Upon my the initial news of my huge 7-week PSA jump, post SRT, of course I was in shock and awe at first, so was my doctor, a leap of that magnitude was not expected.
But since about 2 days after the reading, I have developed a strange calm about my entire situation. I am not scared, and in some ways, feel like a weight has been lifted off of me. Of course I don't like and wouldn't have chosen this situation, who would? But, my mind has quickly adapted to this new level of my reality and existence.
I know what my only real option(s) is/are. Not to do anything - like nature run its course, and with this PSA velocity, you don't have to be a rocket scientist to understand that it wouldn't take long to be in mets range. I can do HT now, while the PSA is still under 10 (at least right now), or as some experts and doctors would suggest, wait till it gets to 10 - 20 range, and then slam it with HT. From what I have learned and gathered, that's basically my "choices" at this point. The PSA certainly isn't going to reverse on its own, I accept that.
Like all things PC, it would be nice to have one voice, one opinion, of the effectiveness of HT in general, and agreement on to start now or later. We all know here, those that have researched the subject, that even our experts in the PC world can't and don't agree on an exact strategy.
With 2 major failed curatives attempts in fairly short order behind me, and now a skyrocketing PSA again, and the fact that I started this journey with Rapid PSA before diagnosis, I don't have a lot of confidence in HT helping a lot. Some or many of you won't agree with this statement, and that is cool. We are all learning, and we all have our own natual biases on the subject.
Since my SRT did so much damage to me physically, and left me in a year of pain and horror, resulting (I know some of you are tired of the story, sorry) with a destroyed bladder and bladder neck, resulting in a nuisance of an ursotomy, I wished a thousand times over, that I had never undergone it. I didn't trust on my gut feeling on that decision. Everyone was saying, oh it might work, you need to try it, etc. I did major radiation before, and it put me through hell and left me with major side effects that I still suffer from 11 years later. I made the decision, so I have to live with it. But if I had only known that SRT for me was going to fail within months, I would have never taken the risk.
So now, with a lot of advice saying, I should start HT now, and I can always stop it if I don't like the SE or QOL issues, sounds good on paper. For me, I am not convinced in my particular case that HT will stop the advances of this runaway cancer. I don't want to spends months or years being more miserable than I have already endured. What's the point? If the cancer is ultimately going to win, then why suffer more for little gain? It's not a question in my mind of giving up, geez, I have had to fight a lot of terrible and painful things for over 2 years already.
It's more a question of how do I want to spend the rest of my life. It's a question of not being fooled again with a treatment that is doomed in advance, HT certainly isn't going to be curative, no hope of that.
But despite all this, I do have a calm about it. I would hope that some of you, perhaps just a few in our community here, would understand a bit of what I am saying. I am certainly not advising this line of thinking towards anyone else, I am only talking about my own numbers and my own case.
No decision has been made. Still seeking another medical oncologists opinion. I need that in my decision process, no doubt.
Just sharing this odd sensation of calm. From the day I was dx, and in the years prior to the dx with a rapidly rising PSA, I would never know I have cancer. I don't feel the cancer, no direct effect that I can detect. All the pain and suffering I have and are still going through, are 100% related to the treatments to stop the cancer, not from the cancer itself. It's hard to believe I did all I have tried, just based on numbers on a piece of paper.
David in SC