Friday, February 19, 2016

Back In The Swing Of Things

I'm growing impatient waiting for the radiation treatments to begin.

Today marks 3-weeks since I got my shot of Lupron, and my testosterone level should be near zero for the remainder of 4 months. I'll be re-dosed at that time, and I currently expect the hormone treatment to continue for at least a few years.

So far, so good! Side effects are slight enough that I'm not even sure I'm feeling any.

I've got my exercise mojo back now, and that feels good. I didn't have any real trouble running, and I'm back up to doing a 5-mile run in just over 45 minutes. I'll push the pace a little further, but I'm happy with where I'm at. I also have been back in the pool, and it took no time at all to get my wind back. For my YMCA Survivor challenge the past two weeks I've done a single 5-mile run paired with two 2000-yard swims (netting a whopping 550 Survivor points for the week).

I've also returned to Tae Kwon Do, which I'm currently doing 3 nights per week, 2 of those teaching, and 1 as a student. I'm back up to about 4.5 hours per week of Tae Kwon Do. Throw in a few dog walks with TKD and the above, and I'm back to between 7 and 10 hours per week of activity, burning 4K to 5K Calories. If I can maintain this level of exercise throughout the hormone treatment and the radiation treatments coming in April and May, then I should be able to minimize any side effects.

On Monday I'll meet the medical oncologist to see what he can tell me about my condition and my treatments. I'm not quite sure what to expect from him, but I'm looking forward to learning something new.

Little enough is going on now in my fight against PC that I'm growing impatient waiting for the radiation treatments to begin. I feel like I'm ready, but I have another 6 weeks to wait. All for the good, though, because the family will gather for Easter at the end of March, and radiation therapy will begin the following week.

Monday, February 1, 2016

Angst And Hormones

I can be a bit grumpy.  I'm full of angst, and hormones.

-- Nicholas Hoult (1989-), English actor, interview in The Mirror, 2 February 2012



I find myself dosed with hormones, but not so full of angst.

On Friday 29 January I travelled to Northwestern to see my surgeon, Dr William Catalona, for my post-surgery follow-up. It turned out to be a hectic day as I spent 3 hours there. I signed up for all of Dr Catalona's research studies and I had 3 vials of blood drawn. This included a PSA test (just 2 days since my last check), and the result came back as 0.03ng/mL -- welcome confirmation that my PSA is "undetectable", well below the 0.10 threshold.

A big part of the appointment was ensuring that I have recovered well from my surgery (I have). I'm now cleared to resume activities that I'm comfortable with. I'll get back into running and swimming forthwith, and will work my way back into Tae Kwon Do.

Another part was introducing me to the direct-injection treatment that is meant to relieve the ED side effects of the surgery. That part went as well as could be expected. I'll continue this treatment at home 2 to 3 times per week for the next 18 months, or until it is no longer necessary.

But for me the most important part of the appointment was discussing my on-going treatment, and getting started on Hormone Therapy (HT). In this case, the HT is Androgen Deprivation Therapy (ADT). It starts with a 30mg shot of Lupron, which is meant to shut down my body's production of testosterone for 4 months. This treatment will be repeated to maintain the ADT for at least a few years.

Lupron, when it first kicks in, actually causes a "testosterone flare", a spike in testosterone production. Over a period of about a week the flare subsides to pre-treatment levels; at three weeks after treatment my testosterone level should drop to near zero. To counteract the flare, I'm spending 10 days taking Casodex (bicalutamide), which blocks the uptake of testosterone.

I've been concerned about the side effects of ADT. Right now I'm at the peak of the "flare" period, so it's too early to tell. But I'm optimistic that side effects will be minimal. I understand that exercise is the best way to counter these effects. I'm signed up for this year's YMCA Survivor "get-in-shape" program, and this is the second week. After work today I'll go for a 3-mile (or thereabouts) run on a treadmill. I hope to work my way back up to the 5-mile runs I did 3 times per week when I was preparing for the 2014 Illinois Half Marathon. My near-term goal is a 5K run in May; longer term, I'm shooting for my first marathon in Spring 2017.