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If At First You Don't Succeed...

In last week’s blog entry, I mentioned that my PSA is on the rise again after nearly six months of precipitous decline while on Pluvicto. I’ve mentioned before the nervous anticipation that cancer patients go through when waiting for test results. I would venture a guess that with rare exception, that feeling affects all cancer patients, no matter how long ago you were diagnosed, or you’ve been told that “there is no evidence of disease,” or “it looks like you are in remission,” or the thing that all cancer patients dream of hearing… “you are considered cured.”

My wife Diana and I had such an amazing trip to the U.S. Virgin Islands last week. It was a “do over” trip for us as we were both sick with respiratory infections for most of the week when we went to St. John six months ago. This trip could not have been more different. We both felt well and had one of the most active vacations we have had in a long time.

We did several day-long snorkeling trips and for the first time in 20+ years, we took a jet ski out for the afternoon. The jet ski was the most exhilarating and terrifying thing I have done in a long time. Diana is our daredevil whenever it comes to driving something. I have been more than happy to let her drive us around Rome in past trips to Italy, as she seems to prefer the stress of driving over the stress of having someone else control her destiny. So naturally, she took the wheel of the jet ski and I held on for dear life.

Having only done this one time before, I had no idea that holding onto the handles on the back of the jet ski was a terrible choice relative to the better option, which was to wrap my arms around Diana’s waist and hope for the best. For the first 20 minutes of the trip, the possibility of dying from cancer was the farthest thing from my mind, as I thought there was a decent chance that I would meet my demise on the back of a jet ski.

But now it’s back to real life, and what to do about my rising PSA…

I’ve spoken with my medical oncologist at MD Anderson in Houston, and we have a plan. I will go to Houston on December 19th for a PSMA PET scan and consultation with him about “next steps.” One possible option is to do targeted radiation on the tumors that remain following Pluvicto. Another option would be some sort of clinical trial like bispecific antibody treatment that could hopefully be done on an outpatient basis and allow me to commute to Houston rather than move there for some period of time. Dr. Logothetis’ most recent text message to me said, “No worries. There is still plenty we can do,” so I am going to roll with that. Happy holidays, everyone!

Until next time,


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