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BRONZE

Allister Murphy and Laura live in Belfast, Northern Ireland. He was 51 when he was diagnosed on February 18, 2008. His initial PSA was 153.0 ng/ml, his Gleason Score was 7 (3+4) and he was staged T3bN0M1b. His choice of treatment was ADT (Androgen Deprivation Therapy). Here is his story.

Had blood and urine test after (briefly) passing blood (just once). Re-occurrence of previous kidney stone problem suspected (11 years ago). Test showed kidney OK but PSA "elevated". What's a PSA I asked?

No symptoms of any kind, no peeing problems, no pain - age 51 at diagnosis February 18th 2008 - Diagnosed T3b N0 M1b with advanced metastases to entire torso skeleton (bone scan). PSA 153.0 (Jan 08) rising to 214.0 (Feb 08).Gleason 7.

Opted for STAMPEDE (Systemic Therapy in Advancing or Metastatic Prostate cancer: Evaluation of Drug Efficacy) trial and got Zometa & Celecoxib arm. Initially on Zoladex but now on Decapeptyl and 50gm Casodex.

Unusually for HT (Hormone Therapy) patients I have virtually no side effects other than loss of body hair and dry orgasms. Still playing soccer and rugby and living life to the full :-)

 

UPDATED

January 2010

 

 

My PSA had been climbing slowly but steadily all of 2009. It had never gone sub 1.0 and is now 19 and probably higher. The consultant did switch me from Zoladex to Decapeptyl (Triptorelin) a few months ago but after an initial response the PSA just started to climb again. Casodex 50mg just doesn't seem to work for me either.

The good news is that my testosterone has never been at castrate level, bottoming out at 1.6 nMol/L and now at 4.0 nMol./L. The PSA has always followed the variation in testosterone so the oncologist does not think I am hormone refractory (yet). Today (Jan 11th 2010), I started on Degarelix (Firmagon) with a 240 mg double injection. I expect to lose libido (something Zoladex never did to me) but this is a small price to pay if the PSA comes down.

Still playing soccer and rugby and loving life. My stomach hurts a bit but then no pain, no gain! I'll update in a few weeks :-).

 

UPDATED

March 2010

 

 

Now on my 3rd shot of Degarelix (although the technically 1st one is triple strength). The injection site reaction is noticeably less and not much worse than Zoladex. The first two injections were very unpleasant and took up to 10 days to settle down.

Despite the new treatment PSA continues to rise alarmingly - now at 40. Initially the Degarelix got my testosterone down from 4.2 to 1.9 nMol/L but it's now gone back up to 2.7 so not as much success as I had hoped for. On the plus side I still have a reasonable libido despite two years of HT and the oncologist still thinks my cancer is hormone sensitive, hence we are discussing an orchidectomy if the drugs can't get my testosterone down to castrate level.

Still exercising regularly and feeling great.

 

UPDATED

March 2011

 

 

Degarelix was proving more and more painful without any improvement in results. Each monthly injection left me sore and unable to train / go to the gym for at least a week (bit like having a duck egg appear under your skin every 4 weeks!). The PSA rose relentlessly until by July 2010 it had hit 117. Testosterone stubbornly refused to come down much below 2 to 3 nMoL/L and an Orchidectomy was provisionally scheduled for September.

In an experiment (not 100% agreed with the Oncologist but we'll not go there ...) I started 1.0 mg of the steroid Dexamethasone and stopped Casodex. A month later the PSA exponential rise slowed dramatically to 124 before heading rapidly downwards to 65 the following month. Oncologist also agreed to abandon Degarelix / Orchidectomy and I elected to return to Zoladex. My testosterone also went castrate for the first time ever at < 0.7 and the PSA continues to fall, now at 6.4.

Side effects are minimal, mainly putting on about 4 or 5 pounds (which I know I can lose). Despite the low testosterone, I remain fully functional with a reasonably good libido and decent sex life :-) Still playing rugby & football, still full of energy and no symptoms despite the mets..

Allister's address is: allister.murphy@btinternet.com