Varmint hunting

​Greetings friends and family.
 
I guess this is becoming sort of a yearly publication, but it’s also true that this is a time when I have more doctoring activities and updates and some newsie items. It’s also, obviously, a change of season from darkness-er to lightness-er as we welcome another Summer.
 
So, for those of you who are interested (or, as Dave Letterman used to say “For those of you scoring at home”) here is a run down of my health updates…and a few little nuggets about my intervening activities in the last 12 months.
 
The back: 
Is holding together as planned (promised) and I’m not having any pain or discomfort…when I’m not doing anything.  Because I have not been on-task as much as I should be with general exercise, PT activities from my large file of same, and sufficient attention to keeping healthy eating habits, the back (muscles) get sore/stiff/out-of-sorts *when I do something that involves them* (the back muscles.)  I have good intentions to get this (and the rest of me) back into better shape in the coming months.
 
The cancer:
The best way to be clear about what’s happening now, is to start back at this time last year, Spring of 2024....
 --Because my PSA score had begun to rise in a notable (although not alarming) way, I went on “Xtandi” which is a stronger add-on drug to hormonally suppress more/harder/further activities related to the prostate and things like any remnant testosterone that might be feeding the beast.  On one hand, this worked well as my PSA score went down to 0.00 immediately. On the other hand, (and partly because I started on a pretty heavy dose) I had quite a lot of ‘toleration’ problems and unpleasant side effects.  After a couple of months I went back off Xtandi, at which time Dr H oncologist and I talked about taking a hiatus, seeing what happened, and then, perhaps, going back on it with a smaller dose.  Reminder that through this (and from day one of my treatment in 2020) I continue to get injections of Lupron, a hormone (testosterone) suppressant. As another reminder, testosterone is the main/big feeder of prostate cancer and related abnormalities.
--Last Spring (’24) my yearly pet scan showed a couple “suspicious” (but not definitive) activity spots on my bones that might or might not have been some small-scale metastatic shenanigans.  Also noted at that time was some moderately problematic negative activities in the prostate gland itself (possibly increase of cancer in the poor little devil.) Pin in this last bit in re: items below.
--Moving forward into Fall ’24, my PSA score stayed low/inconsequential for a few months after ditching the Xtandi.
--With the dawning of 2025, however, the PSA score began to move up:  February—0.21; April--0.53. As previously noted, if you’re not scoring whole numbers (1.00 and up) you’re not in terrible shape, but this kind of quick upticks and “doubling” the score are attention getting with patients in my situation.
--Time for my Spring PET scan. April ‘25
--Results were…  To the Good:  “no metastatic activity” (nothing happening in the bones, all known sites remaining dormant.)  Yay!  To the less-good-but-not-terrible: more problematic activity in the prostate gland itself like reported in ’24 scan.  Boo.
--Dr. H oncologist comes to the post-pet-scan appointment (April ’25) with a new idea. Rather than restart the Xtandi on lower dose or something similar, and partly because all these drugs (currently) wear out their efficacy over time, she floats the notion of *radiation* of the prostate gland.  I have not previously had radiation (2020 involved chemo only.)  In layperson’s terms, blasting the devious little F-er now will likely kill the ‘activity’ and also degrade potential for PSA pumping of any consequence. At least for a while.
--So, here’s what is about to commence.  Ann and I are leaving for Florida tomorrow (5/3/25)—hooray! When I get back on the 12th, I will immediately start radiation treatments on the 13th.  The protocol will be for a four week journey (20 sessions) every day Monday through Friday. I had a prep appointment a couple days ago to get the machine calibrated, “targeted”, and help them formulate the plan for the “live ordnance firing.”
--Once we get the system sorted and rolling, these appointments are expected to take about 5 to 10 minutes: lay down, assume the position, set the ‘weapon’ sites and FIRE AWAY!
--I’m told there may be some minor side FX, perhaps in the last weeks or so. Obviously, this schedule will put a little crimp on potential summer shenanigans that involve traveling, etc., until mid-June. On the other hand, it is, as I often say, “better than the alternative” to be able to (in Dr H’s words) "kick this can quite a way down the road" before we have to look at other drugs or protocols.  My more direct Midwest farm life metaphor (and probably also front of mind because I’ve been touring around this Spring with TheatreMidwest’s production of The Gun Show) is, “If you’ve got problematic varmints living in your barn or basement, sometimes you just have to shoot-to-kill the pesky MFers.”
 
Did you follow all that?  Here’s the exec summary:  everything is pretty good, there’s some activity in the P-Gland that’s problematic, we’re going hunting for 20 straight days and gonna shoot the little bastard every day.  Expected result?  PSA back down to 0-ish, no action in the bones, steady-on.
 
Thank you so much for your support, your check-ins, your good wishes and vibes and all the variations of love.  “No news” will continue to be “good news”, but I will share updates if anything notable happens.
 
Also, quick reminder: if you want to talk about or ask more questions about anything related to this stuff, let’s do it.  In-person? Vid-chat? Email? Text? And you can ask me anything.  The only operational limit is:  *we’re not doing any of these things on the social medias.* 
 
All the best for a great and fun summer, my dear squad!
TW