Tuesday, May 1, 2012

Medication changed ... and PSA down!!!!!!!!

First of all, for anyone who may be reading this who is dealing with their own prostate cancer and is interested in the numbers, here they are:

When Marshall was in the hospital in early March, his PSA was 48.  When he was diagnosed and went to the University of Colorado just a few weeks later, the PSA had risen quickly to 93.99, his Gleason score was 8 and the cancer had metastasized to his bones (rib cage, spine and upper right leg).

When we got to the University today, the first thing they did was draw blood.  When we were in the car coming home -- around 5:00 -- the oncologist called us to tell us that the PSA had dropped to 9!  I don't know who was more excited, the oncologist or us.  Dr. Flaig said that he loves to be able to give patients news like that.  The doctor also said that he is shooting for Marshall's PSA to get down to 2 or less.

During the visit, Marshall asked Dr. Flaig if chemotherapy and/or radiation was in his future.  Dr. Flaig said he believed it probably would be, but that it would be "YEARS down the road."  That was good to hear, too.

Last month Marshall's hormone injection was degarelix (Firmagon), two rather painful shots in the stomach.  Today, Dr. Flaig asked Marshall how he would feel about changing hormone treatments and getting Lupron instead of Firmagon.  Marshall said, "Doc, if you were sitting in my chair, what would you do?"  The doctor said he would take the Lupron.  So that's what Marshall decided to do.

He said with the Firmagon you had to be on a rigid schedule of two shots for the first treatment and then one shot EXACTLY every 28 days.  Plus the Firmagon injections were painful.  The Lupron is more flexible.  You get a Lupron shot every three months, it's not nearly as painful, and the side effects are not as severe.  In addition, with the Lupron, if your PSA levels stay down for a period of time, you can even take vacations from it. 

So today Marshall got a Lupron injection.  Even though it was a three-month shot, we still need to monitor the PSA, so we go back on June 11 for lab work to be sure the Lupron is doing what it is meant to do.

Dr. Flaig said that experience has shown that at the 7-month mark -- which for us will be around the end of September or early October -- we will know whether the hormone treatments are going to continue to work, so he says we will have a serious heart-to-heart at that time about what we will do going forward.

Hormone treatments cause bone weakening over time, so at our next visit in three months, Marshall will probably be started on a bone strengthener.  Right now, Dr. Flaig advised that we should start on Vitamin D and calcium supplements in addition to very moderate exercise.  He said that vigorous exercise would not be good and Marshall should stick to walking on a treadmill and maybe some stretching exercises.  He also said that the bone strengthener injection he intends to give Marshall (Xgeva) is well tolerated but sometimes has a side effect of causing problems with teeth, so he wants Marshall to see the dentist before our visit at the end of July and get any dental work done that needs doing before that visit.   Interesting.

On the way home, we felt so good that we stopped at Pikes Peak Harley Davidson and spent a few hours looking at Harley trikes and pricing them.  Saw one we really liked...........

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