October Cancer. Always something

After I had taken casodex for a month, I suddenly had blood and blood clots in my urine. Well, the first time you see that it is unsettling, though like everything else about managing this disease, you toughen up.  . It is not as bad as it looks. Probably it is cystitis, an inflammation of the bladder wall caused by radiation. Another test looms.

I once spent time in the Arctic with a fellow who had spent winters there. He told me that up there a person has to learn to fight the cold. It can depress you and make you lethargic, potentially putting you at some risk. I recall the conversation frequently. I am not worried and I am not afraid and I am willing to be candid about my condition, but I fight every day. 

Here is the email I sent to my family and support group detailing this new turn:


OCTOBER 14, 2014
Hi, this email contains a bit of graphic detail about my condition but I tried to keep it vague. To bring some people up to date, I started taking casodex in early September. This drug is an androgen receptor blocker. Basically that means that it hampers the ability of cancer cells to connect with the testosterone that they need to expand their presence into various parts of the body. After about a month —hear comes the graphic part—i began to have   blood and clots in my urine. This happened three times and does not happen with each urination. The clots are like little black pieces of fiber. No pain associated with their passing.  The oncologist suggested I stop taking casodex until we could talk. I did. After our conversation he said that my description of these passings did not sound (or look, I took a picture of one) like the side effect of casodex. He recommended that I begin taking casodex again, which I will do in the morning. I offer these emails with the candor I do because I believe that this disease must be discussed openly so that the fear level it creates is dramatically reduced.

Here is what I sent out earlier to my children:
Hi, today I met with Dr. Basu. My PSA went up slightly in the past month. From 7.3 to 8.2 He is not concerned. He says that if the PSA is going to go down, that will not happen until December or January. He had suggested that I stop using casodex until he could talk to me about the blood in my urine. As it happened, I have a picture of one of the clots in the toilet. After he looked at that and listened to my explanation of the way the bleeding occurred, he told me to go back on the casodex. What he saw and I described is not what casodex does. He then ordered a cystoscopy next week in order to determine whether the blood is coming from the bladder. Some years ago, when I had first had blood, Dr. Sershon investigated, found lesions from the radiation in the bladder, and cauterized them. Dr. Basu wonders whether what I am currently experiencing is a recurrence of lesions, a long range side effect of radiation. I will find out on Wednesday, Oct. 22.

We also discussed whether change of diet will help my immune system enough to impede the progress of the cancer. He was skeptical. He felt that the change could have various positive benefits but for the new diet to make an immune system change, it would need more time, maybe several years.

I also have an ongoing “deal” in my right groin up the side to just below the ribs. It moves around. He wants first to have the urologist determine that nothing in the bladder or kidney is causing it. He is pretty certain that the tumor in the iliac crest is not causing it. 

After I meet with the urologist next week, I will write again.

Love,
D

PS. I told the doctor that I have previously taken photos of piles of shit, but this was my first one of a pot of piss. He did me the courtesy of laughing.