Good news! I get to go through menopause.
Really. I met with the oncology team about my prostate cancer today and they recommended a treatment plan of hormone therapy plus radiation. The hormone in question is testosterone, which is the main feedstock of prostate cancer. So basically the idea is to suppress testosterone and starve the cancer. As a side effect I'll be getting hot flashes and fatigue for the next two years.
Do you want more details? If not, just scroll on by. But I've been oversharing about cancer for a decade and I'm not about to stop now. For starters, here's a picture of my prostate:
The bright white patch is where the PET scan lit up, and it's basically the entire prostate with a large bulge on the left (note that the image is reversed). The bulge prompted the oncology team to lean against surgery because there was about a 50-50 chance that I'd still need radiation treatment afterward. So why not just do the radiation instead?
That makes sense. However, although the PET scan showed no spread of the cancer outside the prostate, the size and aggressiveness of my cancer make it likely that there are still microscopic amounts in my bones and lymph nodes. That's what the hormone therapy is for. It (hopefully) kills off the micro cancers and makes the prostate a little more amenable to radiation.
Overall, my doctor says this combination has about a 100% chance of very significant improvement and a 70-80% chance of complete remission.
The radiation involves daily visits for six weeks. After a prep session, they program the machine and then target my prostate with beams of—something. I forgot to ask about that. It's either X-rays or protons. By the end of six weeks my prostate and all the surrounding areas (bladder, rectum, etc.) will be nice and inflamed, which promises to be unpleasant. But then it's over.
The hormone therapy is a drug called Lupron that's injected once every six months. The doctor I met with was very nice and assured me I could take some time to think about this, but why bother? I've been dealing with this crap for ten years, so I'm ready. My first injection is next Tuesday. The radiation treatment will start in July.
Anyway, testosterone suppression really is analogous to the loss of estrogen that causes menopause in women. So that's what I'll get. I wasn't really expecting that the ladies out there would have much advice for me about prostate cancer, but it turns out they might! But don't tell me. Let's make it a surprise, OK?
POSTSCRIPT: I know what you're thinking. This has all been about me me me, but how does it affect you? The answer, I think, is that I'm likelier to become crankier, and if Donald Trump wins the election I'm going to get really cranky. Bewarned.
I think that the reason women are said to get "crankier" after menopause is because the testosterone that they were previously converting to estrogen isn't being converted any more, and the newly-abundant testosterone in their blood makes them act more like men.
Some women even start growing facial hair, buying Jeeps, and leaving the toilet seat up.
Men, of course, interpret more aggressive behavior in women as "being cranky".
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That's medical science in Sensorama.
Menopause increases the capacity to look like you're going to kill somebody by about 300%, so perfect for a political blog in a presidential election year. Or any year, really. Menopause is the juice you can use.
I think you still have Kaiser? Request/demand to do your radiation at either the Anaheim or Bellflower Radiation Oncology Center. Bellflower was just opened and modeled after the Anaheim facility. https://about.kaiserpermanente.org/news/making-cancer-care-more-convenient-in-southern-california
I did mine at Anaheim and it was newly opened at the time, these are state of the art facilities. I went through menopause about halfway through radiation when my ovaries were good and fried. No bladder problems.
Pro tips:
1. Get a bidet seat, skip the cheap ones and go for a brand name that heats water and drys. We like the Kohler ones ($200-$400).
2. To take care of burned skin I used My Girls skincare products overnight after radiation, washing off in the morning after being told "we don't want anything in our radiation field". I also slathered on weekends when you get a break.
3. I also used MediHoney as the skin damage got worse and alternated with Calmoseptine Ointment on weekends only (it has zinc in it, so not during the week).
4. As your treatment progresses you can get something called Proctofoam to help relieve the anal canal discomfort - do not turn this down.
5. As radiation therapy progresses you will likely get something delightful called Radiation Enteritis (commonly known as diarrhea) from the radiation irritating the cells of the bowel. I found relief using Visbiome Probiotics, they were the only product I ran across with efficacy against radiation enteritis. You can get these on Amazon order directly. They will come refrigerated.
6. I also took Beta Glucan 1, 3D #500 from Transfer Point. Beta Glucan has been shown to be radio protective and help your immune system recover faster.
This was my radiation skin care regimen:
* Wake up in morning, wash off all ointments and skin creams using Cetaphil liquid soap.
* Go to radiation
* Immediately after radiation session, go to their bathroom and liberally apply either the Calendula, Aquaphor, or MediHoney (sometimes Silver Sulfadiazine).
* About 4 hours later, wash off and apply a barrier like Aquaphor.
* Continue to apply until bedtime as needed or as washed off during cleanings.
* Apply heavy layer before bed of either the MediHoney or Aquaphor (sometimes Silver Sulfadiazine).
*Wake up, wash, rinse, repeat.
* On the weekends when I didn’t have radiation I would keep covered in Calmoseptine, which helped healing the cracks and blisters.
Use old sheets on the bed because the skincare will get messy.
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Fantastic. If you're not a nurse, you should be.
Thank you, I am not a nurse but I research the living sh*t out of things relentlessly. I was giving advice to my cancer care team by the time I was done.
I will also note the I didn't start experiencing radiation issues until after two weeks in. The first two weeks I was like "Woo, this is a piece of cake, why all the drama?" By week four I knew and by week six I was crying when I rang the bell because I was so glad it was over.
I also created a wall calendar for myself using yellow stickies to count down the days and crossed them off daily. It really kept me going towards the end to see how far I'd come and how little was left.
That is great information.
Look into tamanu oil as an oil to add to skin care regimen, especially burns. Medi-honey is great too, I'm a big fan of manuka.
On the health bounce back front (beta-glucans), I often make soup/chili stock from maitake, oyster, lion's mane & shiitake mushrooms purchased at Whole Foods or Asian supermarket (w/onions & garlic quartered including skins), and for extra punch Stamets MyCommunity or Stamets 7 is a great tonic with beta-glucans and more (often on sale at Sprouts).
Of course I round out the stock with carrots, celery, and all that jazz, sometimes even a smaller turmeric root or a galangal if recently by the Thai market (galangal is good!).
Fabulous info. My friend who went thru radiation for prostate cancer had a lot of diarrhea and could have used your advice. He also had to change his diet and avoid certain foods, but I forget which ones.
Maybe look into supplementing Evening Primrose oil.
"Evening primrose oil has been shown to help relieve hot flashes in menopausal women, including their severity, frequency, and duration. One clinical trial found that in addition to hot flash relief, participants taking the oil also improved other metrics like social interactions and sexuality."
Good luck , sir. Looks like Art Eclectic has some good ideas for you . He left out the part about cat cuddles though.
Looks like Art Eclectic has some good ideas for you . He left out the part about cat cuddles though.
He? Is the part about "ovaries" slang for something else?
Cranky Kevin is the best Kevin.
Snark without the Evil Dex.
It's also, as transphobes like to point out, one of the meds used for delaying puberty. There's a whole host of different androgen-blockers, as well as doses, so make sure you work with your doctor to not take too much. Too much of Lupron, specifically, can hurt your bone density.
It probably won't be, with your age and weight, but for some reason many studies excluded controlling for weight, and hormones tend to be diluted by weight more than some others.
But also: some people just have better or worse reactions to the different hormone blockers because our bodies produce the hormones from multiple pathways, and each one is slightly better or worse at each pathway.
Hats off to Art Eclectic! She may not be a nurse, but maybe she’s a Doctor. Some snark there but we shouldn’t presume that “ she”
Is a”nurse” if you get my drift.
Anyways, sounds like good advice.
Art gets a big BRAVO great comments and information. As a female who had a breast cancer diagnosis in 2008 with a bilateral mast w/ reconstruction which was hormone driven that created the "gift" of instant menopause with no options to use hormones to offset the misery - I can say that you might need more fans as in electric fans - it really helps. Frozen Peas to instantly cool off .....and yes you might get a bit annoyed by the sweating - but one day it will all of a sudden ....stop and life becomes normal again. A real PITA but doable. Hang in there.
Oh, hell, if trump retakes the White House, we'll ALL be "really cranky!"
I just hope that your treatment's effects don't include night sweats.
Maybe I had an unusually easy time, but I didn't mind menopause. No night sweats, and my hot flashes were like that feeling you get during the build-up of excitement when you anticipate something thrilling, ending with the sensation of a warm iron being pressed against my back.
I sort of miss that feeling. And frankly I'm crankier now than I was then.
Get that treatment behind you Kevin. We are all pulling for you.
Ha! Some women will definitely know a LOT about this. My partner went on Lupron to... reduce the size of her giant uterine fibroid before her hysterectomy! I can't judge the effects on her because if there were any, they were subtle, but I CAN say the hysterectomy was GREAT! No more cramps! No more blood. She did keep her ovaries, so no hot flashes or anything and she's planning to go through menopause at the same stage in life that everyone else does.
As to if TFG gets re elected, we’ll see you in the camp.
No (transdermal) Estradiol in conjunction, just an anti-androgen/androgen-blocker?
In the huge fwiw category…. I read these health updates first and always have, from the first one a decade ago to this one please continue to overshare
Keep on truckin’, Kevin.
Take everyone’s advice, we are all rooting for you!
On the upside, you can now officially be a crazy cat lady 😉
i get a Lupron shot every 3 months plus take 240 mg of Erleada (my first treatment 9 years ago was a prostatectomy) daily. i haven't noticed an uptick in hot flashes but my body has lost tone despite getting regular exercise and staying the same weight. Six years ago i did the 6 weeks of radiation when the prostate cancer came back - it was a breeze compared to adjusting to life post-prostatectomy and, later, chemo (the cancer came back again 3 years ago). I seem to have entered a constant pre-diabetic state, too, regardless of what i try, which consternates my primary doc.
My wife recommends bourbon.
Four Roses was William Faulkner's favorite tipple, and you kind of have to give the nod to an alcoholic Nobel Prize winner.