Friday, March 1, 2013

Today's visit to oncologist

First thing on arrival at the hospital, Marshall was sent to radiology for x-rays of the left and right femur to try to see if anything has changed that would cause the leg pain he's been having. We won't get those results until over the weekend or on Monday.

Then blood was drawn to see where the PSA stands today. Before we could talk about the clinical study for GTX-758 (an estrogen treatment), the PSA needed to be rising. If it went down, he would not be eligible for the clinical study and we would have to go a different direction. Well, the PSA was 31.06 ... almost tripled in six weeks. Kind of a downer, but on the plus side, it definitely makes him eligible to apply for the clinical study. (Note: today's tests showed that the testosterone level, which is the hormone that feeds the prostate cancer, has gone down to less than 20ng/dL. I just did some quick research and learned that the castration level of testosterone -- which is what they are shooting for in prostate cancer treatment -- is right at 20 or below, so to me that is progress.)

But also, in order for Marshall to be eligible for the clinical study, he needed to meet certain criteria, one of which was a BMI of 35 or lower. We knew it was going to be close. When he got weighed when we arrived, they calculated his BMI at 35.1. Bummer.

But we had a really cool nurse and she asked Marshall if he wanted to try again with all his clothing and jewelry off and, of course, he did. So he stripped down, removed all jewelry, put a hospital gown on and went to the scale again and woo-hoo, the BMI worked out to 34.7! So that hurdle was conquered.

They went over the initial paperwork with him and he signed all the consent forms. They took DNA swabs (not sure what that was for but she said they had to sign a release saying they would not send any results to the paternity database!), they took a urine sample, and then they took a bunch of blood. The bloodwork was to assess his propensity to possibly have blood clots. They will get the results of these tests back in the next week or two and then he will be contacted to see if he has been accepted into the study. I know Marshall is going to worry himself silly these next two weeks constantly thinking about a rising PSA, but hopefully he'll also think of the lowered testosterone.

Our oncologist says that he thinks this GTX is going to be the treatment of the future for prostate cancer patients. The initial studies have shown that there are very few side effects and the results have been extremely promising. Marshall suffers from extreme hot flashes now and the GTX takes away the hot flashes. The GTX also strengthens the bones.

So now we wait. One of the things I love about the clinical trial is that Marshall and the other participants will be monitored very closely (way closer than he is being monitored now) and to me that is very comforting.

In the meantime, over the past several weeks Marshall has slowly but surely come up with a painkiller regimen that has been working rather well. In the morning he takes an anti-nausea pill. Then when he feels the slightest onset of leg pain he takes two oxycodone along with four Senokot laxative pills and 30 minutes later he takes 3 Advil. Last night we even went out to dinner (thank you, Donna & Russ!).

We are all settled in a hotel room now for tonight. He's going to visit with his nephew this evening and I'm going to kick back and read a book on my new Kindle (I want to see what all the Kindle fuss is about.)

Stay tuned for updates.
PS: We asked Dr. Flaig about whether the leg pain could be caused by the Xgeva injections and whether switching to an alternative bone strengthener (like Zometa, given by IV) might relieve that situation. He said that every man is different and it is possible but that the toxicity of the Zometa is dangerous and his advice would be to stay on Xgeva. So that's what Marshall will do.


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