THE JOURNEY CONTINUES – PART III

In Parts I and II, I have chronicled my 12-year journey with prostate cancer. I ended Part II with my beginning in March 2023 taking monthly Lupron shots.  I have been on monthly Lupron shots now for two years. How has my journey on Lupron shots been? 

Let me preface my answer by saying, “I am still alive and very blessed.” Life on Lupron is not a picnic by any means. It can at times be a living nightmare, but the trade-off is, that they are keeping the cancer dormant, and I am still alive. Regarding the side effects of Lupron shots, they are an unwelcome nuisance and do impact one’s life.

Lupron reduces the testosterone in the male, which prostate cancer cells feed upon. Testosterone is the “drive” which allows a man to be a man. At last check, my testosterone had been reduced to an alarmingly low level!! For a man my age (73), one’s testosterone level can range from 156 – 700 ng/dL, with normal being 300 – 350 ng/dL. I couldn’t see those numbers with binoculars!! Lupron eventually brings about chemical castration. The turtle for all practical purposes never goes outside the shell except to water the grass! And there is no longer any need to book the Honeymoon Suite unless it is for obtaining a good night’s sleep!  My favorite song has come to be the old gospel hymn, “Precious Memories!!!  Well, enough on that issue…you get the picture.  It is a God-send when one has a loving and understanding mate who loves you for who you are, and who takes seriously that “for better or worse” clause in the wedding vows. 

With low testosterone, your metabolism is shot to “you know what.” You start to gain weight. I was told by the doctor when I first started taking Lupron that I might gain five pounds.  That was either a gross understatement or outright falsehood. Well, I gained over twenty-five pounds. To help ward off weight gain, I diet, ride a stationary bike daily, or do an elliptical. I still occasionally run…maybe two to three times a week, but I can no longer run like I once did. With testosterone diminished, one finds the onset of growing fatigue takes hold as the day wears on, so I exercise in the morning, as my energy level is at its highest. I don’t depend on motivation to daily exercise, as sometimes I don’t feel like it, I embrace a mindset of commitment because I know I must.

One on Lupron finds the muscles begin to turn into mush. Because of loss of muscle mass from lack of testosterone, it is best to lift weights to help in slowing down that process. I lift weights about five times a week to try and maintain the muscle mass I do have.  This I know, lifting weights helps a bunch. One truth is for sure, I always feel better afterward. The best advice is to keep moving. Don’t become a couch potato.

In addition to the weight gain, one on Lupron becomes a victim of gynecomastia. That is a fancy name for “man boobs.”  When a teenage boy, such “sights” were appealing when on the opposite sex, but they are not too appealing when the mirror reveals they are on you!!! Yes, this is embarrassing and strikes at the core of one’s manhood.  I try to lift weights to tighten up my chest. While it helps some, but not as much as I would like.  When wearing a shirt, I wear an underneath t-shirt purposely made to help compress “them.”

Loss of bone density and joint pain is another problem for men on Lupron. If measures are not taken osteoporosis can occur. I take high-dose calcium tablets with vitamin D and Glucosamine to help slow the process and help with joint pain. One can take an infusion to ward off the onset of osteoporosis. I have not done that yet.

Then there are the hot flashes.  They come without warning and last anywhere from a few seconds to a minute.  Some are not too bad; others make you feel like you are on fire starting on the inside to progressing outwardly. Now I sympathize with women going through menopause.

Lupron can, as well, at times hold hostage Mr. Sand Man from visiting in the nighttime hour. Most nights I find it difficult to fall asleep and stay asleep. Also, urgency finds one having to take a couple of trips of necessity during the night. I treasure when sleep does overtake me, as it is no fun waking up more tired than when you went to bed!  An over-the-counter sleep aid is most helpful.  

One taking Lupron will find themselves experiencing at least once a month a volcanic emotional upheaval where you for no reason want to sit around and cry all day. The day arrives without warning. The day before the volcanic eruption and the day after you feel fine, it is just that one day you must deal with. On those days surround yourself with people who will make you laugh and light up your life, and listen to good upbeat songs.  

Not sure how common it is, but when the sun goes down, I from time to time feel chilled/cold for a bit and have to wrap up in a blanket. The length of time the coldness lasts is never the same, and then it will vanish as quickly as it came. And did I mention there are evenings I experience nausea for a brief time? The nausea can be curtailed by sipping on some Ginger Ale.

Like a five-gallon water bucket with a hole in it, by the end of most days, my energy level has seeped out. I just can’t seem to muster enough energy to make an appearance at a square dance!! I must admit there are times when I grow weary of feeling like I have been hit by a Mack truck.  But I remind myself I am still alive and very blessed.

While I have mentioned many physical side effects, there are also financial side effects. Suffice it to say insurance doesn’t always cover all the costs of the shots or the many doctor visits incurred. The total cost adds up quickly. I have learned what the Golden Years mean…the doctor gets all your gold!!!

Then there is the emotional toll of prostate cancer. It is always in the back of your mind if it has spread to other places, or what if the Lupron shots quit working, or how long will it be before it finally gets me?  Many can’t deal with the emotional toll. Current evidence indicates that the risk of suicide is increased among men diagnosed with prostate cancer, particularly those aged 75 years or older, twelve months after diagnosis, and treated with hormonal therapy (National Library of Medicine, August 2018). The suicide rate for men with prostate cancer, the rate is 274.7 per 100,000, which is about 3%. While that is not an extremely high number, any number is too high.

Despite all the effects of Lupron, I must say I am a very, very thankful man to still be hanging around. I am too blessed to be depressed. Those on this rocky road can’t give up, we must fight onward. While prostate cancer can take much from us it need not rob us of our ability to love those around us and enjoy their company as long as the Good Lord grants us life. Prostate cancer can touch our bodies, but we need not let it rob us of our inward emotions whereby we feel and love deeply. If anything, prostate cancer has enhanced my ability to feel deeply, be moved with compassion for others who are hurting, and appreciate the precious gift of everyday life.  I have grown to appreciate the true wealth of riches around me that transcend the material; such as the beautiful music of laughter, the gentle touch or embrace of a friend, the vitality of grandchildren, the kiss of a gentle breeze upon the cheek which signals you are alive, the amazing inward warmth when family expresses love to you, and the sight of another sunrise and sunset.

The journey with prostate cancer can be a long one and at times a rocky one. I have been on this journey for 12 years now…but I don’t plan on throwing in the towel or calling it quits.  Attitude is everything. A good attitude will find you soaring with eagles; a bad attitude will find you in the pits of despair. Whatever your journey, no matter how rocky the road is….press on, my friend. It is a great day to be alive.

Blessings,

Dr. Dan

THE JOURNEY CONTINUES – PART II

In Part One I began chronicling my 12-year journey with prostate cancer. The reader can refer to Part I for a refreshing of the mind. Suffice it to say that after being diagnosed in June of 2013, after 43 radiation treatments, life for the most part returned to normal and all was well. God was in the saddle, and all was right with the world. However, calm waters don’t stay calm forever. The stormy waves can become rather high and cause a sinking of the ship.After eight years of calm waters, the waves became without warning rather choppy.   

Fast forward eight years, which passed all too quickly into the vault of history. It was now 2021, and I was now 69 years old. When my PSA was checked in February 2021, it was elevated. The doctor was not concerned, but I was. Six weeks later, my PSA was checked once again, and it had gone up again. The doctor told me my numbers were not yet in the danger zone, and not to worry. However, I insisted on a scan. The doctor would later tell me he was thankful I insisted on having a scan.  Well, I knew my body, and I knew something was skewed.

To my dismay, the scan revealed some cancer cells had “escaped” from my prostate and settled in a couple of my lymph nodes. I was informed that because it was now outside the prostate it was categorized as Stage 4.  I was stunned.  “Stage 4” is not something you want to hear, because there is no “Stage 5.”  When I enquired about the solution, the doctor suggested radiation for the spots and to begin Lupron shots.  While I agreed to the radiation, I refused the Lupron shots as I had heard too many horror stories about the side effects.  Lupron would be an option when I had no more options.

Through the month of August 2021, I received 25 additional radiation treatments. My insides were now fried as counting my first radiation treatments of 43, I had now been zapped 68 times. I had to drink water consistently, if not I would start hurting. But drinking water is a small price to pay to keep hanging around.

Yes, that the cancer had spread was a bummer, but if possible I was not going to let it slow me down. To show one can be active and strong in the face of life’s potholes, I begin training for a half-marathon to be held that November. Even while undergoing radiation treatments, I trained every day to reach my goal. I refused to give in to my diagnosis. With the encouragement and help of great friends who trained with me and the Good Lord, I completed the half-marathon (13.1 miles) in 1:57:30…wearing a t-shirt that read, “Stronger than Cancer.”

I seemingly had no major problems and lingering side effects from the radiation and my PSA kept going down each time I had it checked. I was doing so well, I began training again to run road races. As 2022 dawned, I entered my 70th year on planet earth. I was most thankful to be doing so well. During 2022, competing in the 70–75-year-old age group, I ran 18 races, mostly 5K races.  I won my age group sixteen times, including capturing a silver medal in the 10K (6.1 miles) at the North Carolina Senior Olympics State Games…which I was most proud. At the race I again toed the line wearing my “Stronger than Cancer” t-shirt.

As 2022 came to an end I was looking forward to continuing my competing in age group road racing.  But a prediction my doctor made in August of 2021 became a reality. Since the cancer cells had gotten outside the prostate, the doctor informed me the radiation treatments were probably only a temporary fix. His prediction hung over me like a dark shadow, and was always lurking in the back of my mind. Well, the doctor was right. In February of 2023, approaching my seventy-first birthday, my PSA started rising again. A scan revealed it had now spread to four places, and radiation was no longer an option.  The doctor insisted I begin taking Lupron shots immediately. It was mid-March.  

When I asked the doctor what would happen if I did not take the shots, he emphatically but calmly replied, “You will die.”  He went on to add, “You do not want it to advance into your bones, that would be a painful death.”  This time I had no other options. Now backed into a corner with no way of escape, I agreed to begin taking the shots. However, I had been training hard to run in a 10K road race at the end of March, only a week after my seventy-first birthday. I asked the doctor if it would be alright if I ran the race for which I had been training. He agreed a couple of weeks would not matter, so he gave me permission to run in the race.  I knew it would probably be the last road race I would ever run, so I cherished every step of the 10K race. I ran exceptionally well, and won the 70-75 age group easily.

Another chapter in my life was about to close, and another chapter open…and it would be a road covered with much-broken pavement. On the last day of March 2023 I took my first Lupron shot. I was given the choice to take them monthly, every three months, or every six months. Don’t know if it would make any difference, I chose to take them once a month. The three-month and six-month shots are said to be on time-release, but that “stuff” is still in your body.

I have been on monthly Lupron shots now for over two years. How has my journey on Lupron shots been?     

Stay tuned for Part III for the answer.

Blessings,

Dr. Dan

THE JOURNEY CONTINUES – PART I

I have been thinking about writing this for some time. However, to do so requires me to become transparent and vulnerable.  However, when one has a desire to encourage others along life’s journey, transparency and vulnerability take a backseat to the main intent. Sometimes it is beneficial and encouraging when others openly share their experience, as the reader realizes they are not alone in their struggles on the road of life. So, I hope my words will serve as an encouragement to fellow struggling journeymen to keep pressing onward, and realize you don’t travel the road of life alone.

What I share will unfold in Three Parts. So, let’s unfold Part I.  

Life is truly a journey. It is a journey filled at times with smooth traveling roads that make the trip through life most enjoyable. However, the road of life is often filled with potholes, speedbumps, detours, and dead ends. I must say, I have been greatly blessed in my journey these seventy-three years. It has been filled with a mixture of smooth and broken roads, and the normal potholes and detours of life.  For the last twelve years, part of my journey has been on broken pavement that has required proper navigation for the journey to continue. It is a journey that involves prostate cancer.

In March of 2013, I went to my family doctor for my annual check-up.  I was 61 years old. As a person who had been an active runner since the age of thirteen, I assumed all would be well and life would continue on as usual. However, a couple of days after my examination, I received a disturbing call from my doctor that my PSA was significantly elevated from the previous year. I had no problems that indicated a high PSA. Anxiety seized my heart. I had always heard there are two types of men; those who have prostate cancer and those who are going to get it.

Making an appointment with an oncologist, all types of tests and medication were taken to see if the elevation could be reduced. However, nothing lowered my PSA. In June 2013 I had a prostate biopsy. That was without a doubt the most uncomfortable and intrusive procedure I have ever had done. There are not words to describe the experience. The nurse came in after it was over and asked if I was ok. My response was, “Well, I certainly don’t feel like going to the prom right now!!”  The doctor took twelve samples from my prostate to evaluate for possible cancer. I was told it would be a couple of days before I heard from the results. May I say, it was an anxious few days!

On the evening of June 13, 2013, as my wife and I sat down for supper, the phone rang. It was 6 o’clock. I knew intuitively who it was. Jumping up to answer the phone, after saying “Hello” I heard these words, “Mr. Merritt I wish I had good news for you, but you have prostate cancer. Of the 12 samples, nine of them were cancerous.”   I heard little else the doctor said. My heart dropped to my feet. I was stunned.  The doctor told me he would be in touch, and we would discuss treatment options. The news was devastating. Collecting my thoughts over the next few days, it was decided to take the bull by the horns and do what was necessary to lick this intrusion in my body.

If there was good news in the bad news, I was told the cancer was caught very early and treatable. I was given several treatment options, but it boiled down to two: to remove the prostate or have radiation. After consultation with the doctor, much thought, and prayer, I chose radiation. I was to have 43 radiation treatments. To say the least, I was filled with apprehension and uncertainty. I had three gold “radars” implanted in my prostate and was marked with tattoos in areas that no one else will ever see!

My radiation treatments began in September and my last one was on November 7, 2013. I requested for my treatments to be mid-morning so I could run early and then go get zapped. I had few side effects other than growing very tired by the end of the day. I must confess the treatments at first were most intimidating, as I went into a dimly lit room, lowered my pants in front of strange ladies, and lay on my back and stared at a red dot on the ceiling while this huge machine passed over me a couple of times. However, after a couple of weeks, it became part of my daily routine.  

A few weeks after my radiation treatments were over, the doctor took my PSA and it had been cut in half. Every six months I would have it rechecked and each time my PSA was lower than the time before. All was well for the next eight years, and life had seemingly returned to normal. I wish, though, that was the end of the story.  But it is not.

Stay tuned for Part II

Blessings,

Dr. Dan