Oncology Outpatients and GFR Estimation 3 Sample Scan and other stuff – 21st July 2021

Well, it’s a full and busy day at the hospital today in preparation for starting chemotherapy on Friday.

Before having any treatment at UCLH you now need to have a Covid Swab Test done at the hospital which is understandable. What I don’t fully understand is why you don’t need the test for scans and other tests.  So, this is another reason to be here twice in a week.

On arrival I headed for the Blood Test department and booked in for my Covid Test, as it was early, I only waited a few minutes before I was called in for my blood test.  The phlebotomist had barely got the needle in my arm when the receptionist appeared and said I was in the wrong place as I was booked into something called “The Pod”.

Just arrived at the hospital.

So, without hesitation the Phlebotomist pulled out the needle and aborted taking my blood which seemed a bit strange as she had completed the painful and difficult part of the process and could have soon drawn my blood as well!!

I was thinking that today I will be a human pin cushion!!

I got myself sorted and made my way upstairs to “The Pod” which was a portacabin type building setup just outside the exit doors.  I was met by the nurse who was going to take my blood and do the covid swab.  He wasn’t quite sure why I was booked into the pod, but I suspect someone had made an error while booking me in and booked me into the wrong place.

Anyway, the covid test and the blood test then went smoothly although by now I had two plasters on my arms where the different needles had been put into my arm.

Then it was off for my outpatient’s appointment, I had my eye on the coffee stand and a Flat White but thought I should head up for the appointment.

The outpatient’s appointment went fairly smoothly and was just a simple check up to see how I was feeling and to get me to sign the consent form for chemotherapy.

Job done it was now time to head for the main building and the Nuclear Medicine department where I was going to have the GFR Estimation 3 Sample Scan.

The Main Building.

Once again, I eyed the coffee stand but I knew there was another one in the main building so off I went only to discover that the coffee stand in the main building was closed!!

It was too far to go back and so I headed up to Nuclear Medicine and checked in and while the procedure is called a scan it’s not.

What happens is that I was injected with a radioactive source and then had to wait 2 hours while the source circulates around my body and then they would take 3 blood samples each an hour apart.  The 3 different blood tests are then compared and from that comparison they can work out the strength of the chemotherapy I can have.

GFR stands for Glomerular Filtration Rate and is a test which measures Urine Albumin which is a protein in that is filtered by the kidneys and so by measuring the amount of Albumin over the 3 different blood tests they can work out how well my kidneys are working and how much chemo I can have.  The radioactive source enhances the test and they can see how fast the radioactive source is being processed by my kidneys.

I hope that makes sense?

This is the first time I have been through this process and so it must be something that they do when using Carboplatin the chemo I was going to have this time.

Back to being a human pin cushion!

What the process also meant was that I was to have 2 cannulas fitted, one to inject the radioactive source and the other to be used to take the three different blood samples.

Cannula One

I was fitted with one in my left hand and the radioactive source was administered and then the cannula was removed.

I was then told I could do what I wanted for the next 2 hours while we wait for the source to circulate and so I thought it was coffee time!  Only to be told no tea or coffee, I needed to be caffeine free!!

Ah well.

I checked the map and looked for a nearby park to sit in and read my book for an hour.  I found a park called Gordon Square which was nearby and found a shady spot to read. 

As an aside the book I am currently reading is “The Stand” by Stephen King, which is about a global pandemic, quite topical for a book first published in 1978!!

Time passed quickly and soon it was time to head back to the hospital another cannula and the first of my blood samples to be taken and then it was a case of waiting an hour for the next sample and so on.  I couldn’t go far and so read and dozed in between the samples being taken.

Finally, the third sample was taken, and it was time to head home, it felt like a long day and I was feeling a little tired, I also had four plasters where the different needles had been.  I call these sympathy plasters as they will get me a few minutes of sympathy when I get home!!

I would soon be home and be able to rest before returning on Friday.

Chemo (Carboplatin 1) 23rd July 2021

Well the big day has arrived and I am back at UCLH for the start of a new chemotherapy treatment for me, Carboplatin.

But before I go into that I thought I would just recap on my treatments so far, once again starting with chemotherapy.

Having been diagnosed in Nov 2016 I was quickly started on Hormone Therapy followed by…

Jan 2017 6 x Docetaxel

Dec 2017 Enzalutamide

July 2018 Immunotherapy Trial

Jan 2019 Cabazitaxel x 4

Aug 19 Lutetium x 8

And while these are the main treatments I have also had various parts of my body zapped with radiation including my spine, shoulder and sternum.

So overall it has been a bit of a rollercoaster of different treatments and emotions as I start each one and then come to the end of treatment or it is stopped because it was not working as was the case with Immunotherapy, Enzalutamide and Cabazitaxel.

And so given that the Lutetium also stopped working I have great hopes for Carboplatin although I  also have a great deal of apprehension but with all these things you have to go into it with a great deal of faith and hope and a positive attitude.

I do think that my positive attitude has really helped get me through a lot of this and while it is hard and some mornings I have to look in the mirror and force myself to smile, I do think it works.  The mind can do wonders and help keep you strong.

I have also done as much as possible to stay ‘fighting fit’ and am currently doing a virtual walk along Route 66 but that’s a story for another day.

So the big day arrived and I was a little late for my appointment due to traffic delays.  And guess what, my blood pressure was a little high, so a few moments of relaxing and breathing and I was retested and it was fine.  I am always amazed at how blood pressure can fluctuate and change so quickly.

Checks done and I was met by the nurse who would be looking after me and he was someone who had looked after me before and we both recognised each other.

He got me seated in the chair which would be mine for the next hour or so while the treatment was administered.

Then quickly and efficiently, he fitted a cannula and got me hooked up to a drip, I would be having fluids with extra steroids and  other things prior to the Carboplatin going in.

The nurse also organised a sandwich for me which I was ready for by this time and I think helped fortify me for the coming treatment.  I order a chicken sandwich and vanilla ice cream, yum!

Lunch

And before I knew it the Carboplatin was flowing down the tube and into my arm, no reaction from me so all good!

It only took about 30 minutes for the infusion and then I was done, the cannula was being removed, I closed my book and packed up ready to go.

I was feeling fine, although a little tired and was looking forward to getting home.  Only time would tell if I would get any side effects but for now I was feeling good!

A Week Away

I am fortunate enough to have just had a week’s holiday in the Gower Peninsula and while it was not planned it came at the perfect time as it allowed me to rest and recharge both my body and mind prior to starting Chemotherapy on Friday.

We had plenty of time to relax but also spent time walking along the beaches and headlands in the fresh air.

I now feel ready to take on chemotherapy and whatever it may throw at me.

Tomorrow I am at UCLH for an outpatient’s appointment and a scan and then on Friday I have the first of this series of chemo treatments.

PSA 305 – 2 July 2021

As part of my visit to UCLH on Wednesday for my outpatient’s appointment I also had a blood test and today I got the results which are for the most part ok but one of the things I keep a close eye on is the PSA or Prostate Specific Antigen.

And on Wednesday at the time of the blood test my PSA was 305 which of course is very high and has gone up 10 from 295 at the start of June.

While it has gone up, I am actually pleased that it has not gone up by much.  That said I started the year with a PSA of 150 so it has doubled over a six-month period.

For those who may not know the PSA for my age should be around 4 so 305 is very high but it has been as high as 1,585 so in many ways it is in a good place.

The PSA is not an indication of cancer but a high or rising PSA can suggest some kind of problem with the prostate like an infection or cancer.  But as we know that I have Prostate Cancer any rise in the PSA most likely means an increase in cancer activity (growth).

This of course all ties in with the Lutetium treatment ceasing to be effective against the cancer and so hardly comes as a surprise.

When I start my new treatment, Carboplatin, in a couple of weeks I will be looking for a decrease in my PSA and the bigger the decrease the better.

So watch this space as I will be taking a keen interest in my PSA over the coming months.