Diagnoses, Treatment & Side Effects to Date (March 2012)
- Initial Diagnoses: Acute Sciatica;
- Referred to a Neurosurgeon after 3 months treatment.
- After examination he arranged MRI & Blood Test.
- Result: 4 shadows base of spine' cause of Sciatic. PSA 126ug/L Most probably have Prostate Cancer Referred to Urologist
- DRE, PSA & Biopsy
- Result 14th. July 2008 aged 62yrs. PSA had risen to 138ug/L in 5 days,
- Metastatic Prostate Cancer; Stage IV T3 M1+,
- Gleeson Score 8 + 7
- Secondaries: Pelvis, Lumbar Spine, Thoracic Spine, R. Shoulder, Rib #01 R. side
- No Symptoms;
Note: PSA & DRE done every 12 – 24 months max as Dad had PC, did not die from it and elder brother has it and successfully treated.(Radiotherapy) Urologist said I had a very aggressive type of Prostate Cancer and that I should not beat my head against a brick wall as PC tests are not absolute, even the Biopsy depending on experience of Urologist may not be conclusive. PSA & DRE indicators only.
Treatment & Present Status
- Hormone Therapy, Zoladex Implant - quarterly, plus daily Anti androgen tablets 10 days at commencement prior to implant;
- Radiotherapy for Pain management; Feb/ Mar 09;
- Zometa infusion monthly;
- Arthritis Mgt: Methotrexate & Folic Acid (10/09 - 07/12); and
- Pain Mgt: Tramadol or Oxy-Contin
- Changed from Private to Public system April 2011;
- Increasing Bone Pain May - Aug 12: Series of tests and scans , soft tissues & heart all clear. 1 ne lesion left ribs, possibly 4 right ribs but not clearly defined.
- Commenced Fentanyl Patches 05/07/12
- Little or no Bone Pain (Magic)
- No more popping painkillers.1 in 3wks! (Fantastic)
- PSA 1.1
Note 1: 7 Zoladex Injections since commencement 30/07/08, latest one /07/12 Note 2: 11wks Androcur Nov, Dec 09
Note 3: 7 months Cosudex 03/10 with implants
Note 4: 10 monthly infusions Zometa, commenced 19/04/10 now out to 6wk intervals.
- Hot flushes;
- Chills (cold spells12)
- Loss of libido;
- Penile reduction;
- Erectile Dysfunction;
- Extreme tiredness & fatigue;
- Cognitive Issues; (Lack of concentration, decreased mental sharpness, short term memory loss.)
- No stamina;
- Weight fluctuation;
- Muscle degradation;
- Depression; (Minor, no treatment or visits to Drs.)
- Mood Swings; (Temperament)
- No strength;
- Loss of Income;
- Demeaned by Insurance Company;
- Loss of neat writing ability;
- Psoriatic Arthritis (hands);
- Osteoarthritis (Lower Spine, Knees & Hips); and
Future: Where is my Crystal Ball and the Specialists
Contact Details: 07 4613 6974 Mob 0407 927 060
DHA 14th. August 2012 V3
ADT is still working but perhaps not as effectively as previous. Recent NBS clarivied a few more secandries on my ribs but nothing startling. CT Scan for Chest, Abdomain All clear. My Med Onc beleives I'm now CRPC and should consider starting Chemo in a couple of months. Went for a secand opinion a was told most unlikely that I was moving into CRPC, possibly another 12 months!!!!!!!
My Bone Pain is now under control which is magic. Saw a Palliative Care Consultant about 9months ago, which was the best decision so far of my journry. Pain is being managed by Fentanyl 50 patches. changed evry 3 days. Take occaisional break through 20mg Oxy Norm.
Side Effects and Impacts.
Please note that I have found that some Specialists are genuinly interested in side effects others are not. They all should be as they are working for you. I have changed Specialists!! Never mind that now but here is my list. Happy Reading.
By the way Lenard Cohen was great.. Hoep I'll be as active as he was when I'm 80yrs young.
David HA Nov. 2013
Side Effects of Treatment (ADT) & Impact;
1: Fatigue, Extreme Tiredness;
2: Muscle degradation;
3: Cognitive Issues;
4: Cold Spasms/ tremors; av1/ month
5: Hot Flushes; 4-6/ day
6: Loss of Libido;
7: Erectile Dysfunction;
8: Psoriatic Arthritis (hands);
9: Osteoarthritis (Lower Spine, Knees & Hips);
11: Nausea (minor);
12: Weight Loss;
13: Hoarse Voice;
14: Penile reduction;
15: Depression/ Anxiety; (mild)
16; Urination issue;
a: Unable to Work/ Loss of Income; 1, 2, 3, 14 = reduction in overall lifestyle.
b: Unable to walk one of my dogs; 2, 9
c: takes about 2 - 3hrs to hover & mob the floors; 1, 2
d: Some days have to sit down after a 30' walk; 1, 2
e: Unable to go swimming / surfing; 1, 2
f: Unable to do heavy gardening tasks, split logs, mow the grass; 2
g: Hill walking; 1, 2
h: Drive long distance; 1, 3
i: Clean the car; 1, 2
j: Hold extended conversations; 3, 14
k: Stand for periods of time; 1,2, 10
l: Concentrate for short periods, let alone longer periods; 1, 3
m: Unable to Open a twist top, bottle of wine; 2
n: Hands lock together, shaking hands, clenching fist; 8
o: Sleep interruption, self & wife; 4, 5
p: Personal Relationship; 3, 6, 7,14, 15
q: Mood swings, irritable, confidence; 3,15
r: Increased frequency during day; 16
#1 is by far the worst. Impacts on everything!
Commenced Chemotherapy 22 Oct 14
Had first bout of Severe Chest Pain: Scale 7 - 8 Max; 4 -5 Av; 3rd. Nov. lasted about 3hrs middle of the night. Since then have experienced 16 bouts of chest pain the longest lasting 13hrs.* ranging from very mild to severe.
06/11/14; GP felt that that I had inflamed ligaments where Ribs join sternum.
12/11/14 Had ECG, immediately prior to 2nd. Chemo infusion. ECG Result Clear.
13/11/14 03.00hrs * Severe chest pain. Following MO & Cancer Nurse instructions called Ambulance. In ED by 03.45hrs Given 2 morphine shots by Paramedics. When in ED given 100ml fentanyl and 20mg endone over 3.5hrs pain not controlled. 2 ECGs 2 blood counts Chest X-ray. Cardiac and lungs All Clear and Good.
13/11/14 07.30hrs transferred to day ward. 3rd ECG and bloodcount taken about 10.00hrs Given another 20mg of endone. pain still not controlled, spasms not so severe. ECG and Bloods ok. Discharged 12.30hrs. Spasms finally abaded by 16.00hrs.
Cause of PAIN???!!! Not specified! Possible flair! Referred pain New secaodry in sternum. If pain persists in severe mode report back to Hospital Oncology Unit.
Pain has continued intermittently through till 24//11/14. Very mild to moderate. Will try and arrange for high resolution scans. (PET/MRI or Sodium Fluoride PET.) Till next Time. Good health and Travel Safe David Abrahams
This time last year I was in the middle of chemotherapy. Owing to side - effects (mainly periphial nuropathy and tiredness) the medical oncologist stopped the programme after after 6 infusions. (last infusion beging March 2015. Still suffer from the periphial nuropathy. When havinga break post chemo walking along a beach at Yamba northen NSW when my left leg suddenly gave way and I hit the deck (fortunatly sand) with a thump. I was stunned and winded & my my wife thought I had a heart attack. She tried to move me a bit but no success and was just calling tripple zero when a wave washed over me. That woke me up very quickly & I quickly stood up. Like a drowned rat covered in sand. We then had a 30' stiff legged walk back to the lodgings. Left leg gave way a secand time but as my wife was walking beside me I was able to grab her shoulder. Has not reocurred. Was very lucky as there was steep concrete steps down to the beach near where we were staying.
Another chap in the support group had a similar experiance as did a another classmate at hydro therapy where I go twice a week for 60'. The lady was having chemotherapy for breast cancer. All 3 of us had doxecyle.
Changed from Zometa to Xgeva mid year. Continuing on with Zoladex every 3dddmonths since finishe chemo.
Progress Report January 2016 - The Battle Intensifies: SBD
PSA continues to rise slowly. 4.1ug/L to 5.0ug/L (19/12/15) in 6wks.
Weight Loss: 1.5 – 2.5Kgs lost in 6wks, depending on which Hospital scales one believes. (nor am I having Maggie Beer or Nigella Lawson speciality diets!!!)
Have been re tattooed for radiotherapy which is due to commence on Tues 5th Jan 2016. L3 and Sacrum. Only able to have small dose, 20rad, which may or may not be beneficial, according to the Radiologist owing to the small dosage*. (had 2x40 rad doses in Feb/ Mar 2009.)
Ga68 PSMA PET-CT Scan conducted 16 Dec 2015
Summary of Findings:
Ongoing intense PSMA uptake in the enlarged prostate! Has not been enlarged before)
Active skeletal metastases in the sacrum, L3 and fifth posterior rib with ongoing intense PSMA uptake.
Mediastinal, retorocural and para-aortic lymph nodes demonstrate C, indicative of nodal metastases (despite the fact that these lymph nodes are not enlarged by CT size criteria). 3 are in the Abdomen, para-aortic region. One in the Thorax near T7 and a fifth on right side of abdomen.
Due to commence Abiraterone (Zytiga) on 4th February, which may or may not work.
Happy New Year and Improved or at Least Steady Health and Prosperity throughout 2016 and way beyond to All Readers.
David Abrahams, Toowoomba,Qld.
*One wonders if it is worthwhile having this additional Radiotherapy. Both my Palliative Care Consultant and my Medical Oncologist feel it could be worthwhile. In for penny in for a pound!!!!! But I have to wear the side-effects they do not!
Progress Report February 2017 - The Battle Continues: SBD
Apologies for the delayed update, cannot believe 12 months plus, have passed since I did my last update.
How time flies when you are having fun!
I ended my last update wondering whether it would be beneficial having some more radiotherapy to L3 and Sacrum. Both my Medical and Radiation Oncologists felt it would beneficial.
In itself the radiotherapy was ok but it did nothing to help minimise bone pain. In fact I had to increase my fentanyl patch size from >50 - 75mcg/hr. To make matters worse I ended up with Radiation Colitis and having 8 days in St Andrews. Unfortunately not the town that carries that name and is the Golfing Capital of the world, (that is if you're a golf fanatic, which I'm not.) in Bonnie Scotland, but a Hospital in Toowoomba.
Needless to say and fortunately, I do not have to see either of the fore mentioned Oncologists! My Palliative Care Consultant and GP now manage my ailments!
October 2016, commenced participation in the following trial run by the Dept. Urology Princess Alexandra Hospital Brisbane Qld. A Novel Liver Targeted Testosterone Therapy for Sarcopenia in Androgen Deprived Men with Prostate Cancer - A Blinded Randomized Controlled Trial. Requirement: take 40mg oral testosterone daily (3x13.3mg/ day) for 6 months or a placebo. Had a whole body Bone Densitometry scan at commencement of trial and will have another at trials end.
Medication/ Treatment: Zoladex implant every 3 months. Xgeva injection every 6wks. Fentanyl patches for pain management.
During the past year (14 months) my PSA has fluctuated from a low of 3.9ug/L to a high of 6.1ug/L (23rd Feb) with my Testosterone going from <0.5L to <0.3L
Bone pain is slowly increasing: Lower spine, hips and pelvis predominantly left side and femur. To keep the pain tolerable without use of break through tablets (Oxy-norm 20mg) patch size has been increase gradually throughout the past year from >50 - 100mcg/hr.
In addition the peripheral neuropathy in my feet has recently started to get worse (chemo side –effect), increasing fatigue and weight loss. Now 68kg.
The good news is that I still enjoy my single malt and good red wine. Walk the dogs most days, 20 – 40min; 2hrs of hydro therapy & 60' of social bowls/ week.
To close a very, very belated Happy New Year and Improved or at Least Steady Health and Prosperity throughout 2017 and way beyond to All Readers.
David Abrahams, Toowoomba, Qld. 03/03/17
David's e-mail address is: firstname.lastname@example.org