Tuesday 12 November 2013

Some Thinking Needed


The oncology appointment has come and gone. I was told the result of the latest PSA blood test and the full-body, bone X-Ray.

I'm beginning to wonder if there's any point in submitting myself to these tests. I say that not to dismiss the efforts of the health professionals but to say that the results were no surprise to me. I anticipated the results. I'm not clairvoyant, it's just that I'm aware of what's going on because I'm being told by my body.

So I was told that my latest PSA is now 114. That the hormone suppressor is no longer as effective as it once was is not news to me. It's documented that it has time-limited efficacy and I anticipated that. What's not known is how long, in each individual case, it will be before the body overcomes the artificial blocking of testosterone production.

I had about nine months of relief and I'm grateful for it. It would have been nice had it lasted longer but let's not be greedy. To recap, my PSA scores have gone from 55 to 1.75, then to 77 and now 114.

The additional daily treatment of 50mg Bicalutamide hasn't achieved anything so I've been told to desist taking the tablet. Sod's Law! I'd just renewed my prescription (I wonder if they'll sell on ebay?).

I still have to submit to the three monthly injections. They may still be doing something other than inducing the deeply annoying side-effects. My PSA score might be higher and climbing faster without them.

The X-Ray has confirmed what I know; Charlie has spread his tentacles to a hip, a femur and my pelvis. The latter is in the region of my coccyx and is the most noticeable or persistent source of discomfort.

Apparently the X-Ray isn't terribly clear when it comes to my femur and it was suggested that I have another X-Ray of the affected bone to see the extent better. It was explained that if it's severe it could cause a fracture. If that's the case the proposed route is surgery to insert a strengthening rod into the bone.

The offer was to go there and then for the X-Ray. I declined. I think there's an element of "belt & braces" in this suggestion. The femur isn't causing me much discomfort (at present) so I think it's unlikely that it's any more of a fracture risk than falling off a motorcycle is. I'm also reticent about such an invasive procedure when I'm already in what may be termed a less than tip-top condition. That's bound to adversely affect recovery from surgery.

The other offer is a course of Chemotherapy. It was expressed that Chemo might stunt Charlie's growth and this in turn may extend my life. I did sign the necessary permission and release forms there and then. This I did so that if it is borne upon me that this is a good course I can relatively quickly begin the procedure but my first reaction is to decline Chemotherapy.

So that's the reason for the title of this entry.

I have some information to hand. Had I committed to Chemotherapy there and then it would begin in December. I'd be prescribed (more) steroids to be taken before each session. The sessions themselves would be administered in hospital, last about one hour and Docetaxel (Taxotere®) given via a drip.

I have a list of the likely side-effects. None (bar even more weight gain) really bother me specifically. What does is the fact that the treatment itself reduces quality of life for some speculative improvement at some undefined and tenuous period in the future. Do I submit to months of feeling even worse than I do at present and wager those months against a putative improvement? Those who know me well will know that I'm not much of a gambler. My instinct is that there are too many variables to take a punt. There are certain things that I want to be in a fit enough state to do in the next few months, I want to be able to welcome the next family member into the world for one thing and I have a project to finish.

I need to think.