“Hormone therapy generally makes everything shrink”, the radiation oncologist told me.
“Like, everything?”,I asked.
“Yes.”, she replied.
( Cough, Cough )
“Yes, it’s a potential side effect.”
“Can I, uh, quote you on that?”, I replied.
“Sure!”, she said with a smile.
And then she explained to me how shrinkage was a good thing – at least for future treatments. Smaller tumors mean less invasive surgery. Smaller tumors also mean less radiation when undergoing radiation treatment. You’ve heard it here first.
Shrinkage is good.
She explained that hormone therapy also starves “free floating” cancer cells that have broken away from the main tumor. By starving and killing these vagrant cells the hope is to stave off metastasis to other organs.
Next she told me that cancer is treated based upon where it originated.
If cancer cells break off from the main tumor and spread somewhere else, the new tumor is still the same type of cancer. Prostate cancer that has spread to the bones is still very much prostate cancer and as such can be treated with similar therapies, such as hormone therapy. Cancer that originated in the bones is a different type of cancer altogether and as such must be treated differently.
The upside of all this, at least for prostate cancer, is that the PSA score is a systemic indicator of prostate cancer in the entire body – not just within the prostate. If the prostate is removed for example, and the PSA score keeps going up, chances are good that the prostate cancer has found a new home elsewhere. That’s the bad news. The good news is that the same arsenal of treatments are effective against it no matter where it is. Well, as long as the treatments can reach it.
I’ve been on the hormone therapy medication, Degarelix, for almost a week now.
After being told of the side effects and reading one too many reviews online I thought I was in for pure hormonal hell. So far my fears have been exaggerated.
The injection sites are painful.
I now have large painful bumps to the left and right of my belly button. Sneezing of course, hurts. So does sitting up from a prone position. When laying down I’ve opted to flop around like a beached seal instead of twisting. I wake up a lot, too, but I seem to fall back asleep easily enough. I can only assume that this is a result of the other side effects of the medication. The worst pain so far? The removal of the band-aids that were covering the injection site from my unshorn belly.
It makes me a little lethargic.
Everything takes just a little more effort. I’m more tired, a little spacey, and forgetful. I was told to lift weights to counteract the muscle mass and bone density that is lost as a result of the hormone therapy. I’ve managed, but I get winded faster and everything feels just a little heavier. I’m lucky in that I have a sedentary job where the heaviest thing I need to lift is a computer mouse. If I were moving furniture however, I’m pretty sure I’d be well, screwed.
I’ve kept my anxiety under control.
This is what I was worried about most. Just thinking about anxiety makes me anxious. If you remember the 80’s movie Beetlejuice, when the titular characters’ name is said aloud too many times he jumps out and terrorizes everyone. Well, anxiety for me is kind of like that. I have an entire bandoleer of Ativan at the ready if necessary, but so far I haven’t had to use it. Staying in the moment has helped the most. As there is no clear path for my treatment yet, worrying about it is probably the worst thing I can do.
And then, of course, there’s the occasional hot flashes.
They’re not bad and they are rare, but they happen. I can best describe the sensation by flip-flopping the typical advice given to someone for public speaking: Picture yourself naked on stage talking to a large clothed audience. That, to me, is what a hot flash feels like.
A couple of days after my first treatment our neighbors invited us on a hike. While we were getting ready my oldest daughter, Ashley shoved one of those battery-powered handheld fans into my hands. This one in particular even had a water reservoir.
“Here, dad!”, she said excitedly.
“Uh, thanks… um, why?”, I replied.
“In case you have hot flashes on our hike!”, she said proudly.
So, yes. My daughters have my back. It’s reassuring to know that when menopause hits the Vandervort household someday that I can take at least some credit in grooming my girls to take care of their mom, too.
Last but not least, I bought Jodie and the girls necklaces to wear to mark the start of my cancer treatment. The necklaces are simple silver chains, each adorned with three heart pendants. One heart for each girl. To me the necklaces are a symbol of solidarity. It seemed an appropriate gift for the three people who are going to be on the front lines with me throughout this fight.
Take care. Stay healthy. Live life.
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