Drink of choice: Vodka (Stoli) on the Rocks with Dolin Vermouth and excellent olives. If you drink Martinis, you understand.

Two weeks ago today I received my first injections and started the pills. Here’s an update.

Side effects that are scientifically measurable.

1. Pain, redness and swelling at the injections sites. Yowee!! Woke me up with a 6.5 out of 10 the night after getting them. Hurt like a Mofo. Ibuprofen helped. Went to the gym in the a.m., albeit with some trepidation. Lifting helped ease the pain, especially working the triceps. Glad to report all is now well. Must remember this as there are 12 more to go.

2. I get tired more often. I go to bed earlier and want to sleep later. To combat this I have stopped my daily 20 hour fast. I have started eating small amounts over the course of the day and have upped my caffeine consumption. I am hoping the calories and the caffeine can replace the testosterone to some degree.

Side effects that are not measurable and may not be side effects, who the fuck knows.

1. Mild Psychosis. I walk. A lot. Ask my FitBit. Or TL. Often when I’m walking, I fantasize about lying down and curling up in the fetal position in the Parkway. It happens often. Like every day. I’ve resisted, so far.
2. Had an episode a week ago Tuesday, first Tuesday after injections. I went to do my stairs at 6:00 a.m. Did my first rep. Felt my left calf tightening up as I neared the top.   Then, as I walked the top deck, My right quads started acting up. Could barely make it dow the stairs. Didn’t ever cramp up, but was tight. Decided to try and walk it off. Walked four blocks to a different set of stairs. Walked up them. Didn’t feel right. So I walked flat ground for about 5 more miles. This was my first fantasy of lying in the parkway. That afternoon I went back and just walked the first few reps of stairs- no running, Did fine. So I finished off by running them all and did an extra rep. Who knows? Likely I had been pushing myself too hard.
3. See number 1. I often feel detached. Not quite Out of Body, but not all together there. When I drive I have to concentrate. In meetings I have to concentrate. The only time I feel whole is when I am exercising. All other times, put a nickel in me and see what you get.

Bravery is being the only one that knows you are afraid. So I am giving away bravery. My  last PSA test before treatment was 6.84. High for a healthy male with a prostate gland. Extraordinarily high for one without. That would be me. Plus, my most recent scans were mushy. Nothing definitive, but changed from the last ones. What I need is to see these numbers to come down. Soon. There is a form of Prostate Cancer call Castrate Resistant. To quote “Seinfeld,” “Prognosis Negative.”  One tries not to dwell on this and one thanks the gods for strong drink, but. The next 14 days will be more in a chain of nerve- wracking days. Nothing to be done about it. Except exercise. And work. And the odd bit of strong drink.

A bit of good news. I used the Big Boy Potty (urinal) for the first time on September 30. Have continued to do so ever since. Thank the gods for small favors. I look forward to the day when forestry products are not a part of my daily wardrobe.

Two more weeks until my next round of testing.Two more weeks of living day by day, hour by hour, minute by minute. More importantly, two more weeks of exercise, literally my salvation. Pleased to say that on day 15 I am in the best physical shape of my life.

Thanks to everyone for your support. It helps more than I can say.

 

 

 

 

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.

 

 

 

Fair warning. This blog contains coarse, graphic language. I like to use all the words, and the subject matter revolves around the male nether bits. Proceed at your own peril. You’ve been warned so no bitching. None.

On May 8th, 2017, I was diagnosed with Prostrate Cancer. Gleason score of 9, Stage II (Google it). On June 14th I had a Robot Assisted Laparoscopic Prostatectomy (Ibid). Biopsy of tissue showed evidence of spread in the pelvic region. Now I am Stage III. Also lost one of the two nerves that make an erection possible so I have a 30% chance over the next two years of having an erection.Wish me luck. Better still, wish my wife Good Luck.

Six weeks after surgery my PSA’s were 2.26- high for a guy with no Prostrate. Six weeks later- this week- they are almost at 6. More than doubling in 43 days.

There is, however, some good news. I recently had a Pelvic MRI- in which they shove the world’s Largest Turkey Baster up your arse, wrong end up- as well as a Prostate specific PET scan. Both showed no signs of metastatic spread. So I have Cancer Cells- and lots of them- but no cancer.

Which brings us to here. We have decided (finally) on a course of treatment. I am going to be part of a Clinical Trial that consists of a 12 month course of “Androgen Deprivation Therapy.” In layman’s terms- Chemical Castration. The purpose of the drugs is to eliminate testosterone.  Thus the title, “My Year as a Eunuch.” A regular Varys, but without the little birds.

Which brings us to this paragraph. The last several months have been hell for me and my family. The waiting, the not knowing; pure agony. But what happens, once you get some good news, is that you tend to forget how hard each day- sometimes each hour- was to endure. Most days it was all I could do to make it to Four o’clock which has become Martini hour. I’d have one, make another, and head off to the World’s Greatest Shower, having pissed my diapers full all day. Even though that was so recent, my memories of it have faded- a human survival mechanism. We don’t remember the details of pain we have endured. If we did the memory alone would kill us. Would me. So there are many nuances of my existence since I was diagnosed that have gone by the wayside. Not this time. Why for this Blog. I intend it to be a raw, real time capture of the emotional, physical  and psychological aspects of The Treatment. I do not want the benefit of Hind sight or acceptance. I am going to post how I feel emotionally and physically on a daily basis. I will use “All the Words.” Again, you’ve been warned.

Its is going to be a wild ride. I might grow tits. I will have Hot Flashes. I will not have sex nor will I want to. I might join the Boys Choir. It will not make me Gay- that would be an Upgrade and I don’t have the Frequent Flyer Miles to qualify.

So friends, grab a  hand and come long. When the going gets weird, the weird get going. Here I come.