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stopping treatment

User
Posted 27 Jul 2014 at 21:34

Hi Im new here so thanks for listening in advance...

Hubby has decided to stop treatment he has become depressed and angry with the life he has due to treatment.....

Emotionally beaten, anyone know how long you live after stopping he had been on HRT for 19months and had 8 weeks RT, turp and awaiting circumcision due to turp............

Gleason 5+4=9, 100% all cores local advancement initial psa 92 now down to 0.5 x

Shaz xx
User
Posted 27 Jul 2014 at 21:34

Hi Im new here so thanks for listening in advance...

Hubby has decided to stop treatment he has become depressed and angry with the life he has due to treatment.....

Emotionally beaten, anyone know how long you live after stopping he had been on HRT for 19months and had 8 weeks RT, turp and awaiting circumcision due to turp............

Gleason 5+4=9, 100% all cores local advancement initial psa 92 now down to 0.5 x

Shaz xx
User
Posted 27 Jul 2014 at 22:14

Hi Sharon,

Firstly, my heart goes out to both you and your husband in what is an awful and no win situation for you both. We have certainly had men on here who have said 'enough is enough ' a very personal decision and, with all the effects of this damn disease, let alone the side effects of the treatments, I can totally understand anyone taking that decision. You don't say in your post if it is something you have both discussed ? With a Gleason 9, your husband has an aggressive tumour, but no-one can specifically give a life expectancy after stopping treatment. Do you think your husband has some degree of clinical depression or has his decision been taken solely from the point of view of his quality of life and the treatment side effects. Having watched my partner deteriorate over the last year since diagnosis. the thought often crosses my mind, will there be a point he just can't cope with any further complication of illness and side effects.

Have you anyone to listen and give you some support, it is good you have posted here as it is a very close, caring community and you will hopefully get some caring and understanding responses.

Regards and very best wishes, Fiona.

User
Posted 28 Jul 2014 at 07:40
I'm really sorry to hear this. I agree with Fiona's question about whether he is clinically depressed. I am aware of some men who give up treatment when they are terminal and want QOL in their remaining months. Your OH's treatment path sounds like they were aiming at a possible cure and with the drop in PSA it may be working.

What have his medical team said about his treatment?

Bri

User
Posted 28 Jul 2014 at 08:53
Hi Sharon,

Perhaps I should warn you both that the effects of HT don't just disappear overnight and can often take as long to go as your OH has been on HT.

Your OH should consult his consultant and discuss intermittent HT. I went down this path over the past 9 years or so and it worked for me for 8 years with good Q of L but if you read my postings ( 15 years on ) you will see that I have now been diagnosed as terminal and currently am not in a very good place......swings and roundabouts I guess.

Best wishes to you both

Life is for living

Barry (alias Barrington )

User
Posted 28 Jul 2014 at 09:09
Hi Sharon

Firstly welcome to the forum. It must be terrible for you, on one hand wanting to respect your husbands wishes, then on the other wanting him to fight this with, the aim of a cure. The treatment side of things is not pleasant and the hormones change us, and rob us of our masculinity, which is hard to bear sometimes, but the alternative is even worse. I agree with the previous comments, it's time to talk to your medical team, and maybe the nurses here on a one to one basis. You don't say which hormones your husband is on, but if he is having this reaction, ask if he can change the type of hormones he is on. I started at a similar point as your husband, with a PSA of 94.4 high Gleason grade, and told it was locally advanced, I am now at 0.05 after RP, RT, and hormones nearly 2 years on. Initially I received the hormone Decapetyl 12.5 and found this changed me from what I was to a person I didn't like, I always wondered why women could cry at what appeared to be nothing, but now I know, and the hot sweats were debilitating, I have now just come off of Casodex 150g which didn't produce these symptoms, but I did develop "Man Boobs" which I don't like , but compared to the Decapetyl it's far better as this drug castrates you, but the Casodex blocks the testosterone from being taken up by the cancer.

I wish you well, and implore you and your husband to talk to someone, as things can be done to ease the situation you find yourselves in.

Roy

User
Posted 31 Jul 2014 at 00:23
Sorry, an afterthought. Your profile says you are 41, is he a similar age? To be young AND have such high G / high % cores is a pretty toxic mix so I imagine the onco has been encouraging him to go for the 3 year HT regime? Another thing to ask about when you next see the onco is how long the plan was supposed to be for - if it was for 2 years, he isn't really stopping that early but the other way of looking at it is that he only has to take them for another 5 months maybe!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Nov 2014 at 18:11

poor Shaz; double whammy, most unfair.

Picking up on Lyn's notes, I see they did a turp as well - sounds like they were trying for a high percentage of 'cure'.

Let's get practical to make decisions, as per Lyn's notes; knowledge is power, at least to make informed estimates (I can't for you, of course, everyone's different). Sorry if the below is a bit 'clinical' but trying to be logical helped me, may help you guys.

Collect all the history (your onc + MacMillan nurses can help if you've not made notes of it all). What I did was to note down the dates from diagnosis in days elapsed, each major event such as ops, the RT, the days the bloods were checked, when tablets were started, and so on. (A spreadsheet will convert individual dates to elapsed time, get a teenager to show you how, lol!). Put the days along the bottom (horizontal) of your chart - two years is 730 days for instance.

Then plot blood test PSA numbers (and testosterone if possible) on the vertical axis, also write on the graph some stars to indicate when the operations, RT and so on were. You get the first diagnosis (92) high up, over on the left edge of the chart, then probably a series of dots, for each successive blood test, dipping down as you read across to the right, you can join the dots so to speak. Hopefully, it looks like a slow slide down, not a roller coaster.

You'll be able to see if the PSA has bottomed out or - like mine - started to bump upwards again, about 18 months into the graph. From that a realistic idea of 'switching off' the hormones, or, adding another type/line of defence, can be made. Unless you have the history nicely lain out in front of you as an overall picture, there's too many bits of information to judge, specially if you're feeling rough.

I'm sorry I can't figure how to post an example diagram on here maybe someone clever can shew us one.

Of course, best of luck and kindest regards,
b0b

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User
Posted 27 Jul 2014 at 22:14

Hi Sharon,

Firstly, my heart goes out to both you and your husband in what is an awful and no win situation for you both. We have certainly had men on here who have said 'enough is enough ' a very personal decision and, with all the effects of this damn disease, let alone the side effects of the treatments, I can totally understand anyone taking that decision. You don't say in your post if it is something you have both discussed ? With a Gleason 9, your husband has an aggressive tumour, but no-one can specifically give a life expectancy after stopping treatment. Do you think your husband has some degree of clinical depression or has his decision been taken solely from the point of view of his quality of life and the treatment side effects. Having watched my partner deteriorate over the last year since diagnosis. the thought often crosses my mind, will there be a point he just can't cope with any further complication of illness and side effects.

Have you anyone to listen and give you some support, it is good you have posted here as it is a very close, caring community and you will hopefully get some caring and understanding responses.

Regards and very best wishes, Fiona.

User
Posted 28 Jul 2014 at 07:40
I'm really sorry to hear this. I agree with Fiona's question about whether he is clinically depressed. I am aware of some men who give up treatment when they are terminal and want QOL in their remaining months. Your OH's treatment path sounds like they were aiming at a possible cure and with the drop in PSA it may be working.

What have his medical team said about his treatment?

Bri

User
Posted 28 Jul 2014 at 08:53
Hi Sharon,

Perhaps I should warn you both that the effects of HT don't just disappear overnight and can often take as long to go as your OH has been on HT.

Your OH should consult his consultant and discuss intermittent HT. I went down this path over the past 9 years or so and it worked for me for 8 years with good Q of L but if you read my postings ( 15 years on ) you will see that I have now been diagnosed as terminal and currently am not in a very good place......swings and roundabouts I guess.

Best wishes to you both

Life is for living

Barry (alias Barrington )

User
Posted 28 Jul 2014 at 09:09
Hi Sharon

Firstly welcome to the forum. It must be terrible for you, on one hand wanting to respect your husbands wishes, then on the other wanting him to fight this with, the aim of a cure. The treatment side of things is not pleasant and the hormones change us, and rob us of our masculinity, which is hard to bear sometimes, but the alternative is even worse. I agree with the previous comments, it's time to talk to your medical team, and maybe the nurses here on a one to one basis. You don't say which hormones your husband is on, but if he is having this reaction, ask if he can change the type of hormones he is on. I started at a similar point as your husband, with a PSA of 94.4 high Gleason grade, and told it was locally advanced, I am now at 0.05 after RP, RT, and hormones nearly 2 years on. Initially I received the hormone Decapetyl 12.5 and found this changed me from what I was to a person I didn't like, I always wondered why women could cry at what appeared to be nothing, but now I know, and the hot sweats were debilitating, I have now just come off of Casodex 150g which didn't produce these symptoms, but I did develop "Man Boobs" which I don't like , but compared to the Decapetyl it's far better as this drug castrates you, but the Casodex blocks the testosterone from being taken up by the cancer.

I wish you well, and implore you and your husband to talk to someone, as things can be done to ease the situation you find yourselves in.

Roy

User
Posted 31 Jul 2014 at 00:13
Shaz, I think there are two answers to your question. My father-in-law opted not to have any treatment and he lived for four years; there will be men who survive a far shorter time.

On the other hand, unless you have only given us part of the story your OH would not be walking away from his only treatment. If he has had RT and 19 months HT, was that 6 months of hormones before RT and the RT was now 12 months ago? Or did he have 12 months HT before the RT which was then done earlier this year?

It depends really on what exactly has been happening with his PSA levels and whether the doctors think the RT nailed it but it may be that your OH is only on the hormones as a sort of belt & braces approach. We do have members who had RT without any hormones.

Research strongly suggests that where RT / HT are being used together with the aim of cure, the longer a man takes his hormones the better his chance of completely eradicating the cancer. But it isn't automatic so you might find that if he stops the hormones, his PSA stays blissfully low and he is considered to be cured. If on the other hand, his PSA started to rise, he might get to a point where he and his oncologist agree that it is time to go back on the hormones.

If since his RT his PSA has never really gone low, or if the onco already suspects that the RT didn't fully work, then stopping the HT might speed up the growth of the cancer cells. But stopping now does not mean he could never have treatment again and not does it mean his clock starts ticking.

Having said all that, if his idea is that stopping the HT early is going to make him feel better, he could do with a rethink maybe. As TG says, it is estimated that the side effects hang around for approximately as long as he has taken the tablets so it could be a long long time before he feels back to himself. It also seems to depend on other things; if his side effects developed very quickly then they are likely to hang around for longer, whereas if the side effects developed slowly then they abate more easily. Some side effects (like the man boobs and thickened waist) can be permanent.

SO lots for him to think about and discuss with his onco. Exactly which side effects is he finding so difficult? Is there good reason to believe those SEs would disappear if he stopped treatment or is he heading for a big disappointment? Is there anything else that will help the SEs whilst still taking the hormones? Would a different hormone be worth trying? And perhaps most important, was the RT/HT combo attempted as a curative treatment and if so, do his PSA tests suggest that it was successful. I think that once you have the answers to these questions you will be half way to a solution.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 31 Jul 2014 at 00:23
Sorry, an afterthought. Your profile says you are 41, is he a similar age? To be young AND have such high G / high % cores is a pretty toxic mix so I imagine the onco has been encouraging him to go for the 3 year HT regime? Another thing to ask about when you next see the onco is how long the plan was supposed to be for - if it was for 2 years, he isn't really stopping that early but the other way of looking at it is that he only has to take them for another 5 months maybe!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 07 Aug 2014 at 15:30

Hi thank you all for your replies sorry its been so long getting back to you, we have been dealing with the issue so to speak.

Yes I think he is clinically depressed, we always said quality and not quantity, he is 62 an age difference of 20 years, he is on prostap and cyprostat was put on provera ( we feel this was a cause of emotional breakdown) he has now stopped loads of meds too many to name as not all to do with the PCa, he has started going out and getting in touch with old friends and family (thats along story) he is better in himself and disappears for hours at a time, this is sometimes worrying but so far has always come home haha.

I think when we see onco on the 25th sept he will ask for a break from hrt as this seems to be the cause of everything the side effects however annoying are just too much and he has said he's a wimp lol......most men could deal with them the weight gain being 4 stone is not nice for anyone and he hardly eats, but also cannot exercise due to degeneration in his back, he also has asthma and peripheral vascular disease. Hot flushes are massive soooooo sweaty (meds not working to stop this) fatigue and general aches and pains in legs and hips, 

I'm really surprised to be honest at how he is not handling but i suppose unless you are in that situation you don't know.....

Thanks again this is a great forum and its great to get different perspectives on this horrid disease, for now goodbye I wish you all well x

Shaz xx
User
Posted 07 Aug 2014 at 15:38

Hi I don't have any support my father also has this and my mother always goes on about her own life rather than mine, I dont have any siblings and my only friend listens as much as she can but not to good at it haha, always been a loaner but now I wish I wasn't x

Shaz xx
User
Posted 12 Nov 2014 at 18:11

poor Shaz; double whammy, most unfair.

Picking up on Lyn's notes, I see they did a turp as well - sounds like they were trying for a high percentage of 'cure'.

Let's get practical to make decisions, as per Lyn's notes; knowledge is power, at least to make informed estimates (I can't for you, of course, everyone's different). Sorry if the below is a bit 'clinical' but trying to be logical helped me, may help you guys.

Collect all the history (your onc + MacMillan nurses can help if you've not made notes of it all). What I did was to note down the dates from diagnosis in days elapsed, each major event such as ops, the RT, the days the bloods were checked, when tablets were started, and so on. (A spreadsheet will convert individual dates to elapsed time, get a teenager to show you how, lol!). Put the days along the bottom (horizontal) of your chart - two years is 730 days for instance.

Then plot blood test PSA numbers (and testosterone if possible) on the vertical axis, also write on the graph some stars to indicate when the operations, RT and so on were. You get the first diagnosis (92) high up, over on the left edge of the chart, then probably a series of dots, for each successive blood test, dipping down as you read across to the right, you can join the dots so to speak. Hopefully, it looks like a slow slide down, not a roller coaster.

You'll be able to see if the PSA has bottomed out or - like mine - started to bump upwards again, about 18 months into the graph. From that a realistic idea of 'switching off' the hormones, or, adding another type/line of defence, can be made. Unless you have the history nicely lain out in front of you as an overall picture, there's too many bits of information to judge, specially if you're feeling rough.

I'm sorry I can't figure how to post an example diagram on here maybe someone clever can shew us one.

Of course, best of luck and kindest regards,
b0b

 
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