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BRONZE

Keith and Bev Murgatroyd live in Massachusetts and Tennessee, USA. He was 65 when he was diagnosed in June, 2008. His initial PSA was 5.2 ng/ml, his Gleason Score was 10 and although he does not give a staging it seems likely that he would have been staged T1c, or maybe T2. His choice of treatment was ADT (Androgen Deprivation Therapy) /EBRT (External Beam Radiation Treatment)/ Chemotherapy Trial. Here is his story.

My primary Care doctor thought 3.0 - 4.0 rise in my PSA in 2006-07 was no issue. On DRE (Digital Rectal Examination) was "hard but no ridge". But a PSA of 5.2 in early 2008 was cause for biopsy. Referred to a Prostate Surgeon for the biopsy. Most of 16 cores were Gleason 9-10. Consulted with MGH (Massachusetts General Hospital, Boston, MA) because they had Proton Beam. They scheduled scans which showed one large lesion but still less than 1 cm. One of them on DRE could "feel the ridge". When told about the scans the Tennessee surgeon said he would still do RP surgery. MGH group said I was an ideal candidate for their clinical trial involving early Taxotere. They said the "gold standard" was ADT/IMRT (Intensity Modulated Radiation Therapy) and the trial would add 6 infusions of Taxotere - one every 21 days starting a month after the 8 weeks (42 sessions) of IMRT.

IMRT symptoms were manageable with Flomax and Imodium. Taxotere symptoms were easier.

On first infusion we discovered I needed Benadryl to stop an allergic reaction. I was slightly nauseous and almost fainted at the end of this session which they said was due to withdrawal from Benadryl.

During infusions 1, 3, 4 I kept my fingertips immersed in ice water to prevent peripheral neuropathy (PN). I felt some PN develop after infusion 2. Icing the fingertips for an hour was quite painful, but feasible. No nausea. No neutropenic fever. On each infusion there was burning pain on the bottom of one foot and severe peeling of skin off the heel.

On fourth infusion I mentioned "tightness in my chest" which I thought was because of the heavy breathing I had been doing to help manage the pain of icing my fingers.
I was also was slightly nauseous and faint at the end of this session (like the first one) but this time they were more alarmed and sent me to the E/R for cardio monitoring.
No cardio problem showed up.

A redness (almost a rash) developed on my knees and thighs which itched, but seemed to not be an opportunistic infection.

After infusion #4 they contacted me and said they thought I should withdraw from the trial because of the risk of "pulmonary arrest".

At day 10 of cycle 4 (neutrophil low point) I developed a fever which got to 102, and was admitted to the hospital for 3 days while they gave me IV antibiotics and tried to figure out what infection I might have. They never figured out what the infection might be.

I dropped out of the trial as they recommended on the basis that "we don't know that 6 cycles is any better than 4" - - - that's why we're doing the trial. I realize that I am still a useful 4-cycle data point.

PSA after Radiation < .01
PSA after Chemo < .01

I experienced watery diarrhoea for 3 weeks after stopping the Taxotere and Prednisone, which I understand can indicate a blockage in the colon. I am again experiencing pre-stretching lower back pain and neck stiffness as I did before treatment started.

I remain on Lupron depot every 3 months.

Next PSA check - April 20, 2008.

 

UPDATED

September 2010

 

 

This is the second time I have typed this update. Apparently your system lost my last update done 2-3 months ago. [There were indeed signficant system problems at the time, especially with Comcast addresses. This seemed to be connected with Spam filters.] I get a new PSA reading in 42 days. It will be 6 months since my last one. They skipped my last Lupron shot two years after the start of my first ADT. Not sure why. It must be a part of the clinical trial i.e. to get an early indication whether early Taxotere helped.

I am well and active on home remodelling projects. Muscles are weaker due, I think, to 2 years of ADT. Gained about 20 pounds of fat (now 218) due to ADT in spite of lo-carb, lo-fat diet.

With two grandaughters, Ohio State football season tickets, home remodelling, and a great wife, I am happy and blessed.

 

UPDATED

December 2011

 

Stopped ADT after (pre, during, and post of radiation & chemo) total of 20 months.

Ultra sensitive PSA as risen linearly (every 6 months) since then (.02 .04 .06 .08). I've seen the full graph (PSA vs. time) and I don't like where it goes after the linear part. I subscribe to Urotoday, read it all daily, and pray for more rapid progress.

The trial with Zytiga and Provenge combinations is encouraging.

Keith's e-mail address is: bev-keith-murgatroyd@comcast.net