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Advanced Prostate Cancer
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anxiety sadness and depression

have any of you had success in dealing with the anxiety, sadness and depression that comes with the both the terminal illness DX and the side effect of the hormone deprivation therapy? I'm a GS 10, DX june 2015. Had the radical, then chemo. Been on Lupron for two years and also on enzalutamide for a year (as part of a study that includes a new immunotherapy). seriously considering just quitting treating. i'm 55 and this sucks so much more than any of my friends and family know.

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Hi,

I think we all have “bad” days and even longer stretches some times but it seems that you have been having more than your share.

I would try talking with your MO and see if the hospital has someone you can tall to about this funk you are feeling.

I wish there was some profound thing I could say to fix this and maybe someone here can but I wouldn’t wait. I would get in touch with your oncologist and see if they have someone you can talk to.

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I'm really sorry to hear you are sad and depressed about your cancer Dx and treatments. Being in basically the same situation, I can definitely relate.

I'd rather not tell you what to do since I don't know your exact situation. I can tell you what has worked for me in my situation which has a lot of similarities to yours.

My situation is that I was diagnosed in late February of this year with stage 4 prostate cancer, PSA of 463, lots of pain, night sweats, fevers, extensive mets to the spine, pelvis, femurs, ribs and some other parts of my skeleton. That along with some mets in a few lymph nodes. I'm on ADT, plus went through 6 cycles of chemo earlier this year. So far my recovery has been very good, but I have to deal with side effects of course like everyone.

I went through a period of shock, sadness and some depression for a while. But then I really made a commitment to do everything I could to get the most out of whatever time I have left.

As far as depression goes, I definitely have some times, but overall I am happier than I have ever been in my life. I really think it's because I am putting so much more effort into that than before. It is something that you can definitely work on. You don't have to be a victim of it.

When I get depressed, I try to work on the specific thing that's getting me depressed if I can identify it. Usually I can, and getting out in the open and addressing it the best I can helps. If there is an underlying issue that causing it, I try to identify that and deal with it.

Working on the underlying issues in life are what really makes the difference overall.

Taking of care of basics is step 1. Eating properly, low or no alcohol, sleeping, exercise, etc. are the critical foundation. Without those, it's not possible to move on.

For me, one of the reasons I am happier now is because I don't take what I have for granted. I've worked on developing an appreciation for the things I have, not focusing on the things I've lost. This can be done actively by becoming more "mindful" about the wonderful things in my life. Appreciation can be developed and for me it is one the keys to happiness.

Another one is having/finding purpose. Finding purpose in life is important. It's good to develop interests and hobbies as part of that. Some people get involved in volunteering for something that's meaningful for them or they find purpose through their work. When I get in a funk, I find doing things for others helps me get out of myself.

Surrounding myself with loved ones, friends, and family really helps a lot. Being around people who are genuinely caring is something that really lifts me up.

These are some of things that make me want to live. And yes, I have had to make some difficult adjustments since the cancer came into my life. There are probably a lot more to come. I've to adjust what I can and can't do according to the disease. Expecting to be the same as I used to be is one thing that can cause depression for me. "What can I do now?" "How can I find purpose with the new limitations I have?" Working on those issues is a challenge sometimes, but it's very important because those things are changing for us.

Again, this is just what has worked for me. I would encourage you not to give up. It's a challenge, no doubt about that. But every challenge is an opportunity. I've found there is a great reward for accepting that challenge. You don't have to do it alone. There are councelors that can help and also support groups.

I wish you the best in your journey.

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Joel,

I was going to try giving some advice, but everything I thought of saying has already been said very well by Gregg. Like Gregg, I also encourage you not to give up. I suggest that you try the things that he listed.

The things that he wrote that worked best for me had to do with engaging with other people - family and friends and sometimes even strangers. Doing things for others seemed to also do things for me. Being a good husband, a father, a friend, all gave me as much as it gave to others, and it made me realize that what I did for others would live on in their memories after I'm gone. That made me feel good.

I think we'll all die soon enough but while we're still here let's take advantage of life and get everything out of it, and put everything into it, that we can.

I don't know if any of that helps, but I'm hoping that it does. I'm also hoping that the fact that Glsn10 and Gregg and Dan and I, and all the others who may read or respond to your post, tells you that there are people out here who care about you and wish you the best.

Alan

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Awesome words and thoughts ,that help me. I also fight the depression. If i fall into that hole it’s hard getting out ..

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Joel, It is good to see you on here. I like the idea of talking to your MO to see if there is someone to talk to. I also think Gregg has written a great post. I also was dxGS10 except in 2006 , also with high psa, I think everyone that posted so far is in our GS10 club. We are all here for you. I think the depression of the terminal dx diminishes with time, as we realize we can live, and eventually you become super happy to still be alive, after the long white coats predicted our demise.What side effects are you having from medication? What is the immunotherapy you are doing with xtandi in the trial? How is your response? I wish you the best and keep us posted.

Dan

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I think you have to try and stay in the present moment. I try and meditate every day and walk every day. If you try to be thankful for everything even small things each day you begin to shake off the blues. If you overthink and focus on future thoughts anxiety kicks in so try to only think of now. No one on the planet knows their life expectancy (how many people never get the chance to even say goodbye) and I try to feel grateful even for the fact they found the cancer in time for me to use ADT etc. to extend my life. A fellow advanced cancer sufferer once told me I had won the lottery getting my diagnosis in time to get some treatment and he was right. I get down all of us on ADT do, it changes everything but we develop a fighting spirit. You will never give up look at what you’ve already been through. I was dx this year Gleason 9 at 47 with numerous lymph involvement no chance of radiotherapy and with kids one of 4 years old. I refused to let my diagnosis effect my and their life. People like you on this forum give me the strength to face my illness and inspire me with your stories. Stay in the now and talk about your feelings to friends and family it helps. 👍

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Well said. I look at everything since my diagnosis as "bonus time". We are so much luckier than so many other people.

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Im also 55, but recent diagnosis (dx already stage 4 very extensive) - so in a lot of ways, im still working through my stages of personal grief. BUT in the short term what is keeping me going is serving my family. 2 toddlers and a younger wife that is now the sole breadwinner - i wake up everyday and try to find ways to make her life better. Making beds, picking up grocerys, distracting one kid while she reads with the other, etc. I wont be here forever to help her. So focusing on making the best of her days for now - thats how im dealing for now.

Also, since its not yet been said. Depression is a chemical reaction in the brain. You dont just suck it up or try harder. Rather it needs to be treated. Therapy can really help, but true depression and anxiety need to be chemically re-ballanced in the brian. Dont let the stigma of mental health keep you away from treatment. Go talk with a GP or psychiatrist and see if they would suggest a plan.

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i can sure identify wth you. i had to stop taking Casadex because i was crying 24/7 some of these meds are so powerful they are are toxic. i read a book a while back called " the psychedelic explorer's guide " in which he talks about this very thing cancer and depression . he recommends 1/10 a normal lsd dose per day to clear it up + enhance an overall positive attitude with great insights. but no mention on how to obtain it

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magic mushrooms and MMDA....They have actually done clinical trials on both with very positive results.

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Yeah, I saw a documentary on MDMA (AKA ecstasy) and a study where it seemed to benefit veterans with PTSD. Would be nice if they would ease up on the war on drugs just enough to do more research of the potential benefits.

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I’m ready !Where do I sign up. Guess I gotta contact my “ Dead head “ friends in the city by the bay and get on the regiment.

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Highly recommend ayahuasca to all Done it twice in two yrs. Each time with enlightening positive effects Freeing your mind and the rest will follow. Fear of death , suffering and cancer is detrimental to health. Pure DMT is great, mushrooms are great. I receive greatly from all of these drugs. None are bad for your health. The fear that most have are the horror stories you might of heard. You need someone to guide you into it gently and make sure the environment and the intent is good Then you will receive healing. I’m no guru ,, These are not permanent fixes to depression. Personally the feeling of conectiveniss and well being last for months afterward. I’ll take months of no gloom and doom and feeling well over dwelling on the mundanus of my daily reality.

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IMO, the best "trip" you can have is learning to be conscious during your dreams. It's an amazingly "real" world that you can explore, more real than you can believe. You can be fully conscious and experience this alternate reality in 3D high-def color without distortion. All senses can be explored including touch which is the most amazing. Everything can be experienced and evaluated in real time with clear memories after waking similar to waking-life memories. Truly an amazing experience. Great way to expand your consciousness the natural way. Not easy to learn, but well worth the effort.

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Sounds like Nirvana!

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Hard to put into words really. Has to be experienced. The first time I just kept telling myself I don't believe it. Was able to do a bit this morning with some flying. Counted the fingers on my hand and there was more than five. Bingo!

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Some great comments in the replies above.

Agree that getting professional help on the depression front is important.

My experience as follows

Diagnosed 2003 PSA 6 Gleason 8, cancer seemingly confined to prostate

Following radical PSA still 6 and CT and bone scans still clean

Started continuous Lupron 2003 and still on it.

PSA dropped to 0.07 on Lupron but by mid 2014 had risen to 69.

Tumour then identified in pelvic lymph node but rest CT and bone scans still clean.

Clinical trial with certain enzalutamide became available and I grabbed it.

PSA rapidly decreased and has been bumping along at about 1 for the last year.

Lymph node tumour now about 10% the size it was in 2014.

Plan to continue as is for a while and then decide what to do about the tumour.

I am lucky - the cancer does not seem to be readily spreadable, the side effects of the hormone therapy (mainly fatigue) are manageable and the cancer responds quite well to the various hormone treatments.

I have become involved with various support programs, advocacy for new treatments and prostate cancer research projects in Australia.

Understand the tremendous variation person to person in response to treatments and severity of side effects.

I have not suffered depression but in the early days had a cold gnawing fear that came and went.

Then one day thought about it more deeply and the load lifted and have had no more problems on that front.

As mentioned by others suggest you busy yourself on things you like to do

All the best TonyMax

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Tonymax= you received a blessing in your acceptance. That’s what I seek.

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All the comments were excellent. However, because the stress maybe causing a physical chemical imbalance, talk to your medical doctor about anti anxiety medication or a tranquilizer.

Rich

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Proud of you, brothers. Your advice and support for Joel comes from a very honest and caring place. You have to adjust to a "new" reality, Joel. Each day the journey will become easier. Your mind will adjust; your perseverance will grow stronger as the love for family deepens even more.

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I’m 56 and started about the time you did. Had orchiectomy 1yr ago that put me in a suicidal depression that still pops up from time to time. Nothing easy about becoming a drone or and android in fact a unich. So get over those stereotypicall forms that we fit into as macho males. Those are all gone We can accept our lot and I believe that some guys actually will sui over these conditions. Don’t be one of them .I was non op. The horse was outta the barn so to speak .#4 kidney failure ,11/2 yrs of stents and neauphostmy tubes out of my back + the dreaded foley. I’ve had no vis signs for the last yr and1/2. Of course it’s your right to quit treatment. But I wouldn’t suggest it. APC is a worthy opponent it will most likely eat you up in a brutal fashion. We all go through these depressionsand swings. Most don’t speak or it.The fact that you are talking about it is good. You can and will deal with everything that you need to. Find a strong reason to live and never give up. If I can anybody can ..Hang in there brother. The symptoms should diminishes or you will in time handle and accept them better .You don’t want to turn up stream without a paddle. As long as you are alive there is hope. Hope for miracles and advancements in treatments. We are stuck now with mostly archaic methods but with tech advancing so rapidly there is much hope.

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Wow is your post perfect timing for me. I'm feeling sorry for myself today too. I mean whats the point right? Eating well, exercising taking supplements who cares I'm still in my shitty situation. In my 5 years of dealing with cancer picking my body to live in I have learned that this feeling, this depression, this hopelessness comes and goes. It can be triggered by something big or by nothing at all. I've learned that if I allow my "felling sorry for myself" to get a hold of me I suffer. It means that I'm allowing that f**king cancer to get to me.

Ok so here is what I do: I give myself permission to give in to the poor me feeling. For just a period of time. I make a deal with myself to stop feeling bad at a prescribed time. Its kind of like when I'm having a fight with my wife and the phone rings and I say hello like nothing is wrong. I have the power to shift, I'm in control. So at the end of my poor me period I shift. Not always successfully but I start to re-acknowledge that which I am. The person I've become in spite of the cancer. The things in my life that I can be grateful for or appreciate that I have experienced.

If you haven't already I would suggest that you make an "I will list". A list of things that you want to experience or accomplish before you die. My list was a surprise to me. It has also helped me to focus on the future, on making memories and on enjoying my life. I wouldn't say I'm thankful about cancer but I understand the gold that this experience has brought me.

There are lots of things that we are getting short changed on and it sucks. No way around that. And if thats all we focus on then we are going to be sad all the time. I have turned this into a battle. I kind of battle of wills, between me and the cancer. First off I don't "have" cancer. That shit is inside me. Its not me. It creates things that I have to deal with and I'm not letting those things get the better of me. Its not winning. But honestly some minutes or some days it does get the better of me. Then I remember who is actually in charge!

I am currently bald from chemo. I used to feel embarrassed. Then I said wtf am I doing. The baldness is part of me. Its my badge, my scar from this battle, Y'all should now what I'm doing. F you if you're uncomfortable seeing me. I am a warrior. I will not curl up and become invisible.

Wow I guess I had some pent up shit to get out! Thanks for your post. I think we all think about and feel what you wrote about. If we're honest we've all been there. The issue then is not that its unfair or why me. The issue is how will I make my fears about a probable shortened life span bearable. Controlling my fears so that I live and not just exist. Also the comments above about meds causing the depression are valid and I would also recommend talking with your med onc about some solutions. You are not alone brother. Keep reaching out, be gentle with yourself and strive to be alive.

love charlie

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Let it out Charlie! We are all the same. Men yes, but human also, Falable, flawed, especially now. Just keep trucking. Giving up is not a option to be taken. As long as the hearts pumping there is hope. !! Hope springs eternal. A spiritual man once

told me “ eternity does not start when you die, Your path to eternity starts right now , today, make the best of it....when I go through a bad day of depression, the next day I figure it out that I completely wasted and thru away that precious day of my life.. I understand well that there is an end stage including suffering for me. But I’m not there yet. For now we must do what we gotta do to survive. Peace

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I feel like I am experiencing eternity when I can really live fully in the present moment. I've heard it referred to as "the eternal now". I think our lives are a series of "now" frames that we experience one at a time. We have this illusion of time passing when it's a series of still frames. When you experience the present in it's fullest, it's like being outside of time.

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I believe that you are correct sir. We try to be out in nature as much as possible.

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Outside of time is heavy duty. You’re quite advanced.

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Consciousness is eternal.

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when my husband gets down, i download a few articles for him to read about other diseases THAT INSTANTLY KILL YOU. he perks right up. then, we find a few 'shrooms and get silly happy.

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To treat D and A, I was on duloxetene (generic Cymbalta) years before dx with Gl 9 PCa and continue on it. So I don’t have that problem now. But I sometimes get “down” and tired from ADT . It’s tough not to given what it does to us. My biggest problem is weight gain because I eat and drink ( wine) too much to” feel good”. But it makes me crazy so I recently stopped drinking and started eating the right foods. I subscribe to the south beach diet which sends prepared food. In addition, I exercise at a gym 3-4 times a week and golf 2-3 times a week . This helps my mood and strength. Without it I’d go nuts.

This disease sucks and ADT really sucks. But after RP and three bouts of RT after Mets to lymph nodes and femur over four years my psa is <.1.

I feel good most of the time but it takes resolve . You can’t let this control you. You need to look at it as a chronic illness like millions of people have in one form or another.

Bob

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Thank you all very much. I wasn't actually considering quitting, I just felt like it. I do many of the things you've all kindly shared, some help, some not so much. I'm still working, (part time) so some of the suggestions are out of the question in my field. In response to one of the questions, I'm in an NIH study involving hormone blocking (Lupron and enzalutamide) in conjunction with provost (genetically modified virus immunotherapy). I've now been CA stable for a year, which kinda stuns me. Wife is extremely supportive, as well as a few, select, very close friends. Infuriating when people say you look good, you must be ok. They know nothing. I cover the worst of the pain (physical and other) from everyone, and I severely limit my pain med use. Anyway, thanks for all of your support - helped me through a particularly bad week. Hope I can return the favor one day.

Joel

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Joel , Sounds good, we are all here for you when you need to talk.

Dan

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Yes, soon after beginning hormone therapy, I began to get seriously depressed. I now take a low dose of Celexa daily. It doesn't prevent bouts of the blues, but it seems (as my therapist says) to give me enough clarity to accept emotional support and to deal more evenly with my situation.

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In 2000, I had a RP that left me impotent and with Peyronie's Disease. Doc was diffident. The cancer had eaten through the capsule in two spots and started to invade.

Thirteen years later, the PSA was up to 4.2. I had the family jewels removed and PSA went down to 0.3. Three years after that, it was back up to 2.1.

Last year, a PSMA scan showed six bright red mets growing up my left side lymph channel in addition to a regrowth of the original tumor. Doc put me on Zytiga and in six months my PSA is undetectable.

Now about the hick in the head. When doc said he had to cut the nerves and the tumor started to invade, well...

I found out there were things that could be done. Now understand this was almost twenty years ago so things have been marching along apace so everything is better.

BTW, the nerves that get cut are for hard-ons. The ones that let get your rocks off are OK.

Still, this leaves a brown taste in the mouth.

But there are workarounds. Hydraulic implants that let you get a woodie damned near as good as Nature's own - some say better. Then there's blow jobs. And don't forget hand jobs.

As for the other, advanced prostate cancers require a bit of a pragmatic mindset.

Something will kill you. You know that. What makes life OK is you normally don't know what that might be. However, with PC, you know that absent a heart attack, stroke, traffic wreck..., it'll be THIS! And that knowledge sucks.

But as time goes on and you find, by the grace of Providence, that things are pretty much OK. You've adapted.

The biggest hazzard to a cancer man's juju is his sitting on the Pitty Pot. My family and friends would not let me sit on it. Sure, they listened to me very a bit but if I went on too long, they'd knock me off it. Giving a dismissive waive, they'd tell me, "Oh be quiet. You're just fine. Now take out the garbage".

It worked.

BTW, I'm 76.

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