Monday Marshall went to see his VA doctor (in order to stay in the VA system, you need to see your doctor at least once a year). We didn't expect much, but ended up getting the VA to pay for Marshall's Spiriva prescription. That was a biggie. The Spiriva costs $250 a month and insurance will only pay $150 so our co-pay was $100 a month. Thank you, Dr. González.
Dr. González also mentioned that new studies are showing that Metformin (a diabetes drug that Marshall is taking) depletes Vitamin B12, so he ordered lab work to check the B12 levels.
This morning we stopped at the VA to get blood drawn for the lab work. They will mail the results to us. Then we headed up to the Cancer Center.
Blood was drawn (from the other arm!) at noon for the regular lab work. Then we had our appointment with the Nurse Practitioner (NP) at 1:00. All of the results were in the normal range which is good. But the PSA went up to 9.4 (from 7.4 last month).
It is always disappointing to see the PSA go up, but it was not a huge jump. The NP stressed to us -- again -- that we should not put so much stock in the PSA but should concentrate on how Marshall feels. So since Marshall has no pain, that trumps the PSA. Yeah, right. Very hard to keep that in mind.
Anyway, they have ordered a full set of scans again, which are scheduled for August 12, 13 and 14 and they will compare those scans with the ones taken in June. They will also do another PSA test in August.
We talked a bit about the next round of treatments that could be in store for Marshall. The first one, Xtandi, was the one that mentioned a slight slight chance of seizure. The NP says that they have determined that the seizures can be avoided by simply taking the Xtandi at the exact same time every day. The seizures occurred in men who took two doses of Xtandi too close together. However, there are still a few men who experience falls while taking Xtandi. Bottom line: she saw no reason why Marshall would have to give up driving if he is put on Xtandi. That was excellent news!
Then there's Xofigo, and if I understood correctly, that is an injection of a radioactive drug that targets the tumors in the bones without affecting surrounding organs. The NP says the Xofigo is having great results. Then there is chemo -- a drug called docetaxel. So we have a lot to think about.
Marshall stayed very positive during all of this and is still doing well here at home. I was so happy to see that.
So now we wait another month....