Sunday 27 February 2011

Continuing treatment and ongoing assessment

It's been a while since my last post and I am now into the monitoring phase. Since completion of the radiotherapy I have received two more hormone injections (next one due in March). Latest blood test shows less than 0.1 on the PSA blood test which shows the combined treatment is working at the moment. New phrases have now come to the fore like "time to nadir" - nadir being the lowest measure of PSA reached. This is very relevant because with my stage of cancer with lymph node involvement the disease is not considered to be curable but can be slowed down for a time. Eventually the remaining cancer cells develop their own way of making testosterone and at that point the disease has become "hormone refractory" or "castration resistant"
This is deemed to have occurred when PSA shows two consecutive rises or has doubled from its nadir. I will be monitored for PSA every few months to see when this happens and that will then indicate the disease has progressed to its final stage. There is an assumption,based on my PSA, tumour grade and Gleason score (see previous posts) that there will be micro metastases (currently undetectable by scans) that will be present in areas outside the pelvic region and therefore not treated by the radiotherapy. It is these that are being held in check by the hormone treatment. Bad news is that this is only effective on average for 18 months to 2 years.
I have been spending a lot of time on the internet lately trying to work out a prognosis. For my level of disease (T3bN1M0) it will most likely be less than 10 years,possibly 7 but in reality no one can tell you for certain. Keeping up the dairy free and just embarked on a drive to loose 4 stone. My mind will not allow me to think about anything sexual for more than 2 seconds which is a good job I guess LOL

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