December and January were spent doing furious chemotherapy. That meant going from my low dose once a month back to the old routine of one low dose every week for three weeks with a week off before starting again. Even so, the updated chart of PSA (click on the thumbnail in the post under Recent progress) seems to belie the almost certain progress we’ve made since late November. The post-Thanksgiving CT scan and my newly found walking strength (see below) provide clear evidence that my malignant retroperitoneal nodules are really shrinking. The new drugs we described last time have been postponed, at least in part because the malignant nodules have shrunk to the point where they are now too difficult to safely biopsy. We’re going to take advantage of a break in the action to spend the rest of winter in the land of liquid sunshine!
Lower back pain link to malignant retroperitoneal nodules
Our suspicions about this link have grown stronger since the late November post. In late October I started pushing my walker for greater distances – two loops in the neighborhood, then three, etc. The pleasant temperatures we enjoyed in November and December made such walks easy. By mid-December I noticed that my lower back muscles were getting a bit stronger, and my walking was limited only by fatigue. By Christmas-time I was pushing the walker for a mile round trip. Now, with temperatures rarely as high as 50, I’m up for just a half-mile on a calm day. I haven’t yet tried that trip with just my hiking sticks for balance, but that’s coming soon – maybe when we get to California next week after the SuperBowl.
Halfway point in my 1 mile loop.
Heidi and her birthday flowers. She enjoyed her first birthday omelet in three years!
The updated chart of PSA (click on the thumbnail below) seems to belie the almost certain progress we’ve made since late November. The post-Thanksgiving CT scan and my newly found walking strength is clear evidence that my malignant retroperitoneal nodules are really shrinking .
The chief’s original plan
In late November, at the time of our last post, it appeared my PSA was again increasing rapidly. At the chief’s suggestion, we had planned to switch from Taxotere to Jevtana chemotherapy, as well as perform another biopsy of cancerous tissue in these nodules. It was hoped that Jevtana would turn quickly around the PSA. And, another genetic analysis of the cancer tissue would indicate whether a new drug, Olaparib, could deliver major damage to my remaining cancer cells. We were soon surprised.
First, the local radiologist studying the images from the November 27th CT scan concluded that the retroperitoneal nodules had shrunk too much to safely permit another biopsy in this part of my abdomen so close to a major aorta and my spine. That, of course, we welcomed as good news. But, it also meant that checking the potential effectiveness of the new drug, Olaparib, would have to be determined differently. Next, as noted in the late November post, our local oncologist expressed reservations about switching to Jevtana so quickly. So, I did go back on low-dose chemo on December 7th for the first series of three infusions. To my delight my body did manage to tolerate the old routine very well. We completed the second (and last) series on January 27. The success of this plan B is still somewhat in doubt, as shown on the chart.
Lower back pain link to malignant retroperitoneal nodules
Our suspicions about this link have grown stronger since the late November post.
Looking back at my day-planner I realized that I started pushing my walker for greater distances in late October. The pleasant temperatures we enjoyed in November and December made such walks easy. By mid-December I noticed that my lower back muscles were getting a bit stronger, and my walking was limited only by fatigue. By Christmas-time I was pushing the walker for a mile round trip. Now, with temperatures rarely as high as 50, I’m up for just a half-mile. I haven’t yet tried that trip with just my hiking sticks for balance, but that’s coming soon – maybe when we get to California next week after the SuperBowl.
If all my bone mets are indeed “dormant”, and the Taxotere is chasing down the shrinking nodules, it seems my PSA should really start to fade. Again I hear my ever-present refrain: “the next few months’ blood tests should be very interesting.”
My blood test numbers have been confusing these past two months. (For details please see the chart under Recent Progress.) Fortunately, we already had a long-standing appointment with the chief scheduled for Wednesday, November 18. He recommended a return to a regular chemotherapy infusion schedule to get control of my PSA once again. The chief also suggested we move on to Jevtana, a successor drug to Taxotere. My local oncologist suggested we first return to our tried and true Taxotere routine for a month or two because of his concern for the more severe side effects of Jevtana.
So, on December 7th, I’ll start the first of another series of three weekly infusions of Taxotere. If that proves effective, we’ll go for another series in January. If not, we’ll switch to Jevtana and begin working up to a full dose every three weeks. We continue to look for a tolerable, effective drug regimen. Until recently there was little question about my body’s ability to tolerate the regimen; with the accumulated impact of 11 years of treatment, that has now changed.
Looking beyond Jevtana the chief described some new drugs that are better targeted at cancer cells than Taxotere or Jevtana chemotherapy. He prescribed another biopsy of my malignant lymph nodes to look for the markers that indicate whether or not the new drugs are likely to be effective. We expect to have the biopsy done in December and learn the results of the genetic analysis of the samples sometime in January.
Strength, Energy & Stamina (SE&S)
In spite of my climbing PSA, we have recently realized that I seem to be making progress – however slight – in the SE&S dept. After so many months of feeling like I was “just physically making it” through each day, it has been a welcome emotional lift to be conscious of a sense of improved well-being. On days that are not too cold or too windy I have taken my walker out and made four trips around the loop in front of our house. That’s a distance of about ½ mile. These walks seem to get easier and more comfortable every time I go out. While I now have motivation to get outside and walk, wind and cold seem to take a lot out of me. Fortunately, we’ve had a mild fall. I’m looking for ways to cope with mid-Atlantic winter.
We do hope to escape to California this winter. Since we will be renting a place to stay this winter, we have decided to wait until the week after the Superbowl.
At left, Paula & Emily (15 mos.) at her baptism in the Phillipines this past fall.
At right, Bob & Heidi making gravy on Thanksgiving Day.