Alan A. Hawke B.Sc. M.Sc.(Geology)
229 Tianyuan Lu,
Dagang Economic Development Area,
Tianjin, 300270,
P.R.China
Phone contact : 86-139-20583421
Email: alanahawke@gmail.com
PROSTATE CANCER DIGEST
(Updated: Monday, 09 January 2012)
Date of Birth : 28th May 1946
Now Single
Two Children: Philip and Elana
Occupation: CEO – Tianjin Stone Storm Co.,Ltd.
25th March 1998 PSA BLOOD TEST
Result : 52
8th April 1998 NEEDLE BIOPSY
21st April 1998 RADICAL PROSTATECTOMY
28th October 1998 PSA BLOOD TEST
Result : <0.1
29th October 1998 SKELETAL SCINTIGRAPHY
12th July 1999 PROSTATE BED BIOPSIES
Biopsies of Prostate Bed – 4 cores taken – no evidence of malignancy in these biopsies
13th July 1999 PSA BLOOD TEST
Result : 1.8
15th July 1999 ONCOLOGIST VISIT – John Matthews
20th July 1999 WHOLE BODY BONE SCAN
20th July 1999 CT of ABDOMEN AND PELVIS
21st July 1999 Started Flutimde (Eulexin) 1 tablet 250 x 3/day 750 mg
21st July 1999 Started Multi-Vitamins – x 1 /day
17th August 1999 Started Reprostom (Proscar) Tablet 5mg x 1/day 5 mg
25th August 1999
Started to feel very tired – especially at the middle of the day. Also noticed nipple tenderness. Weight
82-83Kgs. Trouble sleeping through the night.
3rd September 1999
Started
: Calcium Citrate Tablet 1000 mg x 1/day 1000 mg
: E-Complex Capsule 1000 x 1/day
: Vitamin E (as d-alpha tocopherol 1000 IU
: Selenium (as Selenium Yeast) 100 mcg
: Wheat Germ Oil 50 mg
: Vitamin C Tablet 1000 x 1/day as ascorbic Acid 1000 mg
1
: Citrus Bioflavonoids Complex 100mg
: Ginko Bioloba Plus Tablet x 2/day 50 mg
: Gotu Kola Herb Powder (Centella asiatica) 250 mg
: Siberian Ginseng Root Powder 150 mg
: Soy Lecithin Powder 50 mg
: Milk Thistle – Silymarin Tablet 200 mg x 3/day 600 mg
14th September 1999
Started : Tamoxifen Tablet 10 mg x 1/day 5 mg
16th November 1999
Fall from orange tree. Got the oranges though!!!Badly bruised left thigh and back. Think that damaged
4th lumbar disk as sciatic nerve in left leg very painful. – Numbness in lower leg.
29th November 1999 Weight gain of 5 kgs since starting Zoladex. Weight out to 87kg.
29th November 1999
Lower back – numbness in lower left leg. Extremely painful and walking very difficult – like walking
on broken glass inside leg!!! Not able to sleep.
Dolo-Neurobion Tablet 1 x 3 per day
Vitamin B1 (Thiamine Nitrate) 50 mg
Vitamin B6 (Pyridoxol Hydrochloride) 100 mcg
Vitamin B12 100 mcg
Metamizol (Phenyl-Dimethyl-Pyrazolone-
Methylamino-Methanesulphonate Sodium) 250 mg
Voltaren Tablet 1 x 3 per day 50 mg
Panadol Tablets – on demand
2nd December 1999 Acupuncture for pain relief – not much effect!!!
3rd December 1999 Melatonin Capsule 1 x 1 per day (evening) 3 mg
8th December 1999 Visit to AEA re back problems – recommended to see Neurologist.
Stesolid 5 (diazepam 5 mg) – sleeping pill. 5 mg
9th December 1999
Neurologist – AEA. Recommended MRI scan if no change within 5 days.
Rocaltrol 1 x 1 per day – before sleep. 0.5 micro g
Tramal – for pain relief – analgesik – on demand
24th December 1999
Visit to John Allen re back. Recommended to visit Orthopedic specialist. Gordon Howie. Phone 09-
5209676. Fax 09-5209673.
Prescription:
Panadol
Tramal
Voltaren
24th December 1999
PSA and Liver Function test.
31st December 1999
Visit to John Allen re back problems. Submitted ACC forms.
Blood Pressure: 140/80
Prescription:
Temazepam Capsules (sleeping problem) 10 mg
31st December 1999
Pukekohe Physiotherapy
John Marlow treated for back. Assessment done – light exercise/massage/adjustment. Good results.
7th January 2000
Received Zoladex 3 monthly injection.
26th January 2000
Accident Compensation Commission
Claim Number: B6743417/002
22nd February
Prescription for Proscar
13th March 2000
Visit to John Allen for prescription – Zoladex, Flutimide and Tamoxifen.
Blood Pressure : 120/75
Weight : 89kg.
24th March 2000
Zoladex implant
2
15th June 2000
Visit to John Allen for prescription – Zoladex, Flutimide and Tamoxifen.
Blood Pressure : 125/75
Weight : 92 kg.
20th June 2000
Zoladex implant
8th September 2000
Zoladex implant by John Matthews
Health Benefits
Patient Number: PEG2455
Approval Number: HOSP/3343952/Sept2001
10th September 2000
On-set of Bells Palsy. Right side of face dropped. Problem with closing right eye. Problem with
numbness in mouth and right side of mouth did not respond therefore lopsided talk and grimace – no
smile. Looked bloody awful. Looked worse than felt as grew used to it, eventually. Gradually start to
heal itself. As at 19-12-2000 have most of lopsidedness gone but still minor problem with eye and
mouth. Partial smile returned!!
11th September 2000
John Allen – Anti-viral medication + Anti-inflamatory
13th September 2000 Dexa Bone Densitometry
Acupuncture to face.
30th September 2000
Didronel 200 mg 2 x day
Take for 14 days and then repeat in 90 days
8th December 2000
Due for next Zoladex implant but have opted to go into an off period as have had enough of side
effects. PSA has been undetectable since 22nd Sept.1999.
11th December 2000
Stopped Flutimide
Current regime: Proscar 5 mg x 2 daily
Tamoxifen 1 x daily until run out
Calcium complete
Vitamin E/Selenium
Milk Thistle – Silymarin
Ginkgo Biloba
St. Johns Wort
Phyto-Estrogens
Vitamin B Stress Formula
15th January 2001
Current Regime: Started on Bisphosphonate regime.
Proscar 5mg 2 x day
Alovell = Alendronate 10mg tablets (much cheaper than other brands of bisphosphonate!!! As made in
Indonesia.)
1 tablet first thing in the morning, one hour before eating or drinking. Note this is very corrosive and
must not lie down after taking!!!
Kolkatriol = Calcitriol 0.5mcg (again much cheaper than other brands as is made in Indonesia)
1 in the evening
Calcimate Plus 800.
1 at evening meal and 1 before retiring.
Vitamin C 1000 after every meal
Vitamin E – mixed tocopherols
1 in the morning and 1 in the evening
Soy Isoflavone
Green tea extract
Milk Thistle – Silymarin
Ginkgo Biloba
St. Johns Wort
June 2002
Current Regime
Proscar 1 x 5mg/day
Celebrex 1 x 200mg/day
3
Vitamin E 1000mg/day
Vitamin C
Multivitamin
Milk Thistle
Gingko Biloba
7th January 2003
Flutimide
Tamoxifen
Proscar
NSAID
Multi-Vitamins
22nd January 2003
Zoladex Implant
16th April 2003
Zoladex Implant
9th July 2003
Zoladex Implant – 3.6mg
6th August 2003
Zoladex Implant – 10.8mg
6th November 2004
Zoladex Implant 10.8mg
6th January 2004
Zoladex Implant 10.8mg
24th March 2004
Zoladex Implant
1st April 2004
Start Casodex 50mg x1 per day
Stop Flutimide
20th April 2004
Decided that the only way to control the rise in PSA is to change my medication regime and therefore
have stopped Flutimide and gone onto Casodex. I have also researched a lot into the next stage of
control and because of the information sorted through and distilled, I am now starting by adding
Ketoconazole and Hydrocortisone to the regime. The following is what I am now taking:
25th April 2004
Ketoconazole 200mg Tablets x 2 - Morning and Afternoon & Night
Cortisone Acetate Tablets 25mg - Breakfast & Dinner
Casodex 50mg x 1 per day
Proscar 5mg x 1 - Morning & Evening
Ibuprofen Capsules 0.3g x 2 - Morning & Evening
Tamoxifen Tablets 20mg (as citrate) - Evening
Bisphosphonate 20mg x 7 on every Sunday morning upon waking
Multi-Vitamin - Morning & Evening
Vitamin E Capsule - Morning & Evening
Selenium Tablets x 1 - Morning & Evening
Calcium Citrate – Evening
Lycopene 130mg Capsules - Morning & Evening
Omega 3 Oil Capsules – Evening
Melatonin Tablets 3mg – Evening
19th June 2004
Zoladex Implant
20th July 2004
Stopped Casodex
Stopped Ketoconazole and Hydo-Cortisone
Changed from Ibuprofen to Celebrex
Proscar 5mg x 1 - Morning & Evening
Bisphosphonate 20mg x 7 on every Sunday morning upon waking
Rocaltrol 0.25ug/2/day - evening
Celebrex 1 x 200mg/2/day
4
Lovastatin 1 x 2 daily
Vitamin E – mixed tocopherols
Natural Lecithin soft gels
Vitamin E with Selenium
Fish Oil soft gels
Melatonin
Calcium with D3
2nd June 2005 Current Treatment Regime
Added Transdermal Estrodiol Patches – 0.1mg per patch Started with 2 patches
Transdermal Estrodiol Patches – 0.1mg per patch using between 4 to 12 patches per week to get serum
estrodiol to a level of 900. Would like to try this without Zoladex and Casodex!!
27th June Estrodiol Patches now 4
Casodex 1x50mg every 8 hours
Proscar
Bisphosphonate - Alendronate - 20mg x 7 on every Sunday morning upon waking
Rocaltrol 0.25ug/2/day - evening
Celebrex 1 x 200mg/2/day
Lovastatin 1 x 2 daily
Natural Lecithin soft gels
Vitamin E with Selenium
VitaminB3 with Calcium
Fish Oil soft gels
Melatonin
20th July 2005
Added Casodex 2 x 50mg/day
26th July 2005
Casodex – 3 x 50mg/day
2nd August 2005
Zoladex implant
Reduced Estrodiol Patches to 2 x 2 weekly
Flutamin 3 x 250mg per day – Stopped Casodex
2nd November 2005
Zoladex Implant
Estrodiol Patches 3 x 2 weekly
Flutimin 3 x 250 per day.
9th December 2005
Estradiol Patches to 4 x 2 Weekly
Results from Blood test show Liver Function is Normal.
27th January 2006
Zoladex Implant
13th February 2006
Ketoconazole 200mg x 3 daily on empty Stomach
Hydrocortisone 25mg x 2 daily with meals
28th April 2006
Zoladex Implant
Having dull pain in upper vertebrae
20th May 2006
Ketoconazole 400mg x 3 daily
Hydrocortisone 25mg x 2 daily with meals
23rd May 2006
Bone Scan – seems like something on Ribs and will need to recheck in 4 months time.
Liver function is normal
30th May 2006
Vitamin D – 4000 IU/daily
Selenium
1st June 2006 – Current regime
Stopped Flutimide – see what happens now!!
Proscar 1 x 2 daily
Bisphosphonate - Alendronate - 20mg x 7 on every Sunday morning upon waking
5
Ketoconazole 400mg x every 8 hours
Hydrocortisone 25mg x 2
Celebrex 1 x 200mg/2/day
Lovastatin 1 daily
Estradiol Patches to 4 x 2 Weekly
Vitamin D 2000IU x 2 daily + 1 Vitamin E
Selenium 200mcg + Fish Oil + Natural Lecithin soft gels
11th & 14th July 2006 - PET-CT Scans - Tianjin Med. University Hospital
16th July 2006 - Zoladex implant.
1st August 2006 – Current regime
Proscar 1 x 2 daily
Bisphosphonate - Alendronate – 70mg on every Sunday morning upon waking
Ketoconazole 400mg x every 8 hours
Hydrocortisone 25mg x 2 morning and 1 evening
DES 0.5mg 2 x daily
Aspirin – Enteric Coated 25mg x 2 x 2 daily
Celebrex 1 x 200mg/2/day
Vitamin D 1000IU x 2 daily + 1 Vitamin E
Selenium 200mcg + Fish Oil + Natural Lecithin soft gels
10th October 2006 - Zoladex implant.
20th December 2006 – experiencing some pain in the Kidney? Area of my back – noticed it about 2
weeks ago but no too much discomfort – today more of a problem – have upped my fluid intake.
6th January 2007 – Zoladex Implant.
Back pain OK – have been having very hot pool soaks as well as Saunas – has helped a lot. Also think
that some of the pain was kidney related and due to one of the drugs so have been experimenting to
find which one – maybe Ibuprofen so have gone off that and back onto Celebrex.
22nd March 2007 Blood pressure results from hospital visit is 165/95!!! = Crazy – OK now time to
really lose weight!!
Have some back pain below the shoulder blades in the area of the ribs next to the spine.
28th March 2007 – Tianjin Cancer Hospital
Series of blood tests done – results are within normal ranges.
MRI and PET-CT Scans
3rd April 2007 – CT SCANS
18th April 2007 – Zoladex Implant.
19th April 2007 – Start of Chemotherapy
Tianjin University Cancer Hospital – Department of Interventional Therapy
Started Infusion at 9.30am and went through to 6.30pm. 4 bags used. Also pre-injection of anti-nausea.
First bag ?? Second was Doxytaxel with an infusion rate of 5 hours and dosage of 72mg/m2. Third Bag?
Fourth bag?? Prednesone was in third bag +
The whole procedure went very well and just boring lying there. Only ate fruit during the infusions –
Bananas, Apples and Strawberries.
Returned home and took 3 Prednesone tablets along with usual medication that I have been on.
20th April 2007 Added L-Glutamine at rate of I full teaspoon of powder when I took the Keto Tablet –
i.e. every 8 hours.
21st April 2007 Still feeling OK and really no effects so far to worry about!!
23rd April 2007 Blood tests – Seems OK – PSA = 3
25th April 2007 – Stopped Keto and DES
27th April 2007 – Problems with Chemo so far: are very tired and sleeping a lot; really bad taste in my
mouth; and lower stomach grips which has meant spending a lot of time on the toilet!!!
28th April 2007 Spent time outside in the sun and afterwards found out that I had become
“SunSensitive”!!! = Blotchy Skin on the back of the hands and face – learnt that lesson!!!
30th April 2007 Blood Test
1st May 2007 Still tired but certainly feeling much better.
3rd May 2007 - Hair finally on the fall!!!
4th May 2007 Blood test results show liver function problem as well as low white blood cell count.
Into Hospital for injection for liver function plus start:
Tiopronin Tablets 1-2 3x daily
Oral Liquid Leukopoiesist – a herbal concoction recommended by the Doctors.
6
Finally not going to the toilet so frequently
9th May 2007 – High Dose Calcitriol – 50mg = 200 caps!!
10th May 2007 - Second round of Chemotherapy
12th May 2007 – Seems to be kicking in as now starting to get damn tired – go and have cat naps when
really bad!! Taste in mouth now not nice!!
14th May 2007 – Blood Test – PSA-4.6
31st May 2007 – Third round of Chemotherapy – used Ice for fingers and toes plus kept head cool.
Have been taking the following to help counter the effects of the Chemo as well as the hot weather and
fitness training: Mix a drink containing the following:- Powerbar Recovery Sports Drink + BCAA
Stack containing Glutamine, Leucine (as L-leucine), Isoleucine (as L-isoleucine), Valine (as L-valine)
+ Creatine S3 Also add L-Carnitine tablets to help counter tiredness.
Supplements - B Complex 100 formula 2 x daily; Vitamin C 1000 x 2 daily; Vitamin A 5000IU & D
400 IU x 2 daily; natural E 400 IU with Selenium 100mcg x daily; Vitamin K 500mcg 2 x daily; Milk
Thistle – Silymarin 160mg x 2 x 2 daily; Gingko Biloba - 12mg Ginko Flavonglycosides – 2 x 2 daily;
Fish Oil Caps 1 x 2 daily.
Prednisone Acetate Tablets 5mg x 2 daily
Sheng Bai Kou Fu Ye = Oral Liquid Leukopoiesist 20ml x 3 daily – for Leukopenia induced by
chemotherapy.
4th June 2007 – Blood Test – PSA stable now at 4.7 & Testosterone <20
6th June 2007 – Blood pressure: 160 – 93, Pulse 84, Body Mass = 29
6th June 2007 – Effects of Chemo – Still tired but coping with have short sleep in after noon plus going
to fitness. Also bad taste in mouth!!! Did have some soreness in hips after day 2 but seems to have
cleared. Currently feel OK. Hair loss seems to have stabilised – now have fine down left!!!
21st June 2007 – PSA has jumped to 6.07!!
Started HDK and DES again to see if I can bring the PSA back down!!
2nd July 2007 – PSA dropped to 3.94 – now not sure if from the chemo or the hormones!!!
Blood results all OK.
5th July 2007 – Operation for Gynocomestia = big boobs. Operation was 2.5 hours. Hopefully this will
remove my embarrassment of have ladies boobs!!!
24th July 2007 – Zoladex Implant
Had some of the stitches removed and final lot out on 28 th July!!
PSA SUMMARY OF RESULTS.
Date: 25th March 1998 Result: 52
Date: 28th Oct 1998 Result: <0.1
Date: 15th April 1999 Result: 0.7
Date: 28th June 1999 Result: 1.3
Date: 13th July 1999 Result: 1.8
Date: 22nd Sept 1999 Result: <0.1
Date: 9th Nov 1999 Result: <0.1
Date: 24th Dec 1999 Result: <0.1
Date: 14th Feb 2000 Result: <0.1
Date: 15th June 2000 Result: <0.1
Date: 8th Sept 2000 Result: <0.05
Date: 6th Dec 2001 Result: <0.05
Date: 12th June 2002 Result: 0.6
Date: 17th June 2002 Result: 0.7
Date: 30th July 2002 Result: 1.79
Date: 16th Dec 2002 Result: 10.2
Date: 23rd Dec 2002 Result: 7.1
Date: 11th June 2003 Result: 0.07
Date: 26th Oct 2003 Result: 0.08
Date: 23rd March 2004 Result: 0.22
Date: 6th April 2004 Result: 0.10
Date: 27th April 2004 Result: 0.03
Date: 4th June 2004 Result: 0.08
Date: 14th Dec 2004 Result: 1.30
Date: 5th April 2005 Result: 6.5
Date: 1st June 2005 Result: 5.07
Date: 23rd June 2005 Result: 3.70
Date: 14th July 2005 Result: 5.2
7
Date: 22nd July 2005 Result: 6.23
Date: 11th Aug 2005 Result: 8.00
Date: 23rd Aug 2005 Result: 6.36
Date: 10th Oct 2005 Result: 4.95
Date: 6th Dec 2005 Result: 6.34
Date: 17th Jan 2006 Result: 6.54
Date: 7th Feb 2006 Result: 6.95
Date: 28th Mar 2006 Result: 6.76
Date: 16th May 2006 Result: 13.52
Date: 23th May 2006 Result: 15.70
Date: 4th July 2006 Result: 2.13
Date: 15th Aug 2006 Result: 2.10
Date: 10th Oct 2006 Result: 3.56
Date: 19th Dec 2006 Result: 3.50
Date: 06th Feb 2007 Result: 3.40
Date: 26th Mar 2007 Result: 3.00
Date: 23rd April 2007 Result: 3.00
Date: 8th May 2007 Result: 3.51
Date: 14th May 2007 Result: 4.6
Date: 4th June 2007 Result: 4.7
Date: 20th June 2007 Result: 6.07
Date: 2nd July 2007 Result: 3.94
Discussions and Notes:
Reflections about Combined Hormone Blockade (not in order of importance). (2001)
Weight Gain
Managed to sneak on 10 kilograms (22lbs) seemingly overnight. My standard weight was 80 to 84
kilograms before – now I have hit 94 kilograms and have a fat belly overhanging my belt. Have been
actively going to fitness clubs to work out and have at least stopped adding weight. Now that I have
gone off the Hormones, I am actively trying to loss weight. Have built good upper body muscle tone
and now need to get rid of the “pot” belly – have abs there somewhere.
Loss of Libido
Absolutely no interest in sex!!! I used to be continuously thinking about sex and enjoyed masturbation,
pornography and sexual intercourse of course!! At least I am better able to concentrate on so called
more important things, such as work!
Penis and Testicle resizing
Use it or lose it!!! How true this is. Am now ready for a sex change as there is very little there to play
with now!!! The loss of Libido made me lazy in trying to keep up with having at least three erections
per week. After 3 months on CHB had absolutely no interest in trying to get an erection and did not
even wake up in the morning with an erection. Mind you, after have a radical prostatectomy, did not
have much in the way of erection capacity even before starting CHB. So I am now off CHB and I look
at what is left and despair at the result. The saving grace of all of this is, that I feel as though I have
gained extra time and therefore the lack of penis size is a small price to pay. Still, a man is a man, and
likes to be able to stand at the public urinal and be able to slap it against the side of the urinal to shake
the drops off!!! Now, have to have a piece of string tied to it to be able to find it even!! Only joking
BUT. Don’t under estimate the effects and the results.
Depression
This is a real problem and must be understood this is going to occur. Somehow the other people in ones
life must be aware that this will happen and that there will be times when support will be very
necessary. I have never cried so much in all of my life as I have over the last 12 months. Mind you, I
have had a difficult period to live through – no paying employment and a marriage break up!!! Taking
the supplement St. Johns Wort seems to help a little.
Hot Flushes or Flashes = menopause!!!
I am now very sympathetic to the older women who are going through or have gone through
menopause. It really is a pain in the bottom, so to speak. This brought about by the lack of testosterone
caused by the Zoladex medication. Wow, I can be in a cold room and suddenly go red in the face and
8
break out in a sweat. Causes some odd looks from others in the vicinity. I take a supplement of Phyto-
estrogens which helps a little.
Breast Development (or Gynocomestia)
My 12 year old daughter was not impressed when I said that I would need to borrow her bras!!! Started
on Tamoxifen to control nipple soreness and breast enlargement. Seemed to work . Have been working
out at the gym and doing exercises to build chest muscles and therefore don’t know if the bigger chest
that I now have is the result of muscles or just small breasts!!! I like to think that it is the muscles!!!
Looks OK under a T shirt, and that is my story!!!
By the way, most Oncologists suggest radiation to the breast area to lessen the growth of breast tissue
but I did not like the idea of being zapped in that area as too close to my lungs!!! Don’t really want to
get Lung Cancer as well!! Some friends have had the radiation and only seemed to partially work for
them. I reckon that my way was best for me, anyway.
Short Term Memory Loss
What did you say? Seems to be a problem but I forget what it is. Take Ginkgo Biloba for that. Not sure
if it makes any difference as I have always had a problem with names and short term memory,
therefore did not seem to make much difference for me anyway – friends and relatives would probable
disagree on that.
Tiredness
This is only a problem if you are not self employed!!! A nap in the afternoon solved the problem.
General Well Being
Really feel great considering what I have put into my system and what is eating away in there!!! It is
great to be alive, even with the weight of the world on my shoulders!!
Would I do it again?
Will, in all probability, have to repeat it all when the PSA starts rising again, but I am hopeful that at
least I have given the beast within a good belt in the mouth!!! Hope to keep it down for a good long
time. Will watch my diet and continue with Proscar and recommended supplements. And the short
answer is YES!!!!
Other comments:
It is through the efforts of Strum, Scholtz, Barken and Myers of the internet medical fraternity, plus
discussions with my Oncologist John Matthews, that I have been able to get the beast under control.
There are great resources on the internet and my time there has been well spent but my education of
Prostate Cancer is ongoing, as I have the will to fight through education and understanding.
To Check – For Osteoporosis
Strongly recommended!!!
Test for Calcium levels in Urine.
Fosamax Tablets 7 x once/week 10 mg Or Alovell To be taken on empty stomach 30 minutes before
breakfast.
Rocaltrol - Hecterol = Doxercalceferol = Vitamin D like drug (new) – watch this.
9th July 2003 – Update
I am now living and working in Northern China which has been a major challenge to cope with but I
must say that I am enjoying the work and living here. I live in a city called Tian Jin (10 million people
– I think!!! (have met most of them on bicycles!!)
I have met a very good Prostate Cancer Specialist in the main Hospital here and have found him to be
very good even with his limited English and my non-existent Chinese. He is happy to organise blood
testing and getting medical supplies but will not offer recommendations as I have Mr. John Matthews,
Oncologist, in Auckland New Zealand helping me.
As can be seen from the above, I have started a new cycle of triple hormone blockade which is going
OK – not too many side effects this time around – anyway don’t have time to worry about them
anyway. Only problem seems to be the weight gain – back to 94 kilograms this time and will have to
work to hold it there and even start to remove that – all very difficult here as the food is to my liking as
is the beer!!!
25th April 2004
I have been drifting along and not taking too much note of my PSA etc as was feeling good. Also doing
a lot of work and really did not make the time to test and then evaluate the results. All that came to a
stop when I did my PSA in March as there was a distinct rise!!! Back into research mode to see what
this could mean and then how to stop this progressing any further. I have changed my diet drastically
and reduced calories and doing fitness work to lose weight and get back muscle tone etc.
The results of my research indicate that the High dose Ketoconozole with Cortisone would be
beneficial to help both reduce the testosterone to castrate levels as well as bring the PSA back. I have
also changed from Flutimide to Casodex.
19th June 2004 – last Zoladex Implant – I am having a rest!!
9
20th July 2004 – off all major medication – still taking Proscar – see note above for the rest.
4th June 2005
It is time to do something and I have been following discussions on the Internet (Don Cooley’s site)
about Transdermal Estrodiol Patches. Contacted my Oncologist in New Zealand and was given a
prescription for Novartis Estraderm Patches. Started with 2 Patches on the 2 nd June and want to try
them without Zoladex and Casodex to see how the PSA responds.
I feel OK with no apparent symptoms and therefore want to run with this change to see if it works for
me. The only problem that I am having is with weight control – now have a “Pot Belly” and a pair of
“Breasts” – have been watching food intake and doing exercises – even going to Acupuncture – to try
to reduce the 10kgs that I added in the last 18 months!!
Oh and by the way I have virtually no libido but can achieve satisfactory intercourse with the use of a
vacuum device. Viagra and Cialis only gave me a headache!!
September 2006
Time for a change!!! I have been having major problems with the management of the company that I
helped build and develop into a world class Natural Stone Export company and felt that life was
becoming intolerable with the way I was being treated and therefore I decided to risk all and leave to
help start up and develop a new company here in China, again in the Natural Stone Export business.
WOW – really getting into the HOT SEAT now!! I had to walk away from all that I had done and
invested in during the previous 3 1/2 years in China, to start all over again.
Now 9 months later and in reflection – this is the best thing that I have done for a long time and love
what I am doing and the incredible challenges that the changes have brought!! Talk about “getting a
new life”.
12th May 2006
Well, I am closing in on my 60th birthday – so far so good!! Don’t feel nor act like a 60 year old!!
I must admit that the best thing that I have done since going on hormonal treatment was to start using
Estraderm patches. These changed my life around in the respect that I do not have any further bouts of
depression and am able to work and operate at “Full Steam” again. As I noted above, the main draw
back has been the increased development of breasts, but I am not worried about that and am still happy
to be me, even with an increasing “cup” size.
Weight loss has been non-existent and I now feel that the only way that I can reduce weight is to staple
my mouth shut to all the temptations of good eating here in China!!
Have been having some dull pain in the upper Vertebrae but is manageable. Not sure what this means.
16th June 2006
Mixing Flutimide with Keto and Hydro gave a bad taste in the mouth with a filmy lining in the roof of
the mouth. Stopped Flutimide 1st June as PSA moving upwards and therefore decided to give the
Flutimide a rest and see what the Keto regime can do!! Feel OK but still have dull pain in Upper
Vertebrae.
14th July 2006
Bone Scans confirmed what my body was trying to tell me and that the bone pain in the lower neck
region was real and that I need to watch that carefully!! Will have another set of scans in about 3
months to see if the activity has increased or not. The other areas noted as having activity take-up have
not caused any pain, although do get some pain in the right hip area after walking a while.
22nd August 2006
Today I feel quite good with little evidence of bone pain and only minor headaches now. Looks like
going off the Flutimide and onto the HDK program has given me some good responses as my PSA for
the last couple of months has been 2!!!! Lowest its been since December 2004. Also trying to lose
weight by watching diet and doing a lot more exercise such as swimming, badminton, table tennis and
walking!! Don’t like running as my boobs hurt as they jiggle up and down – maybe time for a bra!!!
23rd September 2006
Feeling good – no bone pain to speak of and now losing weight slowly!!
12th March 2007
Breast growth seems to have accelerated and slight pain when being touched!! Will look at breast
reduction and see if that is worth the while.
Weight is a problem as now out to 96kg. Going to fitness when I can and try to play vigorous games of
Table tennis as well which works up a good sweat!! Sleeping OK but still feeling a little tired (may be
due to boredom as well as not a lot going on in the office).
Feeling good though.
Sexual activity – try for about one time per 1 to 2 weeks – thank goodness for my trusty Vacuum
pump!! – this is a lifesaver as it allows me to have a good “session” without the worry of keeping an
erection!! I am able to climax reasonably well.
10
Have been doing research on the use of Noscapine and so far that looks as though it will be another
string to my bow in the control of the cancer!!!
23rd March 2007
Visited the Tianjin Cancer Hospital for meetings with Dr. Wang and Dr.Guo. They are setting up a
series of tests to be done.
Now 9 years since first PSA result at 52!!
Do have some back pain below the shoulders, in the ribs next to the spine – especially when I am
sitting for long periods.
19th April 2007 – CHEMOTHERAPY STARTED!!
Decided to go with the program offered by the Doctors at the Tianjin Medical University Cancer
Institute and Hospital, which is 3 lots of combined Docetaxel (rate 72?/m2) at 3 week intervals.
The thinking of this is to try to drive the PSA down which is thought to be caused by Hormone
Refractory Cancer.
1st May 2007 I think that I may have taken the effects of Chemotherapy a little too lightly but certainly
got pulled back into line after about the third day when I started to feel tired and increasing visits to the
toilet. Tiredness is OK to handle as my office and bedroom are only a mater of metres apart so that
when I feel tired I just go and have a rest on demand!! The toilet visits are lessening so not too worried
about that.
The thing that really bugs me is the terrible taste in my mouth all the time!!! Food just is just fuel and
no enjoyment to eat!!
Weight is bouncing around 91 to 93 kilograms as have not been spending any quality time at the fitness
centre due to the tiredness problem!!
5th July 2007 – Chemotherapy effects seem to be wearing off at last. 21 st June I went back on high dose
Ketoconozole plus DES to bring the PSA down as it seemed that the Chemo did not do that or was I
too quick waiting for the results from the Chemo?? Anyway, seems as though the PSA is reducing
now.
Went and had the operation for Gynocomestia as was getting embarrassed with people staring at my
Ladies Boobs!!! When I went to fitness and the bath house!! Mind you, this girls seemed fascinated by
them!! The operation was 2.5 hours and they removed a hell of a lot of mammary gland tissue and then
sculptured by removing some fat on the ribs!!!
Reports
8th April 1998 NEEDLE BIOPSY
Specimen : Prostate Biopsy – Right Lobe
Gross Description
Specimen consists of 5 cores of grey tissue measuring up to 15mm in length.
5 6L NR
Microscopy:
Sections show needle biopsies of prostatic glandular tissue extensively invaded by adenocarcinoma.
Tumour involves 90% of the area of biopsy material sectioned.
The appearances suggest a grade 2/3/malignancy (MDA) Gleason score 3 + 4 = 7
Stage pT3
No perineural or extra-prostatic spread is identified.
PROSTATE BIOPSY – LEFT LOBE
ADENOCARCINOMA
Specimen : Prostate Biopsy – Left Lobe.
Gross Description
Specimen consists of multiple pieces of grey tissue measuring up to 18mm in length.
X 6L NR
Microscopy:
Section shows needle biopsies of prostate glandular tissue. Prostatic glands show hyperplasia but no
epithelial atypia. There is no carcinoma in these biopsies.
PROSTATE BIOPSY – LEFT LOBE
PROSTATE GLAND HYPERPLASIA
21st April 1998 RADICAL PROSTATECTOMY
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Specimen : Radical Prostatectomy
Gross Description:
Specimen consists of prostate gland 4.5 x 3.5 x 3.5cm with left seminal vesicle 3 x 1 x 1cm and right
seminal vesicle 2 x 2 x 1cm attached. Total weight 50gm. There is a haemorrhagic area 2 x 1 x 1 in the
left lobe.
A – J1 K – M2 N – Z 1 R
Microscopy:
Sections show invasion of the right lobe of the prostate by adenocarcinoma. Tumour involves 13% of
the area of prostatic glandular tissue sectioned.
The appearance suggests a grade 2/3 malignancy (MDA) Gleason score 3 + 4 = 7.
Tumour extends through the prostatic capsule and appears to extend to the inked margin of surgical
resection in a significant area on the posterior surface of the right lobe. Elsewhere tumour appears
confined within the prostatic capsule and the inked margins of surgical resection appear clear of
tumour.
Perineual invasion is present in the prostatic capsule. No vascular invasion is identified.
Sections from the bladder neck and from both seminal vesicles are tumour free.
29th October 1998 SKELETAL SCINTIGRAPHY
Results
Delayed static whole body images were obtained following intravenous injection of 20.7mCi Tc99m
HDP
There is minor increase in activity in the posterior elements of the L4 vertebra, to the right of the
midline. This is likely to represent degenerative disease in the facet joints.
No other abnormality has been shown in the skeleton.
Normal renal tract activity is shown.
Conclusion : No evidence to suggest skeletal metastases.
20th July 1999
WHOLE BODY BONE SCAN
Agent: Tc 99m HDP 833 MBq I.V.
Findings: Delayed whole body images show tracer distribution throughout the skeleton and soft tissues
with bilateral renal uptake and bladder accumulation.
There is mildly increased focal tracer uptake at the level of the L4 vertebra to the right of the midline
The remainder of the skeleton is unremarkable with mild degenerative changes evident in the
shoulders, sternoclavicular joints and in the left knee. There is no abnormality in the skull, ribs,
thoracic spine, pelvis or femora
Interpretation: Shows no convincing sign of metastatic disease, the mid lumbar focus is likely to
represent degenerative change but correlation with plain radiograph of this area is recommended.
20th July 1999
CT of ABDOMEN AND PELVIS
Indication: The patient presents with elevated PSA post-prostatectomy
Routine scans performed from diaphragm to symphysis using the standard Ca prostate protocol with
fine cuts through the pelvis
Findings: There are a number of tiny, focal abnormalities within the liver. These are seen within
predominantly the right lobe. The largest in segment 6 measures just over 1cm in diameter. A number
of the lesions are only 2-3mm and are thus difficult to evaluate. The most lateral lesion on the margins
between Segment 5 and 6 (image 14) has low attenuation and well defined margins consistent with a
simple cyst. The remainder of the lesions have intermediate attenuation and thus are not absolutely
typical of simple cysts. In total approximately 10 lesions are visualised.
There is no significant abnormality within the spleen, kidneys or pancreas. Adrenals are unremarkable.
No retroperitoneal lymphadenopathy of significance is identified although one or two small nodes are
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present in the para-aortic region none are greater than 1cm in size and are thus unlikely to be
significant.
No significant lymphadenopathy is evident within the pelvis. The prostate has been removed, there is
evidence of post-surgical change in the prostate bed
Lung bases included on the scan are clear. Bone windows reveal some degenerative change in the
lumbosacral region but no destructive bone lesions.
Comment: The scan has demonstrated a number of lesions within the liver. As described above, the
majority of these are small and difficult to characterise. At least one of these lesions has the
appearances consistent with a simple cyst but the majority are somewhat more indeterminate in nature
raising the possibility of metastatic disease.
Recommendations: A follow up study in 3-6 months time. If necessary the lesions inferiorly in the right
lobe could be considered for percutaneous biopsy.
13th September 2000
Dexa Bone Densitometry – Reference: 1806358
Comment: Normal but borderline.
Dual energy x-ray absorptiometry (DEXA) of the lumbar spine and the femoral neck was performed.
The bone mineral density of the lumbar spine is 1.2g/cm2. This is 0.6 standard deviations above the
mean for young men (T score +0.6) and is 1.5 standard deviations above the mean for age.
The bone mineral density of the femoral neck is 0.9g/cm2. This 0.6 standard deviations below the mean
for young men (T score = -0.6) and 0.8 standard deviations above the mean for age.
Conclusions:
The bone density is within normal range in both regions, but is close to the osteopenic range in the
femoral neck region, as osteopena is defined as bone density between 1 and 2.5 standard deviations
below the mean for young men.
Follow-up bone densitometry is suggested in 1-2 years. John Gunn.
Sept. 2000
13
Tianjin Medical University Cancer Institute and Hospital
Imaging Diagnostic Report
Patient Name: Alan Sex: Male Age: 60
PET-CT No. 1933 In-Patient No.205549 / 144015 Ward: Interventional Therapy
Examined body part: the full body Date of Examination: Mar 29, 2007
Imaging agent：18 F-FDG Activity：9.6mci Collecting Method：Fault Collecting 2D
Thickness： 4.25mm Attenuation Emendation：√ Size of Film：14” x 17”
Findings：
keep fasting more than 6 hours，imaging agent injected through vein. It’s getting stared to do
the fault imaging of PET & CT of the whole body after 60 minutes of quiet rest. PET image is
ready to do the attenuation emendation and reconstruction of iterative method. PET & CT
images show multilayer, multidisplay and the images are very clear.
The image of brain is normal. There is no abnormal radioactive accumulation shadow of
nasopharyngeal area。
There is no abnormity of the structure, form and radioactive distributing of maxillofavial and
neck part.
The bilateral breasts enlarged, but there is no abnormal accumulation showing on the PET
image.
The bilateral lung fields are clear, and there is no abnormal radioactive accumulation shadow
or any other abnormal shadows.
The image is normal of heart and macrovascular area. There is no abnormal accumulation or
enlarged lymph node inside the mediastinum.
Multiple low density condition showed inside liver, CT value is 10Hu. In addition, the
radioactive accumulation defect (about 1.9x1.5cm) is shown on the PET imaging. There is no
evident abnormity of the rest of the liver for it’s size, form, density and radioactive distributing.
The Nonhomogeneous density is shown in the gallbladder, CT value is 27HU and there is no
abnormal accumulation in it. The high density node shadows are seen inside choledoch, there
is no abnormity accumulation showed on the PET image.
The size of the spleen is normal.
The imaging is normal of stomach and duodenum.
There is no abnormal radioactive accumulation shadow in the pancreas zone and the form of
the pancreas is normal.
The imaging is normal of the bilateral kidney and bilateral ureter.
It is seen the multiple-tubular-normal-intestinal-shadow with different shapes and chroma in the
abdomen.
There is no abnormal radioactive accumulation shadow in the peritoneum posterior area.
The bladder image is normal.
After the “radical prostatectomy”, there is no recrudescence symptom at the surgery zone.
It is shown the multiple densely lymph node shadow at the left side rib (the
3th,4th,5th,6th,11th&12th), the right side rib (3th,4th,6th,7th & 9th), bilateral iliac bones and left side
pubis. There is no evident abnormity of the rest body part of the bones for their form and
density. There is no abnormal radioactive accumulation of the full body bones showed on the
PET image.
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PET-CT Diagnosis:
1, After the “radical prostatectomy”, there is no recrudescence symptom at the surgery zone.
2, “After the treatment of bone metastasis”, it is shown the multiple densely lymph node
shadow at the left side rib (the 3th,4th,5th,6th,11th&12th), the right side rib (3th,4th,6th,7th & 9th),
bilateral iliac bones and left side pubis. There is no evident abnormity of the rest body part of
the bones for their form and density.
Note: the partial metabolizability is getting down or the activity is choked back
3, The bilateral breasts enlarged
4, It is shown the multiple cysts of liver.
5, The Nonhomogeneous density is shown in the gallbladder, and there is no abnormal
accumulation as PET showed. Considered to be cholecystitis or/and choledoch concretion.
There is no evident malignant symptom on the PET metabolizability image and image of CT of
the rest part of body.
Tianjin Medical University Cancer Institute and Hospital
Imaging Diagnostic Report
Patient Name: Alan Sex: Male Age: 60 MR No.: 20491
In-Patient No.205549 Date of Examination: Mar 26, 2007
Ward: Interventional Therapy Size of Film:14x17’’ Serial No. of Film: 3
Examined body part: Prostate
Clinical Diagnosis: Done the radical prostatectomy for prostate cancer
Technique: Prostate MR Plain Scans （Magnetic Resonance Imaging）
Examined Method: SE,FSE,FSPGR
Findings：
“After the radical prostatectomy for prostate cancer” , the irregular shape of the longer signal
intensity of T1 & T2 are seen in the postoperative zone, which the extent is approximately
3.5cm x 2.0cm.
DWI shows a high signal intensity, the numerical value is lower of ADC, the layers of fat are
lack of clarity around and the filling of bladder is not enough.
There is no evidence of enlarged lymph nodes in the zone of bilateral iliac arteries and veins
and the inguinal zone.
T1 signal intensity shadow which is long and little flaky shaped is seen at the right iliac bone,
and slightly high signal intensity showed up after the fat suppression.
Diagnosis:
1. “After the radical prostatectomy for prostate cancer”, the shadow of soft tissue are seen in
some part of the area.
2. The abnormal signal intensity showed up at the right iliac bone and a ECT examination is
recommended.
15
Tianjin Medical University Cancer Institute and Hospital
Imaging Diagnostic Report
Patient Name: Alan Sex: Male Age: 60
MR No.: 20491 In-Patient No.205549 Ward: Interventional Therapy
Examined body part: the full spine Date of Examination: Mar 26, 2007
Technique: the full spine MR Plain Scans （Magnetic Resonance Imaging）
Size of Film:14x17’’ Serial No.of Film: 4
Examined Method: SE,FSE
Findings：
The flaky shaped and slightly longer signal intensity of T1 & slightly shorter signal intensity of
T2 are seen in the spinous region of the first thoracic vertebrae and the third cervical vertebrae.
STIR shows that there is no evidence of high signal intensity at the third cervical vertebrae, a
slightly high signal intensity shows up at part of the spinous region of the first thoracic
vertebrae.
The shadow of flaky shaped high signal intensity is seen from the second to the fifth lumbar
vertebrae，STIR shows that a slightly lower signal intensity can be seen.
The rest of cervical vertebrae shows that the existence of the cervical vertebrae curve
(physiologic flexure degree) is seen and formed in order.
The rough margin is found from the third to the sixth cervical vertebrae and from the second
lumbar vertebrae to the first sacrum vertebrae.
The decreased signal intensity of vertebrae disc is found from the third to the fourth cervical
vertebrae and from the third lumbar vertebrae to the first sacrum vertebrae.
The vertebrae disc shows a retral protrusion from the third to the fourth cervical vertebrae, the
fifth to the sixth cervical vertebrae and the third lumbar vertebrae to the first sacrum vertebrae,
and it causes the compression on the same level dural sac.
Cauda equina nerve and spinal cord show evenly continued signal intensity.
Diagnosis:
1. There is an abnormality signal intensity at the spinous region of the first thoracic vertebrae
and the third cervical vertebrae, it is suspicious of bone metastasis and recommended to
do the ECT Examination.
2. There is abnormal signal intensity from the second to the fifth lumbar vertebrae, it is
considered to be traumatic change.
3. A degenerative change shows at the cervical vertebrae and lumbar vertebrae. The
vertebrae disc shows a protrusion from the third to the fourth cervical vertebrae, the fifth to
the sixth cervical vertebrae and the third lumbar vertebrae to the first sacrum vertebrae,
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Tianjin Medical University Cancer Institute and Hospital
Imaging Diagnostic Report
Patient Name: Alan Sex: Male Age: 60 Department: Interventional Therapy
CT No.: 111494 In-Patient No.205549 Ward: Interventional Therapy Bed No.
Examined body part: centrum Date of Examination: Apr 3rd, 2007
Technique: Spiral CT Scans(Spiral Computer Tomography Scans)
Size of Film:14x17’’ Page of Film: 1
Examined Method: Plain Scan(Routine Scan)
Examined extent:
From the first cervical vertebrae to the inferior margin of the first thoracic vertebrae.
Findings：
The cervical vertebrae curve (physiologic flexure degree) has disappeared, and the
contraposition is not very good.
The non homogeneous BMD(Bone Mineral Density) is found at the Vertebral lamina of right
side of C2 and the spinous region of C3 & C6, with limited patchy denseness scattered and the
blurring margins.
Narrowing of the intervertebral space of C3/4 and C5/6 is found with the rough vertebral
margin, nuchal ligament with calcified shadows.
In addition, the forming of osteophytes are found on the margins of several cervical vertebrae
and thoracic vertebrae, and there’s no evidence swelling of the soft tissue around.
Diagnosis:
1. The vertebral lamina of right side of C2 and the spinous region of C3 & C6 are with patchy
denseness scattered. Combined your medical history and there is an possibility of bone
metastasis.
2. Cervical spondylosis is found.
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Tianjin Medical University Cancer Institute and Hospital
Imaging Diagnostic Report
Patient Name: Alan Sex: Male Age: 60 Department: Interventional Therapy
CT No.: 111494 In-Patient No.205549 Ward: Interventional Therapy Bed No.
Examined body part: Pelvic Cavity Date of Examination: Apr 3rd, 2007
Technique: Spiral CT Scans(Spiral Computer Tomography Scans)
Size of Film:14x17’’ Page of Film: 2
Examined Method: Plain Scan(Routine Scan)
Examined extent:
From the superior margin of intercristal to the inferior margin of public symphysis
Findings：
“After the radical prostatectomy for prostate cancer” , it has indicated no evidence of tumour
shadows in the Pelvic Cavity.
Non homogeneous BMD(Bone Mineral Density) is seen at the anterior margin of the right
acetabulum, the shadow of little cystic and low BMD is seen and having a thickened and higher
BMD around.
Non homogeneous BMD is found in bilateral iliac bones with patchy denseness scattered, and
no evidence of soft tissue tumour around.
Some lesser tubercle shadows scattered are seen in the zone of bilateral iliac arteries and
veins and the zone of groin, the layers of fat around are clearly seen.
It has indicated that there’s no presence of pelvic cavity effusion.
Diagnosis:
1. “After the radical prostatectomy for prostate cancer”, the change of the denseness scattered
is found in bilateral iliac bones. There is an possibility of bone metastasis.
2. The right acetabulum is considered to be traumatic arthritis.
18