Interim Progress Report

Based on PSA values shown below, it would appear Dr. Myers' protocol has arrested the progression of my recurrent prostate cancer:

A. Prior to beginning treatment:

July   2012   3.1

Oct.   2012   3.96

Jan.   2013   4.7

Mar.  2013   7.3

B. Following treatment:

May   2013   5.25 (30 days into the program)

June   2013   5.26

July   2013    4.90

Aug.   2013   4.73(current)

There can be little doubt that Dr. Myers' treatment plan has extended what remains of my 77 year old slightly battered and moderately tattered quality of life. But for the effectiveness of  his plan, I would be in the throes of full blown androgen deprivation therapy. That is the direction in which I was headed.
USFC issued a brochure titled "Hormone Therapy for Prostate Cancer--A Patient Guide." This publication lists the following possible side effects for this form of treatment: hot flashes, decreased libido, depression, fatigue, reduced muscle mass, breast enlargement, weight gain, hair loss, mild anemia, mental abnormalities, genital shrinkage, abnormal liver function, cardiovascular disease, diabetes and erectile dysfunction. Fortunately I have experienced none of these adverse side effects to date.
Barring unforeseen circumstances my next journal entry will be devoted to my six month checkup with Dr. Myers scheduled for October 29th, 2013. I have begun to compile a list of questions in preparation for this meeting which has the potential for producing some interesting discussion.
Stay tuned.

More Better

 Initially Dr. Myers responded to my "More Drama" entry as follows:
"While radiation induced neovascularization is the most likely cause, a polyp (early cancer) is possible. You need to see a urologist, and he will probably do a cystoscopy."
Shortly thereafter the participant in the internet cystitis discussion undergoing further screening to rule out bladder or kidney cancer reported the findings of his urologist as outlined below:
The cystoscopy revealed only dilated blood vessels in the bladder and prostate, resulting from the proton radiation he had in 2007. This is typical of radiation induced cystitis.
I relayed this information to Dr. Myers who modified his conclusion to: "So yours is almost certainly radiation induced bleeding that will disappear on its own."
As part of my research effort I asked Bob Marckini: "How common is proton radiation induced cystitis?" He replied, "While we have lots of members who have experienced rectal bleeding, we have far fewer who are experiencing hematuria. I would guess that over the past ten years, I've heard from a couple of dozen of our members with this condition. I am not aware of any case that hasn't resolved itself over time."
My research effort on this issue would be incomplete without contacting UFPTI. Accordingly by e-mail I asked my case manager how frequently their patients experienced hematuria. She discussed my inquiry with Dr. Gud E. Nuff and consulted her case manager counterparts . A summary of her telephone response appears below:
UFPTI patients report few cases of hematuria. Rare though it may be it typically occurs between two and four years post treatment and usually happens in conjunction with extreme exertion and/or dehydration.
The consensus of her in-house discussions was that an area of the bladder in close proximity to the prostate gland is radiated to the extent tissue damage results. Subsequent irritation causes sloughing off of new blood vessels in the area of healing. The technical term for this process is neovascularization. In most cases this condition resolves on its own without medical intervention.
As a tennis player I certainly over exert from time to time, and/on those occasions it is difficult to stay fully hydrated. Based on these deliberations I have decided to monitor this condition  pending further development. If indicated I will discuss the matter with Dr, Myers at my next scheduled appointment on October 29, 2013.