wow - i guess this thread hit a nerve. Thanks to everyone for the feedback . I was off line yesterday meeting with the oncologist as to next steps. I also learned a few things along the way. Lesson 1 - Don't jump the gun. When I got the lab report on tuesday, I was immediately in the mode of 'this is the end". After meeting with my oncologist, I see that I was too hasty. I may very well be here of a while yet. Its tough not to react the way I did when you get the news, so Im cutting myself a break.
Here is the synoposis of my visit with Petrylak: I was surprised that he said I was Not refractory. The new tumors are simply differentiated. My PSA is still zero. No HT break, stay on continuous (degaralex and casodex)and repeat the nuclear bone scan in 6 months. If tumors progress, then provenge is likely, although Xtandi or Xytiga is still a possibility before provenge. however, since it appears that I have tumor growth with a PSA of zero, provenge is the more likely option.
As to survivability - Petrylak is very much in the mode that recurrent PC is a race against time. 5 years ago, there was no provenge, no Xtandi, no Xtiga. 5 years from now, who knows. So, his advise to me was, live your life. take the new job if you want it, no point in sitting on the beach waiting to die. Sit on the beach if you want to sit on the beach, but not because you think you have only 4.8 years left (as the recurrent PC vets know, the 5.8 years survivability for HT patients was the outcome of the recent intermittent vs. continuous PC study) .
As to the hot flashes, I asked for the estrogen patch, but he was reluctant. he said there is a small risk that the PC will react to the estrogen, so instead he would rather I try to increase my consumption of Soy, reduce sugar and fats first. He noted that a very famous former NY city mayor patient of his also related the story of sweating in front of clients, so Im not alone. All my clients know about my situation, and they are great about not making it an issue. Its really new potential clients I worry about, and of course, worrying about it brings on the hot flash, catch 22
I have decided not offer up my current condition to my prospective employer. I simply do not think its relevant to my ability to do my job. I will not hide my PC, and if and when I'm hired I'm sure the subject will come up. Of course, I need to do my homework before taking the job. Its not so much the health plan I'm worrying about (the affordable care act did away with restrictions on pre-existing conditions), its the company sponsored life insurance. I currently have a great policy that would provide for my family if indeed I am in the 4.8 years bucket. I need to see if i can keep that policy after i leave my job by paying the premium myself.
Thanks again for the feedback