Hi All, thought I'd introduce myself and share what I've been through recently. As a reference point, back in September of 2017, just before my 50th birthday, I had a routine exam and my PSA level was around 2, just as it had been for a couple years prior. Perfectly normal and healthy, no sign of any disease.
By mid October 2018, my PSA was 216 and a CT scan showed bone lesions, enlarged lymph nodes, and some small spots on the parts of my lung included in the abdominal scan. The urologist immediately did a biopsy and started me on ADT (Eligard) immediately, before getting the biopsy results. The bone lesions matched up with pains that had been developing but I had thought were due overuse injuries and aging.
The biopsy results came back: The right side of my prostate was pretty full of cancer with a Gleason score of 8. The left side was mostly normal, with a small section of Gleason score 6. A cystoscope of the bladder also showed probable bladder cancer, as if the prostate wasn't enough.
October 31st, 2018, what a day. It started off with a consultation with a medical oncologist. I was having a bad flare of pain, and later found out that my PSA on that day was up to 362! After that it was off to the radiation oncologist to start radiation treatment of the vertebrae thought to be causing my back pain. And after that it was off to another part of the hospital to have the bladder tumor surgically removed (trans-urethra procedure under general anesthesia). If that wasn't enough, the hospital sent me home after only having voided a tiny amount of urine. It turned out I had urinary retention and couldn't pee on my own, so off to the emergency room in severe pain (even though I was on an opioid!) to get a catheter after midnight.
The biopsy from the bladder came back with two tumors: One small tumor of bladder cancer that hadn't reached the muscle and was fully removed, and also a small tumor of prostate cancer that had traveled up to the neck of the bladder.
I had 5 days of radiation treatment on the vertebrate. The RO wanted to get it over with quick to "get out of the way" so the MO could start chemotherapy. The radiation didn't provide instant relief, but did seem to cause nausea and loss of appetite. Between that and the surgery I lost 10 lbs in a week. It gets better from here.
I had three weeks "off" after the radiation treatment, during which time I slowly regained my appetite and symptoms subtly improved. At some point I no longer got up in the middle of the night to take more pain meds. It was no longer agony to lean over the sink and spit out my toothpaste. Once free of the catheter I resumed walking and running, and was able to run the Thanksgiving 5K race that I've run every year for the past decade.
This week I started chemotherapy (doxetaxel) along with prednisone. So far the side effects seem to be well controlled. In the blood draw just before starting chemo, my PSA was already down to 1.93! It's coming down faster than it went up, and I don't know how much of that is due to the ADT and how much is due to the radiation.
So that's where I am today. For the short term I'm pretty optimistic that my condition will continue to improve with treatment and I'll be able to be quite active in 2019. Beyond that I start to worry about how fast this could come back, considering how fast it originally developed and how fast it's responding to treatment. I suspect that even among advanced prostate cancer patients I'm a bit of an outlier. My urologist even hinted that he'd never seen PSA go up so much from a normal baseline in only a year.