Hismones 5/21/26

"Die with one condition or live with other(s)?" I received the wonderful confirmation on Monday that I am approved to discontinue Orgovyx after 18 months at the end of June. In that regard, I am extremely hopeful and looking forward, starting my last month of that medication with tomorrow's dose. I did receive some disappointing news yesterday from my gastroenterologist: the radiation that did such a great job of "nuke-ing" the cancer cells did permanent damage to my rectum: the radiation proctitis he is treating will never completely heal and I'll likely cycle on and off medications to help reduce the symptoms of diarrhea, bowel frequency, and bowel urgency. I have found so far in life that no medical treatment of serious disease is 100% effective; there's always compromise in function but typically an improvement over leaving it untreated. Psyllium and probiotic greatly reduced the diarrhea, sucralfate enemas stopped the small amount of bleeding, and mesalamine suppositories reduced bowel frequency from about six times daily to the current 3-4. Unfortunately, there seems no control for flatulence despite taking two maximum strength (250 mg) GasEx daily. I may be excusing myself from time to time during social gatherings. My ulcer and esophagitis are improved with Prilosec which he wants me to keep taking and will continue prescribing the enemas and suppositories as needed. My digestive system is left with something rather inconvenient but not dangerous. Finishing Orgovyx at the end of June, I should notice sometime in September whether Testosterone is returning, bringing with it sexual function, energy, strength, loss of hot flashes, body hair, better weight control, and improved blood levels. I'm cautiously optimistic, but celebrating for now that oral medication will be done in another month and will be discontinued until or unless my quarterly PSA tests indicate otherwise. God is good and the state of the art in medicine continues evolving.

Hismones 05/14/26

"Undetectable," such a lovely word! Following my quarterly PSA/Testosterone blood test on Tuesday, I received news this morning that both were too low to measure (PSA <.01 and Testosterone <10). At diagnosis in 2024, PSA was 6.4 and Testosterone wasn't measured prior to treatment. My follow-up appointment will be Monday (5/18), but I asked to get the test results as soon as available. It's hard to believe that Tammy and I have been going through this awkward maze of symptoms and treatments for seventeen months and should be finishing the series at the end of June. I'm pretty certain I'll still be dealing with symptoms from the treatments for a while, but my body will hopefully work hard to heal itself. This week's results mean that the medication is still suppressing cancer activity, that the disease hasn't developed a workaround to grow despite the medication. Whether the medication and radiation have completely eradicated the disease will be revealed over time. I'll have quarterly blood tests for two years, if the numbers stay low, then semiannually for two years, and finally annually thereafter. Should the PSA measurement rise significantly along the way, I'll go back into some sort of treatment that could involve both radiation and medication again. But for now, we're moving toward completion with the hope that by sometime this fall, I'll begin to feel more normal, hoping that the new normal is much like the pre-treatment old normal! If there's anything different coming from Monday's appointment, I'll post. And thanks for coming along for the ride, praying along the way!

HIsmones 05/03/26

I'm within two months of completing the first (and last?) round of treatments intended to extend my life and perhaps end the progress of my prostate cancer for my practical lifetime. So I'm starting to reflect a bit in my second-guessing way of how I would have approached treatment differently had I known in 2024 what I know now. I read a statement by a patient and skillful pundit that seems worth sharing: "Your best move is the treatment strategy that gives you the strongest expected outcome across survival, disease control, side effects, quality of life, and your ability to live with the consequences." Exactly. "Cancer" is a panicky word; the tendency is to act quickly and aggressively without thoughtful contemplation of the possible or even certain long term effects. I acted quickly and aggressively to take a longer and stronger treatment series in the hope of preventing spread of a cancer that supposedly but could not be absolutely proven to have already begun spreading, along with a tinge of resentment toward a primary care doctor who discouraged me from further investigation due to increasing PSA scores that suggested but could not prove cancer activity "at my age." So, where am I at seventeen months into hormone deprivation therapy and after 44 prostate/pelvic radiation treatments? There is definitely a "new normal" in daily life: I have increased the intensity of daily exercise by adding weight training and stubbornly forced myself to tackle work projects at home regardless fatigue or weakness. I have not been able to beat (yet!) the effects of radiation proctitis which sends me to the toilet multiple times each morning, includes copious amounts of intestinal gas, and is more than willing to interrupt sleep on occasion. But life goes on. Rain falls, sun shines, flowers bloom, and I am seeing a hummingbird at our feeder again after winter. I get to spend time with my wife, daughters, and grandchildren, and enjoy many blessings of retirement. God is nudging me deeper in my relationship with him and in my acceptance and compassion toward others. And just maybe after ending treatment mid-summer, I'll gain some energy and won't have to deal with cancer again at least for a while. If I live long enough for it to return, we won't burn that bridge until we get to it, so to speak. So what would I have done differently? Maybe nothing, but maybe I would have chosen less treatment and more risk in exchange for fewer changes in daily life, lesser side effects. So if you're facing a similar diagnosis, take a few extra moments considering a cancer that is typically slow growing and weigh your length of life and quality of life priorities and treatment options. It may be worth your time. My next PSA measurement is in the next two weeks, and if the results remain as they have been throughout treatment, I will go off medication at the end of June, be tested again in September, and be monitored quarterly to confirm that the cancer is dead or remains dormant. Don't wish me luck but prayers are appreciated. I still belive in a God who hears and answers.

Hismones 3/25/26

"This too shall pass." "Action cures fear." I cannot describe or explain how tired I felt getting up this morning. Normal overnight schedule, but I found myself wanting to sleep more, sore to walk, and wanting to have nothing to do with morning exercise. By the time I had been through the make coffee/bathroom/taking out trash and recycling/pulling the cars around to the front routine, I decided to drive to the "Y" and try my normal Wednesday routine workout. Unbelievably, I left an hour later having done my 30 min. cardio and all six of my oncology-recommended exercises. Then after breakfast on the patio, I mowed the back yard. Now, I'm about to clean up and go to a doctor appointment. Moral of the story, and the overarching title of this blog series: "Why Stop Now?" This doesn't mean to injure yourself through overwork, but it may mean that overcoming energy inertia is your biggest challenge today. As is sometimes said in Twelve Step, "Take the next right step." Your day may turn out okay, after all.

Hismones 3/20/26

Fun expression: "Auto-Correct is my worst enema." Four weeks/56 Sucralfate enemas completed, check! Any bleeding stopped, check! 3-5 frequent/urgent bowel movements daily, mostly unchanged. What's next? Waiting for a response from the gastroenterologist. On the Mayo Clinic Connect patient forum, someone mentioned getting considerable relief (from 8-9 urgent bowel movements daily down to 1-2 less urgent) from Mesalamine enemas. The drug is also available as a 1000mg suppository and is covered by our insurance whereas the Sucralfate was self-pay. It's typically used for ulterative colitis, but might be just the thing to heal what ails me. I have another couple of weeks of PT for torn hamstring (right hip) so my weekly exercise plan is Monday at home, Tuesday/Thursday PT, and Wednesday/Friday oncologist-recommended exercises at the Y, along with MWF cardio. I was blessed to have a track day with our daughter's Miata on Wednesday. The car is a lot of fun, but the fun was mitigated a bit by overheating during the first session. I could keep driving if I slowed down, which is sort of antithetical on a racetrack (Motor Sports Ranch in Cresson). I did what I could and have a couple of calls into some local Miata experts, so hopefully we'll be cruising rapidly by the next track events in May. Whether disease or mechanics, I cannot overemphasize the value of support/networking groups. I'm part of two correspondence support groups and two live online groups specific to prostate cancer. Their shared experiences and recommendations are invaluable, because medical specialists simply don't have the time...and may be treating a variety of cancers, so are challenged to keep entirely updated on each one. I'm typically bringing new information to my appointments. So... I hope the same will apply to my track fun machine, being part of two FB groups and in contact with two local shops. Oncologically, nothing new is planned until the next PSA blood test in May, but hopefully there'll be a gastroenterologist response and recommendation soon. Finishing spring break this week, I'll be back at school volunteering and looking forward to my favorite holiday, Easter. My faith is based first on Jesus' resurrection and then his words and lifestyle example. I really would be lost otherwise. I wholeheartedly recommend him!

Hismones 02/16/26

"You only have 55 left," my sweet wife said right after my first Sucralfate enema today. I'm prescribed two daily to take for four weeks. Hopefully, this soothing medication will help heal the radiation proctitis that started a year ago. I'll have more updates after meeting with the gastroenterologist tomorrow. Now for the excellent news: I met with the medical oncologist's PA today, who shared last week's blood test results: PSA <.01 (called undetectable, based on their instruments' sensitivity level) and Testosterone <10 (doing a good job of starving out any remaining cancer cells). I have another PSA blood test in three months...and another follow-up colonoscopy. If PSA continues to keep its ugly head down, I'll be able to discontinue hormone therapy in late June but continue to have PSA tests at 3 month intervals. If you haven't watched the hilarious PSA screening commercial, "Relax Your Tight End," that aired during the Super Bowl, here's the link. https://www.relaxitsabloodtest.com/ I've started counseling with a longtime friend and professional counselor to help me navigate the various issues of life and treatment, and we're working first on coping with anxiety. I grew up without healthy coping skills, and he has some excellent researched concepts that are already giving me some relief. I didn't get where I am overnight and won't get out overnight, either, but I'm grateful to be taking steps toward improved outcomes.Tammy and I had a fun Valentine's overnight trip just an hour or so away at a BnB and toured a bit of the countryside. On the Saturday return, rain was falling so heavily that I was driving under 50 in a 70mph zone, quite uncharacteristic for me! I continue exercising at home MWF and at the local Y TTH. I spend considerable morning time in bathrooms and get really tired during the day, but hopefully by Tammy's October birthday (90 days or so after stopping hormone therapy) I'll begin feeling more normal again, whatever normal may be for age 75. Thanks for your prayers and friendship!

Hismones 2/5/26

I don't want to pooh-pooh effective treatment, but I had a personal phone call from my gastroenterologist this morning that he has sent the prescription to treat my radiation proctitis with Sucralfate in the form of enemas to be applied twice daily for four weeks (56 total!). "Oh joy, oh rapture!" (cowardly lion, "Wizard of Oz") I may not be able to take these without help, so Tammy is especially excited. Maybe there will be a clear path ahead (pun intended) to reduce my 5+ sit-down toilet experiences daily. In other news, I had a great time traveling to the Houston area to visit our daughter and family and to sing with the Southeast Texas Singing Men and Women at a church in Pasadena (TX). What I noticed during the trip was that my right leg and hip and becoming much less tolerant of driving. I see a pain management specialist in the coming week as a consultation for injections in the hip (hamstring tear), but I'm not sure what to do with the shin pain that also accompanies time behind the wheel. Stiffness, pain, and fatigue continue, but I keep exercising at home and at the Y. I've had the interesting experience of repairing a Kitchenaid mixer this week and changing filters (and now diagnosing and ordering the replacement for a broken internal hose) in a Dyson vacuum. Friday-Sunday, I'm scheduled to be a corner marshall at Eagles' Canyon Raceway outside Decatur for World Racing League enduro races. (Fortunately, a porta potty is handy. :-/) Tammy continues to be incredibly patient and supportive as I hobble around and try to keep myself busy...better to burn out than rust out, no? I still need to purchase and plant a replacement tree for our front yard, hopefully that someday our grandkids can drive by and enjoy. (If you need any, I recommend Texas Tree Farm in Ennis which has varieties not readily available locally.) I'm ready for lunch, then rehearsal and a north central Texas Singing Men concert at Southwestern Seminary this evening. Life seems to go on, and I'm pretty sure I'll be pulling for the Seahawks Sunday evening. :-)