I had written, about a month ago, about my feelings of distress because it appears that after my greatly loved ‘vacation’ from ADT might be entering the its final stage. Well, it is true. Yesterday, I received the latest PSA results and it has continued to escalate. I am now at 0.11.

Yes, the number is still minimal, but it is increasing. This is its third PSA increase
(01/08 = <.04; 03/08 =0.06; 06/08 =0.09 & 08/08 = 0.11). I now declare that the cancer has decided to reestablish itself and remind me that it forever lurks in my body. The doubling time is also a concern. The current doubling time from June to August is now 4.2 months; it is aggressive just like when I had the recurrence. To add to my concern is a test called GFR Estimation. This is a blood test that measures kidney function, or its ability to filter my blood plasma. Normal range is >60, but in June it fell to 57 and now in August it is at 52. I do not know the significance of these individual numbers, but the trend is very clear.

At the same time, I had the prostate cancer recurrence I was diagnosed with renal (kidney) cancer and had my left kidney removed. It is not a problem functioning on one kidney, many people do fine with only one, but I need it to function. I have just sent the blood work to my kidney doc and will have a conversation with in short order.

As to the PSA rise, I am scheduled for my regular prostate cancer oncologist appointment on Thursday. We will discuss it, but I am going to delay restarting ADT. The complicating factor is the doubling time, it is shorter than I would have liked.

I am feeling unhappy about the situation. Both of these complications were very predictable, but I still feel sad.

Joel T Nowak MA, MSW