And so it begins…

Before I begin. The beverage of choice this evening is a 50/50 martini. 50 Pounds Gin, Dolin Vermouth, stirred, up, best quality olives. Usually I drink a 2/1 with which I prefer a twist. With the 50/50, olives are a better choice. Not sure why.

A gentle reminder. I use all the words. This is cancer, not a zit. If you don’t like all the words, now’s a good time to hit the “Back” button.

My Year as a Eunuch has begun. Off to a bit of a rocky start, but the game is afoot. As part of the Clinical Trial, I had a Bone scan on Tuesday. There is a small anomaly on one of my ribs. Not conclusively a sign of metastatic spread. I was given a choice; join the trial or go the traditional route. I chose The Trial.

Why? you might ask. The Trial is 12 months and offers a potential cure. During that time I will be closely monitored. Thankfully Bone scans aren’t a big deal. Had I gone traditional, it is open ended, perhaps a lifetime of hormone therapy. I like the sound of twelve months. Might work, might not. Let’s Give her hell.

I was randomized into Arm B. Prepare to learn some new words.

Arm B: “Degarelix will be as a subcutaneous injection on day 1 of every 28 day cycle for a total of 52 weeks (1 year). Subjects will receive an initial dose of 240 mg (Two 120 mg injections) on Cycle One Day One. On Day 1 of subsequent cycles, subjects will receive a dose of 80 mg.” In other words, they jack you up. Felt like Keith Richards, circa 1972.

“In addition, subjects in this study group will take apalutamide tablets once per day, 240 mg as Four 60 mg tablets starting on Day 1, Cycle 1, and continuing for 52 weeks.”

What, pray tell, does this mean?

“Testosterone is a male hormone that promotes growth of many prostate tumours and therefore reducing circulating testosterone to very low (castration) levels is often the treatment goal in the management of advanced prostate cancer. Degarelix has an immediate onset of action, binding to gonadotropin-releasing hormone (GnRH) receptors in the pituitary gland and blocking their interaction with GnRH. This induces a fast and profound reduction in luteinising hormone (LH), follicle-stimulating hormone (FSH) and in turn, testosterone suppression.^[1]“

See what I mean. A lot of new words.

“As with all hormonal therapies, degarelix is commonly associated with hormonal side effects such as hot flashes and weight gain.^[4][6][7] Due to its mode of administration (subcutaneous injection), degarelix is also associated with injection-site reactions such as injection-site pain, erythema or swelling. Injection-site reactions are usually mild or moderate in intensity and occur predominantly after the first dose, decreasing in frequency thereafter.^[4]”

Fuck that weight gain shit. Ain’t. Gonna. Happen.

And lastly, there’s this:

“Degarelix is studied for use as a chemical castration agent on sex offenders in Sweden.^[9]”

Not sure what the message is here other than don’t be a Sex Offender. In Sweden. Or anywhere else for that matter but esp. Sweden. Or, if you have Prostate Cancer you’ll get the same treatment as a Sex Offender in Sweden. My Oncologist did not discuss the merits of relocating to Sweden during treatment, so I guess there’s nothing there. Might be a nice diversion. Perhaps that’s part of the next Trial? So much still unknown.

Next up: Apalutamide.

“Apalutamide (INN) (developmental code name ARN-509, also JNJ-56021927) is a nonsteroidal antiandrogen (NSAA) that is under development for the treatment of prostate cancer.^[2] It is similar to enzalutamide both structurally and pharmacologically,^[3][4] acting as a selective competitive antagonist of the androgen receptor (AR), but shows some advantages, including greater potency and several-fold reduced central nervous system permeation.^[2][5][6] Apalutamide is (since 2014) in phase III clinical trials for castration-resistant prostate cancer.^[7]”

More new words.

“Apalutamide has been found to be well-tolerated in clinical trials thus far,^[3][6] with the most common side effects reported including fatigue, nausea, abdominal pain, and diarrhea.^{[5][8][9].”}

So I’ve got that going for me.

Bottom Line: I’m getting my nuts cut off, but, thanks to modern medicine, I might get them back someday. To what end and purpose, time will only tell. Still, I’ve grown fond of them over the years. I wish the lads the best fro a speedy recovery.

So what’s going to happen? Who The Fuck knows. I will get Hot Flashes. I will get irascible. WTF, I’m already Archie Bunker. Best to leave the room Little Goil. I might grow tits; my balls might shrink. I might finally hit the High “C.”

Here’s what will happen. I will work my ass off. I will not want to, but I will. Some of the other side effects are bone density loss and muscle loss. That. Will. Not. Happen. Why? Diet and exercise.

Here are some key metrics on Cycle 1, Day 1:

Body Fat: 17%; Weight: 197; Max 1 rep Bench Press: 120lbs. Max Daily Stairs: 131 Stories. Max Daily Calories Burned: 4,471.

The Goal after 12 months of therapy: Body Fat: 12%; Max 1 Rep Bench: My weight+; Max daily stairs- let’s not get nuts, 131 stories is plenty, ibid calories burned.

Hang on tight. Its going to be a wild ride. As I said in the first post, we don’t remember the pain. Just last week I finally regained the endurance and stamina (if not the strength) I had Pre- op. I found myself thinking, “That wasn’t so bad.” And then I remembered. It was that bad. Fucking bad. We are so happy we survived the trauma that we are ready to forget. This blog sets out to record the trauma in real time, lest I forget.

If you are joining me  on this journey; many thanks. If you are not, I don’t blame you. There are better things to do with your life. Like go for a walk.

Ciao Bella.