Drugs: Not the fun kind

Zach: What do you want to babble on about today?

Zelda: All the different drugs you’ve tried.

Zach: How much time ya got? That could take awhile…

Zelda: We’ll skip the recreational ones. 

Zach: I still want to do psychedelics with you.

Zelda: One day, I promise.

Zach: Can’t believe you’ve never done them.

Zelda: I was scared straight.

Zach: You were just scared.

Zelda: Fair point. So let’s talk about drugs. Specifically, the not-so-fun drugs you’ve been on for metastatic prostate cancer. None of them offer a cure. And we're told all of them will stop working at some point. 

Zach: There’s that.

Zelda: And they’re super expensive. One cost more than $11,000 per month, and you were on it for 2 years. Thankfully, insurance covered most of it. I have no idea how people without insurance get these drugs. 

Zach: Maybe they don’t. 

Zelda: And deciding which drugs to try…that was tricky.

Zach: The illusion of control.

Zelda: Word. You did decide when to have chemo–whether to start it early, or wait until you’d tried other things. 

Zach: They said early chemo could buy a couple months. Didn’t seem worth it. Especially if those months sucked because…Chemo. 

Zelda: The first drug you were on was Lupron. 

Zach: Good ol’ Lupron.

Zelda: You get Lupron injections every 3 months to lower your testosterone (prostate cancer feeds on testosterone). It’s a shot in the butt, and it’s sometimes painful for a few days afterward. 

Zach: The only bright spot is you drawing a bullseye on the cheek we want them to use.

Zelda: If nothing else, the nurses remember you for that! 

Zach: I guess I’ll be on Lupron the rest of my life. 

Zelda: That’s the plan. It’s the standard of care, along with other drugs to lower male hormones: “Androgen deprivation therapy.”

Zach: Like I said before, they turned me into a girl.

Zelda: So here’s the laundry list of drugs of drugs you’ve tried over the past 6 years: 

• Casodex

• Orgovyx

• Relugolix

• Xtandi

• Zytiga

• Tamoxifen

Some worked longer than others. All had side effects, some were nasty. Along with Lupron, they destroyed your sex drive, or gave you hot flashes and tender breasts, hence the Tamoxifen. It’s usually prescribed for women with breast cancer, but it’s helped reduce pain and gynecomastia (growth of breast tissue). 

Zach: And even with that, I almost need a training bra.

Zelda: One drug gave you a “swimmy head,” and balance issues. You took a few big spills at home, and stopped doing some of your favorite things, like diving, tennis, gardening. 

Zach: Didn’t want to fall again.

Zelda: And you started logging more couch time. You lost your appetite, lost weight, lost muscle. Your balance got so bad, the doctors ordered a brain MRI to see what was going on upstairs. 

Zach: Finally got my head examined!

Zelda: Thankfully, the MRI ruled out any brain issues. So we went to the next drug: Docetaxel: Chemo. You had your first round on July 3 this year. You decided to delay it until you'd tried the other options.

The docs told us that men tolerate Docetaxel well, but it’s been awful. Nausea, malaise, mouth sores–and a bunch of other symptoms I won't get into now. The second week, we shaved your head.

Zach: Right on cue.

Zelda: The worst part: You were just starting to feel better, when you took a bad fall. I swear, the knot on the back of your head was the size of my fist. I tried to talk you into getting it checked, but you refused. You also hit your back, and you’ve been in constant pain since. But you won’t go see anyone. 

Zach: Don't want to waste my time.

Zelda: You did see an Ear, Nose, and Throat doctor to check for inner ear problems. The doc ruled that out too. And said to improve your balance, you need to be more active. Join a gym. Walk more. He prescribed physical therapy. 

Zach: Obviously, he’s never been through chemo.

Zelda: You’ve now had 2 rounds of Docetaxel. You feel nauseated most of the time, and have no appetite. I end up nagging you to drink a protein shake, and hope you can keep it down. 

I know it’s your body, but I feel like I’m right there with you. When you lose your appetite, so do I. When you’re waiting for test results, I’m anxious too. I feel a tightness, like a swarm of bees in my chest. I’m usually on the verge of tears–or puking.

Zach: I’m sorry I’m putting you through all this (voice catches)

Zelda: I’m sorry too. I just wish there was more I could do.

Zach: Ditto.