Well, hi there. It’s me. Prostate Cancer Guy. It’s been a while.

Which is a good thing. There hasn’t been a whole lot new to report.

Still, this is a long overdue update, mostly to share an important video from one of the nation’s leading prostate cancer specialists. But, first, here’s the personal element of the update.

As a reminder, the background: Now 76 years old, advanced stage-four metastatic castration-sensitive prostate cancer, Gleason 4-3, lesions throughout the lymphatic system from neck through pelvis, a couple of bone mets. Diagnosed in 2018, but it certainly was hiding well before that. Big-time explosion and scare in early 2021.

Elevator version of current status: I’m doing pretty well. The therapies – Eligard shots every four months and four nightly Erleada elephant pills – continue to work, keeping the cancer leashed. A high-tech radioactive body scan last month showed that the lesions are not spreading and some appear to be fast asleep.

The price for all of that, of course, involves side effects. Lots of them and they are deepening. The top hits:

• Significant fatigue – 2-3 naps most days
• Nighttime sleep disruptions, positioning, early awakening, etc. 
• Multi-chapter dreams/toxic dreams/occasional night terrors
• REM Sleep Disorder – involuntary movements/falling out of bed
• Hot/tingling flashes
• Libido dysfunction
• Muscle deterioration, weakness, occasional stumbles and falls
• Body shape changes
• Suppressed appetite, weight loss – major changes in food attraction
• Taste bud disruptions, intermittent
• Testicular discomfort
• Loss of virtually all body hair, including in the nostrils – embarrassing during sniffles season 🙂

The various sleep disorders, apparently caused or intensified by the meds, required a visit to a specialist. The diagnosis is REM Sleep Disorder. Basically, I’m moving during REM deep sleep cycles, which is something you’re not supposed to be able to do.

As a consequence, I’ve fallen out of bed four times this year, twice cracking my head on the night table.

(In one of those dreams, I was reaching for a foul ball in Yankee Stadium. Just as I was about to grab it….boom! Pretty pissed about the whole thing, largely because I didn’t get the ball. Also, you know, the black eye and bleeding and loss of dignity.) REM sleep disorders can be predictive of other troubles down the road, but that’s not a concern at the moment.

The therapy for now is 10 mgs of melatonin nightly. If that doesn’t work, they’ll turn to other pharmaceuticals, which are nasty and I hope not to go there. Also, wife Marion and daughter Allie arranged this low-tech but thus-far effective measure…

So, to summarize: I have nightmares that sometimes have me screaming in terror. I fall out of bed. I need protective devices one step short of bedrails. I’ve become an extremely picky and unenthusiastic eater (due to changes of some sort delivered by the meds). When I have a runny nose, it runnies right down my face (because I have no nostril hairs).

Basically, I’m four years old again.

OK, enough of that. The bottom line remains that it could be a lot worse and we’re grateful that it is not. We’re still living fairly normal lives in retirement, making allowances and finding workarounds when necessary. Major props to Marion, Allie and the rest of the family for their support and flexibility.

Where was I? Oh, right. That informational video.

Here is a lengthy update of the state-of-the-art in treating metastatic prostate cancer, just produced and posted by Dr. Eugene Kwon. He is not (yet) one of my physicians, but he is regarded as one of the nation’s most knowledgeable and successful prostate-cancer specialists.

It’s probably too long for you to watch now, but please archive it and share it with anyone diagnosed – now or later – with metastatic prostate cancer. It might save his life.

So, that’s it from here.

So far, so good.

Guys, don’t forget to get your PSA (Prostate Specific Antigen) blood test at least once a year, preferably more often.

Best wishes from the Merzer/Fleming family. I and we hope you all have a happy holiday season and a healthy, safe and prosperous New Year.