Here’s something to ponder:  we had our second appointment at Duke University Cancer Center yesterday (7 January 2013).   This was to find out and discuss the results of lab work and scans from 4 January 2013.   The pondering is this:  Peter’s PSA count had risen from about 76 in November 2012 to 236 on December 19 and 234 on 4 January.  Well, further pondering explanation:  it’s a huge jump, possible assay differences between UCLA and Duke?   Possible other issues?

It’s not that we don’t accept a rise in PSA, it’s just a rather unusual leap.  Peter’s had increases before, needless to say, but never as dramatic as this.   And it’s always gone up in increments.   Also, the fact that it’s more or less stable 3 weeks apart is also puzzling (good, but puzzling).

So, my theme once again:  investigate, question, inform oneself.   I’m in the process of so doing re the PSA rise, and will continue until I/we have a satisfactory explanation.

Is this the turn in the road of the title?  Yes and no.  Other than the huge increase in PSA, the results from the scans and blood work are ok – neither wildly good nor wildly bad, just ok.    I won’t go into details here, just a note to say that we’re continuing on the current course with Xtandi, Lupron, and monitoring every 3 weeks, PET/CT every 6 weeks, Xgeva every 6 weeks.

Here’s the thing:  we’ll concentrate on what we can do something about, namely Peter’s weight, and physical strength, plus general well-being.   We can’t control the PSA, nor other aspects of the disease, but will continue to work with the medical team to ensure that everything possible and that exists,  is and will be done.

An interesting side bar:  while we were waiting in the very nice waiting room at Duke University Cancer Center, I overhead a group next to us mentioning Provenge.   Now, that means only prostate cancer, so I eavesdropped on the rest of the conversation, which was clearly a clinical trial interview.   When that was over, I talked with the couple involved and we had an interesting discussion.   Turns out, the guy was diagnosed about the same time as Peter, but his disease, while also aggressive, has taken a different path, with lymph node involvement and subsequent radiation, but he now has extensive bone mets in his long bones primarily.   The guy went off to do something in a bit, and his wife and I chatted for a while about what it’s like to live with someone with advanced disease.  We were just getting into ‘men’ and peculiarities of ill men, when we were called into the doc area.   I wish I’d gotten their name, but we’re likely to run into them again at the clinic.   The most interesting part to me was how she talked about her husband’s not admitting to pain, not sleeping well, not eating well, but was still very optimistic and working on various projects for their son’s business.

So I wonder how much the mental activity contributes to a sense of well-being (or as much as is possible under the circumstances) – in Peter’s case, I’d say a lot, and I’m sure it’s true for others as well.   Mental stimulation and activity is so important in just about every aspect of one’s life.   Even after far too many years (yeah, I’m old, even older than Peter, who is nearly 67), there’s still an enormous hunger for finding out, even learning, and discovering new things, or putting together pieces of information and creating a new insight.