Don
Tab and Russ live in Illinois, USA. He was 56 when he was diagnosed on July 12,
2001. His initial PSA was 11.0 ng/ml, his Gleason Score was 4+3=7 and he was staged
T2a. His choice of treatment was Radical Prostatectomy. Here is his story.
For
a year or more I had been complaining to my internist that I was experiencing
trouble breathing. He found nothing to explain the problem. Then on May 12, 2001
I complained of breathing problems again. He sent me to the hospital for X-Rays,
which revealed my stomach had entered my chest via a hernia in my diaphragm. My
stomach was compressing my lung and that's why I was experiencing breathing problems.
In preparation for surgery to repair this problem, he ran a series of test, one
of which included PSA. It was a 11, when it should have been around a 2.
The
pathology report from surgery raised the Gleason to 4+5 =9, Staging became T3a,
and the 22 cc prostate was 90% cancerous, with vascular, neural, and lymphatic
invasion. Plus the cancer had escaped the prostate wall. Surgeon referred me to
a oncology radiology, who explained that would have at best a 50/50 change of
getting the remaining cancer, as it most likely is in the pelvic bed. I completed
40 daily sessions of radiation, and shortly thereafter the PSA began rising.
Lupron/Casodex
became my two buddies during the hormone on-cycles, and Avodart my buddy during
the off-cycles. This hormone therapy kept my PSA undetectable for a while, but
after 3 or 4 years, the PSA began to rise, so my oncologist stopped the Casodex.
Even after stopping the Casodex, my PSA continued to slowly rise, so when it hit
3.82, he prescribed Flutamide, which I started taking on September 22, 2009. My
next PSA test is on October 26, so I'm interested to see if Flutamide helps lower
the PSA.
An added bonus to the cancer medications is that in July 2008
I experienced DVT (deep vein thrombosis) in both of my legs, so initially took
Lovenox shots twice a day for two weeks, then continued to Coumadin ever since.
My internist, medical oncologist, and vascular surgeon said having DVT is common
amount prostate cancer patients. Some have the DVT first, then a couple of years
later are diagnosed with PCa. She also explained that some patients are like me,
with the PCa being diagnosed first, followed by DVT a few years later. She explained
that I'd have to be on Coumadin (Warfarin) for the rest of my life. It's a daily
tablet and is easy to take, but unfortunately it conflicts with a number of food
I enjoy eating, plus some other medications I'm on.
Through all this my
medical oncologist has been following my bone density, and explained about a year
ago, I should started having Zometa infusions. Unfortunately, I was having dental
surgery during that time, so just recently started the Zometa infusions (September
22, 2009), which he said I would need quarterly.
I've experienced a few
bouts of depression through these years of treatment. I think sometimes the treatment
(surgery, radiation, and drugs) are worse than the cancer itself. As far as I
can tell, the cancer hasn't caused any real pain, but I guess I have to thank
the treatments for that.
I'll have a Bone Scan and 3 CT scans, plus blood
test on October 26, 2009, and then see my oncologist on November 4, so will post
an update shortly after that.
The great thing is I feel great most of the
time, continue to work a full time job, plus we enjoy travelling for vacations.
Plus host quite a few BBQ's when the weather is good, as well as a few indoor
parties or dinners when the weather is cool.
....Don
October
2009 DEXA scan showed osteopenia/osteoporosis, so started quarterly Zometa
infusions.
September
2009 As my cancer no longer responded to Lupron/Casodex, stopped the Casodex,
but PSA continued to rise. Started Flutamide (125 mg three times a day). Flutamide
caused diarrhea and found this to be a miserable side effect.
December
2009 PSA continued to rise while taking Flutamide, so switched to Nilutamide
(150 mg each morning). PSA continued rising.
February
2010 Stopped Nilutamide and applied for the TAK700 clinical trial, but didn't
qualify, so started HDK/HC, High Dose Ketoconazole and Hydrocortisone.
March
2010 HDK/HC caused liver problems and PSA continued to rise, so stopped taking
them. PSA continued to rise.
March
2011 Started the Provenge treatment. The first Provenge infusion resulted
in a skin rash, and the second infusion landed me in the emergency room, because
my blood pressure soared, my temperature rose, and I collapsed. Fortunately the
third and final infusion was a non-event. Because no bio-markers have been identified
to evaluate if Provenge helps, only time will tell. PSA is 34.93.
May
2011 PSA rose to 107.34. Bone scan remained clear, as it has since call this
started almost 10 year ago. However, the CT scan identified cancer throughout
my lymph nodes, abdomen, pelvis, lungs and pericardium. Started Taxotere/ Dexamethasone.
Originally was scheduled for four infusions, but that was increased to seven.
My PSA started at 130.51 and by the seventh infusion in October 2011, the PSA
had dropped to 1.68. This was great to hear.
October
2011 Having completed seven chemo infusions with a great drop in PSA, new
bone scan remained clean, and the new CT scan showed most of the enlarged lymph
nodes had vanished, and the other cancer spots diminished dramatically. I have
no way of knowing, but possibly having Provenge prior to the chemo, might have
helped the chemo lower my PSA.
November
2011 Continue on Lupron and Zometa and will have monthly blood tests to determine
how long the chemo treatments will continue to keep the PSA down. Possible future
treatments include Zytiga and/or MD3100. My oncologist doesn't like to discuss
potential future treatments until necessary. I'll have a DEXA scan at the end
of this month to confirm Zometa is still needed.
Don's
e-mail address is: dontab@gmail.com.
