11. First PSA Screen after Lupron, Onward to Chemo.
On February 16, the night before the Love Like You Mean It cruise ended, Juli and I stayed up late with hundreds of other couples to renew our marriage vows to one another under the stars off the coast of Florida. There was a huge wedding cake, and a really cool (pun alert) ice sculpture melting in the warm night air. David Robbins, the new head of Family Life Today spoke vows for all of us to repeat and Juli and I looked into each others eyes saying words deeper in meaning to us after nearly 38 years than they did the first time. Especially the part "in sickness and in health." The next day we would disembark from that floating conveyance of beauty to distant land and seascapes, to enter an aluminum tube racing along at 35,000 feet returning us to the harsh reality of cancer appointments and the start of chemo.
The first appointment on return was on February 22 and this one was big. To this point, it seemed that every appointment had brought another dose of harsh reality and difficult news. The appointment that sounded the gun starting the race was with Dr McAfee. He had ordered a PSA screen and called about 14 hours later to tell me that my PSA was 26.1. As described in an earlier post, 0-4 is considered normal. Friends have had their prostates removed with a PSA of 5 or 6. My 26.1 indicated nothing good. On the 20th, I went to a blood draw station to get the PSA screening done so it could be discussed with the oncologist on the 22nd.
Juli and I walked into the oncologist appointment with a lot on our minds. Exactly 31 days had passed between the first Lupron injection and this appointment. I have been having frequent hot flashes, along with a headache, sinus pain, fatigue, and dry skin, all side effects of the Lupron. Was it worth it? Was it working? The side effects indicated that the Lupron was doing its job in destroying testosterone, but was the lack of testosterone in turn knocking down the PSA count? We talked all around the subject for a few minutes since part of the purpose of the appointment was to prepare for and understand what the chemo was going to do beginning March 2. Finally, I told the doctor I am dying to find out the results of the PSA screen. She said she wanted to know as well and the results had not come through yet. She asked if we would excuse her as she asked an assistant to track down the report. She was gone less than 2 minutes, came back in the room with a piece of paper and told us her assistant had already been trying and it had just come through.
With a PSA of 26.1, the doctor was hoping to see a downward trend. If the number came in higher it would indicate complete failure of the treatment plan. If it came in slightly lower it would be disappointing but at least moving slowly in the right direction. She was hopeful that it would come in around 12 or so, roughly half what it was at the first injection. That would be a strong start that we could live with. She looked up from the paper and said: "This is good."
In that 31 days, my PSA count had gone down from 26.1 all the way to 0.8!
Instant tears on Juli's part, cautious relief on mine. The doctor said that she would like to see it end up being maintained at less than 0.2, but that this was better than she had hoped for. It indicated the cancer was sensitive to this treatment. It meant we were on the right track.
Lord Jesus Christ son of God, have mercy on me a sinner.
I may not be a big fan of the hot flashes and headaches, but I am a big fan of positive results.
Now we prepare for chemo. I will probably not write as much or as often. I was hoping to catch up chronologically with these updates before the chemo begins since we expect to be pretty messed up by it.
If all goes according to plan, I will begin chemo this coming Friday, March 2. When they asked me what day to begin, I wanted to have one last special day with Juli before she had to begin a very difficult process of caring for me, likely for 4 months straight, and our 38th wedding anniversary is Thursday March 1. So we plan to go out to a special anniversary dinner on Thursday night, then Friday at 2PM I will sit back in a leather recliner at the UC Davis Cancer Infusion Center in Sacramento with an IV in my arm. I will receive anti-nausea medication in the line first, then a poison will enter my body, the first time of a minimum 6 times, each 21 days apart, and in the process I will get a new haircut and experience what thousands before me have endured.
We have learned a term called nadir, which indicates my body will be in significant danger of infection from day 5 through 9 with the days before and after providing partial immune protection. Days 1 to 3 are expected to be pretty uncomfortable, but I have been prescribed 3 kinds of anti-nausea medications to help control it. Besides hair loss, there will be many other side effects which I would rather not experience, but we will see.
I asked, if the PSA has gone so low with Lupron, what is the purpose of chemo? The doctor said that in the past, chemo would be reserved for the day when the resistant cancer cells would assert themselves. They discovered fairly recently that doubling up early with both Lupron and chemo, the outcomes were significantly better long term. The chemo fights the remaining cancer cells on a microscopic level, before they have a chance to raise the PSA.
We are thankful for the good news on the 22nd. We are a bit apprehensive about the process facing us right now. But others have gone before, and many others have it far worse. Pray that God will use me through this process to help those who have it worse. Pray that He will make us more righteous through the suffering. Nothing is worse than being a person facing away from God. Pray that He will use us to help turn those faces back to Him for a healing that is permanent.
Lord Jesus Christ son of God, have mercy on me a sinner.
The first appointment on return was on February 22 and this one was big. To this point, it seemed that every appointment had brought another dose of harsh reality and difficult news. The appointment that sounded the gun starting the race was with Dr McAfee. He had ordered a PSA screen and called about 14 hours later to tell me that my PSA was 26.1. As described in an earlier post, 0-4 is considered normal. Friends have had their prostates removed with a PSA of 5 or 6. My 26.1 indicated nothing good. On the 20th, I went to a blood draw station to get the PSA screening done so it could be discussed with the oncologist on the 22nd.
Juli and I walked into the oncologist appointment with a lot on our minds. Exactly 31 days had passed between the first Lupron injection and this appointment. I have been having frequent hot flashes, along with a headache, sinus pain, fatigue, and dry skin, all side effects of the Lupron. Was it worth it? Was it working? The side effects indicated that the Lupron was doing its job in destroying testosterone, but was the lack of testosterone in turn knocking down the PSA count? We talked all around the subject for a few minutes since part of the purpose of the appointment was to prepare for and understand what the chemo was going to do beginning March 2. Finally, I told the doctor I am dying to find out the results of the PSA screen. She said she wanted to know as well and the results had not come through yet. She asked if we would excuse her as she asked an assistant to track down the report. She was gone less than 2 minutes, came back in the room with a piece of paper and told us her assistant had already been trying and it had just come through.
With a PSA of 26.1, the doctor was hoping to see a downward trend. If the number came in higher it would indicate complete failure of the treatment plan. If it came in slightly lower it would be disappointing but at least moving slowly in the right direction. She was hopeful that it would come in around 12 or so, roughly half what it was at the first injection. That would be a strong start that we could live with. She looked up from the paper and said: "This is good."
In that 31 days, my PSA count had gone down from 26.1 all the way to 0.8!
Instant tears on Juli's part, cautious relief on mine. The doctor said that she would like to see it end up being maintained at less than 0.2, but that this was better than she had hoped for. It indicated the cancer was sensitive to this treatment. It meant we were on the right track.
Lord Jesus Christ son of God, have mercy on me a sinner.
I may not be a big fan of the hot flashes and headaches, but I am a big fan of positive results.
Now we prepare for chemo. I will probably not write as much or as often. I was hoping to catch up chronologically with these updates before the chemo begins since we expect to be pretty messed up by it.
If all goes according to plan, I will begin chemo this coming Friday, March 2. When they asked me what day to begin, I wanted to have one last special day with Juli before she had to begin a very difficult process of caring for me, likely for 4 months straight, and our 38th wedding anniversary is Thursday March 1. So we plan to go out to a special anniversary dinner on Thursday night, then Friday at 2PM I will sit back in a leather recliner at the UC Davis Cancer Infusion Center in Sacramento with an IV in my arm. I will receive anti-nausea medication in the line first, then a poison will enter my body, the first time of a minimum 6 times, each 21 days apart, and in the process I will get a new haircut and experience what thousands before me have endured.
We have learned a term called nadir, which indicates my body will be in significant danger of infection from day 5 through 9 with the days before and after providing partial immune protection. Days 1 to 3 are expected to be pretty uncomfortable, but I have been prescribed 3 kinds of anti-nausea medications to help control it. Besides hair loss, there will be many other side effects which I would rather not experience, but we will see.
I asked, if the PSA has gone so low with Lupron, what is the purpose of chemo? The doctor said that in the past, chemo would be reserved for the day when the resistant cancer cells would assert themselves. They discovered fairly recently that doubling up early with both Lupron and chemo, the outcomes were significantly better long term. The chemo fights the remaining cancer cells on a microscopic level, before they have a chance to raise the PSA.
We are thankful for the good news on the 22nd. We are a bit apprehensive about the process facing us right now. But others have gone before, and many others have it far worse. Pray that God will use me through this process to help those who have it worse. Pray that He will make us more righteous through the suffering. Nothing is worse than being a person facing away from God. Pray that He will use us to help turn those faces back to Him for a healing that is permanent.
Lord Jesus Christ son of God, have mercy on me a sinner.
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