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Albert Pugh and Gayle live in Texas, USA. He was 56 when he was diagnosed in December, 2006. His initial PSA was 17.80 ng/ml, his Gleason Score was 9, and he was staged T2a. His choice of treatment was Surgery (Retropubic Prostatectomy + RT + ADT). Here is his story.

I was diagnosed with prostate cancer in Dec 2006. I had an elevated PSA of 17.8 ng/ml and referred to Urologist who found 1cm mass on the left side of the prostate. The following week I had a 12 sample biopsy and 8 of the needles had a Gleason rating of 8/9. The following week I had a CT scan and Bone scan and both were normal. The cancer was confined to the prostate gland and still had fat tissue around the capsule.

I elected to have surgery performed the following week with the idea that all the cancer was confined to the prostate and that would be all the treatment I would need. Maybe a short course of radiation. After wakening from surgery I was told there were adhesions to the colon and in fact the biopsy report showed some cancer FA present in the colon wall. The lymph node and seminal vesicles were negative for any cancer.

Routine recovery and at the 6 week check up was doing great even with the incontinence. My PSA 6 weeks after surgery was 25.0 ng/ml. Thinking maybe a mistake a re-check one week later the PSA was 30.0 ng/ml.

I was started on Casodex and a referral to MD Anderson. My PSA did drop to 20 ng/ml in 10 days after starting the Casodex. No new treatment options from MD Anderson. All they could say was that I had Microscopic disease somewhere in my body, just didn't know where. Their recommendations was Lupron injections and radiation treatment.

I had my first Lupron injection the 1st of Mar and radiation treatment ( a full 37 treatments) started in April 2007. I finished the radiation the end of May 2007. My PSA in May 2007 was 25.0 ng/ml and was told was elevated because the radiation was killing cancer cells. In July my PSA rose to 35.0 ng/ml and was started back on Casodex. To date I am taking Lupron injections every 4 months and 50mg Casodex daily. My PSA has been slowly declining and in Jan 2008 was down to 3.4 ng/ml.


May 2009

In Jan 2008 I was diagnosed with hormone refractory and started on Ketaconzole and Hydrocortisone. I had a gradual decrease of the PSA down to 1.5 in May 2008 and then started to rise again thru Aug 2008 when my PSA was up to 2.9.

In Sept 2008 I started the chemo protocol for the next 24 weeks. In April 2009 my PSA is still only down to 1.5. My last set of scans were all negative and will repeat them again the 1st of June.


September 2010

My PSA gradually worked down to 0.50 after the Chemo while staying on Casodex. In Oct 2009 the PSA started to rise and was up to 2.8 in Jan 2010. At that time I was started on Melatonin 20mg at night, Thalidomide 100mg at night, Cytoxan 50mg in the morning, Celebrex was gradually increased up to 400mg twice daily and Metformin was gradually increased up to 1000mg twice daily.

Last month we stopped the Melatonin due to too groggy in the mornings. My PSA has been plateaued at 1.2- 1.3 for the last 4 months. My last set of scans in Feb 2010 were all clear and I am due for another set in Dec 10.


April 2012

In March of 2011, I had stopped the Thalomide due to progressive neuropathy of my feet and finger tips. I did start back on the 20mg Melatonin in the evenings. For the next 3 months my PSA; gradually increased from 1.0 to a high of 1.5 in May 2011. Then the PSA; progressively decreased to a low of 0.6 in Dec 2011. Since then it has increased slightly to 1.0. My last set of scans in Dec were all clear. Overall I feel great and no other side effects from the combination of the Celebrex, Metformin, Cytoxan and Melatonin.


May 2013

I continue to take Celebrex 400 mg twice daily, Metforman 1000mg twice daily, Cytoxan 50 mg in the AM and Melatonin 20 mg in the PM. I have been on this combination of drugs for the last 3 years. Originally I was also taking Thalidomide for 14 months but developed what appears to be a permanent neuropathy in my feet and ankles that seems to come and go. During this period my PSA; has gone down from a high of 2.9 to a record low for me of 0.4. For this last year my PSA; has been up and down and appears tho range between 1.2 -2.1. All scans, CT and nuclear bone scans are negative. Overall my health is great. I currently am on a natural paleo diet and I think that contributes a lot to my excellent energy levels. I still work full time as a Veterinarian and still have time to care for and ride my 6 horses.


June 2014

Since my last posting last year my PSA made a gradual increase starting in October 2013 from 2.1 to a high of 5.2 in March 2014. I was diagnosed as refractory to the combination of melatonin and metforman. I had been taken off of the Celebrex and Cytoxan in the summer of 2013 because I had developed a mild case of radiation cystitis. It really seems odd that every urinary bleeding episode that I had came immediately after straining to have a bowel movement . Only the first time in July 2013 did the bleeding last for more than one episode.

I was started on Xtandi in December 2013 and even on that drug my PSA continued to rise from 2.1 to 5.2.

I had another set of scans done in February 2014 where it was found that I had a lesion in the C2-3 cervical spine. I had surgery on March 14 to debulk the tumor and was told it came out the spinous process both dorsally and ventrally. They remove the dorsal portion and left the ventral portion to be treated by radiation. This all was a result of my fiancÚ telling my oncologist of the persistent cough and throat clearing that the scans included my upper neck. I then had 5 rounds of stereotactic radiation to treat the remaining tumor and completed that on April 10, 2014. The radiation was really rough as it made it very painfully to swallow and took away my saliva and taste. Since then I am able to swallow pain free and most of my taste has returned. My saliva is still reduced and my energy levels are improving. My last PSA; was done in May 2014 and was down to 3.5. I go back in July for another mri of my upper neck. The biopsy on the tumor was prostate adenocarcinoma.


July 2015

Since my last posting last year I stayed on Xtandi and enjoyed relatively good health. We saw a new range of PSA; from 2.0-4.0 over last year. Early in 2015 my PSA started going up and reached 6.0 before a new set of scans found metastatic tumors in the right femur and in the 5th lumbar vertebral body and right side of the sacrum. At that time I was switched to Zytiga and Prednisone 5mg twice daily and underwent 10 doses of radiation to the femur and spine. At the completion of the radiation my PSA; was 10.0. I have another test tomorrow to see if results are going down.

Three weeks ago I believe that I may have had a severe reaction to the Zytiga as I was sick with flu like symptoms and severe muscle pains whenever I tried to walk or use my arms. After 12 days I quit the Zytiga on the advice of my oncologist and the following day all muscle and joint pains were gone. We are going to start over with the Zytiga with a possible increase in the Prednisone dose due to my activity level. Right now I feel great. I am back to riding horses (weather permitting) and doing CrossFit 3 times per week all while working 45 hours per week.


August 2016

From last summer while on Zytiga I developed an allergic reaction to possibly a bad batch?? So I went off the Zytiga for a month and then my PSA; did start rising again so I started back on the Zytiga and Prednisone and then developed metastasis in my lower lumbar vertebra and right femur and had 10 doses of radiation for that. Then 3 months later found new growths in my right forearm (radius) and ribs multiple. At that time started a round of chemo every 3 weeks until Nov 2016 when I quit the Zytiga again and went to the Bio-Medical Clinic in Tijuana, Mexico. At that time I started on the Hoxsey formula, bone supplements and several other supplements. My PSA; did decrease to about 2.0 over the next 2 months and then started to increase again. In May 2017 my PSA jumped from 10 to 30 and I started a new round of chemo with Carbitaxitol every 3 weeks. I also had an injector of Neulasta attached to my arm to give the automatic injection 27 hours later. The 1st 24 hours after chemo I feel fine but 6-12 hours after the Neulasta injection every bone in my body hurts and causes a really foggy brain for several days. Since May my PSA has been coming down and now down to 15.8.

I also started with cannabis oil about 5 weeks ago. I take a higher THC at night and higher CBD during the day. I am going to keep on the cannabis for at least 3 months before I decide if it is really helping or not

Albert's e-mail address is: apughiv AT gt.rr.com (replace "AT" with "@")