Depression while on HT for Prostate Cancer

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/5/2008 11:48 PM (GMT -6)   
I want to make it clear, I am OK and I would still take the HT option like I first decided.  I have been contimplating how to post this, but i guess I will drag and drop my blog post from yesterday then elaborate over the next day or so...
 
From my blog...
 

Prostate Cancer and Depression...And Another Birthday...

I am a very upbeat guy so this post might be a surprise to many. I have been going through a bout of depression and it's cancer related. Yet another side effect of knowing I have advanced prostate cancer, the 18 months of treating it, and it is also enhanced by my mothers passing. So when I say depression, it's not like clinical depression. I'm not going to hurt myself, or anything like that. But when I am alone, sometimes I feel like tears are coming ~ and they sometimes do. Last night was a good example. I was just typing a letter to a friend and I had to stop and take a few minutes away to get my composure back.

Hormone Therapy is likely the biggest cause. Complete ablation of testosterone has many effects on a man's body and mind. I am no exception. And the peaks and valleys are far more gapped than ever before. I am an emotional man already, so add in this treatment and, well, you get the picture. I mention it here because there are many now following my journal. Some know exactly what I am saying. So everyone else following, too, can know that prostate cancer is NOT the good one. There is no such thing.

The University of Arizona College of Nursing has contacted me and has asked if Ruth and I will participate in a study. It's a well timed support study. We talked about it yesterday and will participate. UA found me in the magazine article. Which is precisely why I volunteer for as much as I can in this fight. I want to make it known that we are NOT doing enough to cure this disease.

Oh yea, the birthday. Happy Birthday to the good 'ol USA. God has blessed our nation with its 232nd birthday today. If you don't think so, read the Declaration' 1st sentence and each and every states constitution (Thanks Cedar). There's a lot of God talk their.

'Those people who will not be governed by God will be ruled by tyrants.' - William Penn

.

AMEN to that! And I will pray for every man and woman fighting to keep our nation strong.


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


taiping
Regular Member


Date Joined Apr 2008
Total Posts : 62
   Posted 7/6/2008 2:28 AM (GMT -6)   
Hi TC,
 
Just wanted to share with you that you are not alone with the effects of HT!!
I'm also on HT and a few months ago I went for a break with my wife and daughter staying at a small hotel. Shortly after we arrived my wife's family arrived and somehow I was expected to ferry them around all day visiting the sights. That night I tossed and turned and eventually broke down - I couldn't hack it anymore. It took quite some time to get back my composure and I later put this down to the effects of HT since I'm normally fairly resilient.
There have been other occasions when I've felt "down" but not as bad as this.
At least I can see the end of the tunnel with the Intermittent HT with less than 3-weeks to go, and I don't regret one bit having chosen this treatment over more radical methods.
I hope you will be able to get over the bout of depression by focussing on the positives.
 
Steve
 
 
Diagnosed: June 2007. Aged 61. PSA 19.6. DRE negative.
Biopsy: June 2007; 2 cores of 18 positive.
MRI and Bone Scan: Negative.
Pathology: 5% of 1 core, "Small focus" in another core +ve.
Gleason 3 + 3 = 6.
Clinical: PCa considered confined to prostate. Stage T1c.
Treatment: After considering RP and HD Brachy, decided on Intermittent Triple Androgen Blockade Therapy for 1-year, using ZOLADEX, CASODEX 150 mg/day, AVODART 0.5 mg/day. Start PSA 19.2 (July 2007).
Current Status: PSA 0.018 (June 2008) - PSA nadir.
---------------


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 7/6/2008 6:12 AM (GMT -6)   
Taiping, I wouldn't feel bad about this. Having to entertain the in-laws for a day would make normal guys break down too :-)  Still, glad you recovered.

Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week PSA: 0 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 7/6/2008 7:08 AM (GMT -6)   
Thanks for the post Tony. I have been one of the lucky ones, as of yet I have not had much anxiety or depression. I will admit to a moment every now and then when the thought of what is to come is a bit overwhelming. I think it is far to say that most people have no idea what hormone therapy or total testosterone ablation does to a man. Also I have found that most people for whatever reason do not seem to take PCa very serious. For us stage 4 guys unless I have missed something the prognosis for ten year survival is grim, and when you have a family that in and of itself can cause anxiety. You are a good man Tony and someone I am proud to call friend. Keep the fight alive, as I am doing the same thing here in TN. I will be on the local radio station for two hours next friday trying to bring awareness to PC and to promote my Celebration of Hope survivor party coming up in Sept.

peace and love
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
cancer in 4 of 6 cores
92%
80%
37%
28%
 


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 7/6/2008 7:59 AM (GMT -6)   
Tony,
 
I didn't realize the full effect emotionally of HT until I got off it.  It screwed me up in a lot of ways, some really subtle.
 
Also, do you ever think that you "had" advanced prostate cancer instead of "have".  True, you had seminal vessel involvement, but your PSA never recurred.  Its not like having a PSA rise after local treatment has been exhausted.  You've got some uphill odds, but is it out of the question that you're cured? 
 
Like me, you had a late stage diagnosis at a young age,....AND, like me, you're throwing everything you can throw at this.   Mabe we're both cured until proven otherwise?
Sterd82
Age 47 - pre-surgery PSA 39
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
PSA as of November 29, 2007 undetectable
PSA as of May 14, 2008 undetectable
Next PSA November of 2008


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 7/6/2008 12:28 PM (GMT -6)   
Tony our connection keeps growing. I do mission work in Haiti, I am actively working on an orphanage there cghmh.org and it is something that keeps me positive, because I have seen the atrocities that go on in third world countries first hand. Life is good my friend, and life in America is awesome.

peace and love
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 7/6/2008 1:13 PM (GMT -6)   
Tony,

My friend, you can't hide too much from those of us who have gotten to know you a bit. I was waiting for you to take that first step toward us..and you have. Yes, the hormone therapy combined with a multiple of emotional crisis you have had to endure are likely the cause.

Ask about a good brand of 5HTP (natrol is good). It sure was a life saver for both Paul and myself 3 years ago. No wild side effects and no drugged feeling using a mere 50 mg. It worked so well.

E-mail me anytime Tony. If there is one thing Paul and I have never mastered but, always managed to make it through, it's a medical crisis. Heaven knows we've seen our share and then some over the years. Hang in there and God Bless.

Vickie
 


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 7/6/2008 8:43 PM (GMT -6)   

Dear Tony,

I have written and erased many thoughts here.  They were all inadequate.

My Best, My Very Best to You.

jetguy - your friend


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.
Seven month PSA is 0.8.


FLHW(David E)
Regular Member


Date Joined Nov 2007
Total Posts : 201
   Posted 7/6/2008 9:16 PM (GMT -6)   
Tony,

After 41 months at this, I hear you loud and clear!
Tell me if this sounds familiar:

It's not that I mope around the house, or stay in bed for hours and hours, it's there are just times when I question things. I question God, I question the doctors, I question the medication, I question my will to fight on. I don't beat myself down about this or harp on it long. It 's just there are times when I question my ability to fight the fight.

Then something happens; perhaps the vision of my beautiful wife, or the laughter of my son. Maybe a bird flies by - something, something always reminds me that "I didn't get cancer, it was given to me" and my mission is to figure out why?

I would argue here that it is all our missions to figure that out? Some of us are moderators. Some people write checks for the cause. Others hold events to raise money. Some do nothing, and that's alright too. We can beat this together and or we can deal with it alone but nothing significant will change unless we band together.

So Tony, my point is that you are not alone. If it makes a difference, I just try to make the lows very brief and shallow and cherish the highs!!!

PS - I re-read this and realized I was kind of rambling. I thought about editing it further but decided just to leave it as is!
Dx'd 2/18/05
PSA 271, bone mets, lymph node involvement
Gleason Score: 7
Current (6-30-08)
PSA: 53.40
Taxotere + Prednisone + Atrasentan
[started June 9th]
Clinical Trial:
http://www.clinicaltrials.gov/ct2/show/NCT00134056?term=prostate+AND+atrasentan&rank=2
Lupron
Personal Blog:
prostatecancerat42.blogspot.com


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/6/2008 9:31 PM (GMT -6)   
Thanks Vicky, Bill,
I will take this to my oncologist in two weeks. If he sees fit I may get an antidepressant. Thank you all posting here. This is a serious issue for many on HT and I wanted to bring it out. I know Biker Jim knows what I am talking about as he had difficulty with his testosterone. I can now say I get it, but it hasn't been as bad for me as it was for him. The fact is that I still have almost another year to go and that kinda sucks.

Dale I looked at the site and I am very impressed with your effort. The priest in my church today was Fr. Tom Hagan (No not from the Godfather but he joked about it) though he is Port-au-Prince. You may have met him.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 7/6/2008 11:19 PM (GMT -6)   
Tony-
Although my dad would never admit to being "depressed", he shared with me this weekend that he just has a hard time getting out of bed in the mornings. He use to love going to the gym and he has to absolutely force himself to go now. I told him that maybe he was a little depressed and he said "maybe". I was shocked. My response: "you had (notice the past tense :) cancer, surgery, radiation and HT all in less than a year and have over a year to go with HT. It is easy to understand why you are depressed". You guys have been through so much and then throw in the effects of HT and wow! I know that you will get through this, but want you to know that you are never alone in your journey. Thanks for being you!

Chayna
[color=#000fe0>DX]Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 3, 08 PSA .02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 7/7/2008 12:26 AM (GMT -6)   
Hi Tony,
 
Thank you for being so honest with us regarding the ups and downs of these mortal challenges we face.
 
Also, thank you for the reminder of the blessings of freedom of faith and mobility we have in the USA that many in this old world do not enjoy.   For those without basic freedom and human rights, our hearts go out to them and they deserve our deepest respect and support.
 
As you have told us so many times, stay positive!  You deserve all the rainbows you can grab on to.
 
 
 
 
 
 

Barry ~ (a.k.a. "Idaho") - Prostate Cancer Forum Co-Moderator

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

1st PSA  09/11/2007  <0.04 (undetectable)

2nd PSA 12/10/2007  <0.04

3rd PSA  03/17/2008  <0.04

4th PSA  06/17/2008  <0.04

My web site: http://pca-info.blogspot.com


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 441
   Posted 7/7/2008 5:26 PM (GMT -6)   

TC,

My heartfelt prayers are with you on your struggles especially including the depression side...   depression robs you of so many things beyond even just traditional happiness and sense of well being...   It is like the theif in the night...   When let rampart to run, it can affect your family, friends, and even your spiritual walk with God.

It is GOOD that you have identified it and have it in the open...  depression thrives in the dark and struggles in the light...  You are proactive and on a positive path to beating this truly evil condition.   With God, family, friends, and doctors, depression can be beat so that it will never rob you again.

I have dealed with 5-6 years of depression that started in my later years due to life's circumstances and most likely some brain chemistry issues that may heave been passed down in some family herdiitary DNA.   As strange at may seem,  my recent bout with PCa actually helped bring to light all the tools and factors for me to finally beat depression for good and put it in my past!

The solution for me was finally truly submiiting and having real faith in God which handled the stressors, and God's blessing of a doctor that was knowledgeanle in brain chemistry who found the lowest and most effective medicines with the least side effects to help balance my brain chemistry.  I have not felt better or more effective as a human being and servant of God for the last 20 years.

With God already in your life and with his blessings (which includes doctors),  I am confident you will whip this condition!   If you ever to need to ask any questions about medicines or their effects as they related to me, feel free to ask!  

God Bless!

pasayten


After 3-4 years of annual PSA 4-6, biopsy recommended
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/7/2008 6:26 PM (GMT -6)   

David,

I did not see your reply sneak between the others. I think sometimes I don't hit update on the page frequently enough.  That's not rambling.  You do indeed get it.  But like you I try to let the thought that has me down go.  I usually can't resolve it anyway.  My point is how the HT works like a magnifying glass.  Not as simple as this but here's my analogy:  "Dang it, that was the last time I spoke to my mother".  Instead of "Thank God I was there that day".  This dang stuff has taken away my ability to negotiate my balance sometimes. 

Thanks for your very heartfelt thoughts.

 

Pasayten, your comments are what a guy like me cherishes.  Thank you very much.

Tony



Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 7/8/2008 5:53:20 PM (GMT-6)


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 7/8/2008 5:34 PM (GMT -6)   

Dear Tony,

My post was so inadequate that I have spent some time thinking about your depression?, or exaggerated mood swings.

It seems to me that over our lives we pick up a certain amount of grief and sorrow.  The deaths of friends and family.  Disappointment in our lives and those of our friends. Perhaps the realization that things aren't going to turn out the way we hoped and expected when we were young and vital.  (Do you remember the song, "The Tavern"?  "We'd live the live we chose, we'd fight and never lose, we were sure to have our way.")

I sometimes awake in the wee hours and realize that I have been dreaming of my mother and want to ask her advice, but it's many years too late for that.  At other times, I think of the man that I am rather than the man I wanted to be. 

Now couple the experiences of a life and add Protate Cancer and HT to the mix.  Then, just to put some icing on the cake, make yourself an emotional man (I also share that burden).  If you don't sometimes feel a bit down, you are weird, nuts, abnormal, don't have a clue what the heck is going on. 

I expect that you will find a way through this, Tony.  It won't be fun, but you will prevail.

My Best to You,

Bill


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.
Seven month PSA is 0.8.


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 7/8/2008 6:12 PM (GMT -6)   
Beautifully written Bill.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 3, 08 PSA .02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

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