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.