll spare you the graphics, but here’s the analysis. I added all the emphases.

Findings:

Lower chest: No pleural effusion, consolidation or suspicious pulmonary nodule.

Abdomen/pelvis: Liver, gallbladder, bile ducts: Fatty liver. Newly visualized 1.2 cm segment 8 hypodensity (6, image 20), unclear if represents metastases or focal fatty infiltration. No biliary ductal dilatation. Gallbladder is unremarkable.

Pancreas: No pancreatic lesion. No pancreatic duct dilatation.

Spleen: Normal in size. No splenic lesion.

Adrenals: Unremarkable. No nodule.

Kidneys: No hydronephrosis. No suspicious renal mass. A 5.5 cm simple cyst in the left kidney.

Bowel and Mesentery: Anterior rectal wall is involved by prostate mass. Otherwise no bowel wall thickening. No bowel obstruction. No mesenteric mass.

Lymph Nodes: New multiple soft tissue nodules along superior hemorrhoidal vessels for example conglomerate lesion measuring 2.2 x 3 cm (series 6, image 145) concerning for new superior hemorrhoidal metastatic lymphadenopathy. New left inguinal lymph node measures 2 x 1.3 cm. No retroperitoneal or right inguinal lymphadenopathy.

Vessels: Patent.

Bladder: Nodularity and posterior bladder wall (series 6, image 170) suggestive of bladder involvement by prostate mass.

Prostate: Increased prostate mass measuring 5.3 x 4.6 cm compared to 3.5 x 2.2 cm previously involving posterior bladder wall (6, image 170-172) and anterior rectal wall (6, image 184-188) concerning for prostate cancer.

Musculoskeletal/Soft tissues: Stable multiple sclerotic osseous lesions consistent with osseous metastatic disease. For example left sacral sclerotic lesion at SI joint (6, image 134) measures 4.3 cm. Another left sacral lesion measures 3.2 cm. No soft tissue mass. Small fat-containing umbilical hernia with hernia sac neck width of 1.8 cm.

First of all, Fatty Liver! Rude! 

I don’t know whether to be pleased or insulted that my gallbladder is unremarkable. On top of all that, I have a hernia!

I already knew my prostate was growing. It’s been tougher and tougher to empty my bladder in the few weeks before the scans. Not so bad during the day when I’m sitting up but getting up at night has been an issue.

This, of course, interrupts my sleep, so my nights consist of two-hour catnaps interrupted with a half-hour to hour reading in the living room.

As I write this, that situation has improved immensely.

From Wednesday to yesterday (Monday, the 21 of November) I added in a previous oral chemo (so twice the fun with Orgovyx and Erleada!).

And today, I had my first-ever IV chemo treatment. That deserves its own post and will follow this one much faster than you expect (or desire) updates.

As a final note, I’d like to thank all the kind people praying for me. Prayer works. Never doubt that. It just might not work in the way you think it should.

A heartfelt thank you to all my friends who check on me and pray for me. A loving thank you to my children who touch base with me often to see how I’m doing and who send me gifts (yeah, you know who you are…)

My heart to my Darling wife who is my touchstone on this planet. She’s always there with me, and she will never really know how much that means to me.

Hey, Aunt Jan. Just mentioning you because you always check on me and pray for me too. Love you.

Finally, a special shout out to a guy name Michael who is a pen pal and works hard to lift my spirits. The guy has a lot of wisdom, as well as some culinary tidbits that I’m still working on. Here’s a snippet from his latest email to me:

In addition to the diet stuff I will have you in my prayers as well. Thank you so much for taking the time to let me know. All this technology is great and makes life better in a lot of ways but it can also distract us from our humanity and how we can serve each other. Ok very best wishes for a great outcome.

Michael, May the Lord bless you and give you peace, comfort and joy in this world. Thanks, man, for being on my team.

Heck, and for always reading my blog. Did you make it to the end of this one?

For those that did, Nice Job.

More coming. IV Chemo. How scary is it?