This is where I am now. I have advanced, aggressive PCa which has become resistant to the standard drugs; decapeptyl and bicalutamide. I am to go on to abiraterone next as an informed choice. Chemo can be given later if I agree and if my condition warrants it. However agressive my disease may be, I'm assured that it's in my pelvic bones only, not in lymph nodes, nor liver nor anywhere else.
I had a very helpful and informative meeting with my consultant urologist yesterday. He's a listener and answers questions truthfully but kindly. He's the best and I go to him when I need to sort out my treatment. Of course he works closely with the oncology team and so knows much more than his surgical training would suggest. He told me; there is no significant difference in effectiveness between the three forms of the long-acting anti-androgens. Zoladex is one, I am on decapepty. Abiraterone is the next logical step after these drugs and he recommends this rather than chemo first, the reverse of the advice of NICE, who often seem to get things the wrong way round.
As far as the oncology unit goes, the hospital has recently appointed one or more extra consultant staff. This may explain why Dr Onc, as I called him in a previous blog, had to see me and all the other patients in the same clinic session in an examination room, not in a proper consulting room. I have another appointment there after Christmas to get my new treatment started including the infusions of Zoledronic Acid (Zometa) once a month to strengthen my bones that have been damaged. I hope the next interview goes better than the last. At least I now know what I should say and ask for.
My urologist answered my question about what may happen to me. Possibly kidney failure when the disease has spread more. He said this is not painful and one can just 'fade away' with the aid of palliative care. Somehow I can, at this moment, face this idea reasonably calmly. I hope I may be able to keep on writing and talking with people for a long time to come.
