April 19, 2005

Houston, we have a problem....

We returned home Monday night...no, this is not good news.

At this point in time, there is no cure for Prostate Cancer that has metasticized to the bone. It's not good, there is not much else to say, details of the trip are below.

Maybe I put too much hope in going down there? My expectations were too high? I'm not sure what I was expecting, good news? A cure? Regardless of what I wanted, what I got was devastating at best. The bottom line is this - there is no cure (at this time).

From Houston:
After what seemed to be a million forms, we went in to see Dr. Mathew at about 9:15. We spoke with his nurse, and he finally came in at 9:45 or so. We talked, he reviewed the x-rays and CAT Scan results I had taken in KC in early February. The CAT scan did not reveal anything new but the bone scan clarified where the cancer had spread. Though it is not in my knees, it is in my hips, pelvis, neck and throughout my spine.
The lab at Anderson modified my Gleason score (indication of how advanced the cancer is in the tumor) from a 7 and 8 to a 7 and 7. (1 being a normal cell, 10 being the most advanced cancer possible.)

After this, then he laid out the options;

Option 1: Countinue the medication I am on and add one additional medicine to fight the bone issues and possible onset of osteoperosis......and wait. Wait until a time when my PSA score begins to increase. The PSA will eventually begin to rise when the cancer finds a way around the hormone blocker. It could be 2,3,4 years or more. At that point the cancer will begin to grow in spite of the drugs. At that time a decision will be made as to the most effective drug protocal to pursue, either chemo, experimental or a combination. Once again, this is not expected to result in a cure, it is hopeful it will extend my lifespan and maintain a good quality of life.

Option 2: MD Anderson is conducting a study in which the second treatment I mentioned above is started earlier in the timeline. The study combines two additional FDA appproved radiation/chemo treaments. It is "hoped" that this will show improvment in duration of life. I could go on more, but the bottom line is that with this option I would compromise my current quality of life, suffer physically, and quite possibly emotionally. Additionally, I would be required to travel to Houston monthly, and in the short term, with very little evidence (in fact virtually no evidence) that it would be beneficial to me personally. (The release form for the study iterlly states "you are highly likely to see no improvements in your condition").

The issue is this, as I understand it, with cancers like Leukemia, or tumor based cancer, chemo can be administered and it will basically travel through the blood stream to the marrow or tumor and attack the cancer. In this case Prostate Cancer that has metasticized to the bone is different. Blood does not travel through the exterior of the bone and in the joint, so chemo has very little effect on the areas infected.

It did not take us long to chose, we chose #1.
If they had offered a new experimental drug that had shown some signs of hope we might have taken a gamble, but in this case there was very little hope of benefit to me and my condition. That might be selfish, but the impact to our quality of life would have been immediate. We believe it will be better to continue on our current path and deal with chemo (or chemo like treament) in a few years. Who knows, maybe there will be something else available at that time? The Doctor was very impressed with our dedication to better diet/nutrition and commitment to exercise. We are hopeful that this will have an additional positive impact to my ability to fight this cancer.

There was one piece of good news. While we were there they took another blood test...my PSA level was....2.1!!! This was an improvement of 33% in 10 days. Very good news!

Next steps:

1) Friday we go back to see my local urologist, Dr. Brad Davis. We will be discussing our trip with him and our decision to proceed with Option 1. Dr. Davis completed his fellowship at Sloan-Kettering in New York. We intend to ask him pursue possible options through this facility. If he finds there are possibilities, we will arrange to pursue any viable treatment options that are identified.

2) I have a long list of things to keep me busy here, painting, yard work etc.

3) I begin the job search at once.

4) Continue to research additional experimental treatments.

5) Pray and pray and pray.........


Anonymous said...

David- We pray as a family for you nightly! Hang in there.

Joe, Christine, Emily & CJ

Anonymous said...

I'm saddened, but I'm still full of hope for some reason. Part of it is how great you look, how wonderful your disposition continues to be, how well you are doing with the treatment course so far. And of course, I'll continue to pray for a completely miraculous recovery, while you do your best to help God out.


Anonymous said...

David- Your courage and strength is amazing. I'm sure your emotions fluctuate throughout each hour. We pray for you and feel your emotional pain.