ALH verses CANCER In graduate school I took a class entitled, " The Eukaryotic Cell, which was basically a study of cancer. The professor opened the lecture series with the declaration, "If you don't die from something else first, you will die from cancer." He then supported that statement with a myriad of statistics. That assertion stuck with me, and I have ruminated on it often. Just for the record, I think I still belong to that statement's first half... I watched Diane die from cancer (an osteosarcoma of her left proximal femur with metastasis to the lungs). She fought it every step of the way with limb salvage surgery and multiple chemotherapeutic regimes. It was a brutal and ugly fight that lasted just over five pain filled years. She kept asking what she was supposed to learn from the experience. I didn't have an answer for her, but for me, the answer is that I'm not going that route. For me, surgery and chemotherapy are not options! (END OF CONVERSATION.)

9 January 2020

PSA (prostate specific antigen) in yearly physical is high. Jumped to 14.0 from 4.0 last year

27 January 2020

Appointment to see Dr. Juan Chipolini canceled due to Barbara's funeral.

17 February 2020

Consultation with Dr. Chipolini. Re-ran PSA, result = 17.9

16 March 2020

Prostate needle biopsy, 12 cores taken.

23 March 2020

Call from Dr.Chipolini. 4 of 12 specimens are cancerous. Gleason score is 9. Diagnosis is stage 5 prostate cancer.

26 March 2020

Consultation with Dr. Shona Doughterty. Of the three treatment choices (surgery, chemotherapy, or radiation) she recommended the radiation regime. I concurred. Banner is to schedule a MRI and bone scan. The prognosis at this time is complete recovery.

8 April, 2020

NUCLEAR MEDICINE WHOLE BODY BONE SCAN Procedure: 21.7 mCi of technetium 99m-MDP was administered intravenously. Delayed imaging of the anterior and posterior whole body with additional spot views of the skull and thorax were subsequently obtained. Subsequently, SPECT-CT of the shoulders and chest was performed. (Translation: A radio active tracer was injected and my skeleton scanned looking for active uptake sites.) Good news and bad news. Good News: 1. No abnormal focus of radiotracer uptake is identified to suggest metastases. (Translation: Cancer has not spread to the bones.) 2. Bladder and bilateral renal activity is noted. (Translation: Both kidneys appear to be working.) Bad News: 1. There is evidence of degenerative changes in the major and minor joints including but not limited to multiple cervical and thoracic vertebral levels, both AC joints, coracoclavicular, and glenohumeral joints, right greater than left with additional degenerative changes involving the manubrium clavicular joint, both hips, knees, and a lesser degree elbows. (Translation: My joints are wearing out.) 2. The lungs are clear except for bibasilar dependent atelectatic changes. (Translation: The bottom portion of both lungs fail to inflate when I inhale.)

15 April, 2020

MRI OF THE PELVIS WITH AND WITHOUT GADOLINIUM Procedure: Multislice, multisequence magnetic resonance imaging of the pelvis was performed with and without intravenous gadolinium. Informed consent was obtained and there were no immediate complications. (Translation: They asked if they could inject some nasty stuff, I agreed, and it didn't kill me.) Good news and bad news. Good News: 1. There is no irregular bulge of the prostate capsule. No tumor is identified penetrating through the low T2 signal intensity prostate capsule. The neurovascular bundles are free of tumor. Normal T2 hyperintense signal intensity is maintained in the seminal vesicles. No extension into the seminal vesicles and bilateral vascular bundles. No pelvic sidewall lymphadenopathy. No osseous metastases in the pelvic. (Translation: Cancer has not spread outside the prostate.) 2. There are multiple nodules of varying signal intensity on T2 weighted imaging within the central gland in an appearance consistent with benign prostatic hypertrophy. (Translation: Growths noted in the prostate were judged to be benign.) Bad News: 1. The urinary bladder is trabeculated in keeping with changes of chronic bladder outlet obstruction. (Translation: The bladder outlet is partially blocked.)

11 May 2020

Four gold BBs (landmarks, target markers) placed in prostate.

22 May 2020

Hydrogel cushion placed between prostate and rectum.

23 May 2020

Started taking bicalutamide, 50 mg, three times daily.

19 June 2020

Completed CT Simulation scan. A mold was made to facilitate positioning for radiation treatments which are scheduled to begin 30 June 2020. Testosterone, Total: 931 ng/dL, Range: 250 - 840 ng/dL PSA, 2.38 ng/mL, Range: < 4.0 ng/mL

30 June 2020 (1)

First radiation treatment, 2:30 PM

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Radiation treatments, 1:20 PM

Finely finished. I escaped with my life but it was a close call.

29 September 2020

PSA = 0.05. ng/mL, Range: < 4.0 ng/mL. Dr. Daugherty, (follow up visit via telephone) was pleased with this result. Will continue taking bicalutamide (50 mg, three times daily) for next three months.

12 January 2021

PSA = 0.02. ng/mL, Range: <4.0 ng/mL. Dr. Daugherty, (follow up visit via telephone) was pleased with this result. Terminated bicalutamide treatment. Will retest PSA and converse with Dr. Daugherty in 6 months. Stopped taking bicalutamide.

Stay tuned for more information as it becomes available.