Friday, June 21, 2019

Post SBRT MRI - Sometimes Bad Genetics Are Hard To Fight



I go to see my onc next Tuesday. In addition to moving, spending a night at the ER to get pain "down there" under control, working a job or two,  I also squeezed in a PSA test and an MRI to see (said in my best southern accent) "what's goin' on down thar."  Well the report came back the same day and my onc knows me well enough to know that I'm pretty adept at reading them and, regardless of the news, I won't throw myself off a bridge if it's not great news, so he kindly posts them once he's read them.

And it's not all great news. But not all bad either.  But not all great.

We'll start with the good stuff.  My PSA is down to a 6 from a 13.  That's the right direction.  For reference, when I was diagnosed in 2014 it was a 5.1.  Highly aggressive PCa tumors don't typically boost PSA much, so this is just one part of the puzzle.....but a welcome one.

Also noteworthy is that the largest tumor "demonstrates mildly decreased size" (3.3cm x 3.2cm vs 2.6 x 2.40). The radiologist notes that the bladder neck is "Grossly (seems like they could find a different word, ya know ?!) unremarkable". This is a good thing.  It may explain why I'm having less and less pain during urination.  I'll take it!

Now the not so great news is that I have a "Pi-Rad" score of 5 which means the radiologist thinks that there is a "very high" indication that I have a "clinically significant cancer".  Well duh!  What do ya think I've been up to for 5 years?!

Also, the extensions of the tumor that threaten my bladder and rectum appear unchanged.  That's not so good.

My reading indicates that the full effect of radiation (the good effects as well as the bad effects) can take months to happen. But the fact remains I still have a highly aggressive, metastatic cancer in my pelvis and likely some cells running around my body.

Fatigue is my number one complaint now.  I had no idea how bad it would knock me down, but it's right up there with chemo and ADT in terms of what it does to energy levels.

And I'm sick and tired if being sick and tired.







Wednesday, June 12, 2019

Almost Three Months Out........How Am I Doing?




June 19 of this year will mark three months since I had my five sessions of high dosage, SBRT. In a generalized sense I can say that the side effects have been really only two, fatigue and urinary discomfort.  I sleep well at night. I rarely if ever have to get up to go to the restroom. I think that I made good choices in terms of the spacer device. And I'll find out soon what affect the radiation has had on the tumor. So here’s to the nitty-gritty. If you don’t like reading about the male reproductive or urinary systems, kindly flip over to the Disney Channel at this time. :-)

U/G Toxicity

I’m still experiencing some issues with burning during urination and I still take the generic Flomax and, on occasion, the Azos, although I am experimenting and I think that the Flomax may be enough and I may need to take only a small amount. And for this we are grateful :-)  as noted before in this blog, I’ve never had any problem with urination whatsoever aside from a brief episode in roughly 2000. So the experience of having extreme burning during the process and having issues urinating was new to me.  But what I can say is that in my research, three months seems to be the median for most men to get back to baseline, like wherever you were when you started, and I feel as it seems I am rapidly approaching that. I’ve had no incontinence or any of those issues (so grateful), it’s just when I’m not medicated and I got to pee,  I need something to grab onto something.......or a bullet to bite:-).I’m grateful to my physicians and rad techs for doing what seems to be a good job on this procedure.

Rectal Toxicity

In terms of what is to be expected from radiation in that area, I’ve been extraordinarily fortunate. I had  a couple of days where there was a little bit of blood and a couple days where it was kind of painful to pass anything.  But other than that? I’ve just had no problem whatsoever and I am more grateful than I can possibly say because it really would piss me off and make me feel like I’d  made a poor choice, if I had to deal with that. I strongly believe that the choice to make space with SpaceOAR, as performed by the highly skilled and compassionate,  Dr. Kenneth Chao, made a huge difference by pushing the rectum a few centimeters away from the "danger" zone. Performed masterfully and with care and consideration of my thoughts and concerns. I’m convinced it made a huge difference because when you’re shooting radiation at peoples organs, a few centimeters makes a big difference. He knows this and he made sure that I got those few centimeters. Hell of a guy, compassionate and knows exactly what he’s talking about. A+  rating from me! If you are thinking  radiation of PCa, consider SpaceOAR. A few centimeters can make a lot of difference.

Sexual Function

 I am relieved that I’m doing pretty well in this department. Giddy is a word that comes to mind. Although I’ve been taking 40 to 60 mg of Sildenifil daily as a prophylactic to keep blood flow to the region, I quit for a week  as an experiment, and I’m happy to report that I experienced both nocturnal and spontaneous erections during the day with a frequency that a man approaching 60 who has had the shit beat of his body should be pleased with😎  I think men, regardless of sexual orientation, will understand just what it means to be able to wake up with an erection or realize that you have one in public for no particular reason. That’s the sign of a healthy penis and a healthy penis is the sign of a healthy male. I need all the signs of health I can find and I particularly like this one just for the record...lol. You’re welcome!



Fatigue 

 My arch nemesis. It doesn’t make a difference if I’m in bed for eight hours or 12 hours, I wake up exhausted. And usually in pain, despite adequate medication. I knew this would be part of it with the SBRT.  I knew it would probably remind me a lot of hormone deprivation and chemotherapy. Bad fatigue is a real thing and I just try to push myself through the day to the degree that I can. I try not to let this wretched disability keep me from working once or twice a week or helping out a friend or just simply being nice. But we’re getting there, we’re getting there :-)

 In the midst of all this, I will complete a move to a dear friend’s home in to the master bedroom of the home (I’m still wondering what I did that gave me good enough karma for me to get the master bedroom). But I am excited, I am honored, I love this friend and her child, OK he’s not a child he’s 21 years old, but still it’s a family. We share similar interests but I think we also understand the need for some solitude once in a while. I’ll be able to cook which hasn’t really worked out well where I am at and that’s really important for people with a live tumor still in their body.

Cannabis/cannabis  oil

I continue to use high CBD/THC cannabis and cannabis oil. Every doctor I’ve had, from the one in Texas to the ones here have always said, ‘I’m not sure what you’re doing but you should be very sick right now, so keep doing what you’re doing.’ That’s about as far out as most in these will go in their suggestion to use CBC/THC as a not only a palliative drug, but also as a quite likely cancer inhibitive and, in many cases, curative.

General Pain

The neuropathy continues to be what it is and, while tiring, I at least am familiar with it.  It is a constant presence in my life and severely limits how much I can physically be on my feet. Pain meds deal with it fairly well!  What is new is a usually quiet area.  I have a constant, dull, throbbing pain that can, at times, escalate to a sharp pain in the lower right part of my abdomen, high above the testicle.....on the same side where the worst of my PCa has been.  Kind of think of it as the right pelvic floor.......and we will see.  But I can tell you that walking around daily feeling like you've been kicked in the groin is tiring.

That's where I'm at currently.  About to move to a new residence and my goal is to build my body back if I can. Also will have the follow up MRI next week.

Cheers!  And thanks for all the support.