We got to the hotel late Monday afternoon and had a pretty relaxing night.
Tuesday morning we got to the hospital at 9:30 to start the day of scans. It took a long time for them to get the IV in his arm in order to inject the radioactive isotope for the bone scan. So he had to be taken to what he called the "vampires" -- the nurses who had a machine to find a good vein. So that delayed things a bit.
Then he drank the contrast liquid for the CT scan. He finished the actual CT scan around 10:30 and he finished the bone scan around 1:30.
Wednesday morning we were at the VA Audiology Department to get his hearing aides checked. They needed to be sent off to be repaired so he will get them back in several weeks.
Wednesday afternoon we were back at the dentist for more adjustments to the dentures. They don't stay in good and they still cause a little pain around the one bone (although much less pain than the prior dentures). Dr. Dhawan did more adjusting and said if these adjustments don't do the trick, he may have to start over. He is a pretty awesome dentist.
Thursday morning we went to the lab for blood draw and then at 1:00 we met with the oncologist. The PSA is now 11.23 (went up from 9.4). All the other blood work was in normal ranges.
With regard to the scans, he said that the scans that were done on Tuesday showed very little change from the ones done in June. So he feels that the cancer is progressing but is progressing very slowly. We told him we have two trips planned in September so he said that we should continue with the present treatment until after we return in early October. We will touch base one more time before the trip -- on September 15 (for blood work) -- and then when we get back in October we will do all the scans one more time and then most likely start chemotherapy.
He said that we will start out with one session of chemotherapy (docetaxel) and then do all the tests and scans again to see if the chemo was working. If it is working there will be at least two more sessions. He told us that with some patients, once they have finished three rounds of chemo, their system gets kind of "reset" and they can go back to the Zytiga cancer pills and they will work again. That would be awesome.
So the bottom line is that we will stay status quo until the end of October. Marshall was depressed today but is coming out of it. He's not in any pain, just the ever-present fatigue and hot flashes.
Dr. Flaig reiterated his opinion that there are three "tests" to consider before getting too worried: (1) is there any pain; (2) what are the scan results; and (3) PSA -- in that order. So he puts the PSA last. As long as there is no pain and the scans show little or no change, then he does not get overly concerned about a rising PSA.
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