And Miles to Go Before I Sleep

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“The woods are lovely, dark and deep.
“But I have promises to keep,
“And miles to go before I sleep,
“And miles to go before I sleep.” – Robert Frost

(This initial post will be much longer than those that follow.)

So, here’s the deal: The prostate cancer is back, big-time.

First appearing in 2018, it had been under control since the beginning of 2020, producing virtually no PSA (much more about PSA blood tests in coming posts). But the PSA signal exploded about a month ago – a nine-fold increase to 6.5 from the previous 0.7, over just four months. That caught everyone’s attention.

We learned Monday, just before seeing the advanced prostate cancer specialist, that the PSA result nearly doubled again in the past month, from 6.5 to 11.6. “Houston, we have….” you know the rest of that. Said my wife Marion: “Damn. They’re just going to dump you in a vat of chemo.” She wasn’t far off.

After a few weeks of examinations, conferences and a nifty full-body nuclear scan (that I lit up pretty good and that, atop lots of earlier radiation, ensures that I’ll never again need a nightlight), the verdict arrived:

My particular flavor of prostate cancer somehow became much more aggressive and spread throughout my lymphatic system. “Extensive lymph node involvement,” was the lede of the story. There is no confirmed bone, brain or organ involvement, other than in the pesky prostate itself, but there is a scientific near-certainty that prostate-cancer explorers are canoeing in my bloodstream, looking to establish colonies on distant lands.

Because of the spread, the case is now categorized as Stage Four Metastatic Prostate Cancer.

That’s a scary term, but it does not carry an immediate or even near-term death sentence. Surgery is out. Radiation is out. But “systemic treatments” are various and offer the possibility of slowing the spread and maybe even repairing some of the damage.

Lengthy meetings here in Tallahassee, Florida, with our urologist (Dr. Robert Bradford, who has been right-on-the-ball), our radiation oncologist (Dr. Philip Sharp, who got us to a form of remission two years ago and is just a terrific guy), and our new advanced prostate cancer oncology specialist, Dr. Scott Sellinger, one of the most experienced in the country, have produced a multi-faceted, promising regimen of treatment.

With no time to waste, we began a new phase of “androgen (hormone) deprivation therapy” two days ago, before we even left that introductory meeting with Dr. Sellinger. ADT works to rob the cancer cells of the testosterone on which they feed. I was injected (twice) in the belly with a much more powerful agent – Firmagon – than I had before (called Eligard). I’ll need a booster injection of Firmagon in each of the next three or four months, and then I may be able to return to Eligard, which is no stroll in the park, either.

Upon approval from the insurance company and a financial reimbursement review from the pharmaceutical company, the Firmagon soon will be augmented with a recently approved agent – either Erleada or the similar Xtandi, both of which carry astronomical list prices.

Working in concert, these two agents – Firmagon and Erleada/Xtandi – should for awhile slow the cancer, which will be tracked through frequent PSA blood tests. These drugs are accompanied by very real side effects, but we’ve been through some of that before and we’re braced for whatever comes. I feel fine at the moment, aside from significant swelling and discomfort at the injection sites, but the other side effects will hit soon.

The docs also scheduled a bone-density scan to get a baseline (these therapies can weaken bones) and a genetic blood test to determine if a genetic mutation is involved in my case – an important factor in determining future treatments and something that daughter Allie and grandchildren Sol and Sophie need to know regarding their own genetic makeup.

Allie and Marion and our closest friends have been great – shaken, of course, but confident that we can deal with this. Grandson Sol, nearly 13, who happened to be in the car when the oncologist first called with the news, knows the basics; granddaughter Sophie and honorary grandson Matty Petley, both 8, are not being told much. We ask that anyone who knows them keeps this in mind when interacting with them.

As far as the future, the docs are being quite clear. This is not a cure situation. It is a monitor, treatment, monitor, change treatment, monitor, etc., situation. Basically, we will climb a scaffold of “systemic” therapies, leaving some behind as they stop working, deploying more powerful agents as necessary.

To quote Dr. Sellinger, “unless a truck hits you first,” this eventually will get me. Being a nosy reporter, I asked him for a definition of “eventually.” The answer: A significant number of years, particularly as new therapies come on line. I’ll be more specific in a future post, but at the age of nearly 74, that’s not a bad deal at all.

So, those are the basic facts, and it feels pretty weird to share this. In 35 years of writing, I’ve used the first person maybe half a dozen times, and only when ordered to do so. It does not come naturally to me. I find it self-absorbed.

This, obviously, is a bit of a different case.

I plan to blog from time to time along the way, generally in much smaller segments than this initial scene setter, employing first person only when necessary. If you’d like to be notified of future blog posts, please find the “Subscribe” button along the right-hand side of the page and enter your email address. I’d like to keep all of this as separate as possible from my Facebook feed, so feel free to leave a reply here (by clicking the comment bubble) rather than there.

I think – I hope – that this blog will help others who face, or one day may face, similar challenges.

Also, I’m a newsman – and this is a helluva story, and I have an exclusive. 🙂

33 thoughts on “And Miles to Go Before I Sleep”

  1. Way to make me 😭 on your first post – even the title of the blog – but it is perfect, esp that poem – always one of our favorites
    I’m proud of your growth and using this as an opportunity to share – be vulnerable- be present in your own experience — I look forward to reading more
    ❤️❤️

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  2. West-to-east hugs to you, my 40+year pal. Paul and I will be following your story closely and send the strongest possible vibes to you and your wonderful family.❤

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  3. Brilliant, moving depiction of a health crisis. Personalized with sharp pointers and even keen wit (the nightlight comment), and instructive throughout.

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  4. Damn. I should have more to say, but just. Damn. Hang in there. And yes, I’m a regular PSA-getter. Two biopsies so far say it’s the slow-growing kind, but as you point out, it’s never not a concern. Hang in there, old friend.

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  5. Thanks so much Marty for being so honest during this difficult time of your life…your transparency will prepare others (including myself) for what may happen even after radiation treatments. Better still, it will urge younger men than us to check and track their PSA scores at least annually. Best wishes over your many, many miles before you sleep.

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  6. My heart is with the Merzers … all of you. ❤️
    Marty, in sharing this journey, you are putting lifesaving information and encouragement into the lives of others. No small thing, as difficult as it may seem at first.
    Also … I’m thinking of those little heat-seeking pharmaceutical missiles as “Scuds for Studs.” I like it.
    Auntie Lee Ann

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  9. You, sir, are a helluva newsman. You have a village out here that’s with you and Marion & the rest of the fam every step of the way – praying, encouraging, inspiring….

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  10. Marty,

    Thanks for sharering this sobering news. You were generous with your advice on coping with my radiation rendezvous a littleover ayear ago. And now you’ll share again as you enter this new and more troubling next phase of treatment. No surprise there. Let’s hope it plays out witha minimum of hardache. We’re pulling for you.

    Doug and Peg Clifton

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  11. Saying prayers that the medical technology and treatment is always way ahead of you, Marty. May you have smooth sailing ahead with the wind always at your back.

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  12. Saying prayers that the medical technology will stay miles ahead of you on your journey, Marty. Your gifts as a journalist continue to bless your readers, even when sharing a deeply personal subject. Sending you the biggest virtual hug.

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  14. Dear friend, we are here with you each step. Thank you for sharing and keeping us in tune with your experience. The journey may have twists and turns, and we’ll be here for you and your family. Keeping you in our prayers!

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  15. You are in good hands with Dr. Sellinger. He gives seminars throughout the US on treatment of advanced prostate cancer (he is also a nice guy, although that is less important than knowledge/competence in this situation). Sending you our best wishes and support on this journey.

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  16. Marty and Marion, Randy and I are so sorry to hear this. We admire your guts and fortitude. We both will be here for you in anyway we can, so please do not hesitate to use us. All that being said, you did make us both laugh and cry with the images you so deftly drew! We understand what you are going through, and wrap both you and your family in our love and concern. Big hugs, Sue

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  17. ❤️ all the best as you meet this new challenge.. although that word is not nearly strong enough nor harsh enough! Thank you for being generous enough to share. 🙏🏻

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  18. Thank you for sharing. I am rooting for you and your family. You give others with cancer hope and show the way to attack it. I’m hoping scientific discoveries stay ahead of the fight for you. It is amazing how far medicine has advanced. Go Team Merzer!

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  21. Marty, I pray that there are indeed many miles to go. Keep us posted, please. Enjoy life, crazy as that may sound. And do continue to let us know what is happening. I may one day be traveling down that very road myself. I follow by PSA’s religiously, watching a tiny bit of increase creep that the docs keep saying is “stable.” Right.

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  22. Marty, We are thinking of you and your family. Hope your treatment plan helps you and that it doesn’t disrupt your life too much. We look forward to following your journey here. Hugs to you, Marion, and Allie.

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  23. Marty and Marion, my shoulders are broad and my ears open to you at any time of the day and night. Yes, the newsman is in you and it will be a hell of a story. Sending prayers.

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  25. How very brave you and your family are, Marty.
    I am so very sorry, but I know that you will fight hard.
    So many good wishes,
    Annetje Lawrence Meyer

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  26. Pulling for you, Merz.
    Thank you for sharing this most personal story.
    I look forward to you writing about the Doc saying the treatments are working and the forecast is bright.

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  27. And the hair was just getting back to normal!! Thank you for sharing this. I know it will help myself and others.

    From your years in the service, to the years you gave your all in reporting, to now this dedication to transparency and helping others during this journey, you sir are a true hero!

    We are all cheering for you!!!

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  31. Marty, I was so sorry to read this report of the latest round in your battle against the Big C. I sure hope there are still many, many, many miles to go before you sleep. You have always been one hell of a writer, and I look forward to following this story as only you can deliver it.
    All best to you and the entire family,
    Clark

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  32. Wow, Merz, I am rooting for you. Get a rental and drive the shit out of it, metaphorically speaking. Meaning the road ahead is rough but you have both the tools and the support to get out of the flood. Keepin’ an eye on you. Thanks for sharing.

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