I saw Dr Parente this morning, and had chemo #4. All went well. The good news from the consult:

1. PSA is now 0.01 (down from 0.03); and
2. I am now, according to Dr P, in remission.

I am still not quite sure if it has quite sunk in. Of course, to put it bluntly, “remission” doesn’t equate to “cure”. Still, I would rather have this result than others! Staying on the ADT should mean that the remission continues as long as possible.

Yesterday I saw an exercise physiologist. This was as a result of a leaflet given to me at the previous chemo session. There is a push to make exercise much more of a front line treatment for prostate and other cancers. (I wrote about this previously .) So I now have an exercise physio specialising in such matters. What is the difference between an exercise physio and a regular physio? In this context, the former has a qualification in working with particular patients; in my case, obviously, those with prostate cancer. They have the skills to devise and implement an exercise program that will both be tailored for my individual capabilities — any physio does this — and not aggravate the bone mets. The latter is the secret sauce!

What’s so good about exercise, anyway? Apart from all its usual benefits, you mean, like improving sleep (for most of us, anyway), lowering blood cholesterol, stress and risk of heart attack and stroke, and enhancing bone density, cognitive function and general well being? All with next to no side effects, at generally a modest cost. (How much does it cost to go for a walk?) Yes, OK, but what does it do for cancer patients? Well, the more active blood circulation increases the exposure of the tumours to the nasty stuff in the chemotherapy compounds. So they get more of what they don’t like. Why don’t more GPs prescribe exercise, then? Well, for one thing, not many exercise themselves. Some of the issues are canvassed in this recent MJA article [NB: pdf.] As ever, your mileage with your particular GP may vary.

Warning: eyeglazing detail to follow. One can get onto an exercise physiologist via a Chronic Disease Management Plan . This gives five subsidised consults with a physio (any type), chiropractor, nutritionist, or other allied healthcare professional. You can see more than one of these, but you still only get five consults per calendar year. Your GP decides whether such a thing would be appropriate for you, what practitioner/s you should consult, etc. (guided in practice by your input). It is a bit of a bureaucratic echo chamber, and a well-kept secret, but nevertheless a good idea for fairly crook people. Once you jump through all the hoops, the subsidy is much better than you would get for getting those services through your private health fund.