Bob Health Update 5/5/18

I recently heard a band perform a song entitled "Put It In God's Hands".  Seemed like timely advise as a lot is happening these days.

Since my last update, I have continued to have challenges with my digestive system and pain in my left thigh and lower back.  The pain in my left thigh has been extremely painful at times, especially at night when I have had episodes that have forced me to crawl to the bathroom because it hurt too much to stand.  Still, I managed to work through the challenges and was able to enjoy most of March touring the southeast United States.  Once I was home again, I decided to seek help again.  So far the digestive challenges remain; the good news is that I have lost thirteen pounds.  The bad news is that this week I have once again had trouble with digestion, had dry heaves, vomited bile, and run a low grade temp in the evenings.  Then I get days like yesterday when I felt almost normal.  For the leg/back, an MRI showed that I had a compression fracture in the L4 lumber in my spine, caused by the cancer there.  An appointment was set up for me to visit a neurosurgeon in St. Cloud to see if anything could be done to stabilize the area and reduce the pain.  But before visiting the neurosurgeon, it was time to visit Mayo for my quarterly checkup.

The first piece of news at Mayo was not good.  My PSA jumped from 2.0 in January to 16.6.  That tells us that for this time period the velocity of the cancer growth was that it was doubling in size in about a month's time.  (2.0, 4.0, 8.0, 16.0)  Now you can better understand why it has been so important to attack the cancer when the PSA is a small number:  when the cancer starts growing and the PSA starts doubling, it can become a big number in a short period of time.  If this rate of doubling continues, we'll be into some big numbers by fall.  Pretty scary thought - a worse case scenario in my mind.

The next piece of news was unexpected good news.  We are pretty much out of traditional treatment options.  (Trying other chemo drugs is another possibility but that gets into some very concerning quality of life considerations after my first chemo treatment did not go well.)  The goods news is it just so happened that Dr. Kwon had learned of a new prostate cancer drug and related clinical study that very week.  And I am a top candidate to qualify for the study.  The drug is Lutetium 177 and is used when other treatments have failed.  The drug is administered every two months through an infusion with a total of four infusions (so an eight month period).  The trials done so far have yielded very good results.  So the plan is to have me receive additional scans and blood work so that I am qualified whenever this study opens up, which was expected sometime in the next 4-6 weeks.  The study is only accepting 800 participants so Dr. Kwon wants everything in order for me to get the best shot at getting in.  So I will be back in Rochester on June 1-4 for these scans and consult.

During this visit, we also saw the latest scans showing where the cancer spots are growing.  By my count there is approximately fourteen spots in the shoulders, arm, ribs, spine, hip, and thighs.  On the good news front, my liver numbers are back to normal.  I can once again have an occasional adult beverage, assuming my stomach is up to it.

On Friday we met with Lindsey Dingman (PA) and Dr. Gerdes in St. Cloud about my back.  Turns out that the compression fracture was already visible on the CT scan done in January.  Comparing this to the MRI showed that things seemed stable and some healing has probably taken place.  Zooming in on the MRI we could see that the nerve in L4 was being pinched, probably causing my leg pain.  As a result, the plan is to do a quick surgery (45-60 minutes through a one inch incision) to "roto rooter" bone from around the nerve to relieve the pain.  The feeling is that things will be stable enough that after 4-6 weeks of limited activity, not only would I feel better but I can potentially even ride bike again.  (I'm walking with a cane these days so that was music to my ears.  No bike riding in my current state.)  So the process of getting insurance approval and on Dr. Gerdes' schedule has begun.

We knew that eventually the cancer would advance, just a little surprised at how quickly things have been moving lately.  Hopefully we can slow it down a bit, but there are no guarantees on that at this time, just hope.  At times it is all tough to deal with.  The tears flow and anxiety attacks get you worrying about what is coming.  When you consider when I first started having symptoms, we have now been dealing with cancer for a dozen years.  My body is feeling all of those years of treatments.  Yet there are also times when I am surprised at how well Mary and I have held up emotionally/spiritually.  I hope our faith in God is truly that strong moving forward.  Fortunately God has surrounded us with some very wonderful people that help us remember all of the positive that has been a part of this journey.  Just recently I received a beautiful prayer shawl from my sister-in-law Dana's niece as part of her 1st Communion experience.  This past Sunday, Fr. Joe came up to me after Mass and asked if I would like to receive Anointing of the Sick.  What a boost to have that experience once again surrounded by friends.  I have so many people asking how Mary and I are doing, and letting us know that they are praying for us.  That means so much.  Tough to get down for any length of time when you have so many people lifting you up.  And so much easier to "put it in God's hands".  He is answering prayers.  More "moments" await!