Friday, June 17, 2011

Follow Up….

First off… the sigmoidoscopy went well… Took forever to get done as the doc had been called away on an emergency...but only 3 hours late, it was finally over and I was on my way home.... Just a few small lesions that were cauterized… He also warned me that the upcoming radiation treatments would probably cause more problems… but not something I can do anything about as I need to have the radiation at this point… at least until one of the new treatments being worked on make it through trials and then get approved in Canada…

Radiation treatments have been going well… today will be my 5th and final treatment… Things have changed slightly since having radiation in 2005… The new machines are pretty incredible… After climbing up on the bed and being tossed around until the tattoos are lined up properly the radiation techs leave the room… an Xray is taken...compared to the original positioning of the CT scan and then the bed moved so that the two images are aligned… once that is done, the treatment begins… first from the top...then from the bottom… it takes a minute or less in total… then the techs return and I am free to go.  There is no pain...in fact, other than the slight hum from the machines, you would never know anything was happening.  I have also not had any of the ‘flare’ that I was told might happen.  The treatments sometimes cause inflammation around the site which increases the pain in the area… I have had no increase in pain...in fact only a very slight ‘ache’ and mostly only when I lay on that side… so very lucky!

The only thing that originally bothered me about the whole thing was that the first day they had me remove my t-shirt, wanted me to remove my gym shorts and leave on my underwear (sorry, they are actually sewn together...so left them on with permission) and then put on a hospital gown and housecoat… I complied and went through the first treatment… seemed like such a waste of time and added cleaning costs for the hospital.  I mentioned that I NEVER had to put on a gown during my 7 plus weeks of radiation in Calgary...that I wore a t-shirt and gym shorts for every session… They seemed shocked as it is hospital policy that patients gown up… but they said I could do the same here, so now I just go to the waiting area and then go in for treatment… No changing involved.  In my opinion, it is much easier… and I think leaves the patient feeling less stressed and more dignified… So hopefully they will allow others the same!  Time to change the policy.

The only real stress this week has come from trying to get my PSA and Testosterone results… I had an appointment booked with my urologist on Monday morning… but a family emergency caused him to cancel all his appointments this week… My family doc is out of town this week...on holidays I was told.  So I tried to get in to see other docs or find another way to get the results… Road Blocks at every attempt… Finally, yesterday, after my treatment, I talked to one of the nurses at the radiation unit… we talked about how the treatments were going (great!) and she asked if I had any questions… My only question was if she could get my results… she quickly checked with the radiation oncologist and grabbed them… the oncologist came to see me and we talked about the treatments and then she told me the results…

My PSA levels are up slightly from March… from 12.4 to 14.6....  My testosterone levels are down… from 9.7 to 0.7… She suggests getting another PSA in a month or so to see which direction the PSA levels are going, and then adjusting treatment if needed… I see my urologist next week, so that will be the topic of discussion… what is next??  Is Treatment still working?? or is it time to add something new??  So, I’ll post an update next week after that visit…

Until next time…

Posted by John on 06/17 at 08:40 AM
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Wednesday, June 08, 2011

Radiation Oncologist Meeting…

Although my appointment got started late and ran late...it went well.

Cindy and I arrived on time and made our way to the Jack Ady Cancer Centre… This was Cindy’s first visit to the cancer centre in Lethbridge… It is a great facility that is state of the art when it comes to the equipment… and so far the doctors aren’t too bad either.  After filling in some forms, we were escorted to the examination room… answered some more questions, got weighed and measured, then waited just a few more minutes for the oncologist, Dr. Sandra Wajstaub. She took an in depth history (which continually got updated as I remembered things throughout the visit...) and then did an exam...checking lymph nodes, reflexes, strength and movement of my extremities, and looking for any painful spots in my pelvis and spine (none).  She then explained what was found in the bone scan...and after I explained all the problems during my initial pc diagnosis, she went to double check the bone scan herself.

She explained that the only spot found was in my pelvis...and that it was still small… She explained the options available… Do nothing… 1 radiation treatment or 5 treatments… She talked about side effects and what may happen if I chose not to have the radiation.  She seems to think that I do not currently have ‘castrate resistant prostate cancer’ (hormone resistant or hormone refractory are other terms for it)...and that the current treatment is still working… I explained that I had not had a PSA test recently, so she ordered one to be sure one way or the other… here’s hoping that the current treatment is still working!!  After that we talked a little about other therapies and about a medical oncologist taking over my care from my urologist… only because the urologist does not do chemo therapy...so if it is needed, I will need to see a good medical oncologist.  I suggested getting a second medical oncologist opinion from outside the city and she agreed it would be a good idea… but in the meantime she is referring me to the local one. She then answered a few more of our questions...and asked a few more of her own as the history taking continued as I remembered more things to add.  We then agreed on doing 5 radiation treatments to really kick the cancers ass!!

After all of that we were escorted down to the radiology floor...where the CT’s and radiation are done… We were given a quick tour of the facility and after a short wait we met one of the radiation technicians. He explained about the side effects (minimal) and how things would run… since I’ve had radiation he explained that it would be pretty much the same...and that since my previous ‘tattoos’ were still visible, they would use those as markers and the next step would go pretty fast.... So we headed in to the next room and I hopped on the CT table… down went the pants and then I was moved in to position using my ‘tattoos’ as the guides… once i had been jostled into place everyone else left the room and I was slid into place… a few minutes later I was moved out of the scanner… got dressed and we were on our way.  Next stop the scheduling desk… booked an appointment for Monday and we were ready to head out…

Everyone at the cancer centre were great… they treated us with respect and even had a few laughs with us…

From the cancer centre we headed over to the lab for my PSA and Testosterone blood draws… that done, we were on our way home… Cindy was feeling just a little less (and I mean very little less) stressed… but now we are back to waiting for test results...and more doctors appointments…

Next up is a sigmoidoscopy on Friday… then a weekend off… then back to the urologists...hopefully they will have the PSA and T results by the time I get there.

Until next time....

Posted by John on 06/08 at 09:16 PM
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Tuesday, June 07, 2011

The Waiting Game….

Well, we’re back into the waiting game… Although my test results and history were passed on to both my urologist and the local radiation oncologist on Friday last week, I have only heard from the oncologists receptionist (and that was just before noon today).  At least I only have to wait until tomorrow to see the oncologist.  I phoned and made an appointment with my urologist for Monday… he seems to be away this week ( what’s with that?? doesn’t he know I need him NOW !?! )

Tomorrows oncologist visit is basically an hour long, one on one (or two as Cindy will be there with me)… I imagine we’ll be discussing the severity of the metastasis, options for treatment (or lack there of) and what we want to do....  I get to ask questions, so I’ll be writing down all the ones I can think of today… I’m sure more will come up after hearing what the oncologist has to say.

I’ll update again after the appointment…

Until next time…

Posted by John on 06/07 at 01:45 PM
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Thursday, June 02, 2011

With the Good Comes the Bad…

Today has been quite the day...and not in a good way… Although some good was had.

After all the good news we have received over the past couple of weeks… the legislated WCB coverage for prostate cancer and the results of my physical… the bad news came.

After my physical last week I went for a bone scan.  I had been having some left hip pain for a while...I thought it was something I had done and hoped that with rest it would go away.  It didn’t.  So after some discussion with my family doctor, he set me up to have a bone scan.  He didn’t think it would be anything related to the prostate cancer...since I had started back on hormone deprivation again in March, if it was the cancer, it should have settled down with the treatment.

This morning I got a call from the doctors office...he wanted to see me.  NEVER a good thing… Good news they generally tell you over the phone.  I went in to the office an hour later.  He came right in...he didn’t have a smile on his face...and I knew what he was going to say.  The prostate cancer had metastasized.  It is into the ischium and surrounding area.  He didn’t go into a great amount of detail on the amount seen… He did say that he had already contacted my urologist...and the local radiation oncologist (we, as of last year, have a radiation unit in our local hospital...) and the paperwork had been started for me to prepare for radiation.  He explained a little about the coming process and asked if I had any questions.  Since I have been through radiation, I am ok with that...but there are some new meds available for treatment of hormone resistant prostate cancer (which is what I now have).  So I asked him about those… He thought they were available in Canada...but I will have to wait to talk to my urologist and the oncologist to see if I can use them… I’ll be persistent…

So...what the %^$& happened??  From the way I understand it...the prostate cancer feeds off of the testosterone...because the hormone deprivation blocks the production of testosterone in my body, it had none to feed and grow on… This %^^&%^$ stuff, since it was being deprived...figure out how to produce it’s own food source...and in doing so was able to grow...resulting in the metastasis… It may have been there all along...or it could have moved there once it became active...it really doesn’t matter now… It’s there...and we are going to do everything possible to stop it!!  NOW!!

The toughest part of the day today...at least for me...was telling my family… I HATE having to spread the bad news… And I still have a lot of people to tell… Some family that is away...as well as some friends… Some unfortunately will find out here… I’m sorry you have to find out this way...but for now, it’s the best I can do…

The best part of this day… I met up with Tim and Ali… Tim is my riding buddy from the Cycle For Life rides...and more importantly, one of my very best friends… He had been away for a while and just returned back to this area...passing by on his way home.  So we both made the effort to meet up...I’m sure he wasn’t expecting the news I had to share...but we had a great visit… Far too short...but all time would allow for now.  THANKS Tim!!!  THANKS Ali for helping make it happen!

Well, for now, that is the news of the day… A lot more thoughts to share in the coming days… But for now....

Until next time....

Posted by John on 06/02 at 09:16 PM
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