Well, the meeting this week with the medical oncologist was good and bad. The meeting was primarily to discuss the results of the bone can and CT scan ordered following rising PSA, to determine what treatment options may apply.
The bone scan shows an improvement from last year’s scan, so there is no need to consider bone strengthening medication yet. I actually took a peek at the screen when they were doing the scan and thought I was lit up like a Christmas tree, so I was expecting bad news. What a relief!
The CT scan shows a growth in my pelvis, which is probably responsible for the recent increasing PSA. The medical oncologist’s motto is “treat the person, not the numbers”, so he does not recommend taking any action until side effects become apparent. This will probably entail referred pain down my right leg, and other malfunctions. If the side effects occur a quick decision will need to be made as nerves are involved and avoiding permanent nerve damage will be the goal.
So….the options to ponder are: –
Radiation Therapy – my medical oncologist will refer this to my radiation oncologist to see if this is viable. It may not be possible if treatment is required in the same area as previous radiation treatment.
Chemotherapy – this involves six infusions at three week intervals (although this can vary depending on how you respond). It also involves a long list of ugly side effects. So around five months of treatment to get a statistical fourteen month average period of impact. Does not sound like a great deal. But, as always, the decision is difficult. Some side effects may not occur, or they may be minor, or they may be treatable. Plus, the impact may be a lot longer than the statistical average. If the side effects are really bad, you can stop treatment.
Hormone Therapy – additional hormone therapy treatment can be undertaken. Also confusing. If you take this instead of chemotherapy, a stronger version of the cancer may survive, which may make subsequent chemotherapy less effective.
I was disappointed to hear that Immunotherapy has not been proven effective against prostate cancer.
And there is always the “do nothing” option. This will probably result in spinal nerve damage and resultant incapacity. Having been there nearly four years ago, and narrowly avoiding paraplegia and any permanent incapacity, I am not keen to go down this path again. I may not be so fortunate a second time.
A lot of stuff to ponder. I am meeting with my medical oncologist mid April to discuss the radiation therapy option and update the PSA test results.
Outside of the medical world, things are good. Our tree change is transitioning from the cost and stress associated with establishing our country property into a time where we can enjoy what we have achieved.
Good health and happiness to all. Cheers, Phil