THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2015 SO THERE IS NO UPDATE.

I was Diagnosed at the tender age of 50 years. I always knew that I would get Prostate Cancer as my father had it; his only brother died from it; my paternal grandfather and his father died of "prostate problems." Needless to say I started monitoring my PSA at about age 40.

I decided to go the route of Laparascopic surgery, however at that time this procedure was relatively new in the U.S. I live in New York City (Brooklyn) which had just experienced the 9-11 and so it was extremely difficult to move around the city and very difficult to get appointments with doctors. I was able to identify a few surgeons who had been trained in the procedure, however none of them had performed the surgery more then 10 times. This was not acceptable.

I did finally find a surgeon who had just left Worcester Medical Center (Ma.) and started a practice at Mass General Hospital in Boston. I was his 96th surgery.

I continued PSA monitoring which was always undetectable. Then in January of 2006 my PSA jumped up to a high of 87.9 ng/ml with a doubling time of under two weeks!!! I had a complete battery of scans and tests including an MRI and bone scan. The bone scan was negative, but the MRI showed that I had micro-mets in the lymph nodes and it also showed a tumor of over 10 cm in my left Kidney.

I was referred to a Kidney specialist who removed the Kidney. I was now a triple Cancer guy; recurrent PC, Kidney Cancer and Thyroid Cancer (dx in the summer of 1998).

Because of the significant PSA velocity I started Hormone Blockade while still hospitalized from the kidney surgery. My PSA tumbled as quickly as it had doubled and soon the PSA was back to being undetectable.

I stayed on the blockade for about eight months and then elected to go take a vacation. I have now been off the blockade for four months. My PSA still remains undetectable.I will add that I was one of those guys who had every possible side effect, plus some I invented, from the HB. Being off of the blockade has really made a major QOL improvment. It is only now I realize how terrible I had been feeling.

I have just completed my first year of being intermittent. My PSA remains < 0.04 and am feeling very well. I pray for the PSA to stay down for a long time.

In March 0f 2008 my PSA again began to increase - it is now 0.11 ng/ml. It is doubling in 4.2 months, a similar velocity as when I had the initial recurrence. Additionally, some of my kidney functions are beginning to decrease. I am arranging to see a nephrologist to figure out if I can do anything to slow the decline.

In the mean time I continue to write my blog at and monitor the PSA rise.

Joel reports a PSA of 0.58 ng/ml but makes no other comment.

PSA climbed to 4.46, so in February of 2011 I started Casodex and added Degarelix (GnRH antagonists) in the beginning of March 2011. I elected to try Degareix instead of returning to Lupron to hopefully avoid the horrendous negative side effects that I experienced.

I was aware that by day two I was either castrate or well on my way as I began to experience warm flushes and a rare hot flash. The flushes and an occasional flash continue, but I have not yet experienced the severe problems I had with Lupron. I did have some neuropathy in my hands when I initially started the Casodex, but it is rare and tolerable.

The one concerning issue I have experienced with the Degarelix is an injection site problem. Initially, a loading dose is given which involves two separate injections of 120 mg each and then one injection of 120 mg every 28 days. I developed both two lumps under the skin (a commonly reported side effect) along with a painful and very red band across my entire belly. My doctor put me on an antibiotic which has calmed down the color and the sensitivity of my belly.

Having had the bad reaction to degarelix I changed over to Zoladex and Casodex. [Joel's dates are in US style month/day/year. So 07/05/12 is July 5, not 7th May.]

03-23-11 PSA 1.23
03-29-11 Zoladex, 3 month formulation
6/22/11- PSA <0.04 Testosterone 29 ng/dl
6-29-11 Zoladex, 3 month formulation
9-29-11 Elected to stop ADT
12-30-11 PSA <0.04
Testosterone <20
C-Reactive Protein 8.1
07/05/12 PSA 0.1
C-Reactive Protein 4.1

I remain on intermittent ADT with off periods of over 2 years. I have just added finasteride during off periods with the goal of lengthing the off periods. Normally, my doubling time is slightly over 3 months. Three months after starting finasteride my PSA dropped from 0.35 to 0.25.

All things are well and I feel very healthy, however I have had two bouts with Melanoma (primary), but currently it too remains under control.

Joel's e-mail address is: joeltnowak AT gmail.com (replace "AT" with "@")

NOTE: Joel has not updated his story for more than 15 months, so you may not receive any response from him.