Tag Archives: bone cancer

The Xtandi Factor

Part of my life this year has been spent on the road.  While a couple of those sojourns have gone to the southland, most of those traveled miles have been within the northern part of California.  And much of them have been to see my dad, who has been battling prostate and bone cancer for the last five and a half years.  This time last year, my parents made a journey to my neck of the woods, seeing a doc at UCSF, where chemotherapy was advised.  Taxotere was introduced into Dad’s retinue in late January, 2014.  Suddenly this whole cancer-gig was more than the quarterly Lupron shot and doses of Zytiga, which not longer did the job.

And as it seems, just as speedily another year has passed.  How many miles have been collected by my car, how many miles has my father trekked?  Far more than I’ve traversed, for my dad isn’t the same.  He might have been feeling on top of the world in late September, claiming he had another twenty-five years in the tank, but now in mid-December, he’s a different person.  Radium 223 is still off the shelf, so Xtandi is the next option, a drug similar to Zytiga, taken in pill form.  Dad will start Xtandi this week, and we’ll see if it helps, his PSA and overall demeanor our gauges.  He’s also lost ten pounds since September, the chemo-style nausea having returned, without the chemo.

If you’ve never heard of any of these terms, no worries.  Neither had I, until Dad was diagnosed, but the realm of cancer is like an alternate universe.  We’ve been relatively fortunate; prostate cancer is quite treatable, and some men live for many years.  But not all.  Dad also has COPD, so that complicates matters.  When he was first given this news, I wondered how he would cope with chemotherapy; he has an indefatigable spirit, but the body is a separate element.  The doc at UCSF maintained that Taxotere is a milder form of chemo, compared to other drugs.  And for the first seven rounds, Dad tolerated Taxotere like a champ.  But in the eighth and ninth sessions, Taxotere came out with mean left hooks that left my father gripping the sides of the ring, wondering what in the hell had happened.  There was no tenth dose; in early July, Dad was clearly on the ropes.  But in late September, he had regained strength, his appetite, even his love of ice cream was returning.  Another quarter century looked like a walk in the park.

Two and a half months later, those extra years seem fleeting.  It makes me wonder about the nature of medical intervention, but more, I ponder if one day I am in a similar situation, what I would choose.  Dad isn’t doing this all for himself; he’s doing it for Mom, their children and grandchildren.  We all love him, want him to be around forever.  But forever on this corporeal planet just doesn’t happen.

On other planes, yes.  But not on Earth.

As Christmas approaches, I ask my husband and kids, “Okay, is there anything else you want?”  We’re lucky, for tangible blessings are within our grasps.  But the intangible aspects are all I wish for my father; to be pain-free, to be comfortable, to not be nauseous.  I will never forget coming home from that UCSF appointment in a pouring Bay Area rain, traffic on I-280 at a standstill due to a nasty looking accident just south of San Francisco.  My father’s impending date with chemo butted up against intense gratitude that my husband and I weren’t involved in that collision, that life and death were constantly battling for supremacy.  One year later, I mull over that evening, so many nights and days in between, miles on motorways, a baby born, more on the way.  And my father is still here, telling tales, also looking like a man I have never before seen.  He is still my father, but no longer is he the strong, forceful character of past days.

Where Xtandi fits into all this remains to be seen.  I hope it lowers the PSA, I hope it affords my dad some relief.  But respite isn’t a cure.  Through all of this, I have prayed for the will of God to be done.  And every day that prayer has been answered.  I don’t know why chemo left my father so debilitated, while his PSA bounced right back up as soon as Taxotere stopped being administered.  But I do know that regardless of what Xtandi does or does not do, Dad will continue to chat and joke until he simply can’t.  I’ll keep driving, as long as my car holds up.  Blast the tunes, be they Christmas-themed or tropical pop; Dad’s still holding court.  I’m ready for another road trip, on this concrete and ethereal pathway taking my father home.

Peace Pie and other musings…

So the World Series is tied one all, fitting to send it to San Francisco.  I won’t lie; I’d LOVE the Giants to take it at home, which they have not done in their previous two wins.  However, I don’t want to appear greedy, so as long as they win…

Ha, well, nothing greedy about that.  I will note that this contest has brought out the small sports fan in my eldest, or maybe it’s Buttercup who appreciates the Giants, although last night’s game was hard to watch, once Jake Peavy allowed two Royals on base.  But now these teams have gotten a rout from each of their systems, so perhaps the following contests will be closer.  (Albeit with a San Francisco victory sealed at the end…)

But what does that have to do with peace pie?  Not that much, nor does peace pie correlate with the recent news that Radium 223 is not currently being manufactured, in Norway by the only company that makes it.  I accompanied my folks to Sacramento yesterday, where we learned that no radium treatments are being offered anywhere in the world.  The doctor’s assistant wasn’t sure why, but we discussed other options, like Xtandi and Ketoconizol, which is an anti-fungal that just happens to work well for prostate and bone cancer patients.  Dad will make an appointment with his oncologist to map out the next step, however I’m hoping that Bayer can sort out the Norwegians in a timely manner.  Radium 223 would truly best serve my father at this time, and time is a most precious commodity.

Still, I hear you rumbling, “What in the hey does that have to do with peace pie?  Is it some autumnal thing, baseball related, or Buttercup’s favourite dessert?”  Actually, it’s what happens when I have too many fireflies flitting in my brain (thank you Laura!).  My brother visited with the folks last weekend, then asked me what we were all bringing for Thanksgiving, which was his way of saying, “Hey sis, start a thread, will ya?”  I complied, noting that we would bring Grandma’s fruit salad, homemade cranberry sauce, and peace pie, with perhaps some vanilla ice cream for said peach pie.  Note the error?  I didn’t, but my beloved little brother did, answering what in the heck was peace pie (ya hippie!)?  I countered that I would also make some deviled eggs, they had to have an attitude, to which my sister replied how much she loved our family, big smiley face icon included.  And I answered that yes, at lease we are entertaining.

Then Mom asked why we had a lease?  And on it goes…

I said that’s what happens when I’m not writing, my spelling goes right down the loo.  Which is somewhat true, in that WordPress and my email provider, as well as Word, note the misspellings, but not the erroneous miscues.  Peace pie, at lease, the list is endless.  Similar to Radium 223; we assumed that was the next step, but maybe not.  Assuming is a tricky deal, not always for the best.  Maybe it’s best to be like Buttercup, hording the remote, ready to change the channel if the Giants get wonky.  And at least (not lease) Buttercup doesn’t care how I spell peach pie or at least.  She just wants to eat the pie, peaceful or not.

Dad wants pie too, and while ice cream is tasting good again, he prefers Cool Whip.  I also know he’d prefer radium over other treatments, just as he and I and Mom and my hubby and probably even Buttercup would prefer SF to win the Series at home.  But what we prefer is at times irrelevant.  All we can do is wait and see.

And eat the peach and peace pie with great big spoons.  And cheer on the Giants to perhaps another World Series championship!

The Radium 223 Road Trip Part One

 

If my life were longer, say another couple hundred years, I’d write a novel based upon this entry’s title.  But even if I live to my nineties, most likely the last few days will remain as a memory, barely touched on within this and the accompanying post.  So many things happened over the last few days that snatches will waft through me, until as Julie Brown once said, I can’t recall them anymore.

But obscure pop culture references aside, I want to recount a few tidbits of my recent days, because while life is meant to be lived in the here and now, what we pass along to others matters too, be it in the confines of doctor’s offices or over ice cream, or even when alone, conversing with a creator who made the whole kit’n’kaboodle.  At times, time is frozen, like the sign at a Bakersfield liquor store, advertising the sale of film, sandwiches and picnic supplies.  When I saw that sign, I had to pull out the phone, capturing that piece of a bygone era.  Who sells film, or even notes its sale, anymore?

(Later I learned that no, they don’t sell film.  But I’m glad they still have the sign.)

When Dad saw his oncologist a few weeks back, radium was already on the proverbial treatment table.  His visit to the UC Davis Medical Center last week was the preliminary step, introductions between Dad, Mum, me, and a very personable doc who thought Radium 223 was Dad’s best option, assuming Dad isn’t anemic.  Radium 223 is relatively new, approved by the FDA in early 2013 after very promising trials.  It’s infused right into the bloodstream, going straight for the bones.  Fatigue and diarrhea will be the main side effects, but Dad was optimistic, especially after hearing that the next treatments were Jevtana, the bully-chemo-cousin to Taxotere, or another hormone pill that probably wouldn’t do Dad much good, coming too close on the heels of his days with Zytiga.  We might consider Xtandi later on, well after his encounter with Radium 223 is over, but right now Radium 223 will be enough to ponder.  Dad won’t be radioactive, the doc noted with a smile, so hugs are strongly encouraged.

After the low-down was discussed, we were sent to the lab, so Dad could give blood, to make sure among other things that he’s not anemic.  This has become so much of his life now that he doesn’t flinch, even made the doc laugh when Dad said they could poke him wherever they wanted.  “You’re at a university hospital,” the doc slyly smiled.  “Don’t go saying that around here.”  We all chuckled as Dad was called back to give blood.  Mom nibbled on a granola bar while I considered my next activities; we all had miles to go before we slept.  Dad wasn’t in there long, and slowly we approached the main entrance.  The facilities at UC Davis Medical Center were excellent, and everyone was pleasant and upbeat.  As usual Dad was his charming self, which I know bolsters not only his health, but the rest of us too.  Several times the doc noted this wasn’t a curative therapy.  It’s solely to give Dad, and us, as much time as possible.

And again Dad noted that he felt he had another couple of decades.  What more can we ask for?

While my parents had to navigate Sacramento freeways to get back home, I took another route, not one returning me to Silicon Valley.  The Central Valley was my destination, so we didn’t linger long, saying our goodbyes, which are temporary, for Dad will be back in Sac in a few weeks, possibly sooner, depending on the results of his labs.  If his white blood count and platelets are normal, and he’s not anemic, the first infusion of Radium 223 could take place ASAP.  These treatments will continue every four weeks for six months, unless his PSA skyrockets, in which case this option will be dropped.  But the doc noted that PSA’s are no longer the be-all end-all markers of prostate cancer.  In the last five years, PSA’s have mattered less, as long as the patient is feeling well.  With bone cancer now in the picture, not to mention Dad’s COPD, a host of ailments hover.  Dad himself said that prostate cancer isn’t usually what kills, and some men live for years with the condition.  Dad’s thinking another twenty of those years, and we’ll take it day by day to see.

Day by day is all any of us have, whether we’re seventy, forty-eight, or twenty-two, with another life eager to enter the world.  My next stop on the road trip was to see my youngest’s best friend, the mum-to-be of Master Z.  I was also on a quilt-delivery mission, but that destination was at the tail-end of Highway 99.  Before I closed my eyes on that day, Bakersfield, California was awaiting me.  I hugged and kissed my parents, walked to my car, then started the engine.  Pulling out of the UC Davis parking garage, I made my way for US 50, which would take me to 99 South, for Fresno the sign said.  I smiled; many cities and small towns between Sac and Fresno, and a few more separating Fresno and my final stop for the day…

An unexpected Monday

Don’t get me wrong; I knew today was the first day of the week.  That’s not the issue.

The issue is that since the beginning of the month, this day on the calendar has been marked with my dad’s oncology appointment.  Between the lines is Road Trip; since my father’s prostate cancer was diagnosed in 2009, I’ve tried to attend as many of his doctor’s visits as has been feasible.  And when bone cancer was detected over a year ago, every three months I trek to my hometown, making a day of it; I get some breakfast at my favourite bakery-coffee shop, then head to the oncologist’s office, which is close to where my best friend works.  Sometimes I chat with her before I see my folks, sometimes she and I have lunch together, or just a frozen yogurt.  I stop at a local bagel shop for their day-old wares, hit another store for more bagels (I eat them every day for lunch, and my son appreciates it when I bring home poppy bagels), then drive home, singing to all my favourite tunes.

But the focus is my parents, my dad.  So far, just a few cancerous specks mark his left hip, and his PSA levels remain steady, in the upper teens.  He’s on Zytiga, but these quarterly visits are about how he’s feeling, getting another Lupron injection.  We joke that he’s suffering hot flashes on my behalf, and has been doing so for coming on four years.  Bone cancer adds a niggle to the whole situation, but so far, Dad’s a trooper, and what’s a road trip every few months?  I used to live eleven hours away by plane.  Long distances aren’t a problem.

But that I might have been exposed to the flu isn’t something to be ignored.  For a week, my daughter’s best friend was staying with us, and on Saturday, she wasn’t feeling so well.  Yesterday, she left, but took a bad cold with her, and just to be on the safe side, I’m not driving this morning.  I will visit my folks in a couple of weeks once I either get the flu and recover, or am certain it has passed us by.  Sort of odd thinking a nasty bug could be hovering.  Until it hits, I’ll continue with the work.

Sometimes life takes detours, but they’re not always bad.  Today I’ll edit, but the new idea has been pestering me, so I’ll probably spend a good chunk of time at the kitchen table, paper strewn about as notes are made, an outline prepared.  There’s no Monday Night Football, but my 49ers were very good to me on Saturday, not so kind to my husband’s Green Bay Packers.  By the time I see my parents, the NFC Championship game will have come and gone; either San Francisco will be going to the Super Bowl, or licking their wounds.  I received my love of pigskin right from my father and we’ll have plenty to jaw over.

If you’ve read Alvin’s Farm, my dad is a lot like Tommie Smith.  He’s had his sorrows, and his joys.  He was a young grandfather too; my dad isn’t quite seventy, but participated in his granddaughter’s wedding last summer, reading the first half of I Corinthians 13.  He finds my writing intriguing, not that he would read any of my books, but he loves telling his buddies about my exploits, sharing all his kids’ triumphs.  And the grandchildren’s too; he has seven total, my three twenty-somethings, then four little ones who have offered him a lovely glimpse of innocent days.

Life, like the tides, is cyclical.  What comes around, goes around, but hopefully not the flu.  Maybe just a date on a calendar will be rearranged, sans the trip to a doctor’s office.  I’ll get up to see my folks, do all the usual activities, just not today.  Today is meant for this post, some revisions, plotting a new novel.  The road trip is just waiting for Super Bowl contenders to be decided.

My dad

My dad