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A Funny Thing Happened on the Way to the Biopsy

Wow, as much as I enjoy doing this, I can’t believe it’s been five months since I last posted a blog entry on my cancer journey. So much has happened since then but, amazingly… almost unbelievably… not much has changed either.


When I last wrote, my local medical oncologist was conferring with my medical oncologist at MD Anderson about how to proceed since my four-month course of chemotherapy with Docetaxel had proven itself ineffective. There was evidence that the chemo had shrunk the tumors a bit, but not much, and it had not eliminated any of them. All of the tumors were where they were before, just a bit smaller.


What had been decided was that I would go to MD Anderson for a tissue biopsy on November 8th, 2022. The site of the biopsy would be my “supraclavicular node,” an oversized lymph node near my neck in which prostate cancer cells were known to reside. Tissue “cores” would be taken and sent off to the lab for immediate processing to assess the stability of the tumor. This was chosen as the biopsy site because it was assumed to represent the overall molecular profile of my cancer, and because this bit of cancer was much easier to get to than the other sites (e.g., abdomen, lung, rectal wall).

But a funny thing happened on the way to the biopsy…

On November 2nd, 2022, I got into the shower and noticed that my left foot was noticeably enlarged. I asked my wife Diana if it was just my imagination and she said that it was clearly enlarged, and that I needed to get it checked. As (good) luck would have it, I already had a meeting scheduled with Dr. Bill Barrett at the UC Barrett Cancer Center that afternoon. I asked him to look at it and without hesitation, he said “that is suspicious for a DVT.” Said another way, he was about 90% sure that I had developed a blood clot. Further analysis revealed that I had in fact developed three blood clots in my left leg but thankfully, they were not believed to be of the type that would break off and go to my lungs.


Despite that, the trip to Houston was off since I was not able to fly or drive long distances in a car with unresolved blood clots. The visit to MD Anderson was not able to be rescheduled until January 18th, 2023. That biopsy ultimately determined that my tumors were stable enough that there was minimal risk of starting a new therapy called Pluvicto, having things go south with my cancer, and then having to endure a “washout period” to get the Pluvicto out of my body before starting a new form of treatment.


Following my second bout with blood clots since starting chemotherapy, I am now on blood thinners and will be for the foreseeable future. Now I just needed to get approved for Pluvicto. More on that later.


Until next time,


Steve


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