Keith
and Bev Murgatroyd live in Massachusetts and Tennessee, USA. He was 65 when he
was diagnosed in June, 2008. His initial PSA was 5.2 ng/ml, his Gleason Score
was 10 and although he does not give a staging it seems likely that he would have
been staged T1c, or maybe T2. His choice of treatment was ADT (Androgen Deprivation
Therapy) /EBRT (External Beam Radiation Treatment)/ Chemotherapy Trial. Here is
his story.
My primary Care doctor thought 3.0 - 4.0 rise in my PSA in
2006-07 was no issue. On DRE (Digital Rectal Examination) was "hard but no ridge".
But a PSA of 5.2 in early 2008 was cause for biopsy. Referred to a Prostate Surgeon
for the biopsy. Most of 16 cores were Gleason 9-10. Consulted with MGH (Massachusetts
General Hospital, Boston, MA) because they had Proton Beam. They scheduled scans
which showed one large lesion but still less than 1 cm. One of them on DRE could
"feel the ridge". When told about the scans the Tennessee surgeon said he would
still do RP surgery. MGH group said I was an ideal candidate for their clinical
trial involving early Taxotere. They said the "gold standard" was ADT/IMRT (Intensity
Modulated Radiation Therapy) and the trial would add 6 infusions of Taxotere -
one every 21 days starting a month after the 8 weeks (42 sessions) of IMRT.
IMRT
symptoms were manageable with Flomax and Imodium. Taxotere symptoms were easier.
On
first infusion we discovered I needed Benadryl to stop an allergic reaction. I
was slightly nauseous and almost fainted at the end of this session which they
said was due to withdrawal from Benadryl.
During infusions 1, 3, 4 I kept
my fingertips immersed in ice water to prevent peripheral neuropathy (PN). I felt
some PN develop after infusion 2. Icing the fingertips for an hour was quite painful,
but feasible. No nausea. No neutropenic fever. On each infusion there was burning
pain on the bottom of one foot and severe peeling of skin off the heel.
On
fourth infusion I mentioned "tightness in my chest" which I thought was because
of the heavy breathing I had been doing to help manage the pain of icing my fingers.
I
was also was slightly nauseous and faint at the end of this session (like the
first one) but this time they were more alarmed and sent me to the E/R for cardio
monitoring.
No cardio problem showed up.
A redness (almost a rash) developed
on my knees and thighs which itched, but seemed to not be an opportunistic infection.
After infusion #4 they contacted me and said they thought I should withdraw
from the trial because of the risk of "pulmonary arrest".
At day 10 of
cycle 4 (neutrophil low point) I developed a fever which got to 102, and was admitted
to the hospital for 3 days while they gave me IV antibiotics and tried to figure
out what infection I might have. They never figured out what the infection might
be.
I dropped out of the trial as they recommended on the basis that "we
don't know that 6 cycles is any better than 4" - - - that's why we're doing the
trial. I realize that I am still a useful 4-cycle data point.
PSA after
Radiation < .01
PSA after Chemo < .01
I experienced watery diarrhoea
for 3 weeks after stopping the Taxotere and Prednisone, which I understand can
indicate a blockage in the colon. I am again experiencing pre-stretching lower
back pain and neck stiffness as I did before treatment started.
I remain
on Lupron depot every 3 months.
Next PSA check - April 20, 2008.
Keith's
e-mail address is: bev-keith-murgatroyd@comcast.net
