First Xtandi PSA - 38.10

The PSA from a blood draw on Friday, 4/24 was 38.10. This was about 10 1/2 weeks from my final Chemo infusion, and represented a 73% bump from previous (4/9/15). It's now Memorial Day, Monday, 5/25/2015 as I type this post.

Once again, I've gone way too long without a post - my apologies! For quite awhile, my general pain level has been holding at "Not So Good", mostly in my legs. I began my new treatment, a daily oral drug, Xtandi four ½ weeks ago. Thus far, I don't know that it's had any effect on either the progression of cancer, or my pain. For the treatment of pain, I have Oxycodone (10 mg) and Morphine (15 mg). While I'm permitted to take either every four hours, they make me a little woozy, with distress of the lower tract; and providing little relieve. So I don't take them nearly that often. Also, about a month ago, I was radiated for pain treatment on both shins. No joy.

In two weeks, I'll get another PSA number and see my general oncologist.

A BIT OF HISTORY:

As you may know Debbie & I flew to Florida in late March to visit Carl & Trisha, her brother & sister-in-law and my old sailing buddy, John "The Boss" Haste". Even as we walked through the Portland Airport, my legs began to hurt. Once in Florida, the pain increased over time. I felt it walking very short distances, standing and even sitting. Frankly, at that time, lying down wasn't that good either, as it made my feet & shins feel as though they were in an ice chest. Strangely, my best position was the driver's seat of our POS econobox rental. I found I could drive the Ford Fiesta all day in relative comfort! Debbie & I both had middle seats on the plane from Dallas to Portland - I didn't like that!

We returned home on 8 May, and since then I feel pretty good while lying down, so I lie down a lot. In fact, I'm almost always either in bed or on the couch. I leave the house exclusively for medical appointments. My left leg is worse, so operating a clutch is out. Our pickup is an automatic, but don't really trust my right leg with the brakes, so Debbie drives.

LOOKING FORWARD:

As mentioned earlier, the "miracle drug du jour" is Xtandi. It otta' work, as it costs $8,500 per month! Fortunately, my insurance covers it without co-pay or deductible. We were hoping it would start working immediately. After all, two years ago Zytiga kicked in within about a week - and it's only $6,000 per month! Now at 4 ½ weeks I notice nothing from Xtandi. It's too early to be disappointed, as this drug often does nothing for 6-8 weeks. And, who knows? It could be fighting the cancer even now; regrettably without addressing the pain. The results of the next PSA may answer that question.

So, it's wait & see. We might have to start over with yet another miracle drug. Or, the docs might start concentrating on addressing the pain. In the meantime, I'll address the pain:

THE PAIN

Two years ago, severe pain coursed through my body from toes to hair. It was barely relieved with 4-hour doses of Vicodin. I was in bed, hurting a lot! This time, with rare exception, the pain is in my legs - mostly from the knees down - and mostly the left leg. If I'm lying down, I can get rather comfortable. If not, I'm hurting. Standing hurts. Sitting hurts. Walking hurts, a lot. Both shins hurt immediately. After a few steps, it feels as though I've twisted my left knee. And, there's muscle pain in both thighs. Before long, the right knee also feels twisted, while the left knee feels severely injured. The same occurs when I sit for fifteen minutes or more. The longer I "abuse" my legs, the longer the pain lasts - several hours or more. That's about it for now...

Oh yeah, my hair's coming back: I can't complain about that!

LOCAL NOTE:

Since I've been home, I've discouraged visits from well wishing friends. I believed I'd be "Tip Top" in days, so there was no reason to entertain guests while flat on my back.

I'm now comfortable enough on the couch that I don't mind people coming by for an hour or so. I only ask that you call first and DON'T BRING ANY FOOD!

Post Chemo PSA - 22.01

The PSA from a blood draw on Tuesday, 4/09 was 22.01. This was eight weeks from my final Chemo infusion, and represented a 49% bump (but only 7 points) from previous. It's now Tuesday, 4/22 as I type this post.

I've gone way too long without a post - my apologies! For the past couple of weeks, I've been experiencing quite a bit of discomfort or "Not So Good" on my scale. It's unclear whether this is the result of 1) cancer buildup, post Chemo; 2) withdrawal from the steroid Prednisone; or, 3) ironically a blast of radiation I received on Friday of last week - intended to control pain.

The bottom line is that I'm spending more time in bed than out. But, I'll be starting a new treatment in a few days, which should bring me back to "Tip Top".

I can't complain about that!

Post Chemo PSA - 14.77
The PSA from a blood draw on Tuesday, 3/10 was 14.77. This was four weeks from my final Chemo infusion, and represented a 9% drop from previous.

Can't complain about that!

Chemotherapy: 12 of 9 (Bonus 3 of 3)

The PSA from a blood draw last Saturday was 16.23. While that's only about a 5% drop from previous, it was good enough to green-light the 12th and final Chemo infusion.

And so it was, Monday, 9 February I was in the infusion room for the last time. If you count the two years of Zometa (bone strengthener) infusions, I've now been visiting that room for more than 2 ½ years!

It's now Friday the 13th, as I write this post. At the moment, I'm feeling "Not-So-Bad" - as the Chemo side effect kicked in Wednesday evening. Today is better than yesterday, so maybe I'm almost over it. We'll see...

BETWEEN THE NEEDLES

As I related previously, the period between #11 and #12 started with about a week of side-effect pain, followed by a week with a nasty chest cold. Nasty enough, to warrant a chest x-ray to rule out pneumonia. By the 3rd week, it had settled down to become a mild bronchitis. And, the cough continues. Continuing also, is my significant fatigue and shortness of breath.

LOOKING FORWARD

The end of Chemo is strangely bittersweet. While it's been beating me up a bit for the past 6-7 months, it's also kept the negative ramifications of cancer at bay. I've had fantastic results with my various treatments [Focused Ultrasound (HIFU), Hormones (actually hormone blockers), External Radiation, Antiandrogens, and Chemotherapy]. So, odds are, I'll do very well with the next one (actually that's not logical, but I'm going with it anyway!). But, you never know (that IS logical).

For the next six weeks, there'll be no treatment. Instead, the Chemo drugs will be leaving my system. At the 6 week mark, we'll check the PSA. If it hasn't increased much, we'll do nothing for another 3-6 weeks, repeat. Conversely, if the PSA shoots up, we'll begin my next therapy regimen. That'll be an oral drug known as Xtandi (enzalutamide) taken daily. It's another anti-androgen. It works in the body by preventing the actions of androgens (male hormones). While there are all kinds of possible side-effects, most guys experience little.

Also, next week I'll begin weaning off the steroid Prednisone. Without Prednisone, I'll have no excuse for my gross obesity, which'll be nice. I look forward to having clothes that fit, once again. I can't complain about that!

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Sunday Update:

While not "tip-top", with a handful of Advil, I felt well enough that Debbie and I went to "Beer Friday", our weekly dinner out with a few high school friends. In a way, it was a celebration of the final Chemo treatment. I'd done 12 without serious side-effects: I'd beaten Chemo! Or so I thought: I woke at about 1:00 a.m., feeling as though I'd eaten way, way too much - Which I had, but I always eat way too much so that shouldn't have been a problem. After about 1 ½ hours of tossing & turning, the "fullness" turned into acid reflux. At this point, I got up, took a Zantac, and returned to bed for another 1 and a half hours of discomfort. Then, at about 4:00 a.m. I rushed to the bathroom, vomiting violently. When it was over, I returned to bed, falling asleep at about 5:00.

I awoke about 10:00, mildly nauseous with pain level of "not so good". And, so I remained throughout the day and evening. I'm fine now, but humbled. Chemo won the final round!

On Saturday, the 7th, I walked-in for a blood draw in order to produce labs in advance of my Monday, the 9th, infusion. The PSA dropped 5%, so the decision was made to go ahead with my 12th Chemo infusion.

Chemotherapy: 11 of 9 (Bonus 2 of 3)

Monday, 19 January was the date of my 11th Chemo infusion, and it's now Monday, 2 February, as I write this post - or TWO WEEKS LATER! At the moment, I'm feeling pretty near "Tip-Top" - Chemo-wise, and Otherwise. But recently, that wasn't the case:

First, two days after the Chemo (Wednesday, 21 Jan.), I began feeling post-Chemo pain. It continued through Sunday, the 25th, at a level significant enough to keep me home. As it passed on that Sunday, it was replaced with a quite impressive chest cold. I was coughing a lot through Thursday, the 29th, and generally exhausted. It then occurred to me that as pneumonia is a rare but possible Chemo side-effect, perhaps I should tell the Drs. They called me in for a chest x-ray. The x-ray was negative, but I'm still coughing quite a lot, even now.

In the recent posts, I stated that as long as the PSA tests remain promising, and that my body can withstand the harshness of the Chemotherapy, it would continue beyond the scheduled 9 infusions. With the previous cycle, the test results were very favorable, scoring 16.95, a 33% reduction. The current number is 17.14, an increase of about 1%, what they call "stable" at the doctor place. While I was hoping we'd be knocking about a third off the previous score, "stable" is not so bad. And, although the side effects were probably about as bad as they've been, it still wasn't all that bad. So, there'll probably be another (and final) infusion, #12 or "Bonus 3 of 3" next week, on the 9th of February.

BETWEEN THE NEEDLES

The three weeks following the tenth infusion, included more severe and longer side-effects than I'd had in the past. I can thankfully say that I continue to handle it well, but its negative impact is beginning to build a bit. More specifically, I'm experiencing more days of pain/discomfort that before. I also find myself out of breath after WALKING up one flight of stairs. In addition, I'm quite easily fatigued, requiring a chair after only about 5 minutes of standing. I've also reached a new "all-time fat". That said, Debbie and I had a pretty busy social schedule during this period. In addition to attending 3 "Beer Fridays", we also found ourselves in bars to watch the Ducks in both the Rose Bowl and the "Natty". And, we "worked" Portland Yacht Club's booth at the Portland Boat Show, for four hours. We also put on our "best bib & tucker" to attend the PYC Commodore's Ball.

NOW & THEN
I found myself more debilitated by a common-cold, than by Chemotherapy! How can I possibly complain about that! I'm looking forward to next week's infusion...