Well, I had my appointment with Dr Phillip Parente this afternoon. (He is a medical oncologist, and adjunct clinical associate professor and acting director of cancer services, Eastern Health.) We were both impressed by Phillip. He is very concerned to explain treatment options and considerations clearly so that patients understand the issues. He even drew me a sort of ideas map, explaining that his handwriting is better than that of most doctors (it is). Phillip struck us also as energetic, positive, evidence-based, and fully seized of the need to get a move on. I said that I wanted the most aggressive treatment that he would advise, and this is exactly what he wants too.

He needs to find out whether my condition is low or high volume. The latter is three or four bone spots, or any visceral disease (for example, in the liver or another organ). If this is the case, he will recommend hormone treatment plus chemotherapy. Adjunct therapies like this have significantly extended efficacy over a single treatment. So I won’t need to come back so often to repeat or have it changed over to another drug. (As he put it, I have a lot of tricks in my bag.) It is difficult to say how long the effectiveness of a treatment will be, as individuals respond differently. He thinks that, with my (relative – my word) youth and fitness, I will be able to handle the side effects easily. Low volume disease – the former possibility – can be addressed by hormone treatment alone.

So what happens next? I need another blood test, which I had on the way home. I also need another PSMA PET scan, this one at Epworth Box Hill. Phillip’s practice initially made an appointment for me on Friday afternoon. The scan folk, however, have a cancellation for tomorrow afternoon, so I will be going in then. (I have had one of these scans before, and compared to an MRI, they are a walk in the park. I don’t have to fast – although I do need to be hydrated – I can drive myself there and back, and it the scan is done in a large, open space.) After the scan, I will be seeing Phillip on Monday, when he will discuss what is the most appropriate treatment, and (I hope) start it then.

Watch this space.