At the risk of repeating myself, there was good and not so good news from the appointment with Dr Parente today.

(Briefly to recap: the PSA had risen in spite of the radiation treatment. So there was obviously something going on with the cancer. The purpose of the scan I had last week was to reveal what this was and where it was.)

The first piece of good news – and it is a big one – is that there are no metastases in the organs. The ones he mentioned, the lungs and liver, are clear. (I had heard that mets in the latter organ are particularly undesirable.)

The second is something I have thought of, not something mentioned by Dr P, so all the necessary caveats apply. However, the mets that were there in the last scan, in the left hip and left femur, aren’t there any more. So it would appear that the radiation treatment was successful in getting rid of those mets (or spots, as they refer to them).

The less good news is that there are five new spots, all in bone:

• sternum
• rib (right hand side)
• lower thoracic spine
• L4 vertebra
• left sacrum (AKA the tailbone).

(I am inferring that these are all still small. I base this on the facts that they weren’t there at the last scan, and I don’t have any symptoms or pain.)

The PSA has risen a bit more at 8.6, further evidence that things are progressing in an undesirable direction.

So I am starting on conjunct hormone therapy and chemotherapy. The last time I saw him, Dr P did mention a couple of trials that strongly support this combo: STAMPEDE and CHAARTERED . So his view, which we share, is: what are we waiting for? Obviously we have to fire the big gun, as he put it. He rang the hospital pharmacy (Epworth Eastern is literally just up the road) to see if they had a box of Casodex. They did, he wrote me a script, and I have had my first one. I will be taking one of these each day for 28 days. This medication can affect the liver, so I am avoiding alcohol for the duration. (Just when I could have murdered a drink, too!)

In a fortnight I start the chemo part of the treatment:

1. Zoladex; one injection every 3 months, and
2. Taxetere (Docetaxel), once every 21 days, for six cycles (i.e. an 18 week course).

I have to have a blood test, and see Dr P, before each chemo session. The consult with him ended quite late, so his practice couldn’t contact the chemo people to make the first appointment. They will do this tomorrow, however, and let me know.

It is all a bit daunting, and a lot of information to process. We both found the consult fairly stressful for these reasons. However, he seems very positive. He feels that, at my age, and with my (relative) fitness, I will get through the chemo easily. Maybe this geeing-up is what oncologists do. However, I am grateful for it, for both our sakes. From here, I am just strapped in for the ride.

I just want things to be as normal, and mundane, as possible. We are taking some quotes for a new cooling system. I went to the Deakin open day yesterday, to investigate doing a course next year. I am going to a session in October about how to write a (non-boring) family history or memoir. I want to go on socialising, listening to music, fiddling around in the garden, and everything I am doing now. Obviously we will have to see how far this is possible.