Radioactive again

My second Radium 223 infusion was just 5 days ago and right now I am feeling rather crappy, tired and nauseated. Is the cure worse than the disease? It isn’t even a cure, just buys a bit more time. Sometimes I have to wonder if it is worth the trouble. I had 5 medical appointments last week, I feel like a voodoo doll.

At the beginning Dr T, radiation oncologist said that R223 would probably not reduce psa but should prevent it from rising too much. The good news is that the psa has dropped dramatically from 46 to 35. Funnily enough I felt better when my psa was over 2000! Dr T also said it is normal to feel pain after the infusion. He was right about that. After the first infusion I had a small slip as I began to get out of the bath. Next day the pain in my back was almost unbearable despite the Fentanyl patch. It took 4 oxycodone a day for 4 days to control the pain and then it just stopped. I told Dr T and he wants me to have an MRI sometime soon.

Just as I was starting to feel better it was time for the second infusion. Two days later the pain came in my sternum and ribs. Fortunately it only lasted one day and responded well to oxycodone. So, I plan to continue to endure this treatment for the time being in the hope that things will improve.

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.