March 24, 2008

Back to reality......

After a week in Florida (pictures and a full report later) I had my monthly appointment this morning and there were a number of changes:

1) First we switched to a doctor at the University of Kansas Cancer Center.
Dr. V specializes in prostate cancer. We have met with him a couple of times previously for second opinions. He has a compassionate approach and is dedicated to supporting patients with genitourinary cancers.

2) The KU Med Cancer Center just opened in it's current location about 6 months ago. It is fantastic. It is a state of the art facility that was definitely designed to provide the patient with a privacy and comfort during treatment. The staff was consistently polite and compassionate.
In the waiting room there is a lady with a cart and provides free bottled water, juice, etc. The refreshments were offered with a smile and a warm greeting while we waited to see the doctor.
Doesn't sound like much, but it really was a great touch.

3) Because the lab and the treatment room are in the same facility, when they inserted the
temporary port in my hand, they drew blood for all the tests at the same time. Again, not
a big deal, a small touch but it goes a long way.

4) The treatment room or should I say rooms. These are laid out like cubicles in an office environment. No more big room with 15 chairs and 15 patients. Each room has a flat panel TV, DVD player, a door that closes providing privacy. This is going to be real important in the future when I have chemo, now it's just a good addition to the monthly visit.

5) One of the most important benefits for Mary and I - we received the PSA results before I left the appointment! No more waiting for days and placing multiple calls back to the doctor's office.

Now for the bad news, my PSA went up a little bit from 29.4 last month to 34.7 this month.

A few factors that we believe may have contributed:
- I was on vacation and was out of routine; no daily work outs, lots of eating out, etc.
- The week proceeding vacation was perhaps one of the most stressful I have had at
work in years
- The week proceeding vacation, I was also working 4+ hours a night on a volunteer project for our church and therefore sleeping less, etc.

Dr. V, Mary and I decided we will continue the current regimen of Lupron and Nilandron to give the Nilandron a fair opportunity to get the PSA under control. Hopefully, over the next 4 weeks we will resume a better sense of normalcy and routine. I will be back to working out tomorrow morning.

Not much else to share right now, that's my story....and I'm sticking to it!!

Historic Data:
3/24/08 34.7
2/25/08 29.4 (Started taking Nilandron on 2/4/08; Started Selenium 200 mcg on 2/26/08)
1/28/08 36.2 (Stopped taking Ketoconazole and Hydrocortisone in anticipation of next treatment)
12/31/07 30.9
12/3/07 21.9
11/5/07 23.3
10/8/07 19.30
>10/8/07 Changed Lupron from 120 day dose to monthly dose> 9-12-07 Began taking .5mg of Avodart per day. Changed Ketoconazole from 600mg twice per day to 400mg three times per day)
9/4/07 21.80
8/6/07 19.25
8/2/07 16.96
7/02/07 20.30
6/04/07 17.80
4/30/07 16.25
4/2/07 17.68
3/5/07 21.87
2/5/07 20.90
1/8/07 18.90
12/11/06 24.86
11/13/06 43.61
10/16/06 51.48 (Started "High Dose" Ketoconazole and Hydrocortisone, 10/01)[at this point and for a second time we prepared for Taxotere. First my Oncologist wanted to try High Dose Ketoconazole and Hydrocortisone.]
9/11/06 83.97 (started Zometa)
8/23/06 41.77
8/18/06 54.66(no tests in June or July)
5/19/06 11.37 (stopped Casodex)
4/3/06 4.25
3/5/06 1.45 (started Casodex again)
1/27/06 0.46
12/28/05 1.85[at this point we prepared for Taxotere, chemotherapy treatments. First I had a new PSA test and new bone and CT scans, lymph nodes clear, spine clear, ribs, femur and hips stable. The PSA dropped to 1.85 and the scans revealed marked improvement. Chemo was cancelled 72 hours before it was scheduled to begin]
12/15/05 7.18
11/03/05 4.64 (Stopped taking Casodex)
9/22/05 0.8
08/11/05 0.35 [nadir]
6/24/05 0.55
4/17/05 2.51 (taken at MD Anderson, Gleason lowered to 7/7)
4/06/05 3.51 (Six weeks after starting Lupron and Casodex)Original Gleason scores (7/8)
Pre-treatment tests:
2/18/05 Started Lupron
2/11/05 Started Casodex
2/?/05 219
12/?/04 189 (Original test)


Anonymous said...

Thanks for updating - glad things are relatively stable with the PSA - would not be surprised to see a drop next time. Sounds like you are in good hands with your medical team, especially since Dr. V specializes in PCa. Look forward to seeing Florida pics - we need to at least be able to look at a warm place! Sharon

Anonymous said...

David , It sounds like You have found a wonderful treatment center
and a good Doctor
I would just say You have to be careful not to compare 2 psa s taken at different labs , In My own case I was psa 20 at one point in AK and returning to the east psa 32 6 days later. That was 2 months after starting treatment.
best regards