DavidAbrahams Posted May 5, 2018 Share Posted May 5, 2018 David Abrahams Update May 2017. Owing to family visitors from Bonnie Scotland, a pre - trial interview (medical not criminal), plus attending the RBWH in Brisbane have not participated in the APCF Tele-conference, for a wee while, hence the written update. Just 6wks away from my ten year anniversary of this “interesting journey” which has had a major impact on my own journey on planet earth. Overview Initial Diagnoses and Treatment 2008 Initial Diagnoses was Acute Sciatica however after 3 months of unsuccessful treatment refereed to a Neurosurgeon, who arranged MRI & Blood Test. Result: 4 shadows base of spine’ cause of Sciatic pain. PSA 126ug/L Most probably have Prostate Cancer Referred to Urologist. Further test etc including a biopsy. Result 14th. July 2008 (age 62yrs.) PSA had risen to 138ug/L in 5 days, Advanced Metastatic Prostate Cancer; Stage IV T3 M1+, Gleeson Score 8 + 7 Secondaries: Right side Pelvis, Lumbar Spine, Thoracic Spine, R. Shoulder, Rib #01 R. side No Symptoms; Treatment: Hormone Therapy, Zoladex Implant - quarterly, plus daily Anti androgen tablets (Cosudex) 10 days at commencement; once cancer under control intermittent therapy. Radiotherapy for Pain management; Feb/ Mar 09; Pelvis and Right shoulder. Zometa infusion commenced monthly in Jan 2010; Pain Management partially controlled with Tramadol, Methotrexate & Folic Acid. Present Have been on a 12 month hormone therapy holiday with my last Zoladex implant in March 2017. PSA fluctuating between 4 and 8ug/L, testosterone <.3L to <.5L, bone pain under control with the use of 100mcg/hr Fentanyl patches & 2x5mg/ day of Targin. During a Toowoomba PC Support Group meeting in September last year the guest speaker a medical oncologist, mentioned as part of her discussion that 2% of men with advanced metastatic prostate cancer, who still have their prostate and have had Chemotherapy, radiotherapy and hormone therapy may get a secondary prostate cancer which is commonly picked up by having growth in ones prostate. This type of PC principally impacts the victim’s bowel and urinary systems. In 2016 I was in Hospital for 8 days, with a bowel problem which was not specifically diagnosed, perhaps radiation colitis or ulcerated colitis, who knows! During mid 2017 I had bladder problems which resulted in frequent trips to the loo, averaging one an hour with normal to weak flow and occasional dribble, caused by an enlarged prostate pressing on my urethra. The end result was having an indwelling Suprapubic Catheter (SPC) fitted. Short term I had blocked catheter problems (unbelievable pain and extremely high blood pressure) bladder infections and urinary tract infection, which resulted in couple of trips to the Base Hospital Emergency Department. Touch wood things have settled down now and only take anti-biotics for 3 days when the SPC is changed which is every 6wks. A Scotsman has to be very careful when wearing his kilt and having an SPC!!!!!!!!!!!!!!!!!!!! In mid-February 2018 my Palliative Care Consultant and GP. after reading applicant criteria for the national Lutetium 177- PSMA Trial felt that I could be a suitable candidate. Unfortunately this was not to be case as the incumbent had to have had 3 rising PSA over 20ug/L (I had two) and become unresponsive to either of the 2 new super hormone therapy drugs, namely Xtandi (Enzalutamide) or Zytiga (Abiraterone). Clearer patient guidelines are obviously required as we had a “partially” wasted trip down to Brisbane and the trial co-ordinater remarked that they could not understand why they had so many applicants! In a 10wk period from January to April 2018 my PSA more than doubled from a low of 13ug/L to a high of 28ug/L and testosterone from 0.5 - 1.2 Prior to attending the Lutetium 177- PSMA Trial acceptance interview the trial Supervisor recommended that I start immediately on Firmagon, which was done on the 28th. March (2X 60mg) and my 2nd on 27th. May. “Partially” wasted trip, the Oncologist in charge of the Lu177 trail during discussions asked my wife and myself, if we would be interested in having him (Sr Medical Oncologist) look after my cancer care, which after some discussion we agreed. Would necessitate 6wkly visits to Brisbane, but should the travel become too onerous he would refer me back to the Base Hospital Oncology Unit. Results from my latest CT and NBS taken on 17th. April are as follows: Boney Metastases’ were wide spread, “too numerous to count” in sacral, lumbar and thoracic spine and across my ribs with continued activity to the right shoulder, sacrum and pelvis, plus new spots in right arm and left side of pelvis. Two Lymph Nodes are clearly metastasised, lower pretracheal and the para-aortic retroperitoneal measuring over 11.4mm and 9.6mm on the short axis To close the principle soft tissue organs appear to remain clear and my PSA has fallen back to 15ug/L 24th. April and commenced Xtandi 17th. April. Still enjoying single malt good red wine, and our 4 magic grandchildren. Exercise regime is much the same daily walks, occasional resistance training and hydro- therapy once or twice a week, al be it a wee bit slower. The only noticeable side-effect to date is greater fatigue. Early June will see a return visit to the RBWH and a switch back to Zoladex. If any members have had major hassles from Xtandi or a SPC please give us a call. Contact details in member section. SlangeVar David Link to comment Share on other sites More sharing options...
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