Today was my 2nd visit with my new medical oncologist. We spent a full 45 minutes talking and going over things. The good news, even with the new X-rays that were done, no physical evidence of any mets going on with my bones at this time. Keep in mind, none were expected, by either me or the doctors involved. He is sending me to a good orthopedic doctor to review the bone scans and the x-rays, to try to find out what is still causing so much chronic pain in my right hip and lower back.
As far as my PC itself goes, guess you could say we will be practicing AS from this point on. He still wants to wait until December to do the next PSA reading. I have no problems with that. On the dietary side, despite me losing weight without trying (lost another 3 lbs in the past week), he wants me knock off as much sugar as I can in my diet. As far as exercise, he feels that the 2x a week I am doing at the Oncology Rehab is the best thing I can do for myself at this time. On the Vitamin D front, he wants me to continue the program that my GP has me on, to build up my Vit D level under supervision. Doesn't want me to take any vitamins or supplements without talking to him first.
He mentioned a new study out, that points to the fact, that too much Vit D can have an adverse effect with some men with PC. He said it was in the context of men that were self-dosing mega doses. He said he would e-mail me a link to the study when he got back to his regular office. I will be happy to share that here when I get it.
On the chronic fatigue front, he wants me to take low levels of Ritalin, 5 mg a day at first. He said he has seen it help people in my situation. He wrote me a script, and I told him I would have to think about that for awhile. It supposes to ease severe fatigue, and improve concentration. That drug has a bad rap in my mind, so I will have to study that proposal.
On the pain front, he said I am still not taking the med as often as he would like me too. Wants me to increase the Loratab up to 4-6 times a day. And it he said it would be safe for me to take 2 at the time when I am having a particularly bad moment. He laughed, and said he figured after my first meeting, that I would take him literally about what the dosing said on the prescription bottle. He joked that all us accounting/finance nerds tended to be that way. He said he bet that I only took the meds exactly to the minute on the clock when due. Of course I do, lol.
He still feels strongly, that many patients and doctors, are too quick to want to treat the PSA number. He said that men often jump right into SRT when its not really needed or even beneficial to them. Said the same thing happens when SRT fails, that the patient gets scared of a rising PSA number, and insist on being treated with HT right from the start. That is not his approach at all, based on his research and experience as an oncologist.
I like him. I feel he’s a good doctor. He says he spends endless hours keeping up to date on the latest developments in the field of cancer, its treatments, research, meds, etc.
As soon he feels my PC needs further treatment, i.e. HT, he will not hesitate to start up something if I am willing. If the next PSA really spikes at even a faster rate, he said we will have to re-evaluate my situation and adjust it from there. For now, his goal is to improve my day to day quality of life as much as possible.
David in SC
P.S. I see him again in August, and he said he will be checking with me by phone in-between