A Week Of Bad News

Last week started off positive and quickly went over the cliff. In my last post I mentioned that there is a treatment for hip tendonitis that could be a game changer for me. The technology is called extracorporeal shockwave therapy (EST). I won’t go into the details but to say that the doctor who can offer EST required an MRI of the pelvis to confirm compatibility with the EST. He is especially sensitive to my cancer history, as doctors don’t like to disrupt anything cancerous on the theory that disrupting a tumor may cause cancer cells to break off and travel to other locations where they can take root. I had the MRI on Monday and the results showed a lesion on the femur and another on the pelvis. These new lesions put the kibosh on the EST. The concern is that the lesions may be more metastatic prostate cancer (PC), which often spreads to lymph nodes and bones. As noted in earlier posts, PC was already identified in one lymph node and treated back in July.

 

On Friday I went for my six month CT scan and a visit with the doctor who performed surgery on my chest in 2018 for pleural mesothelioma. The scan showed that an existing small and stable lesion on my spleen has grown significantly. He wants to know what it is. He wants an MRI and a biopsy. I explained the bone lesions and the possible relationship to PC. In fact, I was scheduled for a blood draw that same day to monitor PSA levels associated with PC. He decided to delay the MRI until more PC data is available. I had the blood draw and my PSA level is now higher than it was before the July treatment. This likely means that the PC is spreading in spite of all treatments so far, but we don’t know where it is. I already have an appointment next week with the doctor who has been treating the PC. I expect he’ll want to do an imaging study called PSMA PET/CT. This should identify the already detected lesions as PC or something else. It may also find PC in other locations. The spleen lesion, if not identified as PC, could indicate a recurrence of mesothelioma. The worst case here is that I have two recurring cancers. I don’t know if it’s possible to treat them simultaneously.

 

In a perfect world, the Monday MRI would have been normal and I’d be starting EST to improve hip tendonitis. The Friday CT would have been clear, and the PSA test would show reduced PSA compared to six months ago. No such luck.