At any rate, this morning our first appointment was at 8:50AM -- lab work. Then our appointment with Dr. Flaig was at 10:00AM. The PSA has gone up a little more -- it's now 13.2. A little depressing, but Dr. Flaig was not too concerned.
Marshall had started out on Lupron (hormone therapy) early in the diagnosis back in April, and when it didn't knock the PSA down to undetectable by October, Dr. Flaig added a daily Casodex pill, which is supposed to block cancer cells. But he had told us that Casodex can do funny things. In quite a few men, when Casodex is added to Lupron, it brings the PSA down. But in some men, like Marshall, the Casodex doesn't do the trick -- instead of blocking the cancer it starts feeding the cancer -- so they discontinue the Casodex.
Now here's the interesting part: Dr. Flaig says that they have observed a phenomenon that in approximately 30% of the men who don't respond to the Casodex, when the Casodex is withdrawn the PSA shoots down to undetectable. The researchers can't figure out why, but now when they withdraw the Casodex, they wait 6 weeks and re-check the PSA again before they move on to other treatments. Dr. Flaig says he has seen this in quite a few patients, but the best one is a patient from Nebraska who this happened to and after withdrawal of Casodex, this gentlemen has now stayed in "remission" for more than 2 years.
So we are now in that 6-week wait-and-see period. We have stopped the Casodex and we go back on February 28th for another test to see if Marshall falls in that 30% of men. Cross your fingers!
Marshall got his Lupron injection today as well as his Xgeva injection, we went back to the hotel and had lunch and then headed home.
Marshall was a little tense yesterday and today but for the most part he stayed very upbeat. He feels good, no pain, and his energy levels are improving. Dr. Flaig says that the way Marshall feels is a big part of the equation here, so the fact that he's been feeling so good is an indicator of no cancer activity, which is good.
Here are a few pictures of the Anschutz Cancer Pavilion. It's a very pretty, peaceful place.
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