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Since February 14, 1999, poet/philosopher RIC MASTEN has been keeping an ongoing account of his battle with Incurable Advanced Metastatic Prostate Cancer — from diagnosis to the "Latest Update." He keeps this unique digest in poetry, musings and medical tidbits. Updating as the war goes on. He welcomes calls and correspondence from fellow cancer fighters.
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(831) 625-0588
Ric's Nine year Ongoing PC Digest

Poems... Dementia, Helpline Harry,

February 1, 2008

........Here in early February I begin my 10th year battling the big "PC" monster. A a number of things make this entry difficult to write.
........Medically my PSA, CEA and PAP numbers are not responding to Taxotere as actively as they have in the past. In 6 weeks my PSA rose from 15.15 to 16.42, the CEA rose from 24.07 to 32, but the PAP did go down from 7.7 to 7.3. So Doctor Hausdorff and I decided to go another 3 cycles and then on the off week have labs and another CT scan of the chest abdomen & pelvis. The scan will give us a good sense of how things are going.
I have my Foley #14 replaced once a month and this time Doctor Shaheen my urologist said that when he inserted the new Foley there was much less resistance. I asked what that might mean and he said that perhaps the mets in my penis might be reducing in size. That sounded good to me. I have the bleeding in my bladder under control so that is no longer a problem because the nurses at Monterey Bay Oncology turned me on to CATH-SECURE which keeps the Foley from moving around and causing bleeding..
........The 2nd difficult problem I am dealing with is the dementia my dear wife is slipping into. We tell each other we love each other all the time but I miss the sparkle that the meds have stolen away. I wrote about what it is like from my perspective. A very difficult piece to write.

........................DEMENTIA
........................© ric masten
........................
........................when I was 25
........................my parents went on
........................an around the world vacation
........................leaving from the San Francisco marina
........................on a freighter with passenger accommodations
........................back in those days
........................when the gang plank had been raised
........................and the ship was ready to depart
........................the passengers
........................would line up at the rail looking down
........................throwing serpentine
........................colorful paper streamers
........................to friends and family on the pier below
........................we would hold tight to one end
........................while those we hold dear
........................held tight to the other end of these
........................slender fragile ribbons
........................then slowly
........................almost imperceptibly
........................the ship began to move away
........................the paper connections
........................snapping
........................one by one
........................as the steamer headed out into the bay
........................
........................after fifty five years together
........................my cancer is incurable
........................and your memory is fading
........................which makes me acutely aware
........................of time circling the drain
........................running out of the clock
........................wondering whether the love of my life
........................will slip over the horizon
........................before I am forced to leave the dock
........................+++

........The third negative at this entry is the loss of my dear friend and mentor Harry Pinchot. If you look through the earlier pages you will find "Helpline Harry" mentioned on every page. He literally saved my life by practically ordering me to have a CEA scan which is when I discovered my PCa is not "run-of-the-mill" prostate cancer. I have recently discovered that a very small number of men deal with what I have been wrestling with: a PC that produces CEA and only small amounts of PSA. The mets also show up in the penis and there are urinary problems. Through Howard Hanson of the HRPC list I learned that MD Anderson is studying 9 men that have exactly the same symptoms as I do. Thanks to Harry I found this out early on. He visited me at my home and he and his family became our family also. I wrote this piece fort Harry about seven years ago.

........................HELPLINE HARRY
........................ for Harry Pinchot
........................© ric masten

........................"Hi, how are you?"
........................ these days I'm never sure
........................ how to field routine grounders like this
........................ am I simply being greeted?
........................ or does the greeter actually want a list of grisly medical details
........................ my wife says it's easy — she just waits to see if the "How is he?"
........................ is followed by a hushed "I mean… really?"

........................ for the former a simple
........................ "Fine, and how are you?" will do
........................ for the latter the news isn't great
........................ indications are that the miracle
........................ herbal treatment is beginning to fail
........................ my oncologist offering up a confusing array
........................ of clinical trials and treatments
........................ that flirt seductively but speak in a foreign language
........................ I don't fully understand

........................ so Harry, once again I call on you
........................ a savvy old tanker who has maneuvered
........................ his battle scared machine
........................ through years of malignant mine fields
........................ and metastatic mortar attacks

........................ true, five star Generals know much
........................ about winning wars and such
........................ but the Command Post is usually
........................ so far removed from the front lines
........................ I suspect they haven't a clue as to what
........................ the dog-faces are going through
........................ down here in the trenches

........................ it's the seasoned campaigners
........................ who have my ear
........................ the tough tenacious
........................ lovable old survivors like you
........................ +++

........Farewell Harry. I love you and will certainly miss you.

........I do apologize for the lack of humor in this entry but—
........Stay tuned!


RIC'S ONGOING GENERAL DIGEST

Richard Masten, 78. born June 20, 1929
02/11/98 PSA 5
03/19/99 PSA 70
03/04/99 PSA 81 (all time high),
03/19/99 — GS 8, BS#1 pelvic bone x 5 mets (EOD 1)
04/06/99 — ADT1 (Casodex): 50 mg/d
05/07/99 — Rx2 Orchiectomy
07/09/99 PSA 7.3
10/01/99 PSA 0.2
04/12/99 PSA 0.2
01/20/00 PSA 8.21
01/13/00 PSA 8.08 — Rx BS #2 with 2 new bone lesions (pelvis + base of spine).
02/08/00 — Casodex d/c'd
02/09/00 PSA 11.08, — Rx4 PC SPES 9/day,
03/16/00 — begin Vegan diet & Bob Beck zapper 1 1/2 hr/day
06/30/00 PSA 4.42
06/30/00 — Vioxx25mg/day for groin pain
07/05/00 — Rx5 Begin Ipriflavone 200mg/day zapper d/c'd,
07/07/00 — Rx6 Aredia 7/17/00: 90mg q 3 wks
08/03/00 PSA 2.01, increase PC SPES 12/day, resume zapper,
09/14/00 PSA 3.05, PAP 6.8, increase PC SPES 13/day
11/02/00 PSA 6.20, CEA 823
11/10/00 — Rx7 Add 4/day SPES
11/27/00 PSA 6.6, PAP 12.7, CEA 840.5, CgA 9.1, NSE 3.6
12/07/00 — Dx BS #3 no new lesions (pelvis a bit more active)
12/07/00 — Dx CT (chest, adb &pelvis) clean.
02/12/01 PSA 2.03, CEA 898.8 (all time high), Ferritin 144
02/12/01 — Dx CEA scan - Active uptake in large leisons in right pelvis.
02/15/01 — Dx Colonoscopy - clean
02/16/01 — Dx Prostacint scan - uptake in all old leisons
02/26/01 PSA 1.53, CEA 760.17, PAP 20.07 (all time high),
03/05/01 — Rx8 Taxotere 25mg/M2, Decadron (10mg) every Monday
03/17/01 — Rx9 Begin Rocaltrol 0.5mcg 1/day
03/25/01 — Rx10 Begin Potassium Flouride 2drops/day
04/09/01 PSA 1.39, CEA 481, PAP 5.9, Prolactin 13 (all time high).
04/25/01 — Rx11 d/c'd Vioxx
05/14/01 PSA 0.82, CEA 474.6, PAP 2.60, ()
05/24/01 — Begin 3DRT Dose: 50.4 gy -- Ports: AP/PA/LAO/RPO - 5 1/2 weeks.
05/21/01 — Rx13 Taxotere 25mg/M2, Decadron d/c'd for 8 weeks
06/01/01 — Rx 14 Dostinex 0.5mg 2/wk. -- Starting dose - 0.25mg for 2 wks.
06/28/01 PSA 0.49. CEA 616.0, PAP 2.5
07/16/01 — Rx15 Taxotere 25mg/M2, Decadron -- resume
07/30/01 PSA 0.19. CEA 536.1, PAP 1.2
07/30/01 — Rx16 Aredia 90mg q 4 wks replaced by Zomeda
07/30/01— Rx17 Coumadin 1/2mg/day
08/06/01 — Protime 11.2, INR 1.09
08/20/01 PSA 0.11. CEA 415.4, PAP 1.1, Prolactin 2
09/24/01 PSA 0.06. CEA 339.8, PAP 1.6
09/18/01 — Dx BS #4 stable metastatic disease (decrease in degree of activity)
10/22/01 PSA 0.05, CEA 232.6, PAP 1.2
12/03/01 — Rx18 Calcitriol 0.5 mcg/ 1day
12/18/01.PSA < 0.03, CEA < 123.5, PAP < 0.9.
01/02/02 PSA 0.03, CEA 68.6, PAP 1.2
01/14/02 PSA 0.03, CEA 62.5, PAP 1.2
02/18/02 PSA 0.04, CEA 42.8, PAP 0.9, INR 1.11, Prolactin .1
02/18/02 — Increase Coumadin to 1 mg/day
03/27/02 — AP pelvis no fracture but extensive metastatic blastic lesion - rt. Hemipelvis
04/07/02 — MRI of lumbar spine Does not reveal evidence of metastatic disease
04/10/02 — BS#5 disease in the rt. Ischiopubic has diminished and is somewhat improved
05/13/02 — PC SPES & SPES d/c'd
05/19/02 PSA 0.05, CEA 22.3, PAP1.3
05/28/02 PSA 0.04, CEA 18.5, PAP 1.0
07/17/02 PSA 0.05, CEA 9.7, PAP 1.0
07/15/02 — Taxotere 25mg/M2, - 14 week vacation
07/17/02 — Rx21 Low Dose DES 3 mmg/day, Decadron 2mg/day for sciatic pain
07/25/02 PSA 0.03, CEA 5.6, PAP1.3, NSE 15.6, CgA 22.0, Testosterone 17, INR 1.2, Prolactin 1
10/16/02 — BS#5 uptake in the right ischiopubic bones has increased in intensity and extent.
11/11/02 — d/c'd Low Dose DES 3 mg/day
11/11/02 — resume Taxotere 25mg/M2, Decadron 4mg/3 wks-1wk off
11/18/02 PSA 0.05, CEA 6.8, Deoxypyridinol 4.5, Creatinine 0.23
02/08/03 —d/c”d Taxotere 25mg/M2 , Decadron 4mg/3 wks-1wk off
02/10/03 PSA 0.04. CEA 5.7, PAP 0.3 ()
03/19/03 — begin 400mg/d Celebrex
04/15/03 PSA 0.08, CEA 4.7, PAP 1.0
05/20/03 PSA 0.14, CEA 6.5, PAP 1.1
05/27/03 —resume Low Dose DES 3 mg/day,
06/17/03 PSA 0.16, CEA 7.0, PAP 1.4
07/29/03 PSA 0.13, CEA 6.6 PAP 0.9 — d/c'd Low Dose DES 3 mg/day
09/29/03 PSA 0.50, CEA 10.5, PAP 1.0
10/06/03 — resume Low Dose DES 3 mg/day
11/10/03 PSA 0.23, CEA 12.2, PAP 1.6 — resume Celexa 20mg. D/c’d DES 3mg/d, Warferin 2mg
11/13/03 — resume Celexa 20mg. — d/c'd DES 3mg/d, Warfarin 2mg
12/22/03 — resume Low Dose DES 3 mg/day, Warfarin 2mg
12/31/03 PSA 0.72, CEA 12.8, PAP 1.3
02/10/04 PSA 0.59. CEA 16.8, PAP 0.9
02/10/04 CT scan: Osteoblastic changes are present involving the right inferior pubic ramus, right ischium, and right symphysis pubis. Osteoblastic changes are present in the right acetabulum. There is an osteoblastic focus in the left symphysis pubis. Osteoblastic foci are present in the right iliac bone. IMPRESSION: 1. Osteoblastic metastatic changes. 2. Diverticulosis in the sigmoid colon. 3. Coronary artery calcification.
03/28/04 PSA 0.59. CEA 14.8
04/26/04 Bone Scan: When compared to the previous exam of 10/28/02, the increased
uptake in the right pelvis may be minimally more prominent. Progressive increased uptake are now noted at the L3-4 disc space. Small focal areas of increased uptake are now noted in the right pedicles of approximately T6 and T12. Degenerative changes are present in the cervical spine. An ill-defined area of increased uptake is noted in the region of the left mastoid air cells. This is unchanged from the prior exam.
04/27/04 PSA 0.74, CEA 17.8, PAP 1.1, NSE 8.6, CgA 26.
06/15/04 PSA 0.86, CEA 20.6, PAP 1.2
08/02/04 PSA 1.18, CEA 22.9, PAP 1.5
09/30/04 Dx #10 Bone Scan: When compared to the previous exam of 04/26/04 it is essentially unchanged.
09/30/04 PSA 1.11, CEA 22.8, PAP 1.5
11/08/04 PSA 1.28, CEA 23.9, PAP 1.3
12/20/04 PSA 1.45, CEA 19.3, PAP 1.3
01/17/05 PSA 1.77, CEA 21.4, PAP 1.3
03/10/05 PSA 2.32, CEA 23.6, PAP 1.2
04/25/05 PSA 1.87, CEA 24.2, PAP 1.2^
06/06/05 PSA 1.92, CEA 26.0, PAP 1.2
07/12/05 PSA 2.56, CEA 27.3, PAP ?
09/15/05  Rx 26 d/c’ Dostinex 0.5mg 2/wk
10/19/05 PSA 3.04, CEA 27.03, NSE 4.7, CgA 34
11/08/05 Dx"11 CT scan — Impression: Inerval increase in size and number of pulmonary nodules (left greater than right). These are highly suspicious for metastatic foci. Interval appearance of tiny right pleural effusdion with adjacent atelectasis versus consolidation. Stable CT abdomen and pelvis when compared to 03/16/05. Stable appearance to sclerotic lesions in the right hemipelvis and left symphysis pubis.
11/09/05 Dx #12 Bone scan. Vague increased uptake in several of the right ribs, which is the only interval change.
11/07/05 PSA 3.28, CEA 31.8, PAP 1.2
11/22/05 Rx 27 d/c’ Low Dose DES 3 mg/day, Warfarin 2mg
11/23/05 Rx 28, begin Nilandron, 150mg/d
12/27/05 PSA 2.86, CEA 40.3, PAP 0.7
01/31/06  Dx #13  CT scan   Impression:  Very slight increase in size of pulmonary nodules.  7mm - Minimal progression.
01/31/06  PSA 4.39,  CEA 38, NSE  5.6, CgA 189
03/13/06 PSA 4.29, CEA 38, CgA 180
04/24/06   Dx #14 CT scan Impression:  very slight increase in size of pulmonary nodules.  Minimal progression. Now 1.5 cc  Also new nodules in the lymph nodes in the chest.  The largest being 1.5 cc
05/01/06  PSA 5.63, CEA 29.4
06/13/06 PSA 9.86, CEA 39.9
06/13/06 Rx #29 d/c Nilandron, 150mg/d
06/19/06  Rx 15 resume Taxotere 35mg/M2, Decadron 10mg  -- 3 wks on, 1 wk off.
07/12/06  Rx 16 Prochlorperazine 10mg 2/d for nausea
07/12/06  Rx 17 Saline Nasal Spray for show of blood in nostrils — 07/12/06 
07/12/06  PSA 2.06, CEA 38.4
07/17/06  Rx18 reduce Taxotere 30mg/M2, Decadron 8mg  -- 3 wks on, 1 wk off
08/07/06 PSA 1.04, CEA 29, PAP 0.7.
09/06/06  PSA  1.13, PAP 09,
10/02/06 Dx #15  CT scan There has been a decrease in size of the previously seen mediastinal lymph nodes. The enlarged paraesophageal/superior mediastinal lymph nodes have dramatically decreased in size. The left infrahilar lymph nodes are no longer visualized. There has also been decrease in size of all pulmonary nodules. The largest of these were in the left apex, where there is now scarring and no definite solid nodule. The smallest nodules seen in the lingual are not visualized on the current study. No enlarged axillary nodules are identified. Impression: Dramatic decrease in size and number of bilateral pulmonary nodules with almost complete resolution of adenopathy. 
10/02/06   PSA  0.86,  CEA  11.4,  PAP 0.7  
10/06/06  Rx19 d/c’ Taxotere 30mg/M2, Decadron 8mg  -- 3 wks on, 1 wk off.
11/10/06  PSA 3,64,  CEA 11.4
12/29/06  PSA 8.00,  CEA 20.6
01/10/06  resume Low Dose DES 3 mg/day, Warfarin 2mg
02/12/07 PSA 7.35, CEA 35.3.
02/20/07 begin taking MANNATECH -oGlyconutrients
03/26/07 PSA 4.98, CEA 37, PAP 2.9
04/02/07 d/c’ Low Dose DES 3 mg/day, Warfarin 2mg
05/04/07 PSA 13.45, CEA 48.7, PAP 3.6
05/14/07 Dx #16  CT scan IMPRESSION — 1. Overall, mild progression of pulmonary metatastic disease.
2. Mild increase in size of lymph node in the aortopulmonic window.
05/14/07 PSA 20.28
06/04/07 RX began Phase 2 trial on E7389 (Halichondrin B Analogue, 2 wks on, 1 wk off = 1 cycle2
06/11/07 PSA 20.2
07/02/07 PSA 26.73
07/09/07 PSA 18.03
08/10/07  Dx  CT scan  CHEST —The thyroid gland appears normal.  Interval progression of size is noted in some of the multiple pulmonary nodules.  A few previous pulmonary nodules have also decreased in size, particulary in the left lower lobe.  Several sclerotic foci and right anterior ribs appear unchanged.
08/22/07 Dx biopsy taken of lumps in penis. Given the tumor morphology and the patient's history of pros
tatic adenocarcinoma Gleason Grade 4+4 (599-1916), the findings are most suggestive of metastatic adenocarcinoma.
08/21/07 RX d/c’ Phase 2 trial on E7389 (Halichondrin B Analogue, 2 wks on, 1 wk off = 1 cycle2
08/28/07 Rx19 resume Taxotere 30mg/M2, Decadron 8mg  -- 3 wks on, 1 wk off.
08/28/07 PSA 31.01 CEA 40.3
09/24/07 PSA 14.13
10/19/07  PSA  13.39
10/22/07   Rx23 — Continue Zomeda (now every 8 wks.)
11/09/07 resume taking MANNATECH - ambrotose AO (1 cap morning - one cap night), Advanced ambrotose (three 3 teaspoons per day) and PhytoMatrix (one in evening)
11/12/07 PSA 19.23, CEA 24.7
12/03/07 PSA 15.15, CEA 24.7, PAP 7.7.
01/21/08 PSA 16.42, CEA 32, PAP 7.3
ambrotose AO (1 cap morning - one cap night), Advanced ambrotose 3 teaspoons per day