PATRICK'S CONCERNS

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Latest update 3 June 2017.

In my February update I said :-
"""My Psa has risen from 0.39 to 0.45 over last 3 months which shows that Psa is not continuing to fall and that the radiation I
had last July and continuing ADT with Lucrin and with continuous Cosudex from last July was not enough to stop the Pca
from progressing. I have always feared that last year's treatment would only delay the inevitable and sure enough,
Psa is now beginning to rise again rising.""""

The latest Psa test was 0.7 on 10 April 2017, and it looks certain that my prostate cancer is on the march again.

The graph applies to myself only. Anyone else may find that their Psa levels and Pca history are nothing like mine if their cancer cell
type and treatment were very different.

Psa graph updated 13 April 2017.
PSA-graph-history-13-April-2017.GIF

The rise of Psa at far left side indicates Calypso IMRT radiation at Epw
orth Hospital in July 2016 plus addition of continual Cosudex since last July
has not killed the cancer. Before getting the additional treatment,
last year I suspected my cancer was radiation resistant, ie, it would take perhaps
200Grey levels to fry the bastard to death, and I have only had a total of 100grey to PG, and 45Gy to two lymph node spots.  
Cancer often defeats whatever doctors do, and not all cancer cells are the same, and while some cells may be killed by each treatment, others
survive or mutate into something harder to treat any further.

I think this cancer will continue to chase after me for the future I have left.

My next discussion with my good oncologist in June 22 will have to deal with my castration resistant Pca; despite ADT with monthly injects
of Lucrin, and addition of 50mg of daily Casodex pills, ie, bicalutamide, since last July, Psa is zooming up. 

My last oncology consultation was with intern oncologist instead of the specialist doctor on 13-4-2017; my specialist was overseas.
The intern said there have been some improved access to new treatments.

My next Psa test is due 17 June. I expect about 1.5. It probably will confirm the trend of rising Psa. But this is still LOW Psa compared to many
who were diagnosed 8 years previously. A decision will be made about getting another PsMa scan with Gallium-68. now available in Canberra.

I do not know if treatment with Leutetium117 is now available at Peter Mac for $40,000 in Melbourne, but a clinic in Perth offers it.
Usually, you cannot phone to find out about this sort of thing; all inquiries must be via doctors, and at some cost, and always to ensure that
the treatment is appropriate and does minimum harm. In other words, before being considered for Lu117, you need to get over hurdles
of "eligibility", which may include having tried all other treatments and you are facing death soon. I have not seen anyone recommend Lu117 to
treat early stage of Pca like mine, which is so far asymptomatic, ie, I don't have symptoms of pain or multiple metastasis, and there are
no known cancer lesions in bones.
I heard LU117 was being trialed in Sydney, but I am not sure where. My Psa graph indicates the present rate of Psa doubling is 3 months, and
the speed of Psa increase may increase.

Since April, I phoned a relevant research doctor at Canberra Hospital and no Immune Therapy is available in Australia for Pca.
I searched for BAT in Australia and it is now only begun to be trialed in USA by research doctor Sam Denmeade.
See the video at https://www.youtube.com/watch?=fwestwwRTUNo
I think I definitely qualify for Bipolar Androgen Therapy because I am
asymptomatic and have had ADT for last 5 years which has probably
made my cancer cells generate many more receptor cells to accept testosterone, so it can get enough to grow from the tiny amount in
bloodstream despite the ADT reducing. The adrenal gland and muscles produce testosterone, and its impossible to completely suppress all
presence in any man. BAT involves having repeated injections of 400mg of testosterone to give a high level which does not last very long,
and this floods the much increased receptor cells in Pca, causing trauma to Pca cells killing many cells. Survivor cells regain their tendency
to be sensitive to low levels of testosterone so they shut down until they begin to generate more receptor cells. Si it seems BAT can extend
the time that ADT is effective.
During months of BAT, Psa is measured. After a high level shot of testosterone, Psa does rise, but then in most patients Sam Denmeade
mentions, it then falls rapidly, and after a few such "cycles" the levels of Psa go lower than at beginning of BAT. Some patients responded with
Psa becoming so low as to be unmeasurable. One could say that playing with testosterone levels is like Russian Roulette, but just what else
do the doctors have to offer me? It may be more aggressive ADT with Ezalutamide and Abiraterone, or chemo therapy, but I know where
all that leads, a succession of Psa reductions then failures, and the medicine cabinet is soon emptied after one drug fails after another, and
finally the Pca spreads and flourishes and the side effects of treatments become intolerable. Morphine begins to look real good.  

Since last August, bladder and bowels seem to have fully recovered from last year's RT, and from a double knee replacement last February.
I have also been taking daily Flomaxtra pills to try reduce PG swelling and constriction of prostatic urethra. During the day when I am up and
about being busy and now cycling 100km a week, I have good continence, and a good flow rate. But at night, when sleeping, I am woken 6
times in 8 hours to pee, but I go back to sleep within a minute or two. Being horizontal and not active seems to cause bladder et all to be a
bit over active. 

I suspect that that even though there are small amounts of Pca in the lymph nodes, they would still require the same very high amount of RT
to kill the Pca cells. There isn't any harmless way of delivering
"pencil beam" X-rays because even if tumors are small, the beams spread out
to be much wider than a pencil. This is the nature of beam radiation; beyond the theoretical pencil beam there is damaging radiation extending
outwards 10mm to 20mm, and radiation continues on to tissues beyond the target.  

My doc said that the Lutetium 117 treatment can safely deliver 200Gy of beta to areas where Psa is being generated, ie, to tumor sites, and and this
most definitely overcomes any "radiation resistance", and the beta can only penetrate 1mm beyond the molecules of Lu117 held steady by binding
agent to sites where Psa is produced. 

Trials of Lutetium 117 were underway on 30 patients with Pca at Peter Mac last August, while I was in Melbourne. A video was made
of the treatment known as "theranostic radiation". The video showed results on one patient riddled with bone cancer and with months to live.
The initial results were nothing less than miraculous for this patient. But I have now heard not all patients did well, and the full results of the
trial will not be released until later this year, probably at least 12months after the last guy was treated in the trials, so maybe we hear
something official by next October. Time is needed before announcements because the side effects need to be followed up. 

It seems that when Pca spreads, it sometimes mutates into a cancer which does not produce Psa. Therefore a Psa in a blood test may not indicate
the activity or the spread of the cancer, and that MPsa scans will not show where metastasis has occurred, and Lu117 would NOT be effective because
it could not be delivered by the binding agent depending on Psa as the target.
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Back in Early February 2017, I was able to ride over 200km a week on my bike
at average speed of 22.5kph. I could still ride, but walking or working
was painful for my knees.
Weight was steady at 83.9Kg, resting heart rate < 50, and not many uneven beats. I was looking forward to having
both knee joints replaced on 13-Feb.

I had the operation on 13 February. I spent a week in recovery wards, then 2 weeks in rehab ward at Calvary Hospital in Canberra.
If anyone is sick enough to have to stay a long time in hospital, then Calvary is The Best place to be. Their ethics are excellent.

The first week was painful and I was allergic to Endone. I was changed to Targin based pain relief for a total of 5 weeks. I gave up using crutches
at 8 weeks after the op. I had my first bike ride of 6km on 22-4-17, and I felt I could have ridden further. I modified one of my bicycles to have
160mm long cranks instead of 175mm cranks to allow pedaling with much reduced maximum knee bend. The main problem after TKR is getting
enough knee bend and getting knees to straighten.
Being able to ride most road bikes depends on minimum angle between femur and tibia to be less than 80 degrees. I can only just get this with
R knee. L knee has more bend, and it is more comfortable pedaling than R knee. I guess I will improve over time.

I lost over 3Kg in hospital because of the pain medications and hospital food, which is sufficient for survival, not wonderful. The Targin plus
other drugs are fairly toxic to bowel function and probably exterminate many of the gut bacteria essential for good health.

From week 3 to week 8, I slept very poorly at home and was slow to regain weight. But 2 weeks after quitting Targin and have put a Kg back on.
I was sleeping better week 9, not being woken so often by pains. I went back to diet of mainly vegetables with less than 100gm as of carbs or
protein a day. It is The Only way for me to stay well fed, keep weight constant and below
83Kg.
I just had to learn to walk ride a bike again. At week 9, I could walk 1km+ without crutches.
I am now at week 14, and have continued to improve walking and cycling. I walk about 1/2 km daily just getting around to care for myself,
and I've been riding 100km a week; a typical ride is now up to 22km, on mainly flat roads with gentle hills. The bike I have been riding is a
single speed bike with 44t chain ring and 18t freewheel cog on wheel which gives me a 65 inch gear which I am pushing this with 160mm
cranks so the gearing at low speed feels the same as the 72 inch gear with the 170mm cranks I used previously. This gear is a bit
high for me at age 69, but I just slow down and try to concentrate on turning the pedals right around the circle. But after riding say 18km
on 5 consecutive days,
my knee-caps get sore, and I need to take 2 days off bike and I am then better when I return to the bike.

I
have also spent time restoring a second bike with a nice frame using Reynolds 531 tubing. It has old Shimano 3S 3 speed hub gears from
a 1980s ladies bike which was not ridden very far, and in good condition. It will have about the same top gear as I push now, but will have
two lower gears which should allow me to ride anywhere in suburban Canberra, with concentration on pedaling quickly with low stress.
I should be able to turn the 170mm cranks OK. I hope to be back on my 10 speed Cannondale with 175mm cranks within a month or two.
The rate of increase of knee bend is like watching a glacier move along a valley.
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Maybe my knees will get nicely better just in time for the cancer to pull me down again.
But I ain't no quitter, and I will seek whatever other forms of treatment are available. I see my GP in 2 weeks and oncologist in 3 weeks
and will ask them both to find out what is now possible in Canberra or in Australia.
Being positive for me means understanding all the negative possibilities while sensibly taking action to extend life to the maximum.
I cannot live forever.

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Prior to 6 February 2017, I wrote.........
Weather has been succession of heat waves with over 35C, and some hot nights making it impossible to get to sleep before 1:00am.

25 November 2016.
The spring weather has been delightful and my overall condition has improved. For newcomers to my blog here, I had an additional 31Grey
of external beam radiation therapy applied to my prostate gland from July 18 to August 9 this year. This added to the initial 70Gy I received in 2010.
Thus total RT to PG was about 101Gy. Severe radiation colitis occurred from August 20 to about October 30.

Side Effects. But since October, the radiation colitis symptoms of enduring high flatulence and 8 daily toilet sessions at least has eased off and bowel
function has become closer to normal.

The result of RT has mutilated my sexual function. For those not used to the unpleasant facts about prostate cancer treatment, let me explain :-
All men I know who had an RP have had complete ED. One man told me his wife could excite him to an orgasm without a hard-on. Maybe she sucked
patiently, or more likely used a vibrating vagina toy with suction. He would not go into details with me. All this is NOT like the real thing, and probably
most ppl over 50 would just give up wanting sex, and complete their partnered life without sex.

But I estimate more than in 50% of partnered relationships where there has been no disease of sexual organs, the couple have ceased having sex.
Nobody ever admits it though. A small % of women would seek real sex with a whole man elsewhere and maybe get a divorce.
For those who had an RP, and no ADT, desire remains because testosterone remains. But of course most older women's desire and ability to have sex
rapidly dies above age 50 or earlier, so a man of 60 wanting to do things is irrelevant. He cannot even jerk off. All men I know who had an RP found Pca
returned and they needed a full 70Gy of PG radiation. I know a case where one guy had the EBRT a year after the RP, and 18mths later his Psa began
doubling each 2 months, and he is in SERIOUS TROUBLE, and will probably need to start ADT and consider whatever else he can get.

I believe these sorts of Pca troubles are far more likely than doctors like to tell you, or more likely than publications from Cancer Councils and other Govt
advisory bodies.

I did not have RP, and had RT and ADT as primary treatment, and after 5 years at age 66, I suddenly got fibroids in erectile tissue, and Roger shortened by
30%. This is said to be a direct result of prolonged time on ADT. Erections are possible, but it just points down, is ugly, and is useless for sex. There is
no sensation of pleasure, and no ability for the build up and release of explosive orgasm.

So, after Pca treatment, a man has to farewell his sexuality. Suck it up Bro !  There are not many women enthusiastic about a nice black strap on
vibrating dildo.

Despite the chemical castration of ADT, desire for company of women remains strong, and I enjoy talking to those willing to talk. But many of the women
I see around are quite allergic to men after their menopause, especially if they have been divorced. A really good relationship with a partner should not
rely on sex.

Urinary incontinence has never been a problem for me and I am still OK now. It is due to fail at some time due to RT damage to nerves.
Fecal continence is OK, but when I feel I need to go, I need to move very quick, I cannot just put it off for an hour or two.

The PSA graph shows the fall of Psa after RT last July to a nadir of 0.39 last November. I have not had such a low Psa since beginning of 2015.
I am continuing with monthly injections of Lucrin and daily Cosudex and Flomaxtra tablets.

It is still too soon to say I got much benefit from IMRT at Epworth Hospital in Melbourne where I received the Calypso EBRT during July. I would argue
it is impossible to say IMRT did any good, while doctors there would always disagree with me. I prefer evidence based medicine.
I believe the Cosudex is the main agent acting to blockade whatever tiny amount of testosterone is in my body which is not suppressed by Lucrin injections
once a month.

However, it is surely certain that RT at Epworth plus the RT I had at Canberra Hospital in 2010 has done my stubborn cancer cells no favours.

It remains to be seen if my Pca survivor cells which remain after treatments so far will survive or whether they become more difficult to treat
in future, and begin to dominate remaining radiation affected tissues, and then spread or become some other form of cancer which may
not produce Psa and hence not be detectable by Psa tests. There are a number of future possible outcomes which all are quite awful.
I recently read a frightening opinion by well informed medicos about Pca where one doc said the Pca can seed itself in bones and then
come alive some years later. More reading indicates that once bone metastasis has begun, and is detectable, it means you have only 3% chance
of being alive 5 years later.
I do not really know my cancer status; the more one reads, the more certain I am that I am uncertain. But between now and when Psa could measure
50 may be 3 years.
 
But right now, I am well enough to have a big knee operation and put up with the battle it will be to recover and learn to walk without pain and ride
a bike a bit further - before I die, so I can get married to suitable woman, finish projects, get affairs in order, and leave much less mess behind me
than do so many other ppl when they finally die.

I am booked in to attend a pre-admission clinic on 13 December in advance of having titanium and plastic inserts to both knee joints some time after
January 2017.
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Before 20 October 2016 :-
Nothing much has happened to my health in the last month, except I am still suffering effects of radiation colitis, a side effect of having had radiation
of PG in July. So bowel habits are very irregular because the rectum now cannot do its store before dumping routine which everyone else takes for
granted. The condition has very slightly eased over last 3 weeks. I am now seeking a bone density scan, and an injected drug to slow down bone
loss due to ADT which is continuing with monthly Lucrin and Cosudex. Sleep is irregular, with 5 get ups a night, and some nights I sleep less than
5 hours. There is no acute pain and continence is still intact.
 
Before 24 September 2016 :-
My Psa was 0.52 at 24 September, going down from 0.73 at 17 August, and down from a peak of 2.8 in mid July 2016.

Why did this happen?

In Early July I went to Epworth Hospital in Melbourne to have "salvation radiation therapy" using Calypso IMRT applied to my PG and to two lymph nodes
in upper thorax. 31Grey was applied to PG to raise the 70Grey level applied in EBRT in Canberra in 2010 to a total accumulated level of 101Grey.
45Grey was applied to each lymph node. There were two hospital visits before IMRT on July 1, and July 10, with IMRT applied twice a day from July 18
to August 9 to PG, and once a day to lymph 2 nodes.

July 1. I had a minor operation to install 3 x RF beacons to PG to guide the Calypso IMRT to PG. A hydrogel pad of about 10mm thick and 50mm dia
was inserted between my rectum and PG, to push the PG away so that high intensity X-ray beams did not fry a section of rectum tube. In previous EBRT
in 2010, no hydrogel was used, and the amount of RT used on PG is limited by what the rectum can be allowed to withstand, plus other areas.

The Calypso IMRT has multiple beam directions, not just the 4 of standard EBRT, and the path of beams can be chosen to avoid areas previously
radiated or those where little radiation could be tolerated. The radiation beams are not fine beams with sharp boundaries but have diffused beams l
ike a torch light shining. But where all the beams intersect at the target, the accumulated radiation intensity may be 50 times higher than somewhere
only 20mm away.

July 10. I was "measured up" and a temporary body cast made with some sort of plastic-paper foam to allow easy and accurate body alignment
while on the radiation table before radiation. The body cast is not an enclosing cast; it is only 75mm high to wrap around the underside of a body
on a flat table, and the the cast allows easy body alignment by at least two staffers attending before RT sessions began. Tiny tattoos were placed
when information from previous CT scans was correlated so that for each session of RT, my body could be positioned to within +/- 1mm of the
correct positions with laser light beams. It is important that the huge radiation gadget knows where to aim - guided by the tattoos and the three
"radiologically opaque" beacons which had been inserted to my PG on July 1.

I began taking 1 Cosudex pill daily, each 50mg. I was already under influence of previous Lucrin injections. I also began to work on my bowel to
ensure there was no gas or shit in rectum before 9AM. That meant continuing my vegetarian diet, but using one Coloxyl tablet each evening to ensure
a good shit by 8:30am. It was important that I attend all radiation sessions shit&gas free and with a nearly full bladder to keep the PG in the alignment
position as accurately as possible.

July 18 to August 8. There were 2 sessions of RT per day, 6 hours apart, with PG and two upper lymph nodes done at 10am, and PG again at 4pm.
A Psa test was done on July 18, but I was never told what the result was, but I estimate it was 2.8. 
My Psa rapidly reduced from estimated 2.8 at July 18 to 0.73 on August 16, about a week after finishing RT. The RT doctor forecast that Psa would
flare up before reducing, but that has not been observed. By 24 September, Psa fell to 0.52.

I do not think the radiation has caused or assisted the Psa reduction, unless this is proven to be the case in future months.

The RT could only be deemed to be effective if I stopped all ADT and the Psa continued to fall. I am not going to stop ADT.

I do think the Cosudex has caused most of the Psa reduction, because whenever I was previously given a month with daily Cosudex pills,
50mg, there was a rapid Psa reduction, as shown on graph.

I cannot say yet if the large expense and trouble of attending Epworth has resulted in any worthwhile benefit. Medical outcomes after
procedures are often very uncertain, and radiation effectiveness is still quite low. 

The full answer of what my Pca status is cannot be known yet. But I have had Pca since about 2005, with diagnosis in late 2009, with
Gleason 9, aggressive cells. The treatments and dealings with doctors has made me very cynical, and I doubt many things doctors say.
After seeing that so many things doctors said were just "Blatherations of Bullshit", I am sure many of you now know why I am so doubtful
about doctoral forecasts and predictions. No doctor can be assumed to be honest until time proves him/her to be have been truthful.
(( There is a huge disparity between what many well trained, well educated, and obscenely paid professionals say and what happens
later after prognosies have been given. But this is REAL LIFE, and what else is there? honest  fools? people who had no idea? at least
doctors do know more than one who'd trained in 1716. ))

I was told in 2009 an RP operation would be fine, but that idea was abandoned during attempted surgery in April 2010. I was put on ADT,
and had EBRT in late 2010, and told "this will fix you!", but in 2012 I found the RT had been quite useless, and could have been predicted
because the REAL rate of RT success with Gleason 9 is only a lousy 10%. ( Report from St Vincent's Hospital Sydney )

After 2 years of ADT, I paused ADT in April 2012, with Psa < 0.08. But by May 2013 Psa went to 8.0, and I was forced to re-start ADT.
Doctors were WRONG about what they said would happen. It seemed EBRT had done nothing to halt my Pca. Psa went down to 0.2
after ADT was recommenced, not as low as before I paused. I has another ADT pause during 2015, this time the doctors didn't forecast
anything; I thought, maybe good, maybe not good, and sure enough, Psa shot up, and I re-started ADT. But the Psa didn't go as low
again and it began to rise while on ADT at beginning of 2016. This seemed to indicate typical ADT failure where Pca refuses to stop
progressing even with testosterone suppression. But testosterone was 0.9 last February, and higher than the recommended maximum
level of < 0.5 to starve a Pca tumor of testosterone on which it depends to grow.

Was the Lucrin having difficulty closing down testicular function? It seems like it was. The addition of Cosudex ( bicalutamide ) to ADT with
Lucrin starting at July 10 may be doing the main part of good.

The monthly inject of 7.5mg Lucrin is easier to take than the 22.5mg for 3 months. Costs are the same.

By April 2016, the doubling time for Psa rise became alarming. My good local oncologist said I could go Epworth Hospital in Melbourne
to have a new type of scan, the MPsa PET gallium68 scan which has become available in last 18 months. I qualified to attend Epworth
because my Psa was between 1 and 4. Epworth had recently imported the Calypso IMRT method from USA.

On May 2, I had the Mpsa PET with gallium 68 at Bridge Road Imaging and results were viewed on May 3 with the director of Radiation Oncology
at Epworth Hospital. I had an enlarged PG, and scan results showed two distant spread spots in two upper thorax lymph nodes "associated with the
prostate gland." The doctor said the spread spots were not in lungs or other organ. He said these small level spots would not kill me because I
would have much bigger problems with the main primary tumor within 2 to 5 years. Ah, so without his RT, I'd last only 5 more years max.
My PG tumor is aging, and probably began in 2005, but didn't make a big Psa, so it was 2009 when Psa rose above 5. Old PG tumors can end up
being deadly. I have no idea when the spread to the two lymph nodes occurred, but the doc said the lymph node spread was a tiny amount of Pca.
Hmm, and I just thought, "from little things, big things grow!"

The doc said he could offer more "salvation" radiation via Calypso IMRT to increase accumulated level in PG to a threshold more likely to cause
Pca cell death. He was not sure if it was possible to radiate the lymph nodes at the same time.
 
I returned to ACT, booked appointments for second opinions for which I had to wait a month. This gave me time to search online for anything I
could find about trials of salvation RT for patients like me who had RT as the primary treatment. I found very few cases where the PG was
radiated a second time after Pca began to progress.

I was in a tiny minority category of patients.

I considered having a surgeon remove my bladder, PG, and seal off penile urethra well away from outlet from PG, having both ureters brought
to a stoma, then facing life with an external piss bag. The urology surgeon who first saw me in 2009 was not interested in this surgery for me at any
time in future despite having done the same thing for a friend of mine, and who has no Psa, and probably no Pca cells in his body, and he is
doing well. But my friend accepted his op because he didn't want RT or chemo etc, and the usual long drawn out and losing battle.
I'd been radiated, and the bigger op was now not possible - too much danger of bleeding to death.

The most common op is to remove PG and join penile urethra to bottom of bladder. It is the Radical Prostatectomy, RP. It might be OK where
Gleason score <6, but distance from surgery to Pca is less than 20mm, and in many cases the surgery area develops Pca. Therefore many who
have an RP will need to have RT and then have a long battle to keep the demon of Pca under control, they may need the years of ADT and chemo
therapy; the fight is never over until the cancer wins.

The surgeon said he might install a supra-pubetic catheter if my prostatic urethra became constricted. It involves a plastic pipe with balloon at end
inserted below belly button, and direct to front of bladder. The balloon is expanded, has holes in it, and piss flows to a collection bag.
But insertion point is just above the vertical pathway for radiation to PG which was done in EBRT. The holes for catheter insertion heal up rather
like the cells around a thick ring or a bone which some ppl may insert through their nose or an ear lobe. There is always a risk if infections.
My GP has a patient who has had an S-P-catheter for years, but for other reasons than mine. It is the cheap easy alternative to the stoma and bag
to side, but the PG remains with its Pca liable to grow and kill.

He did say I could try the Melbourne IMRT Solution, and getting upper upper lymph nodes radiated in the same sessions as for PG.
I knew that he knew he could not help me much in future, and I felt he didn't have much hope for my long term survival because of what he found
in 2010 when he found he could not remove my PG - too much cancer. He didn't ever tell me that. But what other reason was there?
I also I sought opinions from my oncologist, and from the radiologist who did my EBRT in 2010.

None of the these three doctors in Canberra had the specialty training or the software which could allow them to view the 3D MPsa scans I saw
at Epworth with the top radiology doctor. The Bridge Road Imaging service supplied a DVD with scan info, but it didn't include the IntelliViewer
software so nobody at Canberra Hospital could view my scans any better than I could on a PC with Windows XP, 7, or 10. 

The latest gallium-68 scans give Pca patients and doctors with a much better idea of the cancer status. Without the gallium-68, (or choline-II in USA),
it is difficult to choose the best battle strategy. My scans showed metastasis (spread) some years before any CT scan could show. And by the time Pca
shows up in a CT scan, its usually way too late for treatment to be effective. If there were too many spread spots then the use of any IMRT or EBRT
may be ineffective because so many beam pathways would be needed that total amount of radiation applied will cause intolerable side effects and
damage to healthy tissues. Many small tumors mean indicate systemic nuclear radiation or chemo therapy et all may be better.
Trials of systemic radiation with Lutetium 221 are underway at the new Peter McCallum Center in Melbourne.

Trails of Actinium 225 have been done in USA. The radioactive element is in a solution, like salt in water. There is also a secret binding agent that
is specific for a type of cancer in solution. This clear solution is pumped into a vein or artery and during the next hour or more the solution reaches all
parts of the body. The binding agent binds to tumor locations and brings the radioactive gallium ions with it, and and magic happens; the tumor gets
a lethal dose of RT. While the radioactive ions circulate in the blood circulation network, they don't linger so their radiation dose to healthy tissue
is negligible. This all gives a theoretically positive outcome, but is somewhat subject to many variables and laws of chance, but a success is deemed
where more than 50% of patients gain many years of life afterwards.

But the most sensitive scans cannot show what will happen in my future if I am already riddled with small amounts of cancer spread which are
too small for today's Mpsa scanning methods to detect.

If I had the same MPsa scan in 2018, it is highly possible other metastasis sites would be found, even if all the metastases and the PG itself had
gone into remission. There can be a point where one chases an increasing number of targets all over the body again and again with increasing sense
of futility and increasing expense.  

Epworth Hospital must have invested heavily in bringing Calypso IMRT and Mpsa tests to Australia within last 18 months. Epworth is a "private hospital"
which means they charge exactly like wounded bulls, to ensure their income from patients pays for the investments and returns a healthy profit to
those entitled to such profit from business. The Australian public hospitals are often starved of funds for the
latest equipment available.  

Following the month long pause to think, I returned to Melbourne at beginning of July to proceed with the Calypso IMRT for both PG and 2 lymph nodes.
I signed what had to be signed, giving verbal uninformed consent because the doctors could not answer all my questions.

The proposed PG salvation radiation was to be done exactly the same way as in vented by one Dr Gary Shultz in USA. in 2011, The American Journal
of Clinical Medicine published an article about Gary's and its easy to Google, but there are no records of any trials or patient records to support Gary
Shultz's claim in AJCM that remission occurred in all 45 patients he claimed to have treated. 

These patients had previous EBRT which had failed stop the Pca. Gary's technique is to apply an extra 31Grey to PG with continuing ADT and blockade
( Lucrin + Cosudex ). Calypso IMRT was less damaging to surrounding body than the standard EBRT so the target radiation level could be increased
by about +50%.

Only brachytherapy with many radiated inserts could deliver more radiation to a PG than any external beams. So, Gary's treatment seemed
TOO GOOD TO BE TRUE. I have no idea if Gary treated 345 patients and had 45 successes, while not mentioning the other 300 who may have died
since 2011, suffering numerous tragic side effects and recourse to other futile treatments.

It was not unreasonable for me to ask a professional radiologist that he provide evidence for the likelihood that what he proposed might work.
I was forced to swallow the idea that there was no real evidence that the Gary Shultz method worked at all, and maybe it was no better than
the EBRT treatment I'd already had in 2010 - which did not work.

There was more blind hope than skepticism in my mind. Even if later I find that over time it was a failure, was it not worth a try?

The alternatives available earlier this year included juggling of castration methods and chemical blockade of testosterone, and then inevitable
metastasis and a slow death with one chemical after another. The Internet is riddled with postings by men who are diagnosed with Pca, then get
treated, and a few find they really do get remission but many then go for years living with Pca and suffering the sexual mutilation and premature aging
of the treatments. They stop posting about about it. The ones who continue posting are those battling on, with some having their wives or children
posting when the man has become quite sick, and facing the inevitable. Was I not going to go down over time?

I have been sitting on Puff The Magic Prostate Grenade since diagnosis in 2009, and it is likely to explode any time soon. The Medical System failed
to protect me by ensuring early diagnosis because the Australian Psa threshold level for treatment is 5.0. It is 3.0 in UK, and had it been 3.0 here in Oz,
I would have been diagnosed in 2005. 

Despite the lack of evidence held by the top Epworth professionals, I gave my uninformed consent to proceed. There was a diligent team of young bright radiation operators at the Epworth Centre. There was more than one team, and all were busy, but reliably punctual and friendly.
 
The estimate of costs was presented to me at $22,000 at July 2. I had to pay large invoices each week, without having any clear indication of what
the items were or what the Medicare refund would be. The costs at end of treatment ballooned to about $26,000, with some outstanding bills still to
be paid when I get some explanation of what was done when I discuss all the invoices with a Medicare staff member. So far, Medicare has paid
me about $11,000. The Epworth staff said a private health insurance fund would not have covered my costs to any greater extent.

Not all the item numbers listed in invoices at a Private hospitals will attract a large payment from Medicare. So when you go to Epworth, make sure
you are flush with cash before you turn up. The sobering thought is that this treatment in the USA would have cost $50,000, and there would be no
Medicare funding, and the cost of a 6 week stay in USA would be very high.

I returned to ACT on August 9, and waited a week, then had a Psa test which measured 0.73, so Psa had fallen to 1/4 of the level it had been before IMRT.

The doctor said I might see a Psa "flare", ie, a rise of Psa immediately after IMRT. and then he said Psa should fall. The Psa did not flare, it just dropped,
and then has continued to drop over last 6 weeks to 0.51 at 21 September.

HOWEVER, I am very skeptical about whether the IMRT achieved any Pca reduction.

The EBRT in 2010 did little to halt my Pca. ACT doctors told me the EBRT could work a miracle. But St Vincent's Hospital In Sydney have a document
on their website which says Gleason 9 tumors like mine have only 10% chance of being stopped with EBRT. Basically, the surgeon in ACT who attempted
the RP in 2010 found too much cancer to proceed, then palmed me off to the next best treatment, radiotherapy, and those guys seemed rather over optimistic........

The ADT has been main agent to keep my Psa low.

Before I began the IMRT in mid July, I also began to take 50mg Cosudex pills each day. Gary Shultz recommended that the daily dose should be 150mg,
but the Epworth doctor said 50mg was plenty.

So why did they allow me to have a lesser dose than recommended by Gary Shultz in USA?

I was told by an old lady radiation nurse that 150mg pills were not available in Australia. I asked if I should take 3 x 50mg pills a day.
There was never a clear answer. More BULLSHIT. Cosudex acts to block testosterone getting into receptor cells at the PG tumor.
So with Lucrin to reduce the level of testosterone, 50mg / day may be enough to give enough blockading. How was I to really know? The idea behind
RT is to damage Pca DNA, and then the lack of available testosterone prevents cell division and re-growth so Pca cells are more likely to die instead.
Its a good common sense theory, but the reality of cancer chemistry is far more complex, and not all known.

But older Pca tumors can grow more testosterone receptor cells in response to lower amounts of testosterone due to ADT. Continuing Cosudex
just further stimulates receptor cell production so that no amount of Cosudex will block all testosterone to cause Pca cell death.

In 2010, I began with a month of Cosudex before injections of Eligard began. This was said to give less side effects than starting with Eligard without
Cosudex. Probably, Eligard ( or Lucrin etc ) takes a long time to begin reducing testosterone, so docs go for the thing that gives a quickest drop in Psa.
They may not have liked to keep me on Cosudex after starting Eligard because it may have provoked the tumor to become ADT resistant earlier than
it would otherwise.
I did think continuous Eligard plus Cosudex may have been better after April 2010, but now think the ADT failure now seen would have occurred sooner.

ADT does not ever cure Pca, it merely slows it all down for awhile, in my case, by about 6 years.

Before 2016, the only time I was given Cosudex was at the beginning of ADT ( Eligard or Lucrin) to "lessen side effects" of ADT for a month before
commencing ADT. Not a word was said about what Cosudex actually did. But it has always caused a rapid initial fall of my Psa, and most of what
I am seeing now is probably due to this chemical. 

I missed the monthly shot of Lucrin for July. However these monthly shots have at least a month of overlap if you miss an injection.

Whether the IMRT has worked at all will become obvious in years ahead if Psa continues to fall, and especially if I have stop the ADT with Lucrin
and blockade with Cosudex.

The latest Psa graph update shows a rapid decline of Psa level between 18 July and 16 August. Between 16 August and 22 September, about 5 weeks,
Psa fell from 0.73 to 0.51 in 37days.

Therefore the "Psa halving rate" is now 64 days, about 2 months. If that trend continues then in 6 months after 16 August the Psa may be 0.1, in
February 2017. If Psa rate of fall was linear, Psa would be zero by some time in January 2017. Cancer is a disease that can rise logarithmically
2,4,8,16,32 because cell numbers double after a time period. But I doubt the rate of decline of cancer cells cannot even be predicted, although some
cancers cease their existence abruptly when surgery succeeds to remove all of it.

I gave up all alcohol in July 2014 and I see NO REASON to break out champagne to celebrate a win.  

So, forecasting future Psa level can be an irrational form of stupidity. Nobody could ever make any reliable forecast. In another month my Psa may
well begin to rise again without me having much way to stop it, apart from chemo therapy, and while taking measures to better manage the suppression and
blockading of testosterone.

For the first two weeks after my return to ACT after the 5 week "Medical Holiday", I thought I had escaped sustaining radiation side effects. But then 2 weeks
after treatment, WHAMMO, I am hit suddenly with severe diarrhea and my bowel producing large gas and mucus flows and uncontrollable bowel irregularity.
I've had 2 weeks of fecal incontinence and "explosive shitting events" where I filled underwear with poo while rushing to a toilet. The usually good rhythm of
bowel has gone, and my rectum seems badly affected by radiation.

There are warnings in literature about EBRT. There are side effects, and I had them all, but not as badly as some other fellows. Epworth offered protection
against side effects to rectum by the installation of a hydrogel pad between rectum and PG. I am having much worse bowel troubles now than I had after the radiation in 2010 after the EBRT. So was the hydrogel inserted properly? Methinks the doctor who inserted 3 RF beacons to my PG and the hydrogel needs
to much improve his methods. I will not say the word incompetent. It remains to be seen how well I recover in coming weeks and months.

My condition is now being monitored by my GP and whoever else may help, and it seems I am suffering severe acute colitis after radiation. Google is full of
information with videos about this terrible condition which could go on indefinitely. Just what may possibly be done to alleviate the effects quite unclear so far,
but I probably will have to be seen by a gastro doc. I am not bleeding much, but continue with little regularity some pain, and discharge of gas and mucus.

Stop rolling your eyes, all this may happen to YOU.

The literature supporting Calypso and the use of hydrogel may be misleading. However, probably the hydrogel does lessen the side effects to rectum.

If you seek similar treatment to what I just had, assume you will sustain WORSE side effects than the doctors indicate may occur. Usually they fob off
everything you say, avoid all difficult questions. They just want you to accept treatment to keep their income coming in.

I do not know if the bowel damage sustained at Epworth will be permanent. There have been cases at other hospitals around the world where much worse
damage to bowel/rectum has been sustained despite evidence suggesting that damage would occur.

I read of a classic case in Sweden in 2003 described by caption "how not to do radiation". They just repeated normal EBRT like I had in 2010, and over half
the patients endured the problems with fistulas forming where a rectum wall ruptures and shit exits into perineal cavity and with bleeding and infection
and pain. Such bowel/rectum damage can only be fixed by removal of large section of bowel, formation of a stoma so an external shit bag can be worn.
Radiated tissues in this operation have to be avoided because once cut, they do not heal and may bleed for days or weeks. And the article said there was
not much remission of Pca. 

Before going to Epworth, I was still having occasional bleeds from rectum as a result of EBRT in 2010. These bleeds were bright red arterial blood which
occurred if the shit was lumpy. There was never more than half a spoonful. The bleed lasted only seconds. In 2013, a specialist  gastro doc could not find
where
the bleeds were coming from during a colonoscopy in 2013 to check for bowel cancer. He had thought I had piles, but none were found. I met a bloke at
Pca support group who went on a world cruise after EBRT, and he bled cup-fulls of blood. So he surely had a "bloody holiday", and I guess it was a
voyage of worry for him and his nice supportive missus.
 
A week after I began IMRT on July 18, I needed to get up at night to piss up to 7 times. I began to need to take a nightly Tamsulosin pill aka Flomaxtra to
reduce PG swelling and resulting constriction of the prostatic urethra, making pissing slow, and laboured.

I continue taking a Flomax pill each night since I began treatment to get a better sleep. The bladder seems to have survived. I still can stop or start flow at will.
But experts say that the control I have now will reduce to complete urine continence because of long term radiation damage. The radiation doc told
me the May scan indicated my bladder wall muscle has much thickened because of its extra work over last 7 years to squeeze the piss through a reduced
size of prostatic urethra. Once my bladder decides to squeeze, I need to get to a loo fast or the sphincter control is insufficient while trying to stop the pissing
with pelvic floor muscles. Keeping a piss bottle handy when not close to a toilet is completely sensible !! I spend 95% of my time alone, and there is
nobody such as a fussy wife to become upset by seeing an old man easing a problem in a practical manner. 

I have a date with a continence nurse soon to discuss better ways to manage degradation of my bladder and bowel function by radiation.

On July 1 I had the gel inserted and 3 RF beacons inserted to PG tissue using some kind of applicator tool and guided by ultrasound. The beacon position
in the PG is somewhat critical to ensure the beacons can give the right information to guide the IMRT Varian machine using Calypso software.
If the PG position moves during IMRT, the beams follow the moving target - in theory - and just how successful this is anyone's guess. The beacon
applicator tool was never described to me, but it was a "transient" procedure, and doc cited difficulty with the tissue hardness of my PG. I felt I was among
fools who blamed me or their tools for their difficulties.

The beacon implants and gel insert was done between 12noon and 1pm, Friday 1July. Because I was unaccompanied by a partner or carer, I was
compelled to stay a night at Epworth ( at a cost of $860 I later found ). I was not permitted to just go back to a hotel room, which was normal for other
Calypso IMRT patients who were having IMRT following an RP. But it turned out to be necessary for the night's
stay.

Blockage and inconveniences.
At 8pm, 7 hours after beacon implanting, I could not piss. I dosed off, and at 2:30AM I remained blocked. I asked the ward nurse to phone the doctor
about what next. The male nurse spoke poor English and seemed incompetent and un-communicative, inspiring no confidence in me. But the phone
call occurred, and it worried the doc who had done the beacon insert.

An intern arrived at bedside with a catheter, another poor English speaker, and he was very nervous about what he had to do. I had to calm him down, and
prevent over eagerness to push catheter lest it rupture my urethra somewhere. We got it done OK, and I have NO APOLOGIES to anyone for being quite
SURLY about it all when I wasn't trying to calm upset middle aged male nurses easily offended, and from Philippines or south America, it seemed.
No pretty girl nurses in wards at 3AM, no specialist doctors either.

The catheter was pushed through a soft blood clot which blocked the prostatic urethra. The bleeding continued for some hours with blood seeping
backwards up into bladder. I spent a second day at Epworth ( another $860 ) until they were happy for catheter to be removed and bleeding had
subsided enough for me to be "sent home", ie, to my lodging at Ryder Cheshire, a place run by a charity entity.

The cause of bleeding was never fully understood by docs. They admitted nothing. I figured blood from within cut prostate tissue with beacons had
found an exit pathway via sperm ducts to the prostatic urethra, where it was able to pool and form a clot and urethra blockage to stop urine flow from
bladder to penile urethra. 
The catheter must have pushed through the blood clot, and urine mixed with blood flowed out immediately. More blood may have flowed backwards to
bladder from bleeding prostate to bladder and around the outside of catheter. I did not bleed from penis while catheter was inserted. These details were
not understood by the doctors.

I did get a visit from the insert doc on morning after blockage who said he did have difficulties, and that I was THE FIRST patient to be having salvation
radiation after having had only EBRT as primary treatment.

The removal of catheter was without pain, and I was allowed to leave to go back to my lodgings at Cheshire-Ryder Homes on the Sunday after the
Friday operation. During the next 10 days up to July 10 when I was due to begin RT, I was able to email doctors to question their methods. During the first
week my emails with doctors indicated they did not know whether they had punctured my bladder or punctured my prostatic urethra or both while trying
to insert the 3 RF beacons. Without spelling it out, the doc inserting beacons could not see what he was doing.
The Ultrasound image maker used to monitor such things was not letting him see clearly. So he was stabbing in the dark.

On the second morning of my hospital stay, another doc arrived to chat. He said he had done 1,500 brachy-therapies, and he said less than 1 in 60
patients had bleeding problems and that most of those were like me, from interstate, and he didn't know why. Nor did I because such info was just irrelevant
bullshit; why was he there? why talk to me? what magic thing was he going to do to alleviate my problems? - nothing he could think of.

But, brachy-therapy patients can have up to a hundred radioactive needle size inserts injected into PG with a special tool, less than 2mm dia, and all the
little needle stick injuries all heal within a day because they are still mainly healthy, and heal up before the radiation from inserts affects them.
Brachytherapy can deliver 150Gy to PG, and with fewer side effects to bowels or rectum, so it has been the best RT available. But once PG has been given
70Gy from EBRT, or more from BT, then later the PG blood vessels will not heal quickly if they are cut by any surgical procedure.
 
The BT radiation is known as the best type to have. But it is more expensive, and in 2009, was not available for me as far as I knew. No doctor mentioned
I should get it. Besides, its only radiation, and with a Gleason 9 tumor, the chance of it working was only 50% - maybe. I was told to have EBRT, it was
supposed to be as good, but it just ain't, and later I found St Vincents's Hospital in Sydney has literature at their website which says the probability of
Pca recurrence after EBRT for a Gleason 9 tumor was 90%. 
Brachy therapy BT may have been marginally more effective than EBRT for my high grade tumor.

I explained to both these visiting docs that success of interplanetary space missions depended on rocket scientists having to investigate every possible
way shit can happen. I'd been previously well radiated, and both docs didn't see that I was probably 100% likely to bleed, and I was not in the category
of the 1.66% of BT patients who bleed after BT insertions. I suspect the hospital charged me for the unwarranted unwanted chat on Sunday morning.

Most docs are not driven by charity, and the Sunday doc must have been curious, maybe informed by other doc. And my payments to Epworth paid for
his curiosity. The 2 days in hospital because of bleeding cost $1,700, with none reimbursed by Medicare.

After being told I was the first patient for re-radiation and this made me realize I was nothing more than a laboratory rat for docs to experiment upon
without ANY useful info from the USA doc who recommends this process. If the docs want my respect, they must earn it. 

I left the Epworth Free Masons ward on Sunday afternoon July 3 and settled in at lodgings run by Ryder Cheshire which is an independent entity
which has volunteer workers only, except for one lady who does the books for a total of about 50 one bedroom apartments with two beds for the many
ppl from faraway regions of Victoria and NSW. Maybe there were 40 ppl staying, with many cases of breast and prostate cancers. This WONDERFUL
place allows allows patients and partners or guardians / carers to have cheap lodgings for a typical stay of 6 weeks. One woman had had 29 courses
of radiation, others had lost a lung, or were in a much worse position than myself.
THAT was humbling.

I walked a kilometer to shops for basic groceries, and knees felt very sore, and I was still bleeding from dick a bit from minor op 2 days before.
I had another week to wait before being "measured up" before another week of radiation planning. Those first 2 weeks of my stay at Cheshire was
very pleasant, and there was a mobility scooter available which I used to go to shops, and to a fine Lebanese restaurant, the Gorgia Cafe in Ivanhoe
which became my daily eatery for the 2 weeks where there was no daily radiation.

They had Wi-Fi, so I could email the doc to ask so many questions about why I had bled. I asked what evidence supported the claims by Dr Gary Shultz
in USA. The bleeding kept going for a week, and I do not know if I bled from incision entry point for beacons into the perineal area.

During the 2 weeks with no radiation, I asked more questions and ended up asking the radiation doc to email Dr Shultz to find out more. He sure was not
going to do that. I said better methods are needed for placing RF beacons to avoid damaging or cutting things like bladder or prostatic urethra during
injections. I said he will have other patients like me so he needed to be ready with improved methods. It is possible he totally ignored all I typed.

He ended up admitting there was no information available about Dr Shultz's patients and that I had now been fully informed and that was that.
In other words, there was no supporting evidence that the RT he offered was much good at all. Hence I had given my uninformed consent. We both
knew it may not work as planned.

10 days after the minor surgery, I did try to visit an aquatic center near my lodgings to swim a bit, 400M, and I bled again, so I gave up all silly notions
of doing any exercise while in Melbourne.

The radiation treatments began on 18 July and were completed on August 9. At 10AM each day I had IMRT to PG and to upper chest targets.
At 4PM I had a second round of IMRT to PG only. I filled in time by doing web-page work with my laptop. There were 4 radiation staffers and 2 nurses
in an office who had little to do with me except to lecture me about having a gas free and shit free rectum. They managed to give me enough potty
training to always arrive gas&shit free for RT, and with 500ml of water in bladder. After return to ACT, I have had 3 brief emails from the head radiation
doc asking about my bladder and bowels. All was cordial without me bashing the man with questions was never going to answer. He must have winced
when he tried to read the screen fulls of history and suggestions and about my terrible fecal incontinence. I doubt he read much at all.
I am not officially in his care any longer, and there's little need to contact him. He may read this here.

A week after I returned to ACT, I climbed back onto bicycle. No more bleeding. The entry point for surgical gadgets under crutch had healed OK - not radiated. 
I was able to increase distance and speed, and I regained my fitness levels close to what I had in mid July before the Melbourne trip. But I did notice that
I breathed more heavily riding uphill, and there has been some damage to lung tissue. The doc did say I might have some difficulty swallowing and a sore
esophagus, but I had neither. I seemed to burp more and suffer some slight indigestion. Appetite has remained good but since August 9, and increased bowel irregularity has not stopped me eating the same vegetarian diet. However, I like to make my salads with green fresh green vegetables which i can heat in
microwave to make them more easily digested. There is no need for so much raw food.

Weight has bounced down a Kg while in Melbourne, then up 2Kg, then down again, as irregularity manifests itself with erratic disposal of bowel biomass.
Once past the acute irregular shit-in-pants events, I now have a regular form of irregularity, with rectum not happy with handling shit, and wanting to spurt
mucus and gas at least 10 times a day.

My resting heart rate in mornings is 50, up slightly from the 48 last July. it takes more time for HR to go lower even after short rides. I have a pain in the
lung on right side, similar to having  cracked rib some years ago, so I assume I have poorer lung function, so heart beats faster to get more blood around
to be oxygenated at the lower rate. So the Melbourne treatment had a slight worsening effect on my cardio vascular health. I was told the two distant Pca
spots were in 2 lymph nodes. Their position looked like they were in my lungs. I have ZERO idea of exactly what was radiated in upper thorax; the machine
is able to gain enough info from scans to aim at whatever volumes are on scan without any other tests able to proove that indeed the spots were at lymph
nodes, and not within my lungs. So I can only cross my fingers. I am just a dumb ( and irritating patient ) who just cannot trust the education and
experience of doctors unless they proove they know what they are doing. The world is full of well educated fools on good wages, and beyond anyone's ability
to scrutinize their efforts. Shakespeare wrote many plays about powerful blokes and sheilas who were were so flawed......

Last February, I joined the the waiting list for two new knee joints at Calvary Hospital in Canberra. Walking further than 100M has become painful, and
scans in 2014 proved I need two new joints, all propelled by the crummy genetics I inherited from my dearest mother's genes. She hated all vigorous
exercize, and I never ever saw her raise a sweat. She did like to swim, and I watched her extremely slow motion in a pool where I took her when she was 73.
She got through to 98 years of life as a mindful plodder, an attribute we both had. She had few athletic attributes which allowed others to do twice what
she did. I am much the same, but I inherited my father's zest for exercize; he set a schoolboy record for The Mile in about 1924, and rowed well for the posh
school. He was always ready for real stinky sweaty work for real men and I often helped him eagerly with the work around the house and at his vet practice.
But he neglected a melanoma on his leg, and he died at 60.

If my cancer continues to outwit the doctors and I need chemo therapy, I won't get those new knees. The waiting list was 12 months, but Calvary contacted
me for pre-admission in mid August. I told them I needed more time to allow doctors to decide if I was likely to have a long remission time and hence
allow the knee surgery. It would be extremely pleasant to be able to walk 800meters to the local shop and, and that would greatly help my health and help
reduce bone density loss due not using legs walking. I could also ride a lot further, and I can say I would be most eager to do all the rehabilitation needed
after knee surgery.

During time in Melbourne, for weekdays with radiation there were cars provided to get patients from Ryder Cheshire to several hospitals, all driven by eager
volunteers between 55 and 70. Ryder Cheshire is about 10km away from hospitals in Richmond. The private hospitals' policies give local transport to
the sick coming from all around Victoria and NSW. It helps make the big services of big hospitals available to those in remote regions without the stress of
getting around in a big city. There were some spirited discussions every other day on the 1/2 hour drives from "home" to the hospitals. Most patients had only
one radiation session per day, so they were driven home by the volunteers before lunch. I was the only one getting two radiations per day, at least 6 hours
apart, and Epworth Centre staff gave me taxi vouchers for a free ride home in slow peak hour traffic which cost an average of $33. It meant I did not have
to walk in pain on bad knees. For those who can walk, there is also a good train service from Ivanhoe to West Richmond station, 300 meters from the Epworth
center. From a station at Ivanhoe, bus 548, which reduces 1.4km walk from station to Ryder Cheshire to 300M. There are also taxis from station to Ryder.
I may have had to stand while using public at peak hour times. Epworth did not charge me for vouches worth a total of about $660. They still probably made
a healthy profit from the total of $26,000 they charged me. I would not be surprised.

Ryder Cheshire refused to take a cent from me for the accommodation. They didn't seem to know what rate to charge me, which depended on whether
Epworth would pay them, at a higher rate than they felt they could charge me if I paid direct, ie, $20 per night for 31 nights. I suspect Epworth did pay them,
and paid $38 per night, and the Epworth accounts had no item for accommodations. I have no idea who paid who, but probably the accommodation costs
are buried in the invoices from Epworth. I filled out forms to claim for ACT Government assisted travel expenses. I never heard a word from ACT Govt, for
this little used service. The accounting of costs at Epworth seemed unclear, but Medicare staff in Canberra said all was well with their charges.

I gave the Ryder Cheshire a donation of $1,000 before I left. If I'd had to pay for a Hotel at $100 per night, If have paid $3,100, and not had access to the
daily transport to hospitals, and not had a tiny bedsitter flat to cook in, my costs would have been far higher. If I ever need to get medical treatment in Melbourne
again, I'd want to stay at Cheshire Ryder. It is a lovely simple old fashioned place to stay with ppl about who have troubles like me.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                         
Before my Melbourne treatments a gentleman emailed me to to describe his IMRT which followed his RP some months before at Epworth Hospital
to which I went. I'd met Paul online in 2004 I gave him details for a component he wanted to make for an audio amp he was making. We still share an
interest in DIY Hi-Fi technologies. His descriptions of what happened to him gave me confidence that side effects for IMRT might be minimal, and that
radiation treatment itself was quite tolerable, and that the hospital staff were very nice. Most of this turned out to be quite true.

After his RP, his Psa went very low, then began to rise. He then had the surgery site radiated using Calypso IMRT, and Psa went down again. I met him
in Melbourne and had dinner with him twice.
But some months later, his Psa is rising again, showing that Pca is progressing despite all the surgery and RT. Because his Psa went so low after the
treatments, it was unlikely there were metastases somewhere. When Psa does not decrease much, it could mean there is Psa coming from a metastasis.

I'd say he will have to go to ADT, and probably he may suppress his Pca for some years like me, until the Pca becomes castration resistant which is usually
inevitable.
I began with PG that was NOT removed because the doctor said I had an inoperable Gleason 9 tumor which had slightly escaped the PG capsule- a monster.
Paul will live many years yet, and probably more years than I will, and I'm 10 years older, and much more likely to go down in 5 years, before any
magic cure arrives.

Good links...
Subscribe to this site for continual emails of latest progress in research and drug trials :-
https://prostatecancerinfolink.net
Psa level between age 40 and 60 indicate lethal Pca in later years :-
https://prostatecancerinfolink.net/2016/06/14/another-step-toward-a-rational-risk-stratified-psa-testing-methodology/

If Psa is above 1.0 at age 59 there is good reason to worry.......
Reading:-
http://www.prostateoncology.com/education/glossary/a:hormonal_therapy
http://prostatecanceruk.org/for-health-professionals/latest-research
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Before 29 May 2016.
My prostate cancer progress presents a bigger battle in coming months. All those people who said I would get better and that I didn't have anything
to worry about and that alternative therapies would work WERE ALL WRONG. Today I cycled 45km to give a total of 136km for the last week.
Weight is 84.2Kg, resting heart rate = 52 bpm at 1 hour after the ride, 48 bpm this AM, and nice steady beats with no double beats or missed beats.
My vegans diet is continuing, and I have to be honest, its 95% vegans because I do allow low fat milk for my tea, and 150 grams of salmon from fish
farms in Tasmania. I quit all coffee 2 months ago after realizing it contributed to feeling too hyper after 3 coffees, and probably caused a bout of
uneven fast and slow HR just after last X-mas. I've been on ADT aka HT to block my testosterone production since 2010, so 6 years now, and I had
an eight month pause in 2012-2013, and again last year 2015 for 5 months. After both pauses the Psa shot back up. Since the last pause and after
recommencing HT last August 2015, Psa went to a low of 1.0, and then began to rise to 1.5 by April 2016. Its now 2.3 so it is doubling each 4 months,
fast, and HT with Lucrin injections is not able to keep testosterone below 0.5 for adequate suppression of testosterone, hence Psa is rising, and Psa
would be 128 in 2 years if nothing is done about the situation.Before 4 May 2016 I could not find any available trials of new treatments in Australia.
But when I last spoke with my good oncologist he suggested I go to a Melbourne imaging clinic and consult with a Melbourne radiologist at Epworth
Hospital. These together offered the new benefit of an MPSA +PET scan which shows my cancer status and is a guide to choice of further beam
radiation using the Calypso IMRT method :-
 http://www.wesleymedicalimaging.com.au/uploads/file/New%20PET%20Studies/PSMA.pdf

Calypso seems to be the best way to deliver RT to prostate tumors with much less damage to surrounding organs or bones. I had previous EBRT in
2010 with probable radiation levels of 65Gy, with some side effects on bowels. The proposed Calypso IMRT uses computer program and implanted
RF beacons and hydrogel to much reduce side effects to bladder and bowel.
There are online articles on Calypso such as.... http://www.sciencedirect.com/science/article/pii/S0360301606032767
There are plenty more, and these may confuse patients and make them anxious unless you are a naturally scientifically minded person like myself.
I also found a video suggesting IMRT was no better than older EBRT, https://www.youtube.com/watch?v=XWobSwAnP68

But I think the IMRT is a much better way to deliver RT for me. Doctors like to tell us to stay away from Internet which makes us anxious and confused,
and just rely on their learning and experience. But much of what many doctors told me made me anxious and confused.

The anxiety and confusion did not last long in my mind because usually what the doctor says agrees with what I find on the Internet, and I have a rational
mind. Many modern clinical treatments have been developed over many years of trials which have been regulated by government organizations.

But regulated systems don't always keep patients safe. For example, I should have had a biopsy when Psa reached 3.0, some years before my Psa
climbed to 5.0 when the Gleason score had increased to dangerous 9 and Pca tumor was inoperable ! 

But the fact remains that modern medicine does more good than harm, and I would be dead now without the treatment I have had.But despite all the
modern wonders of treatment, prostate cancer manages to kill 33% of men diagnosed. It is highly likely to kill me because I was diagnosed too late,
even after having regular Psa tests, and then finding I had a Gleason 9 tumor with aggressive cell type.

The doctor at Epworth Hospital is the first doctor who was happy to email me with with considerable information. The IMRT he proposes does seem
safe to me, it means 31.2Gy are to be applied in 26 sessions over 3 weeks, which in theory raises total radiation for my PG to 96.2Grey.
The doctor supplied a paper published in American Journal of Clinical Medicine, Fall, 2011, Page 170, where one Dr Gary Shultz claims he gave
repeated RT to 45 men who ALL had a positive outcome, ie, Psa began to fall.

http://www.aapsus.org/wp-content/uploads/ajcmeleven.pdf

I am seeing my good oncologist on 31 May, and my urologist on 8 June, and I will also see the radiologist who did my EBRT in 2010, on maybe 14 June,
to discuss the following :-

1. Details of small amount of Pca spread to 2 lymph nodes in upper thorax.
2. Permissible maximum amount of accumulated radiation to PG.
3. Case histories of patients with similar Pca progress who have had two repeated courses of RT.
4. Possible side effects of bleeding from blood vessels of PG,
5. Possible dysfunction of prostatic urethra, including disintegration, or stricture, interfering with urination.
6. Possible alternative surgery involving removal of bladder, PG and formation of stoma to allow ureters from kidneys to drain urine
to external plastic bag. ( 40,000 ppl in Oz wear bags for body waste due to cancer or road crashes et all, and they have a good life. )
7. Whatever else they tell me, or what I forgot to include here.
I learnt much from Internet from research hospital publications online, Sloan Kettering et all. Doctors have yet to get rid of my prostate cancer, and
quite a number of treatment plans did not work despite their best intentions and predictions, and to me, not reading the Internet would be like poking
my head in the sand. Am I not entitled to get my info from the Internet just like doctors? The new PMsa scans have become available in last 12 months,
and are on trial in Oz.

It seems the supply of patients for a trial are supplied by a referring doctor, so I probably had no chance of getting into any trial without a doctor's referral.

My local Canberra oncologist and radiologist both said they had referred patients like me to hospitals in bigger cities such as Sydney of Melbourne where
a bigger range of specialist services and treatments are slowly becoming available. My local oncologist said patients he sent away to Melbourne were
helped, but not exactly how many or how their life improved, so I am yet again left to assume there may be some increased lifetime and there was no talk
of a cure or remission.

I am sitting on my Prostate Grenade, and while its growth activities have been slowed by HT, it does not mean it will just die and fade away.
It will slowly swell up and try to choke my prostatic urethra which will slow my flow to a dribble and affect my kidneys. If left alone, it will evolve to
become a worse form of cancer which is more likely to spread in a rush - the grenade pin falls out, and floods my blood stream with Pca, and
overwhelms my immune system. The proposed IMRT is the Last Chance I have to intervene with available treatment in Australia afaik. If this treatment
fails, then I will have to begin chemotherapy, not something anyone can look forward to.

The expense is minimal for the PET scans and course of radiation, and there are costs for travel and accommodation. Not much of all this is funded
by Medicare.

For 2 days in Melbourne to undergo scans and re-diagnosis, return air fare was $432 aud with Virgin, a small room at a Quest hotel was at $150 a night.
On return, I found cheaper accommodation for $80, which I may use in future. Some of the costs of traveling outside ACT for medical treatments may be
paid by ACT Govt. There is a special claim form, not much publicized, and without mention of funds for air fares.

On Monday 2 May, I had a CT scan with radioactive iodine.
Then I was injected with special solution which is able to bind Gallium 68 isotope to places where any Psa is being produced. A PET scanner used to
produce the PMsa scan which tells doctors and myself just where Psa is being produced now, something nobody has known since 2010. The scan is said
to be far more sensitive than a CT scan and very low amounts of Pca are seen. The main source of Psa is the primary tumor at PG.

On Tuesday 3 May, the radiologist said the PET showed no Pca in bones, bladder or bowel, rectum, but there were two small amounts in two upper
thorax lymph nodes. He said these would not be a major problem and would be fixed after the main primary tumor has been radiated. I will need to
examine the follow up carefully. Before being sent to Melbourne I didn't think any more radiation could be used, but it seems I was incorrect.
The Melbourne doc said it could be at a higher dose than the original in 2010. Just what that means wasn't clear, was the total accumulated radiation
to be higher? By how much? My research on Calypso tells me IMRT with 81Gray levels are possible, above the probable 65Gy levels of 2010. So was the
total radiation level to be increased to 146Gy? I searched all over the net to find what was the maximum safe level of radiation by X-rays for the prostate
gland. Many other parts of body were given nominal maximums, but not the PG. I assumed 81Gy. The doc sent me the .pdf showing recommended
treatment by Dr Gary Shultz.
It tells us the IMRT applies 31.2Gray to PG, and when added to say 65Gy with the normal EBRT the total = 96.2Gy. The EBRT in 2010 wasn't a high enough
level to halt the tumor growth, but must have caused some damage, and there has been some recovery, or healing, so the 31.2Gy now proposed may be
well tolerated by healthy tissue, but maybe not tolerated by Pca.

It is assumed healthy tissue will always survive radiation better than cancer cells. The cancer growth depends on a good blood supply which it extends
for itself to do well. Methinks some cancer is could be much more robust than healthy tissue, and unless all blood vessels are destroyed by radiation, and
surrounding healthy tissue as well, maybe then the cancer might just give up. 

Any simplistic explanation of how radiation or chemo actually works is likely to be BULLSHIT.

The original EBRT I had in 2010 used old machines with beams at only 4 directions, each session gave 1 shot vertically up, 1 shot vertically down, and 1 shot horizontal left, 1 shot horizontally right, with no regard for where the entry and exist beams went, and with poor dynamic control of beam direction relative
to prostate, and unknown beam shaping to conform with shape of PG seen in accompanying CT scanning. PG can vary up to +/- 6mm due to breathing,
and bowel content movements. Therefore beams are allowed a 10mm margin exceeding the shape of PG, and this means the rectum walls cop a large
dose of RT. I was expected to drink plenty water before each session to stretch bladder to keep more of it away from PG. 
The Calypso method allows calculation of the best beam directions at many angles all worked out on a computer prior to the radiation. The intensity of
radiation is variable and beam direction is locked on to tracking information from implanted RF beacons within the PG. Hydrogel is inserted between
PG and rectum and I assume bladder as well to nudge these adjacent organs 12mm away from PG, So the beam control uses a much more sophisticated
computer control program, a benefit of progress over last 20 years, and thus offers less side effects, and raises the amount of RT allowed to be given to PG.
The hydrogel hardens to being like rubber immediately after insertion, but dissolves away during 4 following months. Its is said to be entirely inert, and
safe to use.

I don't expect very much additional radiation damage to what I have had already, except to prostatic urethra, all nerves, and thus may bring incontinence.
 
The doc said the IMRT can be over a week, or 3 weeks. The week of RT suits those wanting the cheaper cost, and shorter accommodation, and less
time off work. Being retired, the longer 3 week time suits me, and doc said the longer time gave slightly better results. He said there is a chance
the Tumor Cells Will Be Exterminated. A bit like a Darlek in a Dr Who episode.

Well OK, sure, but all exterminated? will some just modify themselves into something worse? It is cancer we face, and it is real good at making a fool
out of many doctors.

A Psa test 6 weeks later would tell me and my doctors who are all interested if the IMRT has done anything. Psa is supposed to decline. The worst
outcome would be a rapid rise in Psa. I'll remain on HT, maybe monthly Lucrin shots, and Cosadex.

I have provisionally agreed to go ahead. The doc in Melbourne is happy to do the  RT if my other doctors have faith in what is to be done, and of
course to get to see all the doctors I had to book appointments and get around the waiting times of up to a month before my turn was available.
There are hundreds of other patients, some in greater need than me. And I have to wait for one doc to return from time off, and oncologist takes
a break a week after I see him. So unless you get busy to talk to these docs, then expect almost no co-ordination or concern about yourself.
Just make sure you are polite, not ever surly, doctors and specialists are not God, they are just men or women, and you must make do with
whoever is around and I believe this approach leads to the best evidence based treatment you could have. The oncologist didn't know what
Calypso IMRT was about when I mentioned it. After dealings with me he will learn just what is on offer; I very much like talking to my doctors,
and I try to bring then a concise list of my concerns.

Because there is some Pca spread to lymph glands I will have chemotherapy at a later date, maybe in 2 months time. Nobody knows what might work,
or what combination of chemicals might work. Many chemicals merely delay the the end game a few months, but in some cases it gives years of life.
There are chemo drugs such as abiraterone, enzalutimide, taxotere, cabazitaxel, etc.One solution might be the to removal of bladder, PG, and sealing
off penile urethra. Then the two ureters from each kidney are brought together to make a join to a hole at side of lower abdomen for external urine bag.
But because my Pca has some slight systemic spread the surgeon may feel it is a pointless exercise. I know a guy who has been through this, he's
lived happily onwards after this op and gets jobs done around the house and his wife still loves him.

Many websites are a cause of confusion and anxiety, but I found this from the UK...
 http://www.cuh.org.uk/bladder-cancer/your-stories/alan-hoensch
The PET scan showed my bladder is not happy. The bladder is muscular bag with walls normally 3mm thick to expel urine with an easy squeeze to
get urine out along well sized tubing with few  restrictions. But in my case, the urethra in PG is being strangled making it harder to expel, so the bladder
has built up its muscle thickness to 10mm. I don't realize the effort it makes and nothing is painful, unless I delay getting to a loo.

I told the Melbourne doctor that men should be able to have their PG removed before cancer spoils their fun, and before cancer makes it impossible
to spare nerves. But he said no 25yo would want this, but I said many over 55 would much like it, and they are usually able to afford it. It is rich old
men who fund old men's cancer research and treatments.

But prostate surgery often leaves a small number of Pca cells behind, or healthy PG cells which will develop Pca later if the DNA allows it.
I know about 5 men my age well enough to know their Pg condition; all had surgery, and all had Pca return, and all had "salvation treatment"
with RT. Some had HT, while others didn't, so the HT was a spare weapon up their sleeve if the Pca progressed.

One friend had surgery over 6 yrs ago, Psa went down to < 0.02 after a year, then hovered for a year or two, then began to rise to 0.7 before last
December. He then had 35 sessions of EBRT over a month to the area where bladder was joined to urethra. His Psa is now 0.1, and apparently
falling. But his tumor was Gleason 6, and the target for RT was small, so "salvation" RT is more likely to work. I had Gleason 9, aggressive cells,
operation was impossible and I'm in a much worse situation.

There are idiots who suggest Psa testing is all BS, and treatment does not extend life very much. But I would now be dead if Psa tests and
treatments had not been available.

While surfing the Internet I just found a .pdf document prepared by St Vincents Clinic in Sydney about the range of things done at this clinic.

https://stvincentsclinic.com.au/wps/wcm/connect/d4f26437-5af8-46b6-bbed-981b66d7616e/2014+Proceedings.pdf?MOD=AJPERES&amp;CONVERT_TO=url&amp;CACHEID=d4f26437-5af8-46b6-bbed-981b66d7616e

On page 11, there is a table giving Psa levels at which referral to a urologist should occur. For men of 60-69, the Psa level is 3.0. My Psa would have
exceeded 3.0 well before 60, and my GP did not send me to a urologist until Psa went close to 5.0 in 2009, when the tumor had grown to be inoperable
and with aggressive cells.

So I cannot stress how important it is to be diagnosed early, which means a biopsy at Psa = 3.0, regardless of other public health guidelines based on
Psa of 5.0.

Other good reading about radiotherapy, UK
http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/radiotherapy/external-radiotherapy-for-prostate-cancer

General info about survival rates, USA
http://www.harvardprostateknowledge.org/how-to-handle-a-relapse-after-treatment-for-prostate-cancer

From what the Harvard site says, I had a 90% chance of recurrence of Pca after the "normal" level of EBRT used at Canberra Hospital.
The recurrence of Pca was masked by action of HT, so the recurrence was seen in three rises of Psa when I ceased HT 18 months after initial RT.
The maximum rate of Psa rise was much faster than 2ng/L per year.
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My vegans diet includes large amounts of raw vegetables and herbs in salads, and regular quinoa plus almonds boiled together, tiny amounts of low
fat milk, sugar, salt. I use virgin olive oil in many things, but it amounts to less than everyone else's fat intake. I don't eat any junk food, ever,
no chips, deep fried anything, no alcohol, no coffee, no cheese, and I really don't know anyone else who eats like I do. The ONLY way ppl get fat is
because they eat too much. Regardless of all other considerations or invented feel-good justifications or theories anyone anywhere says about food
and weight, if you stack on more weight beyond what is ideal for you at 35, ie, when your BMI should have been less than 25, then you have eaten too much.

I was at my fittest at 42, and weighed 82Kg. I could ride a bicycle 300km in a day at 28kph average. And I have quite poor athletic genes. I'm now 84Kg,
and bike speed is now down to 20kph because muscles have weakened at 69, and I've been chemically castrated for 6 years now. The weight change
is about -5Kg muscle, +7Kg fat, but I still have BMI about 25.0. Despite the terrible condition of my knees which need titanium joints, I still manage to
ride over 100km a week.

I weigh myself naked each morning on electronic scales, and plot each day's starting weight on a graph in my hand-written journal I've been doing
for last 55 years. Only one person controls food flow down your neck, HE IS YOU.

What you eat should be full of vitamins and micro-nutrients. As we age, we need less food calories, but we need good nutrition. We have less muscle
weight and we do not need extra protein or extra carbohydrates; you need less of all things which are calorific.

Breakfast for me is a bowl of chopped raw kale, one raw tomato, one spoon of olive oil, a sprinkle of turmeric and salt with iodine, and a pot of
green tea. I don't need to eat between 8am and midday. Lunch is one vegetable only sandwich and a pot of tea. I found it very easy to accept the more
frugal existence despite my improved finances and the booming roar of advertising shouting at me to eat and drink garbage, and spend my way to
being happy.
Over eating is poisonous, over spending makes you sad. Dinner is a salad  with many green things and red capsicums etc, and staple food is boiled
quinoa with some almonds, which need to be cooked to allow their goodies to be absorbed. I eat maybe 5 small green apples after dinner to midnight.
Being chemically castrated means I have almost no testosterone which slows down my metabolism which has me feeling the cold more. I am unable
to burn excess calories and any slight excess calories become fat shortly after eating.
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For the first 4 years of ADT, erections rarely ever occurred spontaneously, but any seductive images if females brought Roger to life and then this all
changed to less often, and signals to Roger became muddled and only due to a full bladder unlike previous years where this rarely happened before
treatments.The ADT ruined all my sexual abilities by end of 2014. Whatever pleasurable sensations I could have become so dulled that any possible
sexual excitement became not worth pursuing, and absence of testosterone has caused penile atrophy, with fibroids forming in tissues resulting in erectile
deformity, ie, a dick with bend, and very fragile skin. I have the kind of dick no female would ever want have anything to do with. Medical treatment for
prostate cancer always kills Roger.
Most men would not prefer to know the results of long term ADT. I was highly hetero sexual and capable of pleasing myself or any female until about
2013, 66yo. I have now accepted that between now and my death it is highly unlikely any female would ever want to have anything to do with me at all.
Sex with any F after a certain age becomes a liability - not enjoyable if the F is likely to be irrationally angry in your face after a few months, or a few hours.
Although I keep thinking about sex, and having some female company in my life, it is just my silly dreaming.

Some men would have a penile prosthesis installed, maybe for $25,000, but in my case I've been radiated and surgery anywhere in pelvic region is extremely
risky because I could bleed to death due to damaged blood vessels.

I have not heard of any man able to describe sex favourably in terms of how he feels during use of a prosthesis. He would probably be OK if he had RP surgery
only and had full testosterone, and then it should work well. But if a man has had ADT for over 4 years, his WHOLE sexuality is buggered. It is normal that with prolonged testosterone starvation the Roger gets fibroids in the erection tissues, maximum erect length will decrease from 140mm to 100mm, and it is very
likely to have a bend in one direction, often downwards, so Roger resembles a brass garden tap. it looks ugly, and penetration would be difficult to maintain, and the feelings of pleasure all vanish. The skin around the head of Roger become thin and fragile where it joins the shaft, and a gentle rub during a jerk off will easily
tear the skin which then takes days to heal. Erections occur with a full bladder while asleep, and then a man wakes up, and the erection vanishes after a pee.
Even with an erection brought on by a Little Blue Pill, and In the presence of a young fully functional female, a man is not going to do much good, and the female
is likely to flee to a man 30 years younger. Who could blame her?
The intensity of orgasm declines to zero, and no matter how well the female performs fellatio, it just becomes a boring waste of time.
So use of a vibrator may do a better job on the female, but psychologically, it is bullshit, the young female can only be satisfied by a real man. There would of
course where the female has huge medical limitations, and is happy that ANY man is able to be vibrantly intimate with her; but this is actually very rare.
Usually man of 60 has not got to worry about sex with a wife if she's close to his age. The decline in a woman's sexuality is dramatic after about 45, and women
become frail, they cannot and will not try to stay fit, and sometimes they become emotionally erratic and difficult to love, let alone make love to.
Welcome to the land of Old Age.

Between 2009 when I was diagnosed and 2016, I rode about 90,000 on a bicycle, and I think I scared away any possible partners I may have seen. Few women
near my age rode bicycles, and were seriously dismayed I was in much better health than they were. But then, I had a wife who left me at age 22, and she
was similarly afflicted by my vibrancy and indestructability. I was a man they could not root, shoot, or electrocute. Good, afaiac. Why would I ever let myself be
so physically mediocre and so many others????

I have often thought of marrying my bicycle. It may become possible in these days of liberation where even gays can marry. A man could marry his dog maybe.
But marrying a bicycle looks good to me, and why?

Because the man can go for a fukken ride any old time he wants to!!!.

No back chat, low costs, feels good, and its freedom, and I am sure the bike loves it too.

Unfortunately, my preaching is to a mass of men who insist that they destroy themselves by 50 with becoming unfit and overweight, usually from eating
too much junk food laced with fructose and sucrose, sugar, and too much alcohol. Their whole life is one of TOO MUCH.

I found all young women soon vamoosed when the reality of the required co-operation together caused a Female Allergic Reaction.
Love is such a dreadful threat to so many ppl. I doubt any doctor has any answer to the not so uncommon malady of where people look me in the eye
to tell me "I Hate Love". I once read this written in large painted letters on one of Canberra's cycle paths. I had a female boarder in my house for 10 years
who one day blurted out "I hate love". She was a fine responsible tenant to have, but had zero ability to relate to anyone beyond the non personal.
The fact remains that many ppl hate love. I am often lonely, but then relieved I am not married to a Female Dragon who finds fault in all I do, and is like a
millstone around my neck.  I gave all women only ONE CHOICE, to love, and sure, they did for awhile, but then that stops, and they could not stay, and
they repeated the bullshit on the next male victim. I was always gentle and understanding when they departed, while wishing to leave a bootmark on their
arse on the way out the door. I was far to polite to all I met.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
17 February 2016
Not much to report since last January. I ceased riding my bike late last October, and now I am trying to lose the Kg I put on. Becoming Totally Vegans
might do it, and help prevent the severe effects of inflammation in my knees. There is theory lurking in minds of "healthologists" that eating or any
other animal product, eggs, all dairy junk, and cheese junk triggers the immune response to attack cartilage because of molecular similarity.
While young, most of us can eat anything without any worry, except for fact most ppl eat way too much of everything, and including excess sugar,
fats and processed carbohydrates. But as age embraces us, it makes us ache in our joints, and the less we do to encourage this, the better.
I find this true for myself and without knowing if any of a myriad number of theories about diet and health are in any way true, or proven.

Anyway, for me, a fairly strict vegetarian diet is better than taking any pain killers, and it is natural to me to NEVER EVER buy ANY JUNK FOOD,
including all meat. Not even Lindt chocolate bars or a monthly bottle of red wine. Sure they taste nice, but the health benefits are extremely low,
and whatever chocolate you eat, you can't avoid the huge fat/sugar content even though the packaging claims "85% pure cocoa. With wine at 12.5%
alcohol, its much more calorie riddled than green tea. Anyway, I have slowly gained a Kg over 3 months, and I thought 150grams of skinless chicken
3 times a week was OK, but no, it ain't. I used to ride for 10 hours a week, and had a need for protein, but with being sedentary, there's just no need
for so much, and I figured I was getting enough protein for reduced activity. With chemical castration with Lucrin, to combat Pca, my body has become
unable to burn of any excess calories. Right now, height = 1.845M, weight 85Kg, BMI = 24.9 I should be less. Waist is 100cm.

I was 1.865M, and weighed 83Kg, BMI 23.8 when I was very fit and raced on bicycles in 1980s-90s. My waist now measures 100cm, and in 1990 it
was 90cm or less, and I had maybe 4Kg less fat and 4Kg more muscle. Even though my BMI was 24 at 42 , I still had a much higher fat % than the
quickest people I raced against. I was always at a big disadvantage on hills, and in time trials the slim guys have less volume so they cut through
the air faster than I could. Naturally, athletic clubs attract people who are naturally good at sports, and they beat all the slow coaches like me. Their
ego gets the big lift with wins over those less endowed with great genes. It was sickening to witness the constant focus on a win. But occasionally
I did very well in handicap races.

The idea of BMI and waist measurement does not tell us all about a person. A short weightlifter may have waist above 100cm, and BMI 30. Weightlifting
may be all he can do, but he can find a happy path in life like everyone else. We are not all the same. Now as we age, we reduce muscle weight even if
we keep exercising. About 80% of us get heavier, and lost muscle is replaced by fat, and BMI can remain the same. So the weight of muscles I had are
replaced by fat, especially around the gut. There's much more to grab hold of compared to being 40. We should get LIGHTER as we age, we all like
to live well, and enjoy activity, like cycling, even though av speed goes down. I have found it is impossible to get lighter, and I'm 3Kg heavier than
I was when fittest at age 40, so my fat % has probably doubled.

But at least I don't weigh 100Kg like so many other guys my age.

My limiting factor is now my joints, with knees leading Nature's charge to reduce my lifestyle. And while my knees ache, so do hands and wrists and
back; whatever my body is doing, it is having challenges at more than one place. But after doing anything physical, despite the aches and pains,
I am glad I did it, and my mind and body both feel better.
 
Just after last update, about a month ago, I had a bout of heart fibrillation where HR suddenly went to 120, and irregular, so I drove to Calvary Hospital
where they kept me there till 1AM. The docs put me on Sotacor, to slow HR. Within 6 weeks HR went back to normal, and I've now stopped taking the drug.
But I am taking 100mg of Cartia, (aspirin ) daily, if I remember, which may be thinning blood slightly to lessen the hypo-tension I suffer. Hypo-tension is
not to be confused with hypertension. Subsequent heart clinic on 16th Feb looked at heart with Ultrasound, and doc said my heart looked just great.
I said "Hmm, shame about the Pca, I'll be a good lookin' corpse on the slab after it kills me".
 
Two weeks ago I had a mechanic fix the brakes on my 1986 Ford Laser. He had it for 5 days, because suitable parts were not immediately available.
This forced me back onto bicycle, and I rode 100km last week, with 15km ride up the hill to the heart clinic. I figured I'd make it, and all went fine, if I
died on the way, so be it. Doc was not alarmed, but more confident I'd be OK. A bloke of 30 overtook me up steepest hill and maybe he was trying,
but then I caught and passed him just before the crest. Heck, I'd given the yung turk a 38year advantage, so I realized I wasn't near death just yet.
Don't ask me what caused the bout of HR bothers, but I suspect it was eating a few dark red carrots; I'd heard dark red vegies are very high in a
very good anti oxidant. Maybe too good. I can't be sure. I've only ever had it once before in 2004, after coming off VIOXX which later got banned
because it killed ppl with heart problems.

Knees didn't ache later as a result of the rides, like they did back in October. Not as bad as in 2004. We need to keep exercising.

January 7, 2016. Prostate cancer report.
My last Psa test was 18 Dec 2015, and I visit my oncologist later today, 7 January 2016. ADT hormone therapy continues with Psa is not going
down as far or as fast as it has during past applications of Eligard and Lucrin.

The graph gives my Psa history which explains how my treatment for prostate cancer has proceeded with ADT and Radiation. My conclusion at
present is that Psa is not being held down to the initial levels achieved when ADT began in April 2010. Since then, I've had two pauses from ADT,
and during both the Psa rapidly rose indicating that radiation did not have much effect on cancer cells. The underlying value of Psa from 2011 to
present 2016 shows that it is slowly rising, and testosterone is not being fully suppressed by Lucrin injections.

I can see that if the slow rate of increase of my Psa continues, it probably will indicate Pca is going to spread & kill. Its what cancer does.
Use of alternative therapy such as apricot kernels, about 24mg per day of amygdalin seemed to have zero effect on Psa over a long time of intake.
Cannabis oil with low THC, high CBD seems to have done nothing between Feb 2015 and October 2015. My daily dose began at 0.2mg, a very tiny
amount, but it was enough to get a strong high. Sensitivity slowly reduced and at end of period I could take 5mg. I stopped taking it Oct 2015, and
experienced no withdrawal effects. It has been totally non addictive, and gave me good inner calm feeling about life.

Websites promoting cannabis for cancer cures should be considered snake oil treatments until proven otherwise.

There have been NO studies of social groups of ppl who regularly smoke or ingest cannabis products, such as those living in Jamaica et all. I might guess
that any studies might show there are no reductions in cancer rates where it is widely consumed and in tropical regions where it grows so easily it is hard
for authorities to eliminate.  I might add that prostate cancer rates are worst for those with dark african genes, and there is considerable variation in rates
for different races or genetic blocks of men. There is no way yet for a man to alter his genetic make up to not endure prostate cancer. Some websites
promoting cannabis oil say you need to take a GRAM a day but this seems utterly wrong. One gram = 1,000 mg, and has volume = 800 cubic millimetres.
I doubt I ever took more than 6 cubic millimetres a day, a small drop on the end of a little metal spatula I made. So, assuming I averaged 5 mg a day
for 270 days in 9 months, the maximum I would have used was is 1,350 mg, or just over 1.35grams, or less than 2 cubic centimetres, 2cc, and not much
from initial supply of about 20cc, or 16 grams, which was obtained by my friend from about 300 grams of harvested Sativa heads. The oil yield rate is
extremely low compared to rate for the Indica variety that has been subject to genetic selection since 1970s when Indica began to be grown commercially
by hard nosed arsolic criminals who want the product to give a huge high for a small amount which is cheaper to grow. The Indica sold in most underground
sales is "skunk" and very high in THC which has psychotic large effects so beloved by those subject to becoming hooked to drugs.
There is a very low % of CBD oils in skunk, and its these oils which give the calming effect, and boost to immune system, if there is any to be had.
It turns out that our bodies produce CBD chemicals naturally for immune system and calming function. Therefore skunk sold on the streets is having a
very bad effect on the hoards of stupid young people who foolishly believe they can ease the pain of their existence by getting high, and the then so many
suffer schizophrenia or other disorders which make then useless for anything, unemployable, and dependent on welfare. I should know, because I have
a nephew who succumbed to mental illness while trying to keep up with his 2 older brothers, one of whom sold pot to classmates at age 12, and who went
on to become a bankrupt at 23, after dabbling with heroine given to him by a girl friend. The other brother dabbled in cocaine. These three young ppl had
Shit For Brains in the formative years; nothing could be done to get them on the straight and narrow. They were always allergic to hard work. 

So I really do know about cannabis and its effects. My friend who prepared my oil for me did not dilute the oil at all, and in fact it was a dark brown grease,
unable to flow.

Had I had tried to take 1 gram of the oil I had daily, I would probably have become extremely ill. It may have had such a huge psychic effect that I could
have a fall or other accident in the house and done myself an injury. It may have been fatal. Websites promoting cannabis oil for health say the high from
THC need not be strong, just be present, and still allow you to live independently without risk of accidents, despite the feeling of "being remote" while
cooking, or watching TV. The guys promoting "Medical Cannabis" will insist on telling ppl they need 1 gram a day. The density of oil = 0.8 grams per
cubic centimeter.Therefore 1 gram of oil = 1 / 0.8 = 1.25cubic centimeters = 1,250 cubic millimeters = 1,250ml.

The guys selling oil know that ppl only need 2.5ml per day of oil to get a high especially with skunk or a new user taking it for medical reasons.
I have seen websites saying you need 60 grams or 1 gram a day for 2 months for a cancer cure. The active ingredient of raw oil might be
60 x 2.5ml = 150ml = 0.15cc. To this they add 75cc of canola or olive oil, so the bottle contains
75.15cc of diluted oil.

They have diluted the product by a factor of 1/500. The price is only $10,000 - to save your life. The price they get for the raw THD ingredient in
medical cannabis paid by gullible non-street wize ppl is far better than the price ppl pay for the same amount of THC to ppl who need to smoke 2
bongs a day. There is no evidence cannabis oil cures cancer. With the oil my friend provided, I certainly got a high always with less than 5mg.
It seemed so "strong" at times that it is strictly a stay-at-home substance, you MUST NOT tempt fate by driving a car, or doing anything in a workshop.
So this "therapy" is a "mind zonker", even with this variety of Sativa which is just a natural wild variety which has not been genetically selected to
make the THC much higher and CBD lower. The Sativa oil had me "good for nothing a hour after taking it." I found I never ever had feelings of paranoia
which are the hallmarks of psychologically damaging varieties of Indica cannabis which are very high in THC and with hardly any CBD.
should be avoided at all costs, especially by teenagers who can succumb to schizophrenia and other mental illnesses. Natural Sativa variety is
low yield, low THC. And anyone 16 who reads this will not have the slightest idea about what he is buying, and what I say here is all bullshit.
There are ppl very prone to addiction to many things; 80% of alcohol is purchased by 15% of the population, 80% of gambling is by 10% of population
who are problem gamblers. Studies would show 80% of recreational use of drugs is by 15% of population, with a good number becoming addicted.
Tobacco was once smoked by 50% of everyone I knew, with probably 25% smoking twice as much as the other 25%. I once smoked up to 15
cigarettes a day, then said I'd give up, cold turkey, at age 34, when a GF at that time said I stunk like a chimney.

I did give up, cold turkey, but GF went through usual cycle of Love, fading to co-existance, then Hate, and off she went to roam and slut around
world - again - like the year before, in between the years of being employed as a primary school teacher where she could not last longer than a year
without getting fed up, and needing to piss off. This was typical of the many useless dreadful young women I met who could not settle down with
anyone. Their efforts to
relate to me were 120% un-respectable. Sex wasn't especially wonderful, just sex. I don't have an addictive personality, and cannot be addicted
to fraudulent lovers, grog, cannabis or anything else at all. The cannabis oil had me sleeping better, calmer, less worried, less anxious, and being
more able to accept my dismal future. I didn't like being forced off the bicycle with knee pains. There is nothing nice about declining with age and
slowly losing every ability all ppl under 50 take for granted. Aging means everything known and practiced as "human life" becomes very limited,
and denied to ppl when they get older.
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12 October 2015.
HT was restarted 1 August 2015 following Psa 3.3 level 10 July. Psa is going down again.

13 July 2015. Since February  2015 little has changed with my health, except that my knees are beginning to wear out and I cannot ride a bicycle
as fast. But I have finally given up any desire to go fast as I could all the time. My Psa has risen from about 0.4 in Feb to 3.3 at 10th July 2015,
so you can see that there is a very fast doubling time. An acceptable doubling time is say 10 years, so from 50 it goes from 1.0 to 2.0 at 60, then 4.0
at 70, and 8.0 at 80, and maybe you last until 90.
I have a cousin of 70 who has Psa = 0.3. There is a good chance he had a lower testosterone level than I did. In my case, I have paused from
hormone therapy after February and its effect has down over 3 months and my body has resumed testosterone production. Prostate glands
normally generate a high Psa marker chemical in blood due to testosterone presence, and it does this even when no cancer is present. Normal range
of Psa on pathology results is cited to be from 0.3 to 5.5ug/mL but this is misleading because what is normal when you have been previously diagnosed
with Pca?
I've known men whose Psa was 18 but there was no Pca. Well, not yet. So "Normal" is a silly word, and 0.7 at 40 and 1.0 at 60 should be the standard.
THE DOUBLING TIME of the Psa level is much more important that the actual level if the level is "normal." I had no surgery. I was radiated, so the
prostate gland is just sitting there like an internal crouching demon ready to mutate and grow uncontrollably. So whatever Psa chemical is produced,
it could be from cancer cells, or from normal cells. But not one doctor knows the exact state of my prostate gland or if there is any metastasis.
They are only guided by Psa level and its change and the statistics.

Having low testosterone < 0.5 ( normal range 8 to 38units ) in most males will reduce Psa to less than 0.5. The pause in HT is supposed to do my body
good to allow some return to having testosterone and to see if the EBRT in 2010 has worked over time.

This is the second pause in HT I've had, and this time the mental change has been negligible. My bike speed has reduced and general daily desire for
sex and ability to "fix the itch" has not returned. Well, maybe it is mental, because at 68, there is not a woman alive who'd ever want to be with me
in any way. I have moved to the age where I am naturally repulsive to 99% of sheilas. Most are far too polite to mention this fact, because politeness
is something many of them discover is the key to a peaceful sexless life without arguments with men, usually over money, and getting their own way.
It is maybe 20 years since anyone actually touched me with care, except for medical professionals paid over $100,000 pa. Its OK, I just handle it,
rather like my mum of 98, who hasn't had a man touch her since she was 55. I have become polite enough to enjoy women's company without ever
having them feel frightened, angry, or sexually aroused when it is not wanted. 

The Psa rise during 2015 is just like what occurred in early 2012, indicating cancer tumor is alive and well, and intent on killing me.
See the graph above for Psa after January 2008.
Psa rode from 4.3 to 6.3. I was diagnosed after biopsy in late Dec 2009 with Gleason 9, aggressive cell type, young man's type of cancer, prostate
gland was 3 times normal volume. Biopsy gave 9 live samples of 9 taken through rectum wall, a very painful experience with no anesthetic.
Open surgery was attempted April 2010, but abandoned after cutting me open. Cancer had just advanced beyond capsule but had not spread.
HT with Casudex followed by Eligard was commenced, and In Dec 2010 I had 35 RT sessions when Pg had been shrunk to smaller size due to HT.
Eligard was injected once every 3months causing temporary chemical castration. I am presently (12 October 2015 ) back under effects of re-started HT
with Lucrin injections. Psa has fallen, but probably I will never lower it to the 0.08 back in April 2012.
The effect of ceasing and re-starting HT shows Psa rise and fall similar to between 2012 to 2013.

The latest peaking rise in Psa indicates it is likely the radiation treatment has done little if anything to prevent prostate cancer from finally killing me even
if I remain on HT for however many years Unkel Nature has allotted to me. The graph shows an underlying rise in Psa at nadirs during HT, and doubling
time from August 2013 to April 2015 = 16 months. From this I could say that Psa in 6.6 years time might be 32, aged about 75, and I may not be very well.
The idea of living to my 90s would depend on a miracle cure.

There are some miracle cures one hears about, most one hears or reads cannot be taken seriously. There's a drug called Keytruda which works for
melanoma well, its now available on PBS scheme in Oz. It is said to work on other cancer types including Pca, but then it is new, and trial results are
yet to be finished, so I doubt my oncologist is going to prescribe it for me in 5 weeks when he gets back from his winter holiday. So knowing what the
latest cure or treatment may be is fine, but so often we hear BS about something that won't help us in time.

Comments on the graph explain the issues for anyone interested including medical professionals. It should be viewed on a nice BIG SCREEN, and not a
stupid little i-pad or phone. I may be the only man who has published a graph of his Psa levels during treatment for prostate cancer.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Last July 10 2015, 3.3.Previous Psa June 2 2015, 1.4.
The 2015 Psa rise is similar to rise in 2012 when I paused for 6 months from HT injections.

I will start again with HT next week with Casodex tablets followed by Lucrin injections to reduce testosterone to low levels.

I have no cause for optimism, and alternative remedies such as apricot kernels and daily cannabis oil for last 5 months have done absolutely nothing
to change the shape of the curve for Psa rise. Had my Psa risen to only 1.5 with a then begun to fall, the HT + RT could have been said to work, but
as I see it, its only a matter of time and I would bet that when I re-start HT the Psa will not drop drop to levels on early 2014, 0.26.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
6 February, 2015.
After an aborted attempt to remove my PG surgically in 2010, I was given HT for 2 years with a full course of 35 RT in Dec 2010. After 2 years of HT
Psa went to a low 0.08. I stopped HT, but by May 2013 Psa climbed to 8.0 and free Psa indicated Pca was progressing. I started a second round of
HT in early June 2013. By the time the effects of the last injection of Lucrin ceased by about April 2015, I will have had HT for 22 months.
The Psa nadir during the second round of HT has been 0.2 in April 2014. Psa has risen slightly to 0.36 last month, indicating a doubling time of 1 year.
This does not mean the HT has become ineffective. The PG cells I have are radiation affected and some may be healthy, and these produce a Psa
reading along with any cancer cells, and it is difficult to determine where the source of Psa really is, because the HT reduces Psa produced by both
healthy and cancer cells - while the HT it remains effective.

During my last visit to my oncologist at CH, he and I decided to quit the HT and watch the total Psa to see if it rises rapidly and determine free Psa
which will indicate if the cancer is progressing. The oncologist says a pause in HT to allow a return of testosterone production will be good for me.
If total Psa remains below 1.0 then it may be considered the Pca is in remission but that if it rises above 1.0 - and rapidly - then I will have to return to HT.
I will not have a Lucrin injection at end of this month when the next injection was due. I might assume my testosterone will begin to rise in about April,
and I will have a Psa test in late May, just before I see my oncologist in early June.

I may need to remain chemically castrated for the rest of my life.

Castration affects men in a variety of ways, and there are many myths. There is no feminizing apart from some body hair reduction. Drugs like Lucrin or
Eligard which suppress testosterone production do not cause feminizing effect like female estrogen, sometimes given as HT. So I shall not grow breasts
any time soon, or hear rise in pitch of voice etc. I doubt I suffer depression, and I can keep my weight under control, now 83Kg, with BMI = 24.8.
But of course I am aging, and although I am same weight as I was when at my fittest when 41, some muscle has been replaced by fat and there's
nothing I can do to stop this while on HT and and under effects of zelodronic acid to prevent bone thinning.

Unfortunately, many men find themselves depressed by aging, and so many cannot ever control eating, drinking, laziness, and social habits which
are all bad. I'm the exception. Many men blame weight gain and the and drift to other illnesses on medication, and by 60 they become ugly caricatures
of what they once were, and they give up on themselves. Their wives also to the same thing, and its no wonder depression is so common, and
desire for vibrant intimacy has become a thing of the past.

It's been 37 years since I was married, and I'm still looking for a partner and I definitely can function sexually. So while single, I have nobody to displease
by getting old and getting a few health problems. I find most ppl avoid relationships like the plague after age 45, but I'd welcome one. The difficulty is in
"chemistry", and most women have zero desire for a man after their menopause, ie, they have "paused from men", and no amount of chemistry, charisma,
or money, care or anything else will make any relationship possible. There are thousands of females over 30 advertising on dating sites wanting men. Let us
suppose 50% are bogus creations by website "managers", ie, arsole scamsters. The remaining 50% run a mile if a man does suggest a meeting; they say
they want a man, but most are quite incapable of following through with active pursuit accompanied by watchful eye to sort out who is or is not a member
of the army of men from Arsolia or Bastardia where all manner of fellows really want to be euthanized tomorrow.

I continue to cycle a constant average of at least 200km per week to keep fit. Very few fellows overtake me during my rides. There seem to be virtually no
men my age still cycling. I rarely EVER see any woman over 40 on a bike, and 95% of all the females on bikes don't want anything to do with me;
I am an old fart, and they cannot keep up to my speed, despite them being perhaps 40 years younger, and me having bad knees and lack of speed due
to muscle weakness aided by chemical castration.

I probably have high willpower levels, so after July 2014 I gave up wine and chocolate and last Xmas gave up having a cookie during each cafe stop
while out on the bike. The ONLY way a man or woman can prevent fatness by eating less calories than consumed by exercize, ALL THE TIME,
until they die. Between 1993 and 2006 I stopped cycling and doing building work due to knee pain - I have bad knees.
So during 13 years I put on 19Kg, which works out to 2.7 grams per day. This seems like such a tiny weight gain, and ppl hate to think something so
small matters so much, but while living a sedentary life you just have to reduce calories far more than one might think is sensible.
I have GFE genes - Get Fat Easy. The only way for me to control weight is to weigh myself EVERY morning using electronic scales able to resolve
to nearest 0.1Kg at least. Then I plot the graph of weight in my daily diary, and if any jump in weight occurs, I fast, and ride a a bit. Over 2 months you
will see variations in weight of +/- 0.1Kg, but you can SEE the TREND of your weight, and read the average weight for each month.

I allow a Supreme Salad Sandwich every day at my favorite restaurant, the "Siam Twist" at Hackett in Canberra.

Do not believe the poor reviews about the Siam Twist; it is luxuriously pleasant.

http://www.tripadvisor.com.au/Restaurant_Review-g255057-d7110784-Reviews-Siam
_Twist-Canberra_Greater_Canberra_Australian_Capital_Territory.html

With two large cappuccinos, its under $16, which I can afford. Once a week I have a Thai dish, Duck Salad or a Laksa with noodles and tofu in winter.
I enjoy occasional male company and newspapers to read, very pleasant staff, and so I enjoy being away from home.

My knee osteo arthritis is beginning to limit what I do on my bicycle, so as long as I don't ride more than 300km within a week I am OK. I am not yet
begging an orthopedic surgeon to install titanium knee prosthesis to both knees. It may happen, but I'd have to wait a year before getting the operation
and my cancer progress may prevent the operation if the docs think I will die sooner rather than later. Right now, the oncologist does not think my
prostate cancer is spreading. I don't need to ever walk further than 200M ( carpark to movie theatre ). I doubt I'll ever need to walk further, say, along a
beach at sunset with a beloved. If I try walking on sand my ankle injury from a motorcycle prang at age 19 has me completely disabled.
Women dream of romance and expensive resorts, but they need to be able to be happy right here and right now, and then all days following the day you
meet them. They should never need to travel anywhere, but I make an exception for coming out with me on a ride. Like many with leg injuries from a
past life, I can cycle OK. A bicycle is just a wheel chair with one wheel in front of the other.

For last few months I ate an average of 40 apricot kernels a day as alternative therapy which is claimed to stop cancer spread. I doubt its having the
slightest effect but then it seems a benign dietary supplement, although they do cause some bowel irritation. I have have a friend with a HERB which
I will begin to take soon; I cannot say more about it, but if it appears to lower Psa after going off HT, I'll let you all know about it.
I now know of 3 local men who had what seemed to be successful surgery giving extremely low Psa. All have complete ED, and most have enough
continence. After a few years of having Psa < 0.02, Psa rose, so one had additional surgery to remove his bladder and have an external bag fitted,
another had all the RT that I had, and another has Psa of 0.05 after 4 years and he probably will try HT and or RT, and he much fears the Psa rise
at age 75. So even if the cancer is removed surgically, some small amount of prostate gland cells may be left behind, and they too may eventually
become cancerous, if they were not already at time of surgery.

In my case surgery was not possible despite a fairly low Psa at diagnosis in 2009. I still have a prostate gland which is probably much  affected by
RT, but exact status of cancer cells is quite unknowable. Therefore it seems pointless to worry too much about a Psa which is 10 times the level
which alarms other men so much after they have had surgery. I expect my Pca to kill me; the doctors said they just don't have a cure.

Life expectancy for a man in Oz is now 84 years, but that just means very many die well before they turn 84.....Sure, a few live to 104, but I don't
expect to one of them. 
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For anything before 6 February 2015 :- Past history.
My interest in road cycling now reduced, and not much to say at Velosophy
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