It’s funny that just 24 hours after having a discussion with my doctor about this very topic, this article appears on one of my social media news feeds.
My medical team seems reluctant to embrace some of the newer studies like this, sticking to the 0.2 ng/ml definition of biochemical recurrence that’s been the standard for years and years. That makes me wonder how long it takes before the medical community accepts the newer data and studies, and shifts treatment regimens to the new guidance.
Don’t get me wrong. I’m not ready to hop on a table and get radiated just because of this paper (or the two others earlier in the year along the same lines), but it is something that I’ll be keeping an eye on going forward.
More than anything at this point, I’m just sharing an observation of how the medical research community and the medical community at large can sometimes be at odds with each other, knowing how conflicting and confusing it can be from a patient’s perspective. It just reinforces my belief that you have to do your own research, be your own advocate, and make decisions that YOU are comfortable with based on what you’ve learned.
For men who have had prostate cancer surgery, radiation therapy at the first sign of a rising PSA level can reduce the chances of the cancer recurring.
Here’s an interesting development in the field of prostate cancer research. The headline is a bit sensationalistic, but the researchers seem to be seeing “unexpected” and “exciting” results.
Professor Sam Denmeade, from Johns Hopkins University School of Medicine in Baltimore, US, who led the study, said: “”Our goal is to shock the cancer cells by exposing them rapidly to very high followed by very low levels of testosterone in the blood. The results are unexpected and exciting.
This will be a short post this month—my brain has been prostate cancer-ed out after the last few months and needs a respite for a few weeks before I buckle in for the roller coaster ride that is the next PSA test.
Speaking of the next PSA test, I’m planning on going in for the blood draw right around 1-3 August 2016. We’ll have to see how my schedule looks that week.
My urologist has authorized me to get the blood draw as of 1 July, so I could go in tomorrow if I really wanted to, but I’m going to do my best to stick to the first week of August to preserve the even spacing of the last three tests—pretty close to exactly four months apart ( 3 December–6 April; 6 April–3 August).
If I lose my willpower and go early, I’ll let you know.
Scrolling through my Facebook feed, I came across this interesting article, Gentler attack on cancer may mean that we can live with it longer, about taking a less aggressive approach to treating cancer in order to live longer. The theory is that, if you try to kill every cancer cell with a very aggressive initial treatment, any remaining cancer cells become resistant to further treatment and can be more problematic. If you take a slower initial approach to just contain the existing cancer cells, you may be able to extend your life.
I also came across this article, ASCO Endorses Active Surveillance for Prostate Cancer, recommending active surveillance over immediate treatment for those with low-risk prostate cancer (low-risk being defined as a Gleason of 6 or less). There appear to be some common sense reality checks that allow for exceptions to their recommendation as well. It’s an interesting read.
On my own front, I’ve been doing well emotionally knowing that my next PSA test is coming up soon. My appointment with the urologist is on 19 April 2016, but I’ll probably get the blood drawn when I’m scheduled to be in the clinic for another meeting on 6 April (my weight-loss group—81 lbs./36.7 kg lost!). That means I can probably get my results online around the 9th or 10th and, with luck, they’ll still be in the 0.04–0.05 ng/ml range (or less).
Speaking of luck, my streak of bad luck in 2016 continued. On my way home from my new job on my second week there, I was cut off on the highway by some yahoo not paying attention, and I had to stand on the brakes to avoid hitting him. Sadly, the gal behind me didn’t react quickly enough and rear-ended me to the tune of $2,500 USD in damages. <Sigh> Thankfully, insurance is covering the entire cost, as it wasn’t my fault—my deductible was waived. Of course, the guy who caused the accident drove off into the sunset without stopping.
Wow. I haven’t used that little warning symbol in a long, long time, but there is something to report (I meant to put it in my Life After Prostatectomy–60 Months Later post, but forgot).
One of the potential side effects of a prostatectomy is penile shrinkage. I’d say that I had noticed the change, but interestingly, things seem to have returned to pre-surgery size in the last few months. That’s something to discuss with my urologist in April (not that I’m complaining—just to see if it’s common for that to happen, and if it really takes five years for it to happen).
So 2016 is off to a stormy start for me (more on that in a minute) which means that I really haven’t focused on prostate cancer all that much this month. However, there was one article that caught my interest and one that I want to read more about.
The BMJ (formerly the British Medical Journal) published an article on 6 January 2016 titled: Why cancer screening has never been shown to “save lives”—and what we can do about it. Obviously, for those of us walking down this path, that title grabs our attention.
Because the BMJ requires registration to read the full article, here are links to a summary, the BMJ site, and an Infographic that you may want to check out. I’ll go back and read it in more detail when the dust settles after my stormy start to 2016.
My rotten start to 2016 actually began late in 2015 when roots took over the sewer line coming out of my guest bathroom in my house and shut down anything flowing out of the house on New Year’s Eve. The plumbers returned on Saturday, 2 January to clear the line again, and on Monday, 4 January, they were breaking through the concrete slab in my house to get to the offending roots.
Two days and $4,200 USD later, the roots were gone, the hole was back-filled, and it all was concreted over. Of course, now I have to replace the tile, vanity, and sink, so I decided it was time for a refresh of the entire bathroom (another $6K–$8K, potentially).
You may recall that I flew to Chicago in the middle of all of this chaos to visit my sister and brother-in-law and their family. I returned to work on Thursday, 14 January and around 2 p.m. on Friday, I get a call from the Human Resources manager, “Could you please come up to my office?”
I entered the office and there was the HR manager, my boss, and her boss. “This doesn’t bode well,” I thought to myself. Sure enough, my position at the museum was eliminated in a cost-savings move, effective immediately. Bummer. But, hey, at least I’ll have time to focus on the bathroom remodel now, right?
Not so fast…
On Saturday, 30 January, I thought I better get a job search in gear, so that evening, I came across a position which was exactly what I was doing before—volunteer coordinator—at for an organization less than half a mile from my old employer. I sent my resume off on Sunday; got an email on Monday requesting an interview; had the interview on Wednesday; and was offered the job on Friday. I accepted and started the job this week. Oh. and it pays more, which will help with all the repairs.
See, there is a silver lining in every storm cloud!
This is a compelling read for anyone newly diagnosed, highlighting why it’s so difficult to determine the best course of treatment. To me, the most telling statement in the article was:
The loser for the ensuing 35 or so years has been the patient. We really have no clear idea at all what “the best” way is to treat a man with clinically significant, localized prostate cancer who really does need early whole gland treatment, … and we haven’t known for decades.
If the experts can’t figure out the best treatment option, then how are we as laymen supposed to be able to figure it out?
From the perspective of the disinterested observer, one of the very least edifying aspects of issues related to the management of prostate cancer has been the nearly 50-year-long “discussion” between the urology community and the radiation oncology community about the most appropriate way(s) to treat localized disease.
Prior to the initiation of the ongoing ProtecT trial in the UK, there had only ever been three, very small, “completed” trials that made any attempt to randomize patients with localized prostate cancer to radical prostatectomy or radiation therapy. These three trials were conducted by the Uro-Oncology Research Group between 1974 and 1978, and the results were reported by Paulson et al. between (if memory serves) 1979 and 1984. The trial results were based on data from small subsets of the patients, and for a summary of the list of problems said to be associated with at least one of these studies and…