Day 2,241–Doctor’s Visit

My visit to the doctor this afternoon to review my latest PSA results (0.06 ng/ml) went just as I expected it would:

  1. There’s no definitive explanation for the elevated PSA yet.
  2. The elevated PSA seems to be stable, so no need to panic about recurrence.
  3. Retesting in four-month cycles will continue for the foreseeable future.

I’m okay with all of that. I seem to have turned the corner where I’ll always be concerned about my PSA, but I’m not going to let it control my life. It’s too consuming.

He reminded me of how slowly PSA can change and that we shouldn’t even begin to think about any intervention unless the PSA starts creeping up into the 0.15–0.18 range. That’s fine by me. If we get to that point, I’m going to be much more deliberate in selecting what, if any, salvage therapy would be appropriate given where I’m at in life and the potentially debilitating side effects that impact quality of life.

So I’ll call that visit a positive end to 2016. Let’s hope for a happy, healthy 2017!

Blasting Prostate Cancer with Testosterone

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.

Man ‘cured’ of prostate cancer after doctors shock tumour to death with testosterone 

Update: 3 December 2016

Here’s the link to the abstract highlighting the preliminary results:

Rapid cycling high dose testosterone (Bipolar Androgen Therapy) as therapy for men with metastatic castrate-resistant prostate cancer (mCRPC)

Day 2,212 – PSA Results

My latest PSA test on 28 November came back at 0.06 ng/ml, up slightly from the 0.05 ng/ml back on 1 August.

That could just be the difference between a new moon and a full moon or simple instrument error. It’s a concern, but certainly nothing to panic over at the moment.

I’m glad to see that I’m consistently hovering in that 0.04–0.08 range, although, if I were to lay a trendline over the data, it would certainly be moving in an upward direction towards that recurrence threshold.

The one nagging thing that hangs over my head is those recent studies that showed PSA at 0.03 ng/ml can be predictive of recurrence. I’ll press the doctor on that again at my appointment on 29 December.

Lastly, I’ve accepted the fact that this will be my new reality: Testing, waiting, and wondering every four months. Not the path I hoped to be on six years out, but it is what it is.

Thanks to everyone for your thoughts, support, and prayers.

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Day 2,210 – PSA Test Time

Time to buckle up for the next ride on the PSAnxiety roller coaster. I had my blood drawn this morning for my next PSA test. Now we wait, typically three days before seeing the results online.

On the good news front, I’ve been completely unemotional leading up to this PSA test. I’m not sure why, but it’s been a refreshing change from the last PSA tests.

My appointment with my doctor is on 29 December, and I’ll post my results as soon as I have them (and geekily update my spiffy little PSA chart).

Six Years

Six years ago today, I was told I had prostate cancer. Guess what? It’s six years later and I’m still alive and kickin’. Woo-hoo!

PSA Trend 20160803Of course, the cancer storm clouds may be brewing as I head into my next PSA test in a few weeks. Who knows what crazy result it will yield. Remember, in the last 15 months, we’ve gone from undetectable to 0.05 to 0.04 to 0.08 to 0.05. Any bets on the results this time around??

My schedule in early December is quite hectic, so I’ll likely go for the blood draw during the week of 28 November. As usual, I’ll wait three days to get the results online, and then my appointment with the urologist is on 29 December.

Stay tuned. In the meantime, here’s wishing everyone a Happy Thanksgiving with family and friends!

Month 71 – More Studies on Early Salvage Radiation Therapy

With the change in my PSA over the last year, you can bet that I’ve been seeking every bit of information as to what it means and what to do about it. One of my go-to resources for the latest information in the field has been The “New” Prostate Cancer Info Link.

On 21 September, they published the following blog post that really piqued my interest:

Very early salvage radiation has up to fourfold better outcomes and saves lives

It’s certainly a topic of discussion for my next urologist visit in December. By the study’s definition, I’m still in the “very early” group—the group with the best survival if salvage radiation therapy (SRT) is started while I’m still in that group.

If we have to go down that path, my biggest concern with starting SRT is knowing that we’re actually radiating where the cancer is located. That concern is amplified if imaging can’t show where the cancer’s actually at, and we just radiate the prostatic bed because that’s what makes the most sense. Why risk some long-term, potentially nasty side effects on something so uncertain? (Yes, I know nothing is certain dealing with cancer.)

Of course, this is just one study and making a decision on it alone would probably be unwise.

We’ll just have to wait for the December PSA readings to come back and go from there.


On a happier note, I took a little drive through the country last week to tackle a few things on my travel bucket list: October Odyssey: The Mountain West. Check it out if you want to see what it was all about.

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Cimarron Canyon State Park, New Mexico

Month 70 – Sharing Awareness

We’re about half-way through Prostate Cancer Awareness Month and it seems as there’s been some progress in getting the word out. More organizations seem to be helping to increase awareness than in the past, and that’s a good thing.

I’ll have to admit that my own approach to PCAM has changed slightly. I’m more inclined to tell people to educate themselves before making the decision to test.

Those of us who have been dealing with prostate cancer understand how complex, convoluted, conflicting, and confusing it can be. If you’ve never entertained the notion that you can get prostate cancer, you probably haven’t paid much attention to the raging debates in the field. DRE or no DRE? PSA test or no PSA test? Over-treatment versus under-treatment? Active surveillance versus treatment? That’s why it’s so important to educate yourself before being tested.

One of my former managers always said, “If you can’t stand the answer, don’t ask the question.” Your decision to get screened for prostate cancer is exactly that: your decision. You have to be comfortable with either path you take, and the best way to make that decision is by being educated. Please take a few moments this month—Prostate Cancer Awareness Month—to learn more about prostate cancer and how it can affect you. You can start with my Resources page.


I finally made my family and friends aware of my detectable PSA shortly after my visit with my urologist in August. There was concern from those who responded but, on the whole, the reaction was good. I knew that sitting on this for a year would cause some deserved criticism, too, but they seemed to understand my rationale.

It’s a relief to have it out in the open now. As one of my readers wrote on his own blog, “A burden shared is a burden halved.” Yep. It is. (Sorry, I can’t find the quote again to give credit where credit is due!)

On the whole, I’ve been able to push aside the emotions and thoughts that the cancer may be returning, and it feels good to be reengaged in the world. The next PSA test is in December.

Now if I can just get used to the fact that it’s dark when my alarm goes off in the morning… It wasn’t that long ago that the sun shining through my east-facing bedroom window woke me up and not the alarm. Autumn and shorter days are here! (In San Diego, shorter days are about the only indicator of it being autumn.)

Day 2,113 – A Visit with the Urologist

Well that went just as I expected it would:

  • No explanation as to why my PSA is where it’s at and why it’s doing what it’s doing (yo-yo readings).
  • No willingness to state with any certainty whether I’ll experience biochemical recurrence (BCR) at some point in the future.
  • No meaningful discussion of next steps until we know what we’re dealing with.
  • Retest PSA in December.

So we go back into the wait, retest, and wait some more mode for the foreseeable future. I guess that’s okay, but I’m a pretty binary guy, so it really would be nice to know that, yes, the cancer is coming back or, no, it’s not. At least then you can work to come to terms with the answer even if it’s the one no one wants to hear.

We did talk some about using other imaging mechanisms to see if they can pick up on any micro-metastases if the December results are worse than where we’re at now. We also talked a little about salvage radiation therapy, hormone therapy, and the timing of each but, again, nothing that I didn’t already know from my own research.

We also discussed the recent papers that indicated BCR at 0.03 ng/ml and, while he was interested, he pretty much stuck to the standard 0.2 ng/ml definition of BCR and would be using it in the decision-making process.

I did mention that I’m in no rush to start anything (i.e., salvage treatments) until we know exactly what we’re dealing with, and that quality of life is high on my priority list if and when we get to that point.

So that’s that. No real surprises. No real revelations. Just keep on keepin’ on.


On that happy note, remember that September is Prostate Cancer Awareness month. (Hard to believe it’s only a week away! My time flies when you’re having fun…)

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Day 2,093 – The Results

PSA Trend 20160803The results are in: 0.05 ng/ml.

I simultaneously breathed a humongous sigh of relief and got pissed off. “Will you make up your freakin’ mind already!?!?” Yes, I’m elated that my PSA actually came down from 0.08 to 0.05, but I’m pissed that this raises more questions than it will answer, and that I’m going to have to keep riding this wild roller coaster for the foreseeable future.

This round was particularly tough, emotionally. I usually never get worked up in advance of the blood draw but, before heading off to the clinic Monday morning, I was so nervous that I ate one spoonful of yogurt and decided that, if I continued, I’d be seeing that yogurt again going in the opposite direction.

When I finally saw that the results had been uploaded to my provider’s website tonight, my hand on the mouse was shaking and I truly didn’t want to click on the link to get the news. Not good. (By the way, I learned that my provider only uploads the data once a day, around midnight Eastern Time. That sucks.)

It will be interesting to see what the urologist has to say on 23 August. I’m sure part of it will be, “Let’s retest in December.” Yippee. I’m still quite concerned that I have a detectable PSA (albeit a low value) where I didn’t have before. What’s up with that?

Well, I’m spent. It’s time to call it a night. Thanks to everyone for your kind words, thoughts, and prayers.

Day 2,091 – Off for the Blood Draw

So I’m off to get my blood drawn for the next PSA test. (Those 4 months went by faster than I expected.)

Anyone want to get a pool going on what the results will be? (Hey, you got to have some fun with this crap, right??) My money is on somewhere between 0.95 ng/ml and 0.12 ng/ml. It was 0.08 ng/ml in April. Of course, if it doubles like it did from December to April, that would put it at a scary 0.16 ng/ml.

My real desire is for it to be 0.08 or less, but in my mind, I’ve been preparing for it to be in that 0.95–0.12 range. Expect the worst; hope for the best; deal with the facts once they’re known.

I’ll keep you posted as I log into my health account every hour on the hour for the next three days searching for the result. The appointment with the urologist to go over the results and potential next steps is on 23 August.