At our last visit to Dr P on 13th November, my PSA had reached 116. We had both been expecting the PSA to continue rising, as it has pretty much every time this year. Having passed the 100 score, however, felt as though a psychological barrier had been breached.

Dr P was quick to remark, as he has all along, “numbers don’t mean anything”. He said the mark he looks for to change course on treatment is when the scores double rapidly, for example, every four weeks. The “change” would involve another course of chemotherapy. He has said before he wouldn’t hesitate to resort to this if he thought it was necessary. In the meantime, though, he is guided primarily by how he considers I am looking and feeling. He commented approvingly I had put on some weight — something that no patient whose cancer is progressing does. My three-monthly CT and full body bone scan is booked in for early December, following which I will be seeing Dr P on December 11th.

Near the end of the last consultation, we worked out that we had been seeing Dr P for six years, which seems unbelievable. At that first meeting he said he wouldn’t sugar coat things, and he has never done that, but he is also careful to accentuate the positive. This is a fine line to tread, but one he has always managed to stick to.

Otherwise I have been having a fair bit of trouble with sciatica, and stiffness and soreness around the sacroiliac region. That joint has been fused after having ankylosing spondylitis in my twenties. (The AS also left me with several fused joints in my neck.) A few treatments from a medical masseur have helped reduce the stiffness. When my chiropractor comes back from her break, I will resume seeing her. I will probably alternate between her and the masseur, as the need arises. A second line of defence is exercise classes, something I have just been too tired to contemplate returning to. However, I saw my exercise physiologist last week, and she gave me the green light to resume classes, albeit with a program adjusted to cater to my current injuries. The sciatica is responding to a fairly high dose of Lyrica (pregabalin). This seems to bring the symptoms down to the point where stretches effectively deal with them — something that stretching alone does not.

Streaming-wise we were mesmerised by David Fincher’s new film The Killer (Netflix). on that platform also we are also enjoying A Murder at the End of The World, which brings several fresh twists to the classic Agatha Christie-style murder mystery. The Icelandic settings are a bonus.