Ladies and Gentlemen, we have a treatment plan.
After months of research, multiple medical consultations, additional testing, soul searching, long talks, and a few tears, Paul will be undertaking the following treatment(s):
- Androgen deprivation therapy (ADT) beginning mid-July 2018. This therapy needs to start a few months before radiation and ideally continue for six to nine months post radiation. Prostate cancer cannot grow or survive without androgens, which include testosterone and other male hormones. Hormone therapy decreases the amount of androgens in a man’s body. Reducing androgens can slow the growth of the cancer and even shrink the tumors. There is significant medical data that combining ADT with radiation improves long-term outcomes. Paul will be given injections that will block his body’s ability to make testosterone. There will likely be significant side effects, (hot flashes, emotional ups & downs, man-boobs, muscle loss, weight gain, low libido, lack of motivation, fatigue, etc.) but hopefully they will “only” last a year, as his body should rebound once the ADT therapy is discontinued and his hormone levels return to normal. In the meantime, we’ll be going through menopause together.
- Five high-dose external beam radiation treatments (EBRT) over five weeks beginning in late September 2018. EBRT focuses X-rays on the prostate from a machine outside the body. The doctor will direct the radiation right to the gland and pelvic region and adjust the dose to target the cancer – ideally without damaging the rectum or surrounding areas. The treatment takes just a few minutes, and it doesn’t hurt. It’s usually done daily over the course of four to five weeks but Paul has opted for a higher dose treatment given weekly. This is similar to “CyberKnife” – a branded procedure that our insurance won’t cover because of the stage and degree of Paul’s cancer. He can expect some fatigue, but he should be able to keep working during this portion of his treatment.
As we’ve written about before, there is no “ideal” prostate cancer treatment. But after looking at all of the options, Paul believes (and I fully support) that this combination will give him the best chance for a positive outcome with the lowest risk of lifelong side effects.
In much happier news, we got engaged on Valentines Day and are looking forward to getting married, most likely after Paul completes treatment. It may be a bumpy year, but the sooner we get started the sooner it’ll be in the rear view mirror and we can get on with our “happily ever after.”