Hismones 04/30/25

Mission 1 Complete: 44 weekday radiation treatments finished April 22. Radiation oncologist set follow-up labs for May 22 with Telemed conference May 29 to discuss outcomes. I've never been known for being patient. I have a semi-annual checkup with my primary care physician May 1. I asked to have labs done the week prior and to include a PSA (blood) test among the rest. The tests were done the day following my last treatment and posted on the primary care physician portal. Results? Whereas my PSA was 6.x in November when diagnosed, it was down to .11. Excellent early success (!) and my blood pressure and anxiety went down a bit! The tests also identified some deficiencies in my blood work that match side effects listed by the hormone medication manufacturer, so I'll check with primary care and confirm with the oncologist the best approach to compensating. Now that radiation is complete, I have to focus on weight management. I've gained 10%+ of body weight during treatment, in part likely due to hormone treatment but also certainly due to stress eating, so that part is personally manageable. Despite being embarrassed at the lack of self-control, I look forward to talking with my doctor about moving forward. I requested an appointment with the surgical oncologist/hormone specialist for next week. The purpose is to discuss the remaining months of the treatment plan regarding continuing, discontinuing temporarily or long term, or enhancing hormone treatment. The current plan is to take Orgovyx through December 2026 but that length of treatment will likely make permanent changes to the quality for whatever years remain. I'm hopeful that the oncologist will be receptive to my personal life goals rather than simply to optimal cure rates. In the meantime, I anticipate that radiation side effects will subside in the next several weeks and will plan to post again after the primary care and oncology appointments. I participated in an interesting online session from Duke University this evening on the subject of reducing the financial burdens of prostate cancer care. Topics included a referral network, resource specialist in the cancer clinic, and more resource education for physicians and clinic staffs. Whereas my PSA at its highest was still single digit, one of the survivors in the meeting was finally diagnosed when his PSA was 1000+! His disease had metastisized widely, so his treatment included chemotherapy and surgery...but obviously he survived. His story was quite encouraging. So now, back to the Orgovyx and Immodium. My wife was so sweet last week that she took me on a surprise two-day getaway to a condo a little over an hour away for some simple down time. Life could be so much worse; I have ongoing reasons to be very grateful.

Hismones 04/11/25

Wow: steroids are really awesome but just don't play well with radiation treatments! I was celebrating the first anniversary of my left hip replacement with a visit to the orthopedist, also asking him to take a look at my right hip (my last natural major joint below the waist) which had been sore for awhile. He didn't find any major issue but prescribed a steroid dose pack for the pain. Did I mention somewhere previously that I've been having a lot of fatigue associated with treatments? Well, not after beginning taking steroids! I started mowing and cleaning the yard, trimming bushes and shrubs, and getting the bulk waste out to the curb for pickup. That lasted until the next day's treatment Tuesday morning at which I learned a hard lesson: because steroids cause fluid retention, having your bladder full (required for treatment) takes a LOT of water and a LOT of time. I had drunk the normal amount of liquid that morning, but had to double up the amount and wait 45 minutes for the process to be complete. :-( So, no more steroids until after treatments end (7 more/April 22). I also hit a serious steroid withdrawal fatigue "wall" at lunchtime Wednesday. Oof! So I'm doubling morning water because I still seem to be filling up too slowly. I watched a video account of another person's treatment in which he said he was told to drink 40 oz. of water, and my plan is to drink 32 oz. plus coffee. If I'm about to "overflow," I have a handy dandy "incontinence clamp" which is a lot like the business end, albeit cushioned, of a locking pliers. It's not awful, but its use is limited to three hours and gets pretty uncomfortable after two. I don't always use it before treatment, but I'm always "packin'." If you see a bulge in my pocket about the size and shape of a harmonica, that's it. I did have a bit of fun this week in virtually joining a prostate cancer support meeting from the Mayo Clinic. The doctor leading the meeting answered a question about my treatment that I had posted in the chat, suggesting there could be an additional drug to add to my hormone therapy that would give even stronger results. I sent that news to my urologist immediately following the meeting. I also requested a PSA test with my annual labs for my primary care doctor visit on May 1, which will be three weeks before I'm to be tested for the urologist/oncologist. I just want to be a little more confident that treatment is doing what is intended. As the specialist from Mayo commented, all that it takes for cancer to reoccur is for one cancer cell to survive treatment, and that while I'm on a 24 month hormone therapy plan, surviving cancer cells develop immunity to this treatment at about 20 months by developing the ability to create their own testosterone. The additional medication helps eliminate that possibility at the cellular level. All in all, it's a bit hard to be discouraged: I'm sitting in a patio rocker outside on an absolutely gorgeous and comfortable Friday; my radiation treatment team is all smiles because Tammy brought them homemade (from scratch, double boiler style) banana pudding. (It's one of her signature dishes and is wonderful); and she told me yesterday that she's taking me on a "surprise" two-day adventure to celebrate as soon as radiation treatments are complete. Cool, cool, and cool. Happy Friday!

Hismones 04/02/25

F-A-T-I-G-U-E, find out what it means to me.... Today I completed treatment 30 of 44, with the continuing hope of finishing radiation April 22. So far, so tired. The legendary Green Bay Packers coach, Vince Lombardi, said it this way: "Fatigue makes cowards of us all." I'm not sleeping very well (which means that unfortunately Tammy isn't either), making bathroom trips four times during 10 P.M.-5 A.M. Most mornings are the best part of the day, with treatment followed by daily exercise, but my energy is basically gone from noon through the rest of the day/evening. Two Saturdays ago, I was so weak that Tammy kindly said,"If you need to go off treatment, it's okay." But we both know the outcome without treatment wouldn't be optimal. Yesterday morning, though, wasn't going well and I was tearing up during my weekly doctor appointment. He adjusted my medication to try improving my sleep pattern, so we'll try that this week with perhaps some sort of sleep aid to use if that's not enough. I'm writing this late afternoon, so I've been on the verge of sleep awhile on the couch and now amazed by God's new green growth while sitting on the patio outside, but also having to wipe away tears. I'm confident that God is not putting me through this as some sort of test or punishment but rather that he will bring me through this. Maybe I will be able to encourage others along the way or beyond. I'm mostly sad that Tammy is having to go through my daily treatmehts, mood swings, hot flashes, interrupted sleep, wobbly walking, lack of energy, and tears. But I don't want to think what this would be like without her. She commented around the time we married (almost 31 years ago) that she believed God was calling her alongside to fight for me, and she is doing so heroically. The oncologist says that I should be passing through the worst part of the fatigue at this point, but my reading and viewing indicate that relief will take some time. Perhaps by June I will be dealing with "just" the lack of testosterone. I did get two rose bushes planted and our clothes dryer repaired this week, so there's that. Baby steps, as Richard Dreyfuss and Bill Murray said.