Peter goes nuclear - a prostate cancer diary

Tiredness kicks in - time to listen to your body

Within hours of my first chemo treatment yesterday, my body was telling me to go to bed. It was the middle of the day. But experience with the radioactive thereapy two years ago taught me there was no point in fighting to stay awake. So off I went for a solid three hours. I had been warned by my chemo nurse that the treatment package might upset sleep. In preparation for the treatment, a heavy dose of dexamethasone - a steroid drug had been prescribed in tablet form and then intravenously - it gives you a bit of a high. So daytime slumbers were followed by a disturbed night. But it gave me a chance to ponder idly on those prostate cancer cells that had eluded the targeted molecular radioactive therapy in 2022/23. That treatment dealt very successfully with the cancer cells that popped up all round my pelvic area, in my spine and lymph glands around my neck. I remember the relish with which I was shown the results after each treatment. But still after six doses of Lutetium-177, some of then survived. I think of them as having created nuclear bunkers deep inside my prostate. When the targeted nuclear attacks ceased - it was time from them to start growing again and feed on what little testosterone is left in my body. This time I just have to hope the chemo finds them and kills them off once and for all. It is rather hit and miss. Today was little different, I was up early for a healthy breakfast of cereal and stewed fruit, then out to shop, collect a prescription and have elevenses with Tricia in our local Pret. Back home and tiredness whelled up. Fanicful ideas of reviewing a book for Chartist have been put on hold for another 24 hours.

Time for chemo - tactical nuclear attacks failed

Much has happened since 10 May last year when I completed a trial of targetted molecular radioactive therapy. I seemed to be in respite. Energy levels rose with the sun. Digging was an activity I was able to resume. But scans proved respite to be short-lived. Today, I received my first dose of chemo therapy - Docetaxel. It's nine years since I was first diagnosed with prostate cancer. I suspect I have been brooding about being put on chemo ever since. But that's an aside from what happened to my body as the prostate started to grow again with the cancer. My ability to control my bladder has been compromised since October. Male continence pads, as far as I am concerned, proved a 'life-line' - enabling me to maintain an appearance of normality. Then three weeks' ago, I experienced an excruciating kidney pain - our local GP couldn't have been better - tests showed an Acute Kidney Infection probably caused by Bladder Retention - I was refered by the GP to a local Emergency Department. I went to University College London Hospital. Within minutes of a bladder scan, I was catheterised - tube inserted into bladder to drain off into a bag strapped to my right leg. Doesn't sound very appealing, but it sure beats feeling an urge, trying to reach a toilet and failing. So with improved plumbing arrangements, my appetite has improved and I was able to attend for my chemo injection. It was the first of six sessions planned over the next 18 weeks ending 20 May. To mark the occasion Tricia and I went to our local Cote brasserie for a lunch of steak and frites. Meanwhile, at Buckingham Palace - who knows.

Cough: is it Covid?

Coughing started late last night, a horrible tickle at the back of my throat. An interrupted night followed - three pitstops. Wakening at a 'normal' hour was a muddled business. We were meant to be lunching with neighbours. I had no wish to infect them. First question - despite having been quick off the mark to have another Covid booster, had I got Covid-19? We still have an ample stock of test kits. At least that showed I was NEGATIVE. Nevertheless, I called off lunch. Eventually, I ventured out to buy a large suitcase having discovered/remembered that ours had a non-functioning retractable handle. All good despite interrupted sleep. Then I had a call from our neighbour in Poole from whom we had ordered a new dining suite - the van was on its way. We have a small flat and had compromised on a dinky, rickety dining table and chairs from Argos when we moved in. But our neighbour restores mid-century furniture and had a Niels Koefoed teak circular table and 6 chairs on display the last time we were there. Measurements satisfied us it would fit. So it proved. What a difference. (See picture.) The leaf to make it a 6-seater fits under a sofa. What do you with the old stuff? Fortunately, we have a bulky items disposal bay close by in the Barbican. If it (the Argos table and chairs) is still there tomorrow morning I will be surprised. And I will check as it on my route to Barts to give more blood for science. Then I will hear from my clinical oncology consultant as to my prospects. (Must remember to wear a mask.) End of Treatment poses so many questions. Will I remember them all? Time now to stop reminiscing, and write up my list. In particular, I'm interested to known whether the treatment I have just had offers a chance of cutting out (no pun intended) castration. If there is a trial in prospect, I'm volunteering. Regretably, I suspect the answer will be NO!

End of treatment - not quite, more blood required

Scan days require patience. First a CT scan - Computed Topography (see picture) for which a iodine contrast dye is injected via a cannula. The liquid generates warmth in my body as it is pumped round by my heart. I was warned in advance. The procedure was relatively quick today, in and out in twenty minutes. Then off to Nuclear Medicine to be prepared for an all body bone scan early afternoon. By mutual agreement with the clinicians, I keep the cannula in to avoid another puncture in my arm. This bone scan requires an injection of a radioactive tracer with a half-life of about a day, then a wait of 2-1/2 hours before being trussed up in a gamma ray camera. I went home for lunch. In addition to being patient, there is a need to keep the body well hydrated - lots of water. And as all prostate cancer patients know that can mean lots of calls to spend a penny. I managed OK. And then came home for my afternoon nap. On the way out of the hospital I bumped into the Trial Consultant's research assistant who reminded me I need to have more blood tests on Thursday. Hey, ho - another needle! The afternoon was rounded off with scales on my double base. Today I managed over half an hour's practice - getting better, but far short of the time I will need to be playing in Greece. In the midst of all this treatment, sleeping and music practice - I'm gearing up for an active travel campaign in Poole. The junction at Penn Hill on the way to the local Co-op is a nightmare for cyclists and pedestrians. There is a Facebook Group called BH Active Travel, which covers Poole and Christchurch as well as Bournemouth. These three local authorities were joined together for administrative purposes four years ago. This year all the seats were up for re-election. We have now got two Lib-Dem councillors, who defeated the Tories. So I posted my concerns about Penn Hill, and have been pleasantly surprised by the level of interest in "doing" something. Now I have to see if I can deliver anything. Our children and their spouses have form when it comes to campaigning for active travel. No pressure.

A rogue big help out - more gardening

This was definitely not part of the The Big Help Out billed as the third day of the Coronation celebrations. Perish the thought. Nevertheless, a handful of parishoners at St Joseph's Bunhill Row (actually its in Lamb's Passage) gathered late morning to clear out spring bulbs from the parish plant pots. These line the stairs down to the church - access for the able bodied. (We have a lift for those who need one.) It was not long before I was puffing and panting again. Perhaps I should have had breakfast earlier. At one point my head was pounding as well. Drank water. Eventually the five of us had cleared dozens of plant pots and planted vast numbers of nasturtium seeds and those compacted pellets of butterfly and wildlife friendly seeds. I had recovered my poise and all was well again. Oh, I did sleep well through the afternoon. Tonight I joined the bi-monthly editorial board meeting of Chartist. This takes place a week after the publication of the latest issue. May/June 2023 was out last week. We use Zoom, a genuine bonus from the Covid-19 pandemic, which forced the use of remote video-conferencing to the forefront - if you want to get anything done. Tonight we had members from the North East, East Anglia, Sussex, South West and London on the call. We were mulling the last issue, how to improve production, up coming events that articles needed to be commissioned about when we publish July/August. There will have been elections in Greece and Turkey, a possible Ukrainian offensive to dislodge the Russians, the French are pondering the viability of the 5th republic in the wake of civil unrest over extending the state pension age, here in the UK we are facing the biggest clampdown on civil liberties in living memory, and questions about the legitimacy of the monarchy. Knowing there are a group of like-minded comrades willing to meet and discuss, then write about these pressing issues is a great comfort. What suffered amidst all this activity was double bass practice. Not good. Tomorrow is officially my End of Treatment Day - more body scans and possibly blood tests. 36-weeks since I had my first injection of radioactive medicine.

Minor setbacks overshadowed by another WIN

Another undisturbed night did not herald a trouble-free day. Slight chest pains returned while I was in church. Perhaps it was sight of the Order of Service with the National Anthem, you know "God Save the King" as the recessional hymn. Alternatively, it could have been a delayed side effect of the radioactive treatment I have been having. Foolishly, I had no aspirin with me, so I slipped out of church early just in case to get those tablets inside me asap. Tiredness swept over me early afternoon. Then my system started grumbling and by early evening it was a BAD. Not the worst I have experienced, nor did it stop me tightening up my bow and practicing scales on my double bass for half-an-hour. It has been so long since I felt well enough to strike a note, that I decided to think through the scales starting on the open strings and see if I could actually play them. E major has four sharps, A has three, D has two and G has one. I managed the first three but G major involves playing all the notes in the scale on one string - that's for tomorrow. Before I knew it, a familiar theme tune struck up on the television BBC - Match of the Day 2 - an opportunity to see the highlights of Arsenal's away match at Newcastle. Whatever bodily inconveniences I suffered today were swept away by those precious three points at St James Park that could put Arsenal top of the league again before the end of the season.

Double Bass - getting in the mood

With barely two weeks to go before we leave for Greece, my double bass has been cocooned in its case since I started treatment 35 weeks ago (with a couple a exceptions). An attempt to play in a Beethoven 9th weekend just after Christmas proved too much for my ailing body. The other around the same time was to demonstrate the instrument to a four-year-old grandson. I just lacked the energy to hold the instrument, and the bow, read the notes, and reproduce them on the strings. Might sound silly, but that's the way it's been until today. I had hoped to start yesterday, but that wave of fatigue did for me. Today was different. I won't claim to have been full of beans, but there was a little something at work. So I unzipped the case, took out the beast and set up to practice. That involves getting a high stool, music, music stand and rosin. The bow needed tightening up, then I applied some rosin - that helps make a note as the bow crosses the string. Then there is the question of whether the strings are in tune. Elephants Always Drink Gin I was taught - the intial letters are the notes of the open strings on the instrument. As you all know there is an app for nearly everything, and that is certainly the case for tuning. For our music school the first batch of music has already been sent and printed out. I managed two 10-minute sessions. The first was quite painful, not just to me ear, but my left shoulder protested at having to support the weight. So as with my gardening I took a rest, and had another go. As a sign of good intent I loosened my bow and left the instrument out. Tomorrow, it will be scales. Atuning my ear to the notes is like listening to other bodily functions, just easier to talk about. As for those other functions, we were able to get out to that family function this evening without difficulties. With regards to that other 'event', I can honestly say I didn't see a thing, except for a truncated flypast of helicopters and the Red Arrows which screamed over the Barbican en route to a palace south-west of where we live.

Fatigue threatens opera outing

One pit stop overnight didn't help my mood this morning. A pall of tiredness hung over me, despite seven hours of sleep. A promise to shop while Patricia went to see her medical team at the Royal London Hospital got me out of the door. But just walking to tbe local supermarket proved a challenge. I used my asthma inhaler, stopped to catch my breath, felt my chest pounding - I was only pulling an empty shopping trolley. Very difficult to accept, impossible to understand. Gradually, my energy returned and the homeward journey was easier - helped by the gentle downward slope. Listening to the steady stream of local government election results cheered me on especially wins in Plymouth and Medway. Labour Party comrades who share my own thinking about the importance of local organisation were key in both locations. They know who they are. A solid three hour afternoon nap put me right for this evening's outing to the opera. I decided not to eat or drink anything before going out, except for an occasional sip of water. Tonight's performance at the Royal Opera House was Aida. Set in a modern militarist context, this was a new operatic experience for me. My body behaved in every respect. Despite my asthmatic condition, I did not cough once, nor did I need to suck a lozenge. Breathing through my nose helps - but is no guarantee. Apparently there is a national pageant tomorrow. Personally, I would prefer a presidential election modelled on the Republic of Ireland. Fortunately, we have a family event to celebrate, one of daughters-in-law is having a belated 50th.

Good and BAD

Enjoying another uninterrupted night's sleep only to wake up to a BAD feeling is not to be relished. Proceed with caution was my watchword for the morning. We were due to meet a friend of some 50 years with whom we share grandchildren. Her daughter is married to our eldest. We planned to see the main exhibition at the Barbican Centre - Alice Neel - Hot Off The Griddle. And we did. Then it was time to sample the new menu in the recently refurbished Barbican Brasserie. My grumbling system had calmed down and I was able to enjoy a decent meal without worries. Those are precious moments. Earlier I had booked a room in an Athens hotel that we have used many times as a staging post between London and the former Ionian island of Kithira. Unusually the online booking services and the hotel's own website said they were full. Undetered I gave them a bell. Their reservations clerk could not have been more helpful. Even he was baffled by their inability to accommodate us. So he took our details. Credit card at the ready, I asked would you like the numbers? No he said. I trust you to stay with us! So another piece of that jigsaw was in place. Music for Strings in Greece has started to arrive. Now all I have to to do is see if I can actually hold my double bass for any length of time. That's a job for tomorrow. Fortunately, I don't have to take the instrument with me, the course director keeps a couple on the island. I just pack my bow in my wife's violin case en route. In the meantime, I'm reading The Leveller Revolution by John Rees - the gripping story of the radical movement at the heart of the English Revolution (as the blurb describes it). Current protests in the UK about climate change and the state of the Tory nation pale into insignificance compared with the 17th century in the run up to the trial and execution of King Charles I. The prospects of our latest monarch, King Charles III suffering the same fate seem impossible to imagine.

More blood for science

My blood test appointment turned out to be later than I had been told, thanks to a reorganisation at Barts. No longer a simple turn up, take a ticket and wait your turn system. Technology rules now. Book on line, check in online and your name will be displayed on a screen. Ha, ha. It all depends on the technology working. And it didn't. The display was stuck, and the clinic was filling up with increasingly bewildered patients. I was lucky, my trial consultant's research assistant had booked my appointment, checked me in and the moment my appointment time arrived ushered me into the clinic. The phlebotomist muttered the paper system worked, why change it? Before I had a chance to answer, I'd been tourniqued, prepped for a 'scratch' and had three phials of life-giving blood syphoned off. With the End of Treatment day next week would this be the last of my life blood sent to Switzerland? Apparently not, one more set of test-tubes awaits. Amazingly I had a very long uninterrupted sleep prior to going out - seven hours. Wow. That's what a win does for you. Though I can no longer boast: 'We are top of the league" as Arsenal's rivals Manchester City won their Premier League match against West Ham tonight, pushing us down into second place again.