Diagnostics, Medicines …
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.
Since this is the only treatment I’m getting at the moment — besides my once-every-three-months shot of Lupron (leuprolide) — the numbers for my PSA (prostate-specific antigen for those just tuning in) and testosterone levels are particularly important. Even in the midst of chemo my PSA numbers were going up, gradually, but up and not down. Xtandi will hopefully cause my PSA level to go down. There’s people on the Facebook Metastatic Prostate Cancer group with PSA’s of .03 and they just keep going along, year after year like that. My last PSA was 13, which is about 400 times more. I was very nervous about the possible side effects, some of which are pretty disconcerting, but so far, just some headaches and fatigue: manageable.
Leuprolide works by interfering with my pituitary gland’s signals to produce testosterone. It works really well. My last two testosterone levels have been “<7” — less than 7 seems to mean: such a small amount that the resolution of the test just gives a “hardly any” result. The normal range is 193 to 740, which means that just about every Tom, Dick, and Harry is running around with between 30 and 105 times as much testosterone as I’ve got. Everyone assumes that once you cross the line from pre-pubescence to being a biologically adult male there’s no going back. Well, in some special cases, there’s a way to go back. I could say more about leaving post-pubescence and returning to pre-pubescence, but not today. Leuprolide is essentially what they gave Alan Turing, but I’m definitely not going to bite the apple.
Enzalutamide, like leuprolide, wants to deprive cancer cells of their favorite food: testosterone, but instead of interfering with the brain’s instructions to produce testosterone, it interferes with the cancer cells’ ability to consume it. Which means that, if it’s working well, the tumor and the many cancer clumps scattered about my skeleton will actually shrink.
To be honest, I really don’t understand how much difference it could make since there’s hardly any testosterone circulating around in me, because of the leuprolide. I think it might have to do with there being other sources of small amounts of testosterone, the adrenal glands and, I swear to you, the cancer cells themselves. It’s beyond me how a prostate cancer cell can figure out how to produce its own testosterone, especially since that’s not what the prostate does anyway. How does a cancer cell even figure out it would be a good idea to make the attempt? Someone must know (I’m guessing), and maybe later I’ll know too.
At any rate, we are hoping for lower PSA and testosterone numbers tomorrow. I’m keeping my fingers crossed.
On the left, my morning dose of enzalutamide. On the right, the place where Westmed takes blood out of people so the labs can do all the different kinds of tests to learn all the different kinds of numbers to help treat the many different kinds of health challenges.
#ProstateCancer #OurBetterFuture #PaulsCancerJourney
