Happy Birthday to me!

Today I turn 72! Actually I turned 72 yesterday because I was born on the other side of the International Date Line in Australia.

Today is not a day to be thinking about cancer and psa, blood work and radium223, it is a day to CELEBRATE!!

Therefore my darling S and I are going out for an intimate dinner this evening where I may even consume a small amount of alcohol and a large amount of dessert!

Actually I have felt rather well the last few days…..

I believe I will make it to 73!!

PSA not to Zero!

It has been quite a trying week for both of us.
First was the news that my psa has risen from 35 to 63.4, not what we were hoping for...

We saw Dr T on Tuesday at BCCA. I was very tired following the MRI on Monday. I had to lie on the examination bed so I wouldn’t faint. Dr T said that the MRI looked ok but he doesn’t have the complete report yet. We discussed the rising psa and he said it looks like perhaps the radium is not working, however he would like me to continue with the radium treatment. We discussed my fatigue, apparently radium does not usually cause such fatigue. Next it was up to the lab for more blood tests and an ecg (electro cardio gram). It was good to get home. The radium infusion was to have been on Wednesay but Dr T has rescheduled it for Friday. Dr T called next morning and said my electrolytes were out of whack and I am dehydrated, which would contribute to me feeling dizzy and faint. I had the option to go in for an infusion or re-hydrate according to his recommendations. I was already taking electrolytes every second day. He suggested l take Hydrolyte daily and double my water intake. After drinking more water and increasing the electrolytes I did feel better on Wednesday and we managed to go out for lunch. I even had a short walk around the shops so it was a good day.

Today we saw Dr Y who was his usual cheery self. I said I was concerned about the rising psa. He said that “sometimes when cancer cells are dying they give off a lot of psa, text book.” Then he said, “don’t give up yet, I will tell you when to give up….never!”

Tomorrow is the third radium infusion….We wait and see how it goes. Must say I have been better since increasing fluids and electrolytes though. Meanwhile the remaining snow is slowly melting away.

A New Regime

On the last day of 2018 we saw Dr Tyldesley. Psa is up to 46 which means it is back to doubling every five weeks. He showed us the recent bone scan and an x ray. The cancer has spread to some more ribs and also my spine. The main concern however is that now my right femur and right side of the pelvis have significant cancer and there is an increased risk of fracturing my legs. He even mentioned the possibility of inserting rods as a preventative measure, however he thinks the radium therapy might be enough at this stage.
On the second day of 2019 it was back to the Vancouver General Hospital for the radium injection. First we saw a second radiation oncologist who is also a nuclear medicine specialist. He trained in Philadelphia, lectures at the University of British Columbia and also spent 2 years in Brisbane. He explained the process in detail and answered all of our questions. We both feel very confident with this man even though we don’t recall his name. He did mention that the treatment could be continued beyond 6 months if it is beneficial.
Next was the injection. First they inserted a canularĀ  into my arm and connected it to a saline drip. Then comes the radium solution in a syringe which is carried inside a lead container. The solution is then injected slowly into the IV line. I felt no immediate effects. So now I am radioactive. The half life is 10 days. The radioactivity is highest for the first week and any excess is excreted through feces and other body fluids. I miss the French kisses!
Next week it is back to the cancer clinic for a CT scan and more radiation.
After that, who knows? Fatigue and weakness are also becoming major problems. Today I have had a couple of dizzy spells. Is it the radium? Is it due to changes in medications, or none of the above? Time will tell. For now it is fingers crossed and hope for the best.

Decision time….again

Up at 6.0am this morning for the slow wet drive into Vancouver in the dark. I don’t think the sun came up at all today and it’s still raining.

We saw Dr T. and what a change! Whenever we have seen him before he was abrupt, clinical and in a hurry to finish. Today he was totally opposite. The results. The bone scan shows more activity as expected. PSA is up to 20.2, not bad considering.

He discussed 2 options, chemo and radium 223. Radium 223 (Xofigo) is 6 injections of a radioactive isotope that finds rapidly dividing bone cells and kills them. It is not a cure but can give an average additional 3 to 4 months of quality life compared to doing nothing. The injections are 4 weeks apart, cost $5000 each and are flown in from Europe. I would be radioactive, especially Dumpy would be, but not a danger to others and I quote “providing it is not swallowed”!!

The other treatment, chemo, he said would have similar effectiveness re survival time, however, he minimised the side effects. He said the cancer is confined to bone, though if it metastasizes to soft tissue (liver or lymph nodes) radium 223 can’t be used. I asked him what would he do if it was him? He said he would have the radium 223 and then he could have chemo later if need be, but not the other way round. Sounds reasonable to me.

He also discussed giving a single shot of radiation to treat a spot on one rib that gets painful at times. Next it was off to x-ray. They took about 15 x-rays of my ribs, hips and legs. I will see Dr Y. next week and hopefully he will show us the scans and x rays.
Meanwhile I am still feeling reasonably well apart from some blood pressure issues, very high, due to Zytiga. I get tired very quickly and I don’t seem to have the energy I had in the summer. I will have to stop Zytiga before starting the radium223, so hopefully the blood pressure will improve. So, another decision to be made re treatment choices. I suspect I will go with the Radium223.