My Cancer Update

I went to see my urologist in Pueblo Wednesday. This Firmagon injection was only 80 mg; last month I got 2 120s.

This is the whole thing that the nurse laid out for the doctor.

I was surprised to see this was a powder. The vertical line is a reflection of the fluorescent light on the ceiling.

He squirted sterile saline into the vial and mixed it before he sucked the mixture back into the syringe. Then put it into my belly. I tried to take a picture of him injecting but my big belly got in the way! He is good; it was painless.

Then the nurse took a blood sample for a PSA analysis.

The doctor called me this afternoon and “fired” me as a cancer patient. He will continue as my urologist but wants me to find an oncologist. Because my PSA was 40!! Much higher in only two months from the 12.6 in December. I don’t blame him for bailing!

My GP said he knew an oncologist who practices at the Heart of the Rockies Hospital in Salida. So I called his office to get referred to the oncologist. I hope he is taking patients; he is supposed to be retired!

Sometimes this adventure takes me unexpected places.

My Urologist Visit

On Jan 11, I went to see my Urologist in Pueblo. A took him the copy of the CD of my CATScan in the ER. Donna went with but was tired so she slept in the Escape while I had fun.

I got my shots of Firmagon, which were painless. So I have two lumps on my belly (my depots) which became tender to pressure and itch. The doctor somehow sited them perfectly so that when I press against the kitchen counter, I back right off! Doc told me these two shots were 120mg each but my next one will be only 80 mg. It is NOT oil based but water based; the subcutaneous siting inhibits the uptake so it lasts a month.

He had someone set up the CD of my innards while he shot me. After I was dressed, he asked me out to look at it with him. He pointed out the “mass” in my bladder which was more like a gray shadow and showed me the small stone hanging in my kidney. Then he casually asked me if it were OK to take a look in my bladder while I was there. I agreed since Donna was sleeping.

It was interesting how the doctor’s demeanor changed. He was less assured about the cancer treatment, not in the sense he seemed incompetent but more like he could not assure me the injections would cure me. But once we got into regular urology stuff, he was The Doctor! (My GP later explained that is common since cancer is generally incurable and “life extension” is not what doctors wanna do. He didn’t want to take over my injections!)

I returned to the waiting room while they worked me in for another exam. Which didn’t take long. Then I was taken to a different exam room and told to lower my pants.

[Lurid details skipped]

After his looking around, he connected the scope to a TV thingy so I could see. He explained my bladder shows signs of damage, presumably from my radiation therapy; the damage made the walls look like tiles, not smooth as they should be. There was no sign of the mysterious shadow thing. My prostate looks battered and pink.

It took me three days to get over this exam! But it went well and he will get me ultrasounded in the near future. Unless I develop kidney pain if the “cloud” blocks my ureter.

Another Urologist Appointment: Supplemental

I got a surprise call today from my urologist’s office. Mostly to change my appointment from December 27 to January 4. I don’t understand but it had something to do with insurance and shifting it to next year.

Oh, and incidentally, my PSA was 12.6. And my new drug is to be Firmagon.

I learned more from this phone call than I did from the doctor! Lol.

First the PSA. This is sharply higher but I expected that. PSA tests are notorious for lab variability and I had suspected the doctor’s lab yielded higher results. The 4.48 and 12.6 are results from the doctor’s office; the remainder were done by the Centura Lab Services.

This is higher than I expected. Even if this is 10% high and is really 11.4, it is going up faster than I liked.

Enter my new drug. This is a relatively new drug (2008) and works differently from Lupron. Firmagon is the brand name for Degarelix. This drug suppresses the production of testosterone at the source. So does Lupron but they work differently. Lupron causes “flare up” when it makes the patient’s body go crazy making the stuff until the organs give up and quit. That is why I take Casodex. This drug inhibits uptake by cells of testosterone and I may not be taking it with this new drug. This, BTW, is an expensive drug.

Firmagon works through the pituitary gland instead of directly. The side effects are similar to any lack of male hormones: hot flashes, impotence, low libido, weight gain etc. Much like what I am enjoying with my present drug. Kinda like one of the girls.

The bad news: this drug is given subcutaneously and apparently is oil based like an estrogen shot. I will get a lump (which they call a “depot”) which will dispense the drug for a month. I may get local irritation at the site injection. On my abdomen.

I have hopes this will make a difference in the progress of my parasite.