It was not an easy decision. The thought of undergoing hormone therapy was daunting and I had been convinced that it would be more harmful to my health and quality of life than helpful.
I originally rejected hormone deprivation treatment in late June after researching the subject. I assessed my potential risks based on the many side effects of chemical castration and how they might affect me based on my medical history and current medical issues.
At the time, my prostate-specific antigen (PSA) had only risen by four ng/mL in three months, from 33 ng/mL on February 24 to 37 ng/mL on May 20.
Also, the urologist wanted to continue the therapy for two years, which was unacceptable to me.
In my initial appointment in July with the radiation oncologist responsible for my external beam radiation therapy I explained my reasons for not wanting hormone therapy, and he accepted my decision.
Then things changed.
Another subject I discussed with the radiation oncologist was an opportunity to participate in a therapy that involves external beam radiation followed by the implantation of radioactive pellets in my prostate.
It is a combination of treatments that was shown in a clinical study to be more effective than external beam radiation alone. And it had also had excellent post-study results. And I was very interested in the opportunity.
So, the next step was an appointment in August with the oncologist who would perform the pellet placement.
The day before the appointment I received the results from my July 24 PSA blood test. My PSA had jumped to 49.3 ng/mL. Combined with my prostate biopsy Gleason scores of 7’s and 8’s I was now an even higher-risk prostate cancer patient.
The oncologist explained that all the men in the combination study had received hormone therapy as part of the study protocol. And that undergoing the androgen deprivation would shrink the prostate and make the radiation therapy more effective.
He also made it clear that he would respect my decision. By then, he had convinced me that hormone therapy would be the best decision for my overall odds of cancer treatment success. And, it will only be for six months, not two years.
So, I will receive a Lupron injection next Friday to stop my body from producing male hormones, and take pills to keep testosterone from binding to my prostate cells. The oncology processes will begin two months after the injection to ensure full effect of the hormone therapy. So now, after rejecting the therapy in June, I am the one who has delayed my oncology treatment.
Two months after the injection, on October 28, I will undergo a volume study to verify that my anatomy is acceptable for the seed implants. At that time the oncologist will also implant two Visicoils in my prostate that will serve as markers during my external-beam radiation therapy.
If I qualify for the radioactive pellets, then I will undergo five weeks of external-beam radiation therapy (five days a week) followed two weeks later by the interstitial implant. If I do not qualify, then I will undergo the standard eight weeks of external beam radiation therapy.
But first, I am going to prepare for the side effects of hormone therapy.