By-passing my November PSA test

Purgatory said...
thanks guys

edc - i have no plans to pursue HT if the SRT fails, the more I read, the more I don't like it, I dont think I would deal well with it,
and it would still be a stalling plan, not a cure, and more concerned ultimately about QOL issues.

I certainly understand your decision to pass on the November PSA test. In your shoes I would most likely do the same thing.

On the issue of HT you of course are free to accept or reject it. However, from my perspective the QOL issues with HT are much less negative than many people on this forum seem to understand. I have been on HT since August of 2009 and while there have been some problems so far they have all proven to be quite manageable and have not seriously impacted my own QOL. I have not gained any weight, cycle and work out at a local gym on a regular basis, and since I began HT have managed to make five trips abroad (to Mexico twice, and to Spain, Canada and China), each of two to three weeks duration. Loss of libido is perhaps the most significant issue for me, but frankly this seems less and less important to me with time. And my view on this is not unique as many of the folks who are on HT appear to share more or less my view.

No one has a proven recipe for success in the fight against PCa. As a Gleason 9 I am acutely aware of the fact that there is a very good chance that the PCa was not cured by treatment. On the other hand there appears to be good research that shows that HT in combination with other curative treatments does delay the recurrence of the cancer.

Clearly we are not going to live forever. But if HT can forestall growth of the cancer so that I die of something else then I am more than willing to pay the small price required. You say that you would not deal well with HT. But I think I would deal much worse with a slow death from metastatic bone cancer that might have been delayed by many years with HT.

Sancarlos

David:

I said "

Well, it may or may not be wise. But you have to decide that.

 "

You said:

": wise or not wise to whom? its a very personal decision, one that no one but myself can really entertain and answer."

I think we agree.

As I said, I am dealing with that too, perhaps to a lesser degree. (See my other post).

No argument from me.

By "wise or not wise," my thought process would be along the line of this: If the PSA is going down, then no sweat. But suppose it is going up (our biggest fear). If we put it off and it skyrockets, have we lost a window of opportunity to start on HT and get it under control? In other words, is starting HT later when it takes off significantly detrimental? I don't know if it is. Also, that's just one way to look at it. I'm sure you considered that. But then there is this overriding emotional toll of everything you've been through. At some point, one says enough. Also, if you have TRULY decided that no HT under any circumstances, then maybe it is all a moot point. What would you do if the PSA shot up? Are there other options? If not, then maybe you should reconsider HT. It would seem that a protracted death from late stage PC is worse than the side effects of HT.

Anyway, I was just thinking out loud. Please don't misinterpret anything and take it as a criticism of your decision. That would be most presumptious of me -- it is a very personal decision that only you can make.

I am dealing with these same issues and I'm only at the probably SRT level!

Mel

David, seems like a brilliant move to me.

Good on you!

Sheldon AKA Sleepless

David,

I agree with your decision 100%.   My wife and I had similar discussions after my BCR and treatment and we have decided to never schedule a PSA test from Oct thru Dec...  That is only a 3 month period,   no so important for critical decisions on most PCa issues (no all),  but a very important time period for family with the Thanksgiving and Christmas time periods...   Kind of nice to go thru those periods without having to worry about PSA or react to a result of a PSA test.

Between PCa and related depression issues,  we decided that too much quality family time was lost thru this time period which also intensified depression, when in actuality, it could have been postponed til January.  And by the time January rolls around,  spring is just around the corner...

It is an issue that some folks on this board might want to discuss with their partners and families.

David,  I pray that you continue on the positive path of healing and the improvement of your quality of life...

God Bless,  pasayten

David enjoy your vacation from this. I fully understand your wishes and frustrations. I can't blame you a bit for this decision. It certainly shows how individualized these decisions are. What might not make sense for one patient, can be very reasonable for another.

Enjoy your peace.

Tony

I would say you are making the right decision but it is yours to make. You are recovering from the major surgery and building your strength back. I couldn't tackle (or handle) what you've been through.

Good evening, purgatory.

I've just joined HW, though I've been on other groups for >6 years and, pity the poor members , a moderator of one.

I note your message about postponing your scheduled 11/10 PSA test and your concern about the result possibly interfering with your enjoyment of the approaching holidays.

We are individuals who react differently to situations, and I cannot criticize your decision even though I cannot endorse it. For myself.

My med onc has told me that I "do not do well, not knowing." She's right. I must know the facts, all the facts. Then, whatever they are, I deal with them.

I learned long ago, due to the circumstances of my childhood, to compartmentalize my concerns. IOW, to mull over medical matters, then return them to the file drawer and mull over something else until it's time to send it back to file and think about another topic. I cannot claim that it would work for others, but if so I believe that it's is a vital means of coping.

Hi David.

I have received and thank you for your reply.

I do not wish to be considered as critical of anyone's decision. We, each of us, have much to consider when deciding how to proceed, and IMO none of us should criticize another's life choice.

Yes, I have prostate cancer.

Dx in 2004 at age 67. Gleason 9 in 5 of 6 specimens one side. Gleason 8 in other side, missed in this Bx.

First tx = cryosurgery. Failed due to clumsiness of uro.

Second tx = IMRT + LHRH agonist Lupron.

Fired rad onc, who refused to review assessment of my case by a well-respected med onc.

Hired med onc. She cares.

Present: PSA = 0.12. T= essentially undetectable.

Current tx: Trelstar q 28d. Avodart 0.5 mg qd. Casodex (gen. bicalutimide) 50 mg qd.

I agree with you on the PSA, at this point you need a break from it - a break of a few months is likely not going to make any difference. Your wife sounds like a very wise lady.

Enjoy the holidays David, and gain the weight you've lost!
Also get back on the bike in the shed sometime in th next few months.
Enjoy the absence of bladder spasms too.

Smiles,
An

There are means of coping with the side effects of ADT, and I take it unkindly that some medics either don't know or don't care.

Here are links to two excellent articles on the site of the Prostate Cancer Research Institute:

http://www.prostate-cancer.org/education/andind/Guess_TestosteroneSideEffects.html
or
http://tinyurl.com/2ymb8f

http://www.prostate-cancer.org/education/sidefx/Strum_ADS.html
or
http://tinyurl.com/g6fzp

join away, willie, sometimes, you have to say enough is enough