Our consult on Monday morning last with Dr P yielded, at last, some good news:

• The PSA is down to 542 (formerly 625); and
• the bone spots are reducing in activity, and thus in size.

There was some discussion about the latter of these. Dr P commented that visceral spots are easy to imagine; they can be compared to a pea, a marble, or an egg, or whatever object fits the size of the spot best. Spots in bone are a bit harder to conceptualise because they don’t differ so much from the surrounding tissue. Therefore they are described in terms of avidity, or as “hot spots” which can vary, over time, in temperature. I am not certain, after this discussion, whether this temperature scale is metaphorical or actual. Whichever it is, my hot spots are cooling down a bit, so frankly, I’m not fussed! My reading is (and Dr P confirmed this): the spots can go up and down in terms of activity. At the last scan, they tended to the latter. This can lead to me feeling somewhat better or worse.

Dr P commented that, at our first consult, he would not have imagined me still being here six years later — let alone looking and feeling so well. He has never said anything unconsidered, and this might have seemed a touch blunt. But as ever he was actually being considerate in not allowing any unrealistic hope to creep in. I have been in stage 4 from the outset, and no-one ever thought or suggested it was going to go away. Fortuitously I had a session booked the following day with my psychologist, Goldie (not her real name). She suggested I see, and enjoy, this period as “extra time”. I’m certainly feeling very well, and, just as importantly, that I’m coping well with the treatment. To cap off a busy three days, I had a chemo infusion the day after, which wasn’t problematic in any way.

The takeout is: the treatment is pushing back (my words) on the cancer, and therefore the pain I had been experiencing. Dr P said he thought successful treatment rested equally on the doctor, the patient, and the patient’s home support. Can’t add much to that, really!