Strategy and Tactics

Remember, last spring, John found out that his prostate cancer has recurred. He’s been undergoing treatment. I’ll let him tell the recent developments, as he wrote in e-mails to our daughters and his sister.

Tuesday: I went to the urologist yesterday. Back in November when my last four month shot of Lupron ran out, the doctor and I agreed to go three months without the medicine and see what happened. Three months was up yesterday. My PSA had gone from 3 to 24. (should be under 9 at my age, without any history of cancer) So it is back on the Lupron. That is a pretty steep rise.

I asked if it had metastasized, and he said “probably but still in the prostate“. He said that we will continue with the Lupron until it is no longer effective alone, at which time they will continue the Lupron, but add other cancer drugs. When that is no longer effective they add another cancer drug to the mix. He had read the study that Al sent me an article about, and said that there were several small studies like that one and he was trying to keep up to date on them. He is going to hook me up with an oncologist that works with prostate cancer patients. This will give an additional set of eyes on the problem.

So it is back to hot flashes and loss of strength and stamina. I will just have to push myself more on the strength and stamina. As far as I know, there is not a damn thing I can do about the hot flashes except to try not to bitch too much.

Wednesday: I saw the medical oncologist this morning. He explained what our long term strategy would be, and what tactics we would use when needed. The plan is to stay on the Lupron until it alone does not do the job. He said that for my situation the Lupron is the best weapon in the arsenal. I asked for a time guess and he said two years plus-or-minus. He then tried to explain the other weapons that are available now and are likely to become available in that time period. There several things available today and lots more on the way. It will sooner or later require other treatment. When we get there we will look at what option to use.

Time is the question. It will get worse, as cancers do. The longer it doesn't get worse, the better off I am in two ways. First, I need no treatment other than the Lupron. Second is that things are in the pipeline that may work better than what is available today, and what is available today is pretty good. We talked about the side effects of Lupron. I need to continue to get as much exercise as my body will tolerate. I need to learn to live with hot flashes! I need to eat less, that unfortunately seems to be the only way to stop the weight gain.

All things considered, not a bad outlook. It comes with no guarantees.

We’ll keep you up to date..