As mentioned in previous posts, after surviving 2020, and getting through the deaths of a couple of younger friends in 2021, I decided it was probably time that I needed to focus back on my health and my ever unwanted resident guest that lives in my pelvis.
So I started that process and here's where I'm at. This coming Monday, I have a state of the art, PSMA-PET scan at UCSF in downtown SF. I've been to their cancer facility before and I have always been impressed. The scan is light years beyond what was available seven years ago. It's even beyond what was available a year and a half ago with the Auxumin scan. Needless to say I'm grateful that Medicare/my Medicare advantage plan with UnitedHealthcare will pay for this. It will give me and the medical oncologist a lot of information to work with.
What's even more exciting is that in most western countries they have approved treatment using PSMA technology. To make it very simple, using the same technology that they identify prostate cancer specific cells throughout the body for imaging, they can also identify those cells and send, in essence, nuclear bomb's to those cells, leaving the healthy cells around them undamaged. And that's always been the problem with cancer treatments; they don't just damage the bad cells, the cancerous cells… they kill the good tissue and the good cells. And that, of course, is the dilemma for most cancer patients. How much trauma to your body do you want to put up with to live a bit longer with not necessarily great quality. Consequently, this is a very promising technology. More can be found here: PSMA Prostate Cancer Treatment.
I've been very fortunate during this journey. I have little urinary issues, although I do take a flomax every other day; my sexual function is good with medication not required for erectile function but used as a preventative/palliative measure; with regard to sexual function, orgasms are typically incredibly intense… far more so than any time in my life. But they can also be painful about 10% of the time. There is very little "pre-cum" and there is no ejaculate at all. Having the ability to be intimate with another person, even if it's a bit different than in the past, is really important to a person's emotional well-being.
The chemotherapy induced peripheral neuropathy(CIPN) is rearing its ugly head and making it harder to walk and open doors and do anything that involves my feet and my hands. Medication helps but it doesn't take care of everything..and I may also be growing tolerant to some of the meds. It's just something I am doing my best to live with and not complain about because nobody really wants to hear about it.
My old friend fatigue is a wiley adversary. I can sleep six hours, I can sleep 12 hours and I'm still going to have difficulty pulling it together in the morning and I'm going to feel tired like I haven't slept all day. Some prescribed stimulants help that at times, but most of the time they just make me kind of jittery, tired person. I'm not lazy..........I'm just fatigued because cancer cells suck up a lot of energy. A lot.
Also, there's this. As do most men who were in my situation, I get a PSA test done at least three or four times a year. While nobody ever died from a high PSA test, it's a good indication, particularly if you have my history, as to what's going on in the body. In April of this year my PSA was 37. Flash forward five months and it's about 330. So it's about nine times what it was five months ago. Probably not good news.....at all.
The path forward is to get the imaging done next Monday, then to sit down with that information as well as these numbers and speak to the research guy at UCSF as well as my own oncologist and see if they have anything besides castration to offer me. Call me crazy, I'm just not a fan of losing the boys....either literally or chemically.
Regardless of how it goes, I am an extraordinarily lucky man. I have lived longer than they told me I was going to; I haven't done everything they said was "protocol"; I have used medical cannabis and I've kicked it up to a whole new level in the last month and I I'm a firm believer that I kept numbers so low for so many years because of this. But the bottom line is, I'm a very, very fortunate man. This disease allowed me to get to know myself better. This disease has made very clear the people who are true friends and those who are just acquaintances. This disease has allowed me to get closer to family which warms my heart in ways I can't express. This disease has reminded me that there are still so many people that would trade lives with me.
So keep your fingers crossed, say a little prayer or do whatever you do. I'm going to be OK.
I'm going to be OK.
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