(Written Feb. 2001)
In November of 1998 I went off combined hormone blockade (CHB), after a year of undetectable PSA. Through most of 1999, my PSA remained undetectable or very low. However as 1999 became 2000, my PSA began to gradually climb.
By July of 2000 it was fairly obvious that
something was happening, but it is not a good idea to panic. The first thing that Dr.
Weber and Dr. Pomeroy suggested was to try the use of a combination of a powerful
antibiotic (Cipro) and NSAID "non-steroidal anti-inflammatory drug" (Ibuprofen)
to see if this was just a case of prostatitis. By the time a month had gone by,
there was a little reduction in the rate of climb, but not enough to convince anyone that
it had helped. So the next stop was UCSF to pay another visit to Dr. Eric Small.
Dr. Small was very frank in his assessment of the situation. With a
Gleason of 8/10 and 9/10 his opinion was that my disease was systemic and that local
therapy such as cryosurgery or salvage prostatectomy would be basically a waste of time.
He felt that the options would be to go back on intermittant hormone suppression, or to
try an investigational treatment. A new Phase Two trial of dendritic cell therapy was
getting underway, and he recommended that as a good possibility. I agreed. Click here to find out
more about UCSF clinical trials.
There are a number of experimental treatments being investigated for the treatment of prostate cancer. Some of them are listed below.
Dendritic cell therapy is a vaccine. It works on the theory that you can teach the body's immune system to recognize and kill cancer cells just like a virus or bacteria. If you're really curious, you can get the details here.
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The process started at the Stanford Blood Center where I had to show up at 6:30AM. The very friendly and competant staff there put me into a reclining couch and proceded to connect needles to the veins in both of my arms. Then a very noisy machine took the blood out of one arm, extracted the white blood cells, and put the blood back into the other arm. Basically I had nothing to do but watch movies, which were thoughtfully provided. The entire process took about 2-1/2 hours. The only problem with this procedure was that it was impossible to get up out of the couch. Not much of a problem unless you've recently had a lot of radiation treatments to your prostate. In that case, 2+ hours is a long time to go between potty breaks! To make matters worse, you are supposed to drink eight glasses of water in the 12 hours before the procedure.
Next, the white blood cells are shipped off to the lab at Dendreon Corp. Over the next two days, the researchers there do their magic, and produce what looks like a unit of blood plasma. But this is no ordinary blood. It contained (in my case) about four billion dendritic cells, all of which had been given a crash course on fighting prostate cancer. But the interesting part is that they don't actually do the work. They train and order other white blood cells to kill cancer cells, so you might say that the dendritic cells are the "generals" of this army of the immune system. Here is a picture of the tag that comes attached to the container.
After two days, I drove up to the new UCSF Cancer Center on Divisidero Street in San Francisco. I reported to the Infusion Center where an equally friendly and competant group of nurses connected me to the container of blood cells and it went back into my bloodstream. There were a total of three of these treatments over a month-long period.
One pleasant surprise was that for two visits to the Infusion Center, a fellow member of our Internet Prostate Help Forum was also there. His name is Carl Frankel, and he is a retired lawyer from back East who decided to combine an extended vacation in San Francisco with the Dendritic Cell treatment. I shared reports on San Francisco restaurants and had some enjoyable conversations with him and his charming wife.
The next part is actually the most difficult - waiting! This is an experimental treatment, and as such there are no firm rules as to the outcome. As best I can tell, there may be a noticeable effect in a few weeks, or it might take several months, or maybe not at all! the 15th of each month there is the trip down to Unilab for the blood draw, then the wait for the results. Fortunately, I am a very busy person, and don't really have time to do much worrying. Plus I have learned that worrying doesn't seem to help! The outcome is what the outcome is, whether you worry or not.
For the first couple of months, nothing seemed to be changing. Then there seemed to be a little slowing down of the rate of climb, but not any decrease in PSA. Finally in February, a real drop! We will have to see what is next, but who knows, maybe it worked! Stay tuned...
To get information on dendritic cell therapy: Dendreon Corp. website.
And finally, just to prove that there is always something
to be happy about, here's a picture of my grandson Brandon's first Christmas, December 25th, 2000.
I plan to see him at a lot more Christmases!