Diagnosed with Stage 4 Metastatic Prostate Cancer May 5 2021

Documented here so I can better guide my progress based on results, and hope it will be of benefit to others.

PSA history in BOLD print.

April 28 2021 - Went to first ever Medicare Annual Wellness Physical. Rasiklal N. Delvadia, MD. Was given Order to have blood and urine test.
May 1 2021 - Blood and Urine test Parrish Medical
May 1 2021 - Appointment Parrish Medical Center. Blood test PSA 644.4
May 4 2021 - Called in by doctor (Rasiklal N. Delvadia, MD) to review results morning of May 4 2022. Doctor was angry shaking my test results and shouted "I thought you said you were healthy". During the physical he asked me how I felt, not if I was healthy. My PSA was 644.4 and kidney function 26%. I was referred to urologist and made the appointment the same day. Also order for ultrasound on abdomen.
May 5 2021 - Appointment at urologist. Was given physical exam and diagnosed with advanced prostate cancer. Order for Bone Scan and MRI.
May 7 2021 Letter from Rasiklal N. Delvadia, MD informing me to find another doctor. See PDF

                    Exam: E100880407 NM BONE SCAN WHOLE BODY
Exam Date and Time: 05/13/21 1050
EXAMINATION:
NM BONE SCAN WHOLE BODY
CLINICAL INDICATION:
Male, 65 years old. PROSTATE CA
RADIOPHARMACEUTICAL: 26.1 mCi of technetium 99m MDP IV.
COMPARISON: Abdominopelvic CT from 5/30/2021 was reviewed in bone windows
Technique: Approximately 3 hours after the administration of the radiotracer whole body and spot
images of the pelvis and thorax were obtained.
Findings: There are osseous metastases involving the right humeral diaphysis, the left sixth rib, upper
thoracic spine, left superior pubic ramus, left ischium, and right ischium/right acetabulum. The urinary
bladder is significantly distended and there is bilateral hydroureteronephrosis.
IMPRESSION:
Exam is positive for osseous metastatic disease.
The urinary bladder is significantly distended and there is bilateral hydroureteronephrosis likely
secondary to chronic bladder outlet obstruction.
Electronically signed by: Timothy Zelenak MD 5/13/2021 2:21 PM CDT Workstation: 109-9164PB4

June 4 2021 Appointment with new (2nd) urologist Dr Mourad Abouelle. Dr Mourad Abouellehad his nurse perform ultrasound on my bladder, determined I need bladder emptied immediately, which was life saving. They inserted a catheter and drained about 1000 ml from bladder. First Urologist (Gonzales office no one wearing masks, I got the test he prescribed but never heard back for a month...) Just felt wrong.
June 7 2021 Noticed that with catheter ALL pain was gone. I had been splitting Tylenol and taking a half Tylenol every 12 hours. Sometimes every 8 hours. I had years of on off needle and pins pain around my waistline. Much of the time it felt like the burning from pulled muscles. Pain got worse sitting, and wore yet lying down. Again ALL pain vanished after catheter was keeping my bladder empty.
Catheter treatment to keep bladder empty is a learning experience for me. Next appointment with Dr Mourad Abouelle is on July 22 2021. I am determined to learn how to keep my bladder empty on my own without the catheter. Did A LOT of reading/learning.
June 10 2021 - Appointment at Brevard Cancer Treatment Center (Dr Ross). Dr ross told me I might have just 1 t5o 2 years to live with treatment, maybe 6 months without treatment. Prescribed Bicalutamide and their pharmacy gave me my first 30 day prescription right their on the spot. Dr Ross and treatment center staff appeared to operate in a VERY friendly efficient manner. Everyone is so polite and efficient. The in house pharmacy is a plus and the person behind the window does it all. Finds my very low co-pay, made it really hassle free.
June 10 2021 - Treatment - Started Bicalutamide (oral)
June 10 2021 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 747.5
July 22 2021 - Appointment with Dr Mourad Abouelle, got catheter removed against his recommendation. Confident I could keep my bladder empty, had a great drive home. Began walking and jogging again very next morning. Just can't jog with the apparatus in, pain full later with all the jiggle of a tube dangling from you know what.
Aug 25 2021 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 95.04
Aug 30 2021 - Treatment - Started Xtandi (oral), continued Bicalutamide (oral)
Sep 01 2021 - Treatment - Started XEVA Denosumab (every 30 days bone health injection) and Leuprolide (every 90 days Hormone therapy injection)
Sep 29 2021 - Treatment - Denosumab injection
Oct 01 2021 - Treatment - Ended Bicalutamide, continued Xtandi
Oct 27 2021 - Treatment - Denosumab injection
Nov 24 2021 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 17.09
Nov 24 2021 - Treatment - Denosumab injection
Nov 24 2021 - Treatment - Leuprolide injection
Dec 22 2021 - Treatment - Denosumab injection
Jan 19 2022 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 12.75
Jan 19 2022 - Treatment - Denosumab injection
Feb 16 2022 - Treatment - Denosumab injection
Feb 16 2022 - Treatment - Leuprolide injection
Mar 16 2022 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 14.06
Mar 16 2022 - Treatment - Denosumab injection
Apr 13 2022 - Treatment - Denosumab injection
May 11 2022 - Appointment at Brevard Cancer Treatment Center. Blood test PSA 8.8
May 11 2022 - Decided to inform doctor I will discontinue Denosumab for awhile due to side affects and I felt my bone health may be good due to the diet and exrecise I practice.
May 11 2022 - Based on my discontinuation of of Denosumab - doctor ordered tests. Bone scan, total body CT chest/abdomen/pelvis w/ contrast
Jul 20 2022 - Tests at Parrish Medical Center

                            Exam: E101033434 NM BONE SCAN WHOLE BODY
Exam Date and Time: 07/20/22 1327
EXAMINATION:
NM BONE SCAN WHOLE BODY
CLINICAL INDICATION:
Male, 66 years old. PROSTATE CA
RADIOPHARMACEUTICAL: 23.5 mCi of technetium 99m MDP IV.
COMPARISON: Bone scan from 5/13/2021. Also CT chest, abdomen, and pelvis from 7/20/2022 is
reviewed in bone windows
Technique: Approximately 3 hours after the administration of the radiotracer whole body were obtained.
Findings: There is significantly improved low-level uptake involving the cervical and thoracic spine
compatible with improved osseous metastases. Osseous metastases identified elsewhere on the prior
scan are no longer visible. Physiologic uptake is present in the kidneys and urinary bladder. Previously
identified bilateral hydroureteronephrosis has resolved.
IMPRESSION:
1. Significant interval improvement. There are a few remaining spinal metastases with improved low
level uptake. The remainder of the osseous metastases have resolved. No new metastasis.
2. Previously identified bilateral hydroureteronephrosis has resolved.
Electronically signed by: Timothy Zelenak MD 7/20/2022 2:00 PM CDT Workstation: 109-1357

Total PSA

My Diet And Exercise Program?

Disclaimer:I'm not promoting or recommending anything here. Just documenting what I did... And the results when combined with treatment described above.

If you are reading this you can make your own decisions on what is best for you.

There is lots of links to web site information I read to learn about my diagnosis and studies that present findings for diet, exercise used with treatment.

According to my spell checker "salady" is word I made up.
It is up to the reader to learn and make educated decision on what is best for their individual benefit.

My Diet And Exercise Program

Salad based meals and lots of green tea.
Started making Kombucha from green tea in July 2021
I also started ferment some of the Kombucha to help take the edge off. Yes, I did do this. (good place for another disclaimer)
Walking and light jogging to rattle my bones for bone and respiratory health. And any other benefit from light exercise.

Summer of 2021 I bought a lot of water melon, blueberries, red grapes, and strawberries, because they were in season. The fruit was about 50% of my diet. The rest being salady meals in the form of the best salads I knew how to make, and salad wraps, that I make. Salady meals is just uncooked raw mix of whatever tastes good and you can feel satisfied with calling it at least a partial meal. Something you can keep up on a regular basis.
Winter I kept with the salady meals as much as I could bear, and made a lot of vegetable soup from scratch. Seasonal ingredients.

Links to external web pages as further reading

Diagnosed with Stage 4 Metastatic Prostate Cancer May 5 2021

Documented here so I can better guide my progress based on results, and hope it will be of benefit to others.

My Diet And Exercise Program?

If you are reading this you can make your own decisions on what is best for you.

There is lots of links to web site information I read to learn about my diagnosis and studies that present findings for diet, exercise used with treatment.

My Diet And Exercise Program

Links to external web pages as further reading

-- Exercise

-- Cancer

-- Nutrition

-- Kombucha