Month 142 – Two Weeks After SRT Ended

On By DanIn Prostate Cancer5 Comments

After a hectic summer, it’s about time that I get back on my regular posting schedule of at least one post a month on the 11th of each month.

There’s good news and there’s less good news.

The good news: On the fatigue front, that’s been slowly but surely abating and my energy levels are improving steadily. I still have my moments, but it’s much better than it used to be. I expect that my energy levels will be back to pre-radiation therapy levels by the end of next week at the rate they’re going. Also decreasing are the number of trips to the toilet during both the day and night (about 2-3 trips each night). Hopefully, there’s still room for improvement there.

The less good news: The pain in my back, unfortunately, has intensified. Initially, it was a low-grade ache with occasional spikes in pain if I moved in an unexpected way. Now, it’s really become a more constant and prevalent ache, and it takes even less movement to set off a spike in pain. I’m guessing that’s related more to the ADT than anything else, and I’m trying to get some answers from my medical team.

Barring any hiccups, my plan is to get my blood drawn for my first PSA test during ADT and after SRT on Tuesday, 13 September. It’s probably premature (but that’s what the urologist ordered), and I have no idea what to expect. The ADT has had four and a half months to do something to my PSA, but the SRT has had only two weeks. Anyone care to guess?

As a refresher, my PSA was 0.36 ng/ml on 18 April 2022; the ADT was administered on 3 May 2022; and SRT ran 7 July – 26 August 2022. I’ll post the results as soon as I have access to them.

I have my follow-up appointment with the urologist on Tuesday, 20 September, and I just remembered that I need to call the radiation oncologist’s office to get on their schedule for late November or early December.

Be well!

Header Image: Oak Creek near Sedona, Arizona

Upcoming Prostate Cancer Online Seminars

On By DanIn Prostate CancerLeave a comment

Save the dates! Two of the heavy-hitter organizations in the world of prostate cancer will be holding online seminars in the weeks ahead. You may want to check them out.

2022 Prostate Cancer Patient Conference – The Prostate Cancer Research Institute

The Prostate Cancer Research Institute is a great source of information for those diagnosed with prostate cancer. Each year, they hold a Prostate Cancer Patient Conference, and this year’s conference is scheduled Saturday and Sunday, 10–11 September 2022. You can sign up for free and you may also submit any questions that you have.

Their agenda still has some gaps to fill as I write this, but I’m sure more will be known by the time the conference begins. All times are in Pacific Daylight Saving Time (Los Angeles), and you can join by Zoom from anywhere.

You can learn more and register here:

https://pcri.org/2022-conference

Prostate Cancer Foundation Webinar Series

The Prostate Cancer Foundation is launching a new webinar series with its first session being held 4:30 p.m.–5:30 p.m. PDT (Los Angeles), Tuesday, 20 September 2022.

The topics for the first session are “Prostate 8: Simple Lifestyle Changes That Work” and “Mental Health and Prostate Cancer.”

You can learn more and register here:

https://www.pcf.org/pcf-webinar-series/

Day 4,315 – A Week After SRT Ended

On By DanIn Incontinence, Prostate Cancer, Radiation Therapy, Side Effects4 Comments

If you recall my last update, I was all abuzz with energy on my first day after salvage radiation therapy ended. Well, that didn’t last long.

Sunday and Monday I was pretty much knocked out with fatigue, and Tuesday wasn’t much better. The rest of the week saw slight improvements with each passing day, but you would have still found me taking a cat nap here or there.

The urinary frequency is still there, meaning I’m still running to the toilet four to six times a night which is annoying. But there has been another change, and I’m not sure if it’s a result of the radiation, the Flomax (Tamsulosin), or a combination of both.

Post-surgery, pre-radiation, I would get the urge to empty my bladder and I’d have time to make it to the toilet and then consciously start the flow to empty my bladder. Since the radiation, the time between my brain receiving the urge to empty my bladder and the time I need to be at the toilet is much shorter. It also seems that my ability to control the start of the flow is lessened to a degree, meaning it starts flowing on its own. That’s led to one minor accident where I was just a few seconds shy of getting to the toilet.

I’m not overly concerned about this at the moment, as it’s still early after the radiation ended. Plus, it may be the Flomax that’s contributing to this as well, and the radiation oncologist said it would be acceptable to stop taking it around the end of September if I felt it wasn’t helping me with the urinary frequency. However, if it continues beyond that, I may have to get one of those “Where’s the toilet?” apps for my phone. 🙂

This morning, I was surprised by blood on the toilet paper after my morning constitutional. I’m pretty sure it’s from irritated hemorrhoids rather than from something deeper inside. It’s something to keep an eye on going forward.

You may recall that, back in June about five weeks after I received my Eligard injection, I was noticing a dull musculoskeletal ache in the middle of my back. Through the summer, that stayed pretty consistent—just a minor ache in the background not causing any issues. It was tolerable and I didn’t think much of it. In the last few weeks, that’s changed.

The ache is more intense and a bit more widespread across my back than when it first appeared. Plus, I can have brief shots of acute pain if I move suddenly or twist my body in a weird way (like after unexpectedly bumping into something). It’s more like a muscle spasm response than anything else. But it can and does impact how the way I walk (a little more gingerly) and how I stand up.

Of course, hormone therapy is known to contribute to musculoskeletal issues, and one of the listed side effects of Flomax is “body aches.” Perhaps they’re additive.

Of course, my mind also has to go down the path of possible distant metastases to the spine or ribs even though it’s extraordinarily unlikely given where my PSA was at going into SRT (0.36 ng/ml). Still, it’s a conversation that I’m going to have with my urologist in my meeting on 20 September.

Stay tuned for more to come.

Be well!

Image: Salton Sea, California

Website Refresh

On By DanIn Prostate Cancer6 Comments

The eagle-eyed among you will notice that I’ve made a few cosmetic and content changes to this website.

The cosmetic changes are mainly on the home page to make it a little more visually appealing and to get readers to my most recent blog posts faster.

When I started this blog, my content focused mostly on my surgery experiences. But now that I’ve hit the prostate cancer trifecta—surgery, salvage radiation, and hormone therapy—I thought it was time to broaden the scope of the site to reflect those experiences. The old menu at the top of the page used to have “Surgery” as one of the options, and it’s now been replaced with “My Treatments” with the sub-menu items of:

I hope the changes make sense and make visiting the site a little easier.

For those in the U.S., have a safe Labor Day weekend! (Stay cool—it’s supposed to be around 97° F/ 36° C here this weekend! Ugh!)

September is Prostate Cancer Awareness Month

On By DanIn Prostate Cancer5 Comments

“Oh, prostate cancer isn’t so bad. It’s the easy cancer.”

Bull💩. Ask anyone who’s been diagnosed with it just how easy it is. It’s not.

September is the month where we can dispel that notion held by so many by increasing awareness about prostate cancer. Here are some key statistics about prostate cancer in 2022 from the American Cancer Society:

  • Other than skin cancer, prostate cancer is the most common cancer in American men.
  • There will be about 268,490 new cases in 2022.
  • There will be about 34,500 deaths in 2022.
  • About 1 in 8 men will be diagnosed with prostate cancer.

If you really want to learn more—and I heartily encourage you do to so—a great resource is the book: Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, Fourth Edition.

You don’t have to read all 544 pages, but you can cherry pick the sections that are of interest to you and they will give you a good introduction to the topic. Certainly there are tons of other books out there that would be equally valuable.

If you don’t want to buy a book, you can check out some of these resources for free:

Please take some time in September to increase your awareness about prostate cancer before you get diagnosed. Understand the risks—family history, race, age, diet—and how they may influence your decision to get screened for prostate cancer.

Long-term benefit of radiotherapy confirmed in advanced prostate cancer

On By DanIn Prostate Cancer, Research5 Comments

This showed up in my inbox and I found it interesting.

It appears to be focused on initial treatment rather than a salvage setting, and showed that even for those newly diagnosed with advanced prostate cancer that had already spread, there was benefit to radiating the prostate:

“The initial 2018 findings of this arm of the STAMPEDE trial were slightly surprising. Previous thinking was that if the cancer had spread then the horse had bolted and there was no point in shutting the stable door by treating the original disease site. These long-term results have confirmed that this is not the case, and by treating the original site after the disease has spread, some men with prostate cancer lived longer than those on hormonal therapy alone. This could potentially benefit people with other cancers that have spread to other parts of the body too.”

Professor Nick James, Professor of Prostate and Bladder Cancer Research at the ICR, and Chief Investigator of the STAMPEDE trial

Here is the link to the original article:

Long-term benefit of radiotherapy confirmed in advanced prostate cancer

Day 4,308 – What a Difference

On By DanIn Prostate Cancer4 Comments

What a difference a day makes!

I don’t know whether it’s the adrenalin rush of having finished my radiation therapy still lingering, or it’s something else, but I’ve had more energy today than I’ve had in several weeks. And I’m not complaining!

Don’t get me wrong, I’m still firing on about six cylinders at best, but it’s 5 p.m. and I’ve been up since about 7 a.m. and haven’t had the need for a nap or rest period yet today.

I have to wonder if it was subconscious stress that was doing me in the last few weeks of treatments. I would get overly obsessive about the bladder filling routine, and particularly frustrated if things didn’t go quite to plan—especially when I came up short and had to delay. I felt as though I wasn’t holding up my end of the bargain and that would add stress. (Just an uneducated arm-chair psychologist’s theory.)

Speaking of bladders, without the 1.5 to 2 liters of water I would be drinking every morning, my trips to the toilet have been far fewer today, and only three trips last night. That’s another positive sign.

I’m sure there may be setbacks, but let’s hope this trend continues. I’m so ready to get back into a more normal routine. Besides, the dust bunnies 🐇 in my house have turned into dust elephants 🐘 over the last few weeks because of my fatigue, and I need to go on a deep cleaning safari. That, or buy them some peanuts, say they’re my pets, and call it a day. 🤔

My day has been great. I hope yours has, too!

Zapping is Done!

On By DanIn Prostate Cancer, Radiation Therapy18 Comments

The final zapping session is history. Hallelujah!

It’s important to me to recognize the staff of the UCSD Health Radiation Oncology – Chula Vista clinic. They turned what was initially a scary experience (for me) into something that was much more pleasant and positive. They radiation therapists were great coaches, provided compassionate care, and endured my stupid puns and jokes. The nurses were equally compassionate, thoroughly answered all of my questions, and helped assuage my fears in the process. To all of them: Thank you!

I went out for a celebratory brunch with my friend who was there for the first session and listened to me whine throughout the process.

Now it’s time to let my body recover from seven weeks of being stuck in a giant microwave oven. Hopefully, it recovers quickly and I get back to a more normal routine. Of course, we may not know for another year whether it was truly effective. Fingers crossed.

The effects from the hormone therapy will cloud the results of the radiation for quite a while. The six month dose will last into October (and beyond) and, if my PSA has, in fact, dropped, we won’t know whether it’s the ADT or the radiation (or both) that caused it. Realistically, we probably won’t know whether the radiation was successful until late next spring or even summer.

Enjoy your weekend! I know I will.

Zapping: The Final Week

On By DanIn Prostate Cancer, Radiation Therapy2 Comments

Last weekend, I ran out to Cabrillo National Monument where I used to volunteer, just to hang out and chat with some of the volunteers there. It was a great visit and I felt quite energized while I was there. But then I discovered something.

There definitely is benefit in forcing yourself to get out and enjoy a lunch with a friend, a walk along the beach, or just a drive through the country. It is energizing while I’m doing it. But what I’ve noticed is that the fatigue kicks in much harder and much faster than if I’m just hanging out at home.

I could tell near the end of my conversation with my fellow volunteer that the fatigue was coming on fast, and that it was time to go home. When I got home, I was out for the count for a couple of hours after. Not fun.

Monday’s zapping session was dicey. I started drinking my liter of water at 8:30 a.m. and finished it at 9:05 a.m., well in advance of my 9:45 a.m. appointment. As I was leaving the house at 9:30 a.m., I felt pretty good about my bladder fullness, but once I got to the clinic, that feeling of fullness subsided substantially. I told the technician that I though I was borderline and we agreed to take another patient ahead of me. “It will take about ten minutes.” Famous last words.

Long story, short, it was nearly half an hour later when they put me on the table, and by this point I was ready to burst. They even put an absorbent pad on the table and a plastic urinal bottle on the counter “just in case.” Fortunately, neither were needed, the session was completed successfully, and there was no accident.

Word of advice to those managing their bladder fullness timing: Allow a cushion for delays.

When I got home, I was totally spent and spent the entire day in various stages of rest. Ditto for Tuesday. (Hence my Wile E. Coyote post!) Wednesday went as planned, although I was at about 60%-70% bladder fullness.

Thursday’s session went a bit awry. It actually started around 2 a.m. Thursday when I made one of my five runs to the toilet. After crawling back into bed, I just could not fall asleep again. Too many things running through my pea-sized brain kept me awake. I finally dozed off around 4:30 a.m. Ugh.

When I got up, I wanted to avoid a repeat of Wednesday, so I started drinking water as soon as I got out of bed around 7 a.m., and I started drinking my liter of water a full thirty minutes earlier than I normally start. When I got to the facility, I could tell I wasn’t ready, so we skipped me and brought another patient in. Fortunately, that was only about a fifteen minute delay which filled my bladder nicely.

I met with the radiation oncologist after the session Thursday, and we talked about the fatigue and urinary frequency. He said that the fatigue will likely last for about two more weeks after the end of the treatment and then I should see a noticeable improvement. He recommended that I stay on the Flowmax through the end of September to help with the frequency. We’ll schedule a follow-up session for three months from the end of treatment, so I’m guessing late November or early December.

Barring any technical issues, tomorrow morning’s session will be my last. Woo-hoo! I’ll post about that separately.

Be well!