With things more or less back to normal, it was just a case of waiting for the next phase of treatment to start. The Prostap jab was successfully administered as expected, but the nurse said that there was a new version of it that had just been authorised, and I should speak to my oncologist about it. This version is called Staladex, and so Nurse Cathy decided to google it. “You’re not having that! Have you seen the list of side effects?” I wasn’t entirely convinced either way, as Staladex basically comes up under the same listings as Prostap, so it was ambiguous as to whether the side effects were specific to one or common to both.
Meanwhile my oncologist has set up my Full Body Bone Scan and my CT scan – again. It’s only been three months. Just for once I have no obvious cracked bones to report when I get my nuclear tracer and bone scan completed. I’ve only got a walking football induced twisted knee (possibly another Medial Collateral Ligament tweak, but this time on my left knee… common as muck, these injuries) and a kick on the side of my right lower leg. No cracked ribs for once.
Non-contact sport indeed. As I write this, my right arm is covered in a massive purple bruise. It got hit by a shot from about two yards away which deflected away for a corner; I suppose the bruise could have been used as a form of VAR and a free kick given for handball instead. My arms and hands are particularly susceptible to bruising at the slightest bump. Fortunately, the rest of me seems not to bruise so easily.
Still no date for my hernia and prolapse surgery, which is slightly annoying. I had harboured a vague hope that the Registrar who saw me about the blockage (and was a member of Mack’s team) might have suggested to Mack that Zeppy’s prolapse was somewhat out of hand now, and that he needed refashioning as a matter of some priority. But then, it’s hardly a life-threatening condition, so I’m sure Mack doesn’t see it as particularly urgent. I am beginning to notice some pain from the hernia a little more often now.
And speaking of Mack the Knife, looking for an old document on a memory stick I found a photo that Nurse Cathy took in the hospital of my freshly wounded bum at S+13, two days after I had split my original stitches. I remember her asking the nurse changing my dressing if it was OK to take the photo, and I remember her showing it to me, but really, I hadn’t taken it in at the time. Now that I’ve seen the photo in the cold light of a painkiller-free day, I am genuinely shocked at what I see. The surgery was massive. No wonder it took me so long to get back to some sort of normality. I’m happy to report that the scars have faded quite considerably now. A couple of days after I found the photo, one of the lads at football shouted me to “get your arse over here”, so I took my phone and showed him the photo…
There isn’t really much to report as I wait for the 14th July to roll around. I’ve had the scans, and no alarms went off as I was leaving the units, so nothing obvious, I guess. The day after my CT scan it was my birthday. I reached seventy, three score years and ten. I am, for now, the youngest player in our team’s 70+ Walking Football squad. Theoretically I suppose anything more from now on is a bonus; better than average; beyond expectation. The celebrations were good, a couple of meals out, one with friends the other just with Nurse Cathy, and a wide selection of presents and cards. It was noticeable that a lot of the presents did seem to indicate that people’s impression of me is that I drink a lot of alcohol. And that I eat a lot of chilli.
So I go on, trying to put my little bit of scanxiety (an anxiousness about scan results; another word I’ve learned from fellow cancer patients!) behind me. It seems to be such a long time between the scans and my next consultation. I suppose that if they found anything horrendous in there, they’d have got the Grim Reaper to ring, and they haven’t. Then of course my scanxiety gets ratcheted up a notch or two as the Junior Doctors decide to go on strike again. And the Consultants will follow a few days later. Yep, the Juniors are out from 13th July until the 18th, and my face-to-face appointment is scheduled for the 14th. Consultant face-to-face? No chance. Again. Another phone call coming up. Let’s just hope we don’t get a crossed line again.
Oh, and the feared MCL injury to my knee isn’t. It’s not a ligament injury. A quick burst of physio identifies it as a problem with a tendon running from midway up the inside of my left calf to just above the knee. Somehow, I’ve twisted, tweaked, or torn, the tendon playing football. Hopefully it will heal much more quickly than a ligament tear would. It bloody hurts though. Still, the good news seems to be that my arms and hands might not to be as susceptible to bruising as they were…
The tension mounts… today is Wednesday the twelfth of July, and the Junior Doctors’ strike starts tomorrow. I haven’t had anything from the hospital to say that my appointment is under threat. No email, no phone call, no text, no letter. Tomorrow morning is my fasting blood test. Nurse Cathy has said she’ll deliver me to the vampires for eight o’clock so that I can get home for breakfast after twelve hours of purgatory. Like twelve hours without food, coffee, or alcohol is going to kill me… first world problems.
Early morning to the bloods, and changes noted at Oncology. For the first time in a long time there was no requirement to wear a mask. The endless supply of blue medical masks was no longer by the entrance, everyone was face-naked. There’s a freckle on the inside of my left elbow, about a centimetre below the fold of the joint. Years of blood tests have taught me that fractionally above that freckle there is a vein that is so easy for them to hit. I point it out every time, but each phlebotomist usually likes to stab me in what is their individual favourite place. She took me up on the freckle this time and three vials were taken quick as you like, and I was off home for breakfast. Oh, and no email, no phone call, no text message, no letter… tomorrow is still on, face-to-face.
When I went in for my Oncology consultation, the first thing he said to me was “You’re looking well.” Should have quit then really. Be warned, when a doctor says that to you, bad news always follows. And now it has happened, I’ve had my face-to-face with Grim Reaper. It turns out that my scanxiety was well founded. There’s a couple of enlarged lymph nodes showing up all of a sudden. But ironically that was the least of my worries. He showed me the graph of my PSA since first diagnosis, when it was 62. The graph burbled downwards for a while (it did take it’s time) as the hormones and the radiotherapy kicked in. Then it just rumbled along at nice sensible levels for several years, and then it came to this year, where it rose noticeably. Very noticeably. Incredibly noticeably.
I’ve done it myself, playing with Excel or some other spreadsheet and trying to make a graph out of some figures, you make a mistake, and the line goes anywhere but where you expect it to go. Mister Reaper is obviously not much cop at graphs, but then that’s not really part of his job description, is it? Ridiculously the graph had zoomed right up to the top of the screen, way past the starting point of 62. Grim had accidentally put the PSA score from yesterday’s bloods down as 98.2.
NINETY-EIGHT point TWO. As I write this, I am trying very hard not to use some rather vulgar expletives, but f**k it, I can’t help myself. Where the *uc* did that come from?
I was shocked. This is just ridiculous. I should have asked for a recount; give me a bloods form and I’ll go and do it now.
But of course, it isn’t Grim that is telling me this, it’s the Consultant Oncologist. He tries to reassure me that these are only markers to give them information about me. The scans and bloods aren’t anything for me to worry about. They get the information, and they adjust the treatment regime accordingly. The hormone treatment is no longer as effective at keeping the testosterone under control as they would like. He tells me that Prostate Cancer isn’t curable, it is manageable instead. They will give the hormones a booster. I’ll be prescribed pills to take as well as the Prostap jabs.
He produced a consent form for me to sign. I am to be put on enzalutamide (brand name is Xtandi), which I will have to take every day. They will have four weeks’ worth waiting for me on Monday afternoon. Every fourth Monday after that for three months, they will do bloods to check (a) that I’m alright, and (b) what effect it is having. If things are working as they hope, then it’ll be a three-monthly regime instead.
Oh, and you might recall that I was promised some anti-osteoporosis medication a couple of chapters ago. Well, I’ll be getting them too, they are called bisphosphonates. But they come via the GP, and he’ll write to the surgery to advise of my clinical need for them. It’s only one pill a week, so that shouldn’t be too bad. And he said that I am to keep playing football and other exercises for as long as I can. He also pointed out that there is no such thing as non-contact football, so the bones do need a bit of help keeping strong.
Going back to the “You’re looking well” bit, and he tries to make me feel good about my health. Did I feel any less well this morning than I did three months ago? No, just a sore knee, but otherwise I feel just as healthy as I did then. Appetite good, no weight loss? Quite the opposite, weight up a bit (79.1kg); eating too well, some might say, still got a touch of diarrhoea left over from chemo though. No, you haven’t, that’s from the radiotherapy, we often see that about five years after the event. But otherwise, if you hadn’t come here today, you wouldn’t have known any of this; your body is functioning just like always. It’s our problem, not yours.
Sorry, but it feels like my bloody problem. And you can stop laughing you bastard Grim.
Once he’s had enough of trying to reassure me, he packs me off with the Viagra Nurse, who had been sitting in all the while. She is, apparently, more correctly called a Clinical Nurse Specialist in Metastatic Uro-Oncology. She gives me an info pack about the enzalutamide, and a booklet about bisphosphonates. I get the impression that the enzalutamide is in the same general ball-park as chemotherapy. It comes with a Cancer Treatment Alert Card and a 24-hour helpline.
So to Monday afternoon, a quick trip to the dentist (including giving him a meds update, which sounds important from what I’ve read about the new stuff), followed by a trip to the Hospital Pharmacy to pick up my first supply of enzalutamide. Let’s see how this goes. The next chapter could be quite illuminating.
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