hey unc, any updates?

My favourite niece sent me a message the other day saying "hey unc, any updates? how are you doing?" so I thought it was about time I got my brain in gear and wrote another blog. (I call her my favourite niece but it won't upset any other nieces because I don't have any.)

Last week I was really fed up. I had it in my head that I was to see the urologist at the hospital on the 22nd January and, indeed, that was originally the plan but I had received a letter ages ago moving the appointment to some time in March. Normally that would have been no big deal but I had had a PSA test on the 12th January so that the urologist would have the results before seeing me. Again this would have been no big deal if the count hadn't more than doubled from the reading at the end of November last year. The November count was 30.1 (up from 1.1) and could be explained by being taken too soon after my TURP. The new count was 79.1 and to say the least is a bit worrying. I certainly did not want to wait until March to talk this over with the urologist so I called the hospital and have managed to rearrange the appointment for the 12th February.

In addition to the high PSA count I have had some pain in my back and the top of my right leg I suspect that these are due to bone lesions caused by the cancer. So far the pain is manageable with off the shelf pain killers - Paracetamol and Ibuprofen. Never the less I still get some discomfort, particularly when walking - I get a twinge every time my right heel hits the ground.

I saw a GP at the local health centre last week to ask for a test of my testosterone level and to be referred to a particular oncologist at the Christie hospital. I'd picked that oncologist because he specifically mentions hormone therapy and chemotherapy for men with prostate cancer. As luck would have it the GP I saw was actually in training as a GP - he'd had experience as a hospital doctor and wasn't sure how to handle my requests and had to refer them to another GP. She said that they didn't do testosterone checks. There is no reason why they should not, other practices do, but I'll leave it until I see the urologist in a couple of weeks.

The reason for the testosterone check is that the hormone treatment is meant to stop my body from producing testosterone so that it can't feed the cancer. The rise in PSA indicates that the cancer is active so either the hormone treatment has become less effective - testosterone is still being produced and feeding the cancer - and there is room for extra and or different hormone treatment or the cancer has learnt how to do without the testosterone. The testosterone test would give a big clue as to which of these is the case.

With regard to the reference to the oncologist, the GP was not sure as to whether he could refer me to the specific oncologist or just to the department. I said that if it were the latter to include in his letter that my preference is for the particular oncologist. I called the oncologists secretary later but got no answer. I called again the next day and left a message. She called back and was able to confirm that it would be in order for the GP to refer me directly to the oncologist. I passed this information on to the GP's secretary.

There is actually an oncologist from the Christie on the Multi Disciplinary Team at the local hospital. I have met him because he was the oncologist I was first referred to with my testicular cancer but he is primarily interested in radiotherapy and I am particularly keen to have someone with a specific interest in hormone therapy review my case and potentially take over my treatment. Now waiting for a letter from the Christie for an appointment.

There is better news on other health issues. I had an eye test on Monday and although I am slightly more long sighted my current reading glasses are still OK. Also the health of my eyes - the retina and lens- is very good. I also had a check-up with the dentist. No problems with my teeth either.

Now the snow has gone I'm managing to get in an hour or so of walking each day albeit with a bit of a limp and slightly slower. The important thing is I'm loading my skeleton and strengthens my bones. Important because the cancer and the hormone therapy both weaken the bones. That reminds me that one of the things I'll be asking the urologist for is bone strengthening medicine - bisphosphonates such as Zometa. Other chaps with bone metastasis say they have benefited a great deal from such medicines but it is a bit of a post code lottery as to whether they are prescribed. I'm hopeful that the bone pain will swing it.

Enough rambling for now. I won't leave such a gap before the next screed.