Last night I took my last dose of Abiraterone. Two 500mg tablets. Roughly one hundred dollars worth of high octane prostate cancer killing medication. I plucked them with care from my well worn pill case and stopped just short of tossing them into my mouth. Feeling bizarrely nostalgic I pulled my phone from my pocket, shrugged, and snapped a quick picture. Then I swallowed them with no more than six ounces of water. I had learned the dangers of chugging too much water before bedtime much earlier in my cancer journey, it ain’t pretty. I had learned many things over the last couple of years.
“Good news!”, Dr. Stewart smiled as he walked into the exam room. “No Lupron shot today!”
“Right? And, I took the last of my Abiraterone pills last night.”, I agreed.
Dr. Stewart then instructed me how I should go about weaning myself off of my last medication, a steroid named Prednisone. Unlike the Abiraterone pills I downed the night before, Prednisone cannot be stopped cold turkey. Abiraterone affects the adrenal glands. Prednisone is prescribed along with it to replenish what would otherwise be produced naturally by the gland. Stopping Prednisone too fast would make me feel lethargic and tired. I would have to keep taking it daily for two weeks followed by every other day for an additional two weeks.
“So, I’m not really off medication. Not yet.”, I said aloud to no one in particular.
“When will my testosterone start coming back?”, I asked, changing the topic.
It was then I learned that it could take 6 months or more and that the timeline varies from person-to-person. Fortunately age is a big factor, and I’m relatively young at 45. Two years without testosterone has had a remarkable effect on my body. Body hair – gone. Libido – gone. Grumpy and tired – check. A lack of testosterone has even affected my bones; this year I was diagnosed with early onset osteoporosis. Weight gain, man boobs, and muscle loss are the only side effects I’ve managed to sidestep, and I credit my plant-based diet and exercise regimen on dodging those bullets. Boobs are cool, just not on me.
“So, how will I know when my testosterone is returning?”, I asked.
Dr. Stewart told me that he would monitor my testosterone as well as other markers through monthly blood tests. As my body recovered the tests would be stretched out to every three months. My PSA, a marker used for detecting prostate cancer, would be tested at three-month intervals rather than the monthly tests I had become accustomed to.
“You should start noticing things returning to normal as your testosterone levels increase.”, Dr. Stewart continued, “Your libido will get better. Morning wood, maybe …”
“Should I call you if I wake up with morning wood?”, I interrupted, laughing.
Dr. Stewart laughed. I took that as a solid “no”.
“Hey!”, I asked quickly in an attempt to break the awkwardness of the moment. “Do you mind if we get one more picture?”
“Sure”, he smiled.
And, for those of you who have been following my cancer journey here’s a picture from two years ago during our first appointment with Dr. Stewart.
I’m not naïve. I know cancer, especially aggressive ones such as mine, have a tendency to rear their ugly head again – sometimes long after treatment. Dr. Stewart told me as much during my previous appointment and I’ve read about such reoccurrences on the multitude of forums that I follow as well. I’m a realist. I know that my treatment “vacation” and so-called “last pill” could very well be temporary. I know that I’ll be anxious every three months when I get my bloodwork done to check my PSA levels. I know that every time I have an ache or pain I’ll wonder if my cancer has returned. I know all of this, but for now I just want to be a cancer survivor. I want to take off the gloves and figure out how to be me again – not the cancer warrior, but just me.
And, if my cancer ever does decide to come back? Well, I kicked its ass before and I’ll just have to do it again.
Take care. Stay healthy. Live life.
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