When You Come to a Fork in the Road, Take It

I’m not sure I can decide on who had the best quotes ever - Mark Twain, Winston Churchill, or Yogi Berra - but if you base it on sheer accidental brilliance, I think you have to go Yogi, who once said “when you come to a fork in the road, take it.”


Over these past few months, I have relayed many of the twists and turns that have accompanied this process of trying to get some clarity around what is going on with my disease, and how to best deal with it. It has been a rocky road at times, especially since there was no real consensus among the many brilliant doctors I spoke with about what the next step should be. Although there was no real agreement as to the specific next steps, there was unanimous agreement that I had to do something.


And then came this past Monday, when I went to my pre-scheduled appointment to get my quarterly Eligard injection. Eligard, like Lupron, is a drug that basically tricks the body into stopping the production of testosterone, which is a fuel that allows prostate cancer cells to flourish. Eligard can be injected directly into the stomach, which is not nearly as hilarious as the Lupron injections I used to get in my rear end. #humility


The visit for the Eligard injection is always accompanied by extensive blood work, as organ toxicity can develop from long-term use of some of the hormone therapy drugs that I have been on over these many years. Despite being on these drugs for six years now, every… single… one… of the 42 different values in the hepatic function panel (liver values), renal function panel (kidney values), differential (% of white blood cells) and CBC (pretty much everything else) were perfect, except for the testosterone, which was a comically low 24 ng/dl on a normal scale of 175-780 ng/dl.


And then came the long wait for the PSA result. I was in a meeting with my oncologist when the result came back almost two hours later, and we did a high five when we saw that my PSA had DROPPED (from 21.9 to 15.8) for the first time in recent memory. I was shocked since I have only been on this new (but old) drug for a month, and nobody really expected it to be effective.


So whereas consensus was previously hard to come by, all of my docs now agree that this PSA drop is a fork in the road, so I’m going to take it. No clinical trials at this time, and I’ll stay on this drug until it looks like it is no longer working and we’ll figure out what to do then.


Cancer reminds you of your own fleeting existence and all this talk about cancer reminds me of another one of my favorite Yogi Berra quotes… “you should always go to other people’s funerals, otherwise, they won’t come to yours.” Good words to live by!


Until next time,


Steve