Tag: prostap

Bobs Bowel 13 – Chemo !!!


It’s 19th May, 2025 and I have an appointment with an oncologist. This is to discuss potential precautionary chemotherapy following my hemicolonectomy at the end of March.

I am introduced to Dr Mutheramalingam, known as Dr Ram.

He seems to have done his homework, as he tells me all about the various conditions that I am receiving treatment or surveillance for, including Prostate Cancer, Type 2 Diabetes, and possible Non-Alcoholic Fatty Liver Disease (NAFLD). And, of course, not to forget the main event, T3 N1b Colorectal adenocarcinoma, the reason I am in his office.

Dr Ram procedes to explain the situation i.e. the positive results of the surgery and that the scan prior to surgery had not shown any signs of cancer elsewhere.

Interestingly, he mentions that the lesion on my lung seems to have disappeared. This lesion was strongly suspected to be Prostate Cancer, and is the reason I have been on course of regular Prostap injections. We discussed the possibility of my no longer needing the injections but he wanted to defer that discussion to my Urology consultant.

Dr Ram then went on to describe my chemotherapy options, which appear to one of two.

  • Option 1:
    Combined tablet and chemo infusion over a period of three months
    This option comes with a range of potential side effects which also include damage to my liver which is already under surveilance due to the NAFLD.
    This treatment offers a potential 12% increase in my survival prognosis.
    The chemo infusion would be administered at the hospital and therefore require multiple trips to the Queen Alexandra hospital, parking fees, and the time spent during the infusion.
  • Option 2:
    Tablet only treatment over a period of six months
    This option also carries the full range of potential side effects with only a 10% increase in my survival prognosis.
    The tablets would be self administered at home,each two week cycle being 4 tablets twice a day, followed by one weeks rest. During the weeks rest I would have a blood test and a telephone consult prior to starting the next cycle.

It seemed to me that option 1 only giving an additional 2% and also introducing the risk of liver damage was not a good deal. Also, the regular visits to hospital for the chemo infusion was not very appealing, given the many medical appointments I have had since diagnosis of the tumour.

I have therefore opted for option 2, the self administed tablet only chemotherapy.

Bearing in mind the positive results from the surgery we, the medics and me, don’t know for sure if I have any cancer in my body. This chemo, being precautionary, may not actually buy me any more time.

Since that initial oncology meeting I have started the chemotherapy regime having been prescribed Capecitabine. I have just completed my third cycle.

Capecitabine comes with a whole range of potential side effects which include the following:
Appetite loss, Diarrhea, Vomiting, Nausea, Stomatitis, Abdominal pain, Fatigue, Weakness, Hand-foot syndrome, Oedema, Fever, Pain, Headache, Hair loss, Dermatitis, Indigestion, Shortness of breath, Eye irritation, and Myelosuppression.

So far, after nine weeks, I am only experiencing fatigue which manifests itself by me dropping off into a deep sleep with little or no warning, usually when sitting quietly reading of watching the TV. Thankfully, this does not happen while I am actively involved in something.

In the first week or so I did notice, thanks to my smart watch, that my heart rate was spiking quite high. That is I was hitting over 130 beats per minute with no apparent cause whereas prior to commencing the chemo it was rare for my heart rate to go over 80 bpm. I contacted the oncology department and they told me it was probably my body getting used to the chemo. Certainly, the spiking has reduced, both in frequency and magnitude.

So here I am, cycle three completed. What now?

Well, due to a family issue I have had to travel and will be away from the UK for three months. This means that continuing with the chemo is problematic. Because of the type of drug that Capecitabine is and the need for regular blood tests, they cannot prescribe sufficient doses in advance for me to continue the regime.

Apparently taking a short break from the chemo is OK but two to three months may be too long for me to restart when I am back in the UK.

So I am exploring getting access to the local medicare here in Australian so that I can then see a doctor and hopefully get prescriptions for Capecitabine and also the requisite blood tests. There is a reciprocal health insurance arrangement between the UK and Australia but this might just be too complicated to manage.

I have applied to join Medicare and I am hoping that having been previously been accepted it will be pretty much a rubber stamp exercise.

We shall see!

My Prostate And Me – Part 12


Well here we are again. After another long hiatus, I thought it was time to update you all. The lack of posts on this subject is purely down to, in part, happenstance and in part, inertia on my part. So, for that, I apologise.

So, my last post was back in 2020, following a five year hiatus. Only 28 months this time, I must be improving.

My previous post ended with me waiting for various scans, which were duly carried out, as follows:

  • 1st August 202 – CT Scan
  • 3rd August 2020 – MRI Scan
  • 11th August 2020 – Bone Scan
  • 25th August 2020 – PET CT Scan

Much as I like playing with all the NHS toys, I could do without the palaver of driving to the hospital, searching for a parking space, then waiting for my turn in the scanning department. Don’t get me wrong, I am very grateful for the attention that I am getting. Anyway, the net result of all these scans was, overall, a positive one. The scans indicating that there was no sign of the cancer around the prostate itself, and, apparently, no sign of metastasis. Prostate cancer apparently tends to migrate to the bones, or so I believed. So also getting the all clear from the bone scan was a positive thing.

Or, maybe the prostate cancer was hiding ?

Although there was no sign of the cancer around the prostate or in my bones, they did discover something in my lung !!! I became aware, very recently, that Prostate Cancer can metastasise to the lungs. So my case became the subject of one of the hospitals multi-disciplinary meetings.

Apparently there was much chin and arse scratching, bone tossing and probably some discussion about how Pompey were doing in the football league. The net is that my urologist talked to the chest doctors. They, the chest doctors, suggested that, whatever it was, was in a difficult to reach place. They further suggested that “we” should wait for 6 months and then have another scan. Then decide what steps to take.

My man, the urologist, didn’t think that was such a good idea. He felt, if this was the prostate cancer, it would be better to be proactive and treat it accordingly. Consequently he decided to start me on a course of Prostap injections.

And so it was that, on the 14th October, 2020, I started my course of Prostap. One injection every 4 weeks. This continued until November of 2021.

During this time, continuing blood tests and a scan showed the “thing” in my chest had shrunk and my PSA levels were dropping. In the words of my urologist, the “thing” had self diagnosed itself to be Prostate cancer. So we continued on with the Prostap jabs until, following a conflab with my urologist, we decided that I should take a break.

Apparently Prostap, along with most medications, comes with its own baggage. One potential side effect is the impact to ones bones, increasing the possibility of osteoporosis. With everything else that’s going on I certainly didn’t need that in my life.

I continued having blood tests to monitor my PSA and each of those was followed up with a telephone consult with my urologist. Always a very pleasant few minutes chatting followed by wishing each other well until the next call.

Latterly the calls included a concern about the fact that my PSA levels were bouncing around up to a new high of 3.2. Thats up from the zero point something I was at once the initial Prostap course was well underway.

At the end of August 2022, during a telephone consult with my urologist, it was decided that I should restart the Prostap injections. I had the first of the new course at the end of September. This time round the jabs are on a 3 month cycle and my next one is scheduled for March.

Following the last blood test, the Prostap, after only 3 months, appears to be working its magic. My current PSA level is 0.4 Great news by any measure..

From initial diagnosis, Brachytherapy in 2015 and thru to Prostap it has been an interesting experience. If, in the future, I have anything significant to report I’ll post again.

Before I go, I would like to thank all of the NHS staff who have handled my various visits to and stays in the Queen Alexandra Hospital, Portsmouth. You have, thus far, been amazing.

The journey, certainly isn’t over, but for now that is it.