December 01, 2010

Oh, what a lucky man he was (is)

Six years ago this month my new life began. I really had no problem with my old life. I had a good job, beautiful, loving wife, awesome son, appeared to be relatively healthy and things seemed to be going quite well.

What started as a rather minor pain in my right hip, six weeks later, I was diagnosed as having ‘advanced, metastatic prostate cancer’. This all took place around the same time I turned forty-two years old. As a relatively young man, you can imagine the shock and disbelief.

Though Prostate Cancer is very treatable and curable when caught early, in my case, things were not to be. The cancer had already left the prostate gland and was present in my lymph nodes and in numerous places in my skeletal structure. As the x-rays revealed there were lesions present up and down my spine, in my ribs and extensively throughout my pelvis.

This may be misquoting, but the saying goes something like this, “There are lies, damn lies and statistics”. The odds for me were not good from the outset. Chance of cure or remission, none. Expected or typical survival time, 36 months.

Well here I am nearly six years later. I have been through a plethora of treatments. Some of these have worked wonders, though temporarily. My lymph nodes have been clear since six months after I began being treated but the bone lesions remain today.

From the outset I have been on androgen deprivation. This is a wonderful treatment that suppresses my testosterone to the point that I am basically a forty-seven year old man with the hormones of a pre-pubescent boy. In addition I have side effects similar to a menopausal woman. Yes, it is quite the combination! In addition to the constant hormonal treatments, I have been through chemotherapy, radiation, women’s estrogen, a clinical trial and a few other treatments. Each had its puts and takes, its good and bad but again none provided long term benefit, nor as I previously mentioned, a cure.

At this point most of you are probably wondering ‘how can this man think he is lucky’? It probably sounds like I am anything but lucky.

First off, I’m still here. There are a number of men, many close to my age, that lasted but a fraction of the time I have. For that I am truly blessed. There is also the hope of the future. When I was diagnosed in early 2005 a man at my stage, at this point in his post diagnosis treatment regime, would for the most part only have the option of chemotherapy left ahead of him.  The standard chemotherapy treatment for prostate cancer at the time, Taxotere, is usually tolerated better than chemotherapy given for other cancers. This is not to minimize the side effects of Taxotere, I am simply comparing the once every three week treatments to those of other cancers where the patient is subject to daily or multiple weekly infusions. The bad news however is there are very limited long term benefits from Taxotere. In 2005, after completing Taxotere treatments, a man would begin a slow and usually very painful process of dying. It’s not pretty and for someone who one day faces that future, the thought of this is also very hard to write.

This brings us to December of 2010. The future looks bright for those of us with advanced/Stage IV Prostate cancer. Well ‘bright’ might be too Pollyanna, but I challenge one to argue it is not encouraging.  Earlier this year a new drug, in an emerging class of treatments was approved by the FDA. The drug, Provenge is in a class of drugs referred to as ‘immunotherapy’. In laymen’s terms a patient’s white blood cells are extracted, sent to a processing center and three days later re-infused into their blood stream. During this three day period the chemical compound or the Provenge is fused with the patients white blood cells. The treatment process is repeated two additional times every two weeks.  There is some controversy with the price and long term benefit of Provenge,  those objections can be discussed by others in other forms.  My purpose for discussing Provenge here is that six years ago, it wasn’t an option at all. On a personal level, in all likelihood, this is my next step, but not my last.

After Provenge there are several other drugs that are either in late stage or Phase III clinical trials that appear to be an option in 2011. A trial in Phase III is a drug Abiraterone and XL184 is being monitored in a Phase II trial. Both are showing remarkable results. Additionally, there are others; MDV 3100, TAK-700, Cabazitaxel, Alpharadin and others. I’m not going to list them all.  My point is that there is a future, and once again a future offering much more promise than just a few short years ago.

Finally, I can’t help but think of the old adage and offer this, anytime you want to walk a mile in my size ten and a half’s, I’ll likely have to think twice about it, because even in the midst of what appears to be a hellish life, things are looking up. Furthermore, I am confident that I have a few more miles to travel in said shoes than you probably could have convinced me of back in 2005.

4 comments:

Anonymous said...

Hi Dave,

Go for it ! I am sure you will see very good befit and all will work well!.

Good luck and take care
Swati Mittal

Sherry Luttrell said...

Well said. There more options now than every before. I am really thankful for the research going on.


Terence was just taken off the TOK-001 clinical trial (phase 1)- it was too toxic for him. So now we are looking at other options.

Here's to celebrating Christmas 2010 with our friends and families!

Anonymous said...

David , Great Post and yes we are lucky to be going through this in this era.It is great to hear your positive attitude,here you are 6 years later and like Gould who Authored "the median is not the message"you have a long way to go.
By the way that is a song by ELP .
Dan J

David E said...

Dan....
Greg Lake wrote it...ELP sang it:

He had white Horses
And ladies by the score
All dressed in satin
And waiting by the door

Ooooh, what a lucky man he was
Ooooh, what a lucky man he was

White lace and feathers
They made up his bed
A gold covered mattress
On which he was laid

Ooooh, what a lucky man he was
Ooooh, what a lucky man he was

He went to fight wars
For his country and his king
Of his honor and his glory
The people would sing

Ooooh, what a lucky man he was
Ooooh, what a lucky man he was

A bullet had found him
His blood ran as he cried
No money could save him
So he laid down and he died

Ooooh, what a lucky man he was
Ooooh, what a lucky man he was