Regression!

PET-scan-sagittal-2018-08-28
A Slice of Me from Last Week’s PET Scan

In Brief: I saw my medical oncologist, “Dr. Knox”, today. He was very happy with the results of my PET scan last week.  He says it shows the cancer in my bones has reduced in extent and activity. My prostate looks practically healthy. And the cancer hasn’t spread to soft tissue. My primary treatment of Keytruda and hormone therapies will therefore continue. We are thankful.

You may remember from my last update the stated intention of my oncologist, Dr. Knox, to scan me just once a year. When I saw him two weeks ago, I complained of lower back pain, hip pain and leg pain. These are symptoms I’ve had before when my PSA has risen as it has been doing.

Before sending me to the radiation oncologist to see if any tumors in my spine need zapping, Dr. Knox wanted to do another CT scan to make sure there was no “organ involvement’, i.e., that my cancer hasn’t spread to lungs, liver, or other soft tissue. I asked whether I could have a PET scan instead. I’ve heard PET scans are much more sensitive than regular CT scans. He said he would try but that insurance only approved PET scans about 50% of the time.

My PET scan went forward last week. I asked for a disc with the scan images, but I couldn’t make any sense out of what I was looking at. The next day I picked up the radiology report, and the way I read it, my cancer isn’t spreading. But today Dr. Knox explained some of the language from the report. The report is even better than I’d imagined: some bone mets are healing, there aren’t new ones, and my prostate looks “normal.” Elation!

In other good news, my PSA from two weeks ago went down from 24.2 to 21.9. Mostly my PSA has been increasing for the past year and a half, with these occasional dips. I asked Dr. Knox whether my cancer is progressing. The PET scan would indicate not, but the generally rising PSA…? He said the PSA alone is insufficient evidence of progression, so his assessment is that my cancer is NOT progressing.  I asked whether he attributed this regression to the Keytruda immunotherapy, the Xtandi hormone therapy, or to luck. He said to luck. I said I had lots of people praying for me. Thank you!

Dr. Knox gave me some hydrocodone to help with the aforementioned pain. I stopped taking it after two days because the pain was minor enough that ice packs and Tylenol could handle it. Also, I started taking CBD oil (a non-psychoactive extract from the hemp plant). I could be mistaken, but it seems the CBD oil has both erased the pain and made my GI issues improve. I’ve been able to reduce my steroids.

My other side effects–the fatigue and cognitive issues that led to my being on disability–are all still very much in evidence. I have to rest once or twice a day, sometimes napping. I can’t plan more than one or two things per day. I do have the occasional good day when I can power through the day without rests and discouragement. Other days I can’t do much of anything. But…I am alive and can still walk two miles. Yesterday, I took Gibbie on a 2.25-mile walk, his first walk longer than 1.3 miles. He gave me some questioning glances toward the end, but he made it.

I’m excited about an upcoming trip Holden Beach, NC. Liz’s siblings, sister-in-law Teresa, and our son Brian are coming too. We are all flying, so that should make it much easier on us. I like it when I have something on my calendar to look forward to.