September 06, 2006

Doctor, Doctor give me the news....

We met with my new Oncologist this morning and there is some good news, no chemo for now.  He apparently has more direct experience with Prostate Cancer than our previous Oncologist and would like to try a few more things before we proceed to chemo.

Step 1 - stop taking Casodex again, test my blood in two weeks and then again four weeks later.
Step 2a - if this works, ride it out again and see how long we can keep my PSA in check.
Step 2b - if not, before chemo try one more drug that has shown some limited success:
Ketoconazole (Nizoral) Produce response similar to that of antiandrogens. Inhibit a variety of cytochrome P-450 enzymes, including 11beta-hydroxylase and 17alpha-hydroxylase, which in turn inhibit steroid synthesis.

We need to do some additional research on the drug, one of the main things it prescribed for is "anti-fungal"? However, if we proceed and we see positive results from Ketoconazole, again, ride it out for as long as we can.  If we don't see the results we are looking for, well then we cross the chemo bridge. 

According to the doctor, there is no risk in six to eight weeks versus now. If  the bone metastasis was extremely aggressive, we'd begin right away.  But since my recent scans show only a slight  increase in activity we agreed with his recommendation to at least try this regimen first.

The bottom line is chemo is off, once again, for at least 6 weeks, 8 weeks, maybe longer?  On one hand it's a tremendous relief to us both.  On the other hand we have left the station for another ride on the emotional rollercoaster!  The stress of this cannot be conveyed via this blog.  It's constant, it's a burden, it's something we deal with constantly….in between holding down a job, raising a son, running a foundation……breathing…..

We are going to proceed with the Zometa treatments.  This is a drug used with Osteoporosis to help strengthen bones.  In prostate cancer patients (advanced) it helps fill in the areas the tumors may have weakened.  It a fifteen minute procedure give via IV.  This will commence on Monday or Tuesday of next week.

We discussed the leg pains.  After work yesterday they were pretty bad.  The sofa, the heating pad and 800mg of Advil and an hour later I was fine.  Last night I slept very well again as well.  This morning I was able to work out without an issues (upper body only).  He moved and bent my leg and asked me if it hurt?  Of course it didn’t at that time, he thought perhaps I pulled a muscle?  As you'll see, I'm not sure I agree with that diagnosis?

I decided to work from home today.  Everything was fine until about 12:15 when it began to hurt, the heating pad didn’t help, neither did the dose of Advil at 1:30.  By 2:00 I was laying on our bed in agony, it was so bad I couldn't call the doctor.  It did subside enough that twenty minutes later I called and left a message with the nurse.  By 3:00 I was able to do some work. I moved to the couch because it seems to be more comfortable overall and things have been good since (three hours).

I'm not sure what we'll do about the leg?  It's weird that it comes and goes?  Perhaps one on the tumors is pressing on a nerve?  I wonder if radiation is in order?  I hope to doctor calls back soon, I don’t want another flair up tonight….or ever!  That was perhaps the worse pain I have experienced in a long time, in my lifetime.


Karen said...

Hang in there!!! I know what the roller coaster can be like ... and roller coasters generally make me throw up! :)

Anonymous said...

I'm with Karen, roller coasters suck! ;-) Keep your head up Dave!!!