Things have happened since last we spoke. Here’s some of the highlights.

PSA. The concentration of Prostate Specific Antigen in my blood measures how robust and aggressive my cancer cells are. My PSA was steadily increasing starting April until August 31st, when it suddenly reversed course and started going down. It went down to 17! The time before was 19.5. I had blood taken earlier today, and hopefully it will be lower still. It’s unclear whether this change of trajectory is due to enzalutamide or my positive attitude. I’d been having bone pain which has relented in the last couple…


Last Wednesday’s bloodwork revealed my newest PSA number — the key number to OS (overall survival) for people experiencing mCRPC (metastatic castration-resistant prostate cancer) — had increased yet again, this time to 19.5. My last two levels yield a PSA doubling rate of 1.9 months which is the most direct connection between OS and PSA (there are doubling rates of “greater than 10 years”). At the moment I’m not investigating just what that doubling rate means about my own OS because I’m confident my PSA will stop rising and it will become a “what might have been?” question. …


[Spoiler: I’m going to say this at the end of this post: “If anyone out there has any suggestions about oncologists, treatment centers, insurances, tactics or strategies, I’m requesting them from everyone within the sound of my voice.”]

I’ve been on the edge of my seat about my current PSA level and was expecting one of these possibilities: lower (encouraging), the same (disappointing), or higher (very disappointing) — I hadn’t counted on a fourth possibility: we just don’t know. But that’s just what happened. For the first time since before my diagnosis PSA wasn’t ordered as part of my blood…


Diagnostic Thursday is on Wednesday this time. No scans or radioactive tracers this time, just a couple blood draws.

My last chemo infusion was June 23rd. On July 14th I started a new medicine. It’s a hormone treatment, and it’s called Xtandi. (Which name I hate. It sounds like the medicine they give to Care Bears when they get prostate cancer.) It’s all about making my prostate cancer and cancer clumps get even less testosterone nourishment. So, “Candy is dandy; and Xtandi will keep you from getting randy.” I definitely like the generic name for Xtandi a lot more: enzalutamide.


I have to say I have had a few instances in the last couple weeks of losing some of my patience at being a person experiencing prostate cancer. I would go so far as to say I found myself at times in a state of profound irritation at the whole business.

I scheduled an ambitious set of procedures for Diagnostic Thursday last week. I was grateful @mary offered to drive me.

I had an MRI of my neck, an EMG (electromyograph) nerve conduction study of my left arm and leg, and a blood draw. …


Shortly after my cancer diagnosis I started using the noun phrase “my oncologist.” Which led me to realize I had become a guy living with some new facts of life. Last week I saw, for the first time, “my neurologist” (my neurologist reminds me of Dustin Hoffman in Stranger then Fiction (if you haven’t seen it, consider doing so; if you have, consider seeing it again — we recently did and were glad.)) One of my moods today seems to be parenthetical.

My excuse to see my neurologist was that I’ve been having strange sensations in my fingertips and pain…


This is my paperwork for my most recent chemotherapy and a couple pictures of the infusion center. The pre-medications (Fosaprepitant, Ondansetron, Dexamethasone, Famotidine) are different anti-nausea drugs, which work great — I haven’t had any nausea, thank goodness, since I was dreading it. I’ll write about chemotherapy nausea sometime soon, but now I’m going to talk about my main chemotherapy medicine.

Docetaxel (Taxotere) is a chemotherapy medication used to treat a number of types of cancer. This includes breast cancer, head and neck cancer, stomach cancer, prostate cancer and non-small-cell lung cancer. …


I spent a good deal of time last night while not sleeping thinking about some of the responses to the prosecution of George Floyd’s murder and his murderer being found guilty — responses like “the system works” and “George Floyd received justice” and “no one is above the law.” While I agree it’s gratifying to see his murderer led out of court in handcuffs it remains to be seen what the final sentencing, appeals, and disposition of the case will be. And that’s just the beginning of my thinking and feeling on this.

I’m not going to post this on…


Eight days after each chemo I’m most vulnerable to ending up back in the hospital. This time I sailed through without a whisper of a symptom. I’m grateful, very glad not to have gone back to the hospital. I didn’t realize how anxious I was until the danger had passed.

There’s a “nadir” about eight days after chemo (nadir means the lowest point, and zenith the highest). What’s at the lowest point is the number of white blood cells: they’re nearly completely absent (that’s “neutropenia.” With a fever, it’s “febrile neutropenia.”) Since white blood cells defend the body’s principle from…


Some content creators created these fictional content creators …

Just a quick sketch. Working to make this kind of project happen in real life is one of the goals of Our Better Future.

Get ready for the antidote to so much, including the “what to watch” conundrum: Uncanny dread, crime, menace, unlikely couples, and outer space. Honestly, I didn’t think that “content is king” was going to lead us here, but here we are.

Put together a consortium of paid and volunteer content creators and communications professionals to produce cultural content based on real principles, our real circumstances, and the concerns of real people. And have it break way…

Paul Stark

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