After waiting for what felt like an eternity, yesterday was the day that I met with my oncologist for the first time. I had already done my research and was very happy to have learnt that Dr. John is an expert in urological oncology and one of the main-men at the Christie. I knew that I was with the right person.

The latest diagnosis

Dr. John spent some time listening to my recent history and brief list of symptoms: these are still fatigue and back pain and not the urinary symptoms that would more usually be associated with advanced prostate cancer. Dr. John asked further questions before moving on to giving his expert opinion. In summary:

“We don’t yet have the results from your biopsy, although we can expect that these will reveal a Gleason score of 8 or above¹ and is unlikely to greatly affect my proposed treatment plan. I have reviewed your bone scan and it looks to be clear. However, this is not so with the CT scan². This scan reveals that the cancer has already spread. The cancer is in the lymph nodes/glands within your hips, pelvis and chest³. You have advanced metastatic cancer that is is not curable, although there are treatments available that can prolong your life.”

The plan

Dr. John went on to describe options and his preferred treatment plan. He explained that the Androgen Deprivation Therapy (ADT… it suppresses testosterone) that I am currently on would be likely to stop the further spread of the cancer, but that at some point it would stop working and the cancer would continue to progress. He explained that recent research has demonstrated that early use of chemotherapy can be more effective than waiting until the ADT is no longer effective.

So we have a plan: Continue with the ADT until late September and then begin chemotherapy. The chemotherapy will involve 6 cycles of 3 weeks. That’s me visiting the Christie every 3 weeks to get the infusion (18 weeks total). This might be followed up by some radiotherapy. The hope is that this will suppress the cancer for a time, although it will not cure it. Dr. John then went on to explain the side-effects that I will experience… I let most of that go over my head is it sounded crap and we’ve all seen the movie. It is what it is. I also asked to be considered for appropriate trials, although I do feel happy with the current plan.

Now then,

I now have approximately 8 weeks to get as fit as possible before the chemotherapy begins. Dr. John assures me that I cannot do too much exercise, so that’s me out on the bike every day. I’ve also taken up running… I couldn’t sit on the bike the day after the biopsy, and Sam ordered had me not to do a 10k walk. So I avoided all potential conflict by doing a 10k run instead. Actually, it was more of a walk, a jog and a hobble. I’ve not run anywhere for many, many years… I quite enjoyed it 🙂

1 The Gleason score is a rating system used to describe the grade of the prostate cancer. A score of 8 or above is considered to be a high grade cancer.

2 I had been previously told that the CT scan “Looked to be clear” and also that “It shows a spread to a lymph gland”.

3 Right from the start of all this malarkey, I always felt/knew/believed that the cancer had spread… so no surprises there!