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My Journey to date


DavidAbrahams

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 August 19th, 2011

Living in Launceston, Tasmania when on Easter Monday April 2008, in the wee hours I awoke with excruciating pain across my buttocks and down my right leg. Visited on call Doctor as GP on holiday.

 Initial Diagnoses: Acute Sciatica;

Referred to a Neurosurgeon after 3 months treatment with no easing of symptoms.

After examination he arranged for a MRI & CT Scan also a Blood Test to check PSA.

Results - Good News and Bad News: 4 shadows base of spine’ cause of Sciatic pain. PSA 126ug/L Most probably have Prostate Cancer.

Referred to Urologist  DRE, PSA & arranged for a Biopsy                    

Result 14th. July 2008 aged 62yrs.  Metastatic Prostate Cancer;                   Stage IV T3 M1+, Gleeson Score 8                                                          

PSA had risen to 138ug/L in 5 days                                                                                                  

Secondaries: Pelvis, Lumbar Spine, Thoracic Spine, R. Shoulder, Rib #01 R. side

Symptoms; NONE not one!

Note: PSA & DRE done every 12 – 24 months max as Dad had PC, did not die from it and elder brother has it and successfully treated by Radiotherapy. Urologist said I had a very aggressive type of Prostate Cancer and that I should not beat my head against a brick wall as PC tests are not absolute, even the Biopsy depending on experience of Urologist may not be conclusive.

PSA and  DRE are indicators only.

 

TREATMENT CHOICE  3 days to decide on Medical or Surgical Castration. Decided on the former. Intermittent Hormone Therapy, Zoladex Implant - quarterly, plus daily Anti androgen tablets (Cosudex)  Commenced 10 days prior to first implant;

Radiotherapy for Pain Management; Feb/ Mar 09;

Zometa infusion monthly commenced Feb 2010

Methotrexate; Folic Acid; and Tramadol.

Note 1: 5 Zoladex Injections since commencement 30/07/08

Note 2: 11wks Androcur Nov, Dec 09 (Horrible side effects)

Note 3: 7 months Cosudex 03/10 with implants

Note 4: 10 monthly infusions Zometa now out to 6wk interval

 

SIDE EFFECTS August 2011

Hot flushes;

Chills;

Loss of libido;

Penile reduction;

Tiredness and fatigue;

Lethargy;

Cognitive Issues;

Nausea;

No stamina;

Weight fluctuation;

Muscle degradation;

Depression;

Mood Swings;

No strength;

Loss of Income;

Demeaned by Insurance Company;

Psoriatic Arthritis (hands);

Osteoarthritis (Lower Spine, Knees & Hips);

Osteoporosis;

Cognitive Issues (Lack of concentration, decreased mental sharpness, short term memory loss.)

 

Status as at Dec 14th 2011

 

April 2011 - "A Breath of Fresh Air" or I am a person again rather than a number. Changed from Private to Public system, what a difference Chalk and Cheese; Apart from the Medical Oncologists listening to you and asking questions about how you are feeling emotionally and illness wise they also ask about side-effects etc. The other principle advantage is that you have "FREE" access to Allied Health Support.

 

15th. August - PSA now 3.5ug/L lowest 0.13ug/L 10months ago;

 

7th. Nov - PSA 7.7ug/L Testosterone 12. (Increasing back pain, mid to lower) Medical Oncologist referred me to Radiation Oncologist to investigate zapping the secandries. No joy, had my radiation limit in Feb/ Mar '09 when I had 2/3rds of my Pelvis radiated and Right shoulder for pain management. RO very concerned that additional radiation would damage internal organs. He recommended that I recommence ADT treatment again (Zoladex 3monthly implant and daily cosudex pep pill) which I have done. Early days yet, but have cut "drugs" by 50% for pain mgt.

 

Last Zoladex Injection September ’09; 17th November 2011;

 

Zometa infusion now every 6wks, may go to 8wks.

 

Future: Crystal Ball

 

 

 

 

David H Abrahams March 2014

 

 

How time passes when you are having fun. It seems like yesterday that I loaded my story onto the APC Forum website.

What was in the Crystal Ball someone asked. Bone Pain Control - Magic!

ADT is still working but perhaps not as effectively as previous. Recent NBS clarified a few more secondaries on my ribs but nothing startling. CT Scan for Chest, Abdomen All clear. My Med Oncologist believes I'm now CRPC and should consider starting Chemo in a couple of months. Went for a second opinion a was told most unlikely that I was moving into CRPC, possibly another 12 months!!!!!!!

Who do you Believe? especially when you do not see the Medical Oncologist that your appointment was for!

My continuous and debilitating Bone Pain is now under control which is magic. Went through a bad period in May July 2012. Increasing pain in back ribs, chest, breathlessness etc, Sent for NBS; CT Scan Chest x-ray. Nothing conclusive. Increase opiates to max dosage, no difference. Requested GP for referral to see Palliative Care Consultant. The GP said it was not necessary as I was not going to die within 3months. Persisted, which was the best decision so far of my journey*. Had a >90' plus consultation with a Palliative Care Consultant during that period. Pain is now being managed by Fentanyl 50mcg/Hr patches. Changed every 3 days. Take occasional tablet (20mg Oxy Norm) for break through pain.

 My 2nd best decision of this journey as mentioned in my original "Journey to Date". Moving from the Private system to the Public System. Allied Health Support is really great and I see the Medical Oncologist, Palliative Care Consultant and Allied Health Staff if required every 6 weeks prior to my Zometa infusion.

As mentioned in the first part of my Journey I have ADT intermittently which my medical oncologist is against. Therefore I'm presently on a ADT "free" holiday. Now nearly 6 months of the ADT. My PSA was rising slowly prior to me coming off. 0.4ug/L in Oct.'13 now 3.4ug/L and testosterone <0.5L

Side effects: Watch this space; Will post a separate article about side -effects and impact shortly.

Palliative Care: Will post a separate article.

 

The Future: More Crystal Ball stuff!

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