The “Spring-time challenge” I anticipated in my last post (January 2015) is coming about differently. To our surprise my PSA flirted with 4 ng/ml (a five year low) all winter long. (Click on thumbnail of chart at left.) It shows, I believe, that Xtandi alone is still effective for me, at least for several months at a time. Nearing the end of May, I have been off chemo for close to five months. In the meantime I have regained only a small amount of the strength, energy and stamina (SE&S) that I expected to achieve in the California sunshine. I believe I need much more SE&S to continue the fight. Further, the chief now thinks that the side effects of the new drugs identified by the genetic analysis of my lymph node tumors may be too much for my battered body.
So, Plan A is to return to low-dose chemotherapy (LDC) with Taxotere while continuing Xtandi and Lupron. This time, however, I will receive LDC only in monthly doses – each the size of a regular weekly dose – as opposed to 3 weekly doses and 1 week off. The best known side effects of Xtandi are fatigue and diarrhea; we have learned to cope with them. And, I believe I can handle the impact of monthly Taxotere on top of that. If so, the chief thinks my near-term prognosis is good.
Lower back stenosis
It seems the only known way to combat severe loss of SE&S is to exercise. I think I have lost too much upper body muscle tissue to gain much there. But, my lower body seems in better shape. If I could walk again without pain, perhaps I could promote a better appetite, gain some weight and experience a return of SE&S. So, we are making another run at the possibility of “minimally-invasive lower back surgery” to correct the stenosis at the bottom of my lumbar spine. I made it through another MRI of my spine on Thursday. That data should set up GO/NO GO evaluations from a neurologist and orthopedic surgeon in the next month.
In the meantime, we have been enjoying visits from family and friends. If all goes well, we hope to visit our Bay View friends in northern Michigan for parts of July and August. We wish youall an active and fun-filled summer. Love, Heidi and Bob
My cancer behaved itself all winter long. For this we are most grateful. But, now that my PSA appears to be inching up again, the chief suggested last Wednesday that we add monthly low-dose Taxotere chemo to the Xtandi pills I have been taking all winter. Surrounded now by the pleasant springtime, we are also going to get another evaluation of my body’s ability to cope with “minimally-invasive surgery” to correct the stenosis in lumbar spine. This, on top of the return to low-dose chemo infusions combined with Xtandi and continued Lupron. My goal is to be able to walk again without pain while keeping the cancer under control. I think that all the benefits of walking again are needed to keep up that fight.
On the lighter side we were able to enjoy three visits this past winter from my granddaughter, Emily, and her parents, Paula and Todd. It certainly made the flight to California worthwhile to see this happy baby – the first in the next generation of the Whitesel clan. If all goes well we hope to spend at least a few weeks at the cottage in Bay View, Michigan. Grammy and Grandad are still doing OK, as attested by the photos below. On this Memorial Day weekend, a beautiful day in northern Virginia, we wish youall an active and fun-filled summer. Love, Heidi and Bob
Heidi and Bob on Mother’s Day 2015
Bob and Emily – March 2015
All of the emotional trauma of last Fall has subsided. Thanks to reassurance from the chief, I find myself much less fearful. We were able to enjoy good times at Thanksgiving and Christmas with family.
Results from the genetic analysis of the biopsy samples are back. These offer renewed hope, but also point to more challenges on our path to “durable remission”. The chart (click on thumbnail below) shows continued decline of my PSA. I expect the CT scan scheduled for January 12th will show continued shrinkage of the lymph node metastases.
I feel I need a break from this most recent chemotherapy regimen, and the chief agrees. I have gone back into physical therapy so that I can regain the strength to climb the stairs in our California townhouse. We are headed back to California at the end of the month, hopefully for the rest of the winter. While we’re there, I may need one or more “maintenance” doses of chemotherapy. In the meantime the chief promises to devise a new treatment regimen from the results of the genetic analysis. It will almost certainly mean more chemotherapy with Taxotere. The plan is to start the new regimen when more pleasant weather returns to the mid-Atlantic.
Heidi and Bob with grandchildren, Alexis, Luke, and Kate Ashton, Chrismas 2014