January 16, 2010:

He who has promised is faithful. Recently in my devotions I read Hebrews 11, a chapter which is often referred to as the “hall of faith” since it lists so many Biblical characters in whose life faith played a major role. Abraham’s wife, Sarah, was one of them. She was old and barren yet God told her she would conceive a son, named Isaac. Hebrews 11:11 says “By faith, even Sarah herself received ability to conceive, even beyond the proper time of life, since she considered Him faithful who had promised.” I began to apply this verse to myself asking if I truly consider God to be faithful in what He has promised me and if so, what has God really promised to me over the last 7-8 years? First, I have trusted in James 5:14-15 and have been anointed with oil by my pastors and elders. It says that the prayer offered in faith would restore the one who is sick. Therefore some measure of faith is required by myself and the pastors/elders doing the anointing. Even Sarah had to show a measure of faith in considering God faithful to perform what He had promised. Do I believe God will “restore me”? I am not sure. If not at this point in my life, He eventually will “restore” me in heaven with a new body. Right now to me it all depends on the definition of “restore”. But at least at this point in time I can say with conviction that I believe that God will exert some positive effect on my prostate cancer. I must place my faith in this verse even though I may not be completely healed. Secondly, Jesus told me to “touch the hem of His garment”. What can I hold fast to from this statement when my PSA indicates I still have rapidly-multiplying prostate cells in my body? I know I will die of some biological cause, but I believe Jesus will control my disease in such a way that He Himself is glorified. When I touched His garment symbolically, He gave me power to live my life in such a way that He could be glorified When the woman in the Bible touched Him, power left Jesus. Third, when He told me to “show myself to the doctors”, I trust that God will maintain the ministry to physicians and researchers with which I believe He has entrusted me. Fourth, when Jesus recited (sang over me according to Zephaniah 3:17) the words to the hymn “Tis so Sweet to Trust in Jesus,” He was exhorting (singing over) me to just trust Him and the outcome would be glorifying to Himself and conforming to His will for my life. Lastly, He told me to “take up my bed and walk normally”. I take from this He is telling me not to be concerned about my disease but live my life in every way as if the disease were not present. He will control the outcome of the cancer at the right time. This may not mean a total medical healing or cure but a prognosis that would illustrate God’s control over my body in a way that is glorifying to Himself and to Jesus.

These are the promises in which I must put my faith: that He will control my disease in such a way that brings glory to God and Christ. In trusting God, I must trust in His characteristics. He is loving, all-knowing and wise, merciful, always truthful, wanting the absolute best for His children, perfectly just and fair and faithful.

January 20th, 2010:

When our dreams and hopes are shattered, how do we react? Consider Joseph. He was Jacob’s favorite son yet he was sold into slavery by his brothers and eventually was cast into prison in Egypt before rising to a high position. Joseph could have given in to self-pity and anger against God but he didn’t. Instead God’s activity and character were seen through Joseph. The Lord led Joseph to a calling he could never have imagined. For many of us, cancer is an event that could shatter our lives. It could lead us to anger, self-pity and frustration. But we, like Joseph, can also choose to allow God to redirect us knowing that He Himself has allowed this to happen. Our church has been studying Psalm 139 which can be broken down into the following themes.

a) God knows what is going on (vs. 1-6);

b) God is here in this situation (vs. 7-12);

c) God has the power to handle any situation (vs. 13-16);

d) God will take care of us individually (vs. 16-18);

e) God can deliver me from all attacks (v. 19); and,

f) God wants us to yield our heart to Him entirely (vs. 23-24).

February 19th, 2010:

God’s ultimate goal. John chapter 11 recounts the story of Jesus raising his friend Lazarus from the dead. In verse 4, Jesus informs the local Jews and Lazarus’ sisters (Mary and Martha) that his sickness was not unto death but “for the glory of God, that the Son of God may be glorified by it.” Jesus had also delayed coming to see Lazarus for two days, meanwhile Lazarus had died. As cancer patients, we have needs which we desperately want God to meet. But often, God waits so He can work in ways beyond our expectations. Meanwhile we are asked to maintain faith in God’s character, His nature and His promises to us. God does not just want to confirm our faith, He wants to increase it or perfect it. When our immediate needs are greater than our faith in God’s intervention, He may be trying to increase our faith in Him. In Lazarus’ case, Jesus’ late arrival was beyond the faith that Mary and Martha possessed. God sees the needs that we bring to Him but He also sees our need to grow in our faith. So when we feel desperate for God’s help, ask God for more faith in His Word, nature, character, love, promises and purposes and eventually witness that God will be glorified and our faith grows simultaneously.

February 23rd, 2010;

Focus on Christ’s nature and future plan instead of our circumstances.

We all go through doubts and fears. Can God heal me? Will He heal me? Will I die of this? How will this affect me? Why did God allow this to happen to me? Doubts and fears have to be replaced by a deep trust in God’s Word, His plan and His character. Disease can be used for the glory of God as in the case of Lazarus above.

“First, the promise of Christ’s return should make us steadfast in our faith. Have you ever asked yourself why your faith seems so strong one day and so weak the next? There may be many reasons for this-but often the cause is our tendency to be ruled by our circumstances or our emotions rather than by the truth of God’s Word. It’s easy to feel close to God when everything is going well. But what happens at the first sign of trouble? We become unsettled and filled with doubt, wondering if God has abandoned us and we fall back on our own wisdom and resources instead of His provision. But when we focus on Christ instead of our circumstances, when we remember that someday He will return and overcome all the things that alarm us, then our faith remains steadfast and strong.”

[Ref: John Akers, “Christ’s Second Coming: What Difference Should it Make?” in Decision Magazine, September, 2009, pp. 29-31.]

March 2nd, 2010:

Less fear, more trust and an excellent report. I had less fearful, irrational and negative thoughts than I had previously in the days prior to my 4-month PSA test. In fact, the day before my blood test, my pastor anointed me again with oil and prayed over me after our Sunday morning service. My latest PSA test taken Monday came back today as 0.03 ng/mL. When my urologist gave me the news, I could simply say “praise the name of Jesus”. This welcome report demonstrates that the androgen deprivation therapy (hormonal therapy e.g. Lupron) is still working. Will the physicians continue giving me Lupron or will they withdraw it temporarily giving me a “holiday” until the PSA starts to rise again? This is an open question. I am told that neither continuous administration of hormonal therapy or intermittent administration have been shown to extend life. But perhaps withholding therapy may minimize potentially harmful side effects such as those related to heart or bone fractures. It seems this is still an open question. In any event, my heart is very grateful and a burden lifted.

March 3rd, 2010:

We are our best physician. Several weeks ago, I had been contacted by a wife of a man in our church who had prostate cancer but was reluctant to discuss it with anyone outside of his family.

The 65-year old husband had been given brachytherapy (radioactive seed implants) by a local urologist but his PSA was now doubling every 2-3 months. I gave his wife as much advice as I could and urged them to seek a second opinion. Meanwhile, a bone scan revealed that the cancer had spread to several locations in the neck and pelvic areas. As it turns out, the husband had been experiencing a pain in his hip-pelvic area which he attributed to arthritis. Had he been aware that prostate cancer metastasizes to the bones in that area, he might have sought help sooner. But he chose to bear his disease in relative silence. The couple sought help at a branch of the Cancer Treatment Centers of America and are now following up locally with androgen deprivation (hormonal) and holistic therapies. This example demonstrates that being aware of the symptoms and progression of prostate cancer might have short-circuited this disease before it invaded bone.

We ourselves are truly our best physicians when it comes to diagnosing symptoms.

March 6th-7th, 2010:

The same message from two or more sources. I usually try to read 3-4 little devotionals daily, namely, In Touch from Charles Stanley, Today in the Word from the Moody Bible Institute Press, Our Daily Bread from RBC Ministries and Anchor from Haven Ministries. It is a rare occasion when the same theme message is communicated from virtually all of these sources. The theme I received these days was to trust God’s promises above the wisdom of man. One of my favorite verses is 1 Corinthians 2:4-5, where the apostle Paul states that his faith might not rest on men’s wisdom but on God’s power.” Otherwise stated, “my faith does not rest on the wisdom of man, it rests on the power of God.” One of the devotionals (Anchor) quoted Amy Carmichael, a missionary to India in the early 20th century. She said “when a word comes to us twice about the same time, it is for some special purpose. It helps and challenges us. What makes the help so vital is the belief that it did not just ‘happen’, but was planned by our tender Lord, who knows all about us.” We are to watch for these “doubled up” promises. God gave his promise twice to Abraham telling him God was to bless and multiply him. Likewise Today in the Word cited 1 Kings 18, where we read about Elijah taunting the prophets of Baal when the latter could not summon fire from heaven. Instead God sent fire upon wet timber in response to Elijah’s prayer. Again, Elijah did not rest on the wisdom of men but on the power of God. Finally In Touch discussed that many believers seek wisdom from spiritual books and messages, friends and pastors while often neglecting the greatest teacher of them all, the Holy Spirit as He interprets God’s Word. I have been blessed by receiving excellent care by several highly qualified physicians. But even they do not have all the answers to my specific physical needs. However, I know one who does, namely God Himself. He through the Holy Spirit will help me learn and grow and shed light on why God allows certain challenges in my life. When it comes to helping me to know God’s Word, no one is more qualified than His Spirit. “My faith doesn’t rest in the wisdom of man, it rests in the power of God.”

March 10th, 2010:

When we ask God “Why?” Why did I get this disease? Why are “good people” often stricken with sickness, weakness, pain?  We are all tempted to ask this question of God. One of my good friends named Jim suffered with multiple sclerosis for many years and eventually died of this disease. While he was bed-ridden, he told me he wanted to ask God why he was given this disease. But after he thought for a minute, he would say, “God will just tell me ‘why not’?” Jim testimony has always meant a lot to me. He attended my wedding delivered by ambulance on a hospital bed. Job asked God “why?’ and God’s answer in Job 38:4 was Job, “where were you when I laid the earth’s foundation?” We cannot command God to stoop to our demands and give an account of Himself. But we can bring our pain and our problems before Him in submission to His perfect plan. God doesn’t promise answers but He does promise His unending love, compassion, faithfulness, mercy, salvation and eternal life. We must continue to trust Him as stated in Psalm 112:6-7. “Surely he will never be shaken; a righteous man will be remembered forever. He will have no fear of bad news; his heart is steadfast, trusting in the Lord.”

Friday, March 12th, 2010:

Effects of hormonal therapy on bone, new treatments under development, vitamin D, calcium and nutraceuticals. As I have stated before, one of the side effects of ADT or hormonal therapy is the possibility of fractures and bone loss (osteopenia or osteoporosis.) Therefore it is advisable to have a bone density Dexa scan every two years to check on one’s bone density in the hip, spine and forearm. My bone density had been normal in 2006 and 2008 but in 2010, they found a decrease in bone density in my lumbar spine and left hip. It was not enough to classify me as having osteoporosis but instead osteopenia, a lesser form. The bone density decrease can come from the administration of Lupron or bone metastases. I hope it is not the latter but I’ll find out on Monday when I see my urologist. For people like me there is a new alternative to the usual bisphosphonates like Fosamax, that is a new antibody called Denosumab, developed by Amgen.

Denosumab is a synthetic antibody that inhibits a protein the body uses to break down old bone. The protein is part of a natural replenishing process, but too much of it can lead to osteoporosis. Cancer also has an insidious way of stimulating production of the protein to facilitate its attack. A recent review in the National Cancer Bulletin, (Sept. 8th, 2009; Vol. 6, No. 17) described denosumab as follows.

Treatment with the monoclonal antibody  denosumab increased bone mineral density (BMD) and reduced the risk of fractures in men who received a common treatment for prostate cancer that had not spread to other parts of the body, according to the results of a large, placebo-controlled clinical trial. The findings appeared in the August 20, 2009 New England Journal of Medicine.

The Hormone Ablation Bone Loss (HALT) trial included nearly 1,500 men with non-metastatic prostate cancer who were undergoing androgen deprivation therapy, a treatment that can increase the risk of bone fractures. The trial showed that two injections of denosumab, one every 6 months, increased BMD in the lumbar spine (the lower back) by 5.6 percent, whereas men who were randomized to receive a placebo experienced a 1 percent decrease in BMD in the same region. Denosumab also increased bone density in other areas, including the neck and hip.

“The beneficial effects in the denosumab group appeared robust, as they were found as early as 1 month after therapy was begun and were sustained for 3 years,” wrote lead investigator Dr. Matthew R. Smith of Massachusetts General Hospital and his colleagues. The rates of adverse events were similar between the two treatment groups.

Denosumab is the first drug developed that targets a molecule called RANKL, which spurs the activity of cells called osteoclasts that break down bone. It works in a different way than several other classes of drugs, including bisphosphonates, that are currently used to treat osteoporosis and bone loss.

Publication of the trial results coincided with a meeting of an FDA advisory committee to consider whether denosumab should be approved by the agency for several indications. The committee voted in favor of an approval for denosumab for the treatment of bone loss in men receiving androgen deprivation therapy for nonmetastatic prostate cancer but against its use for bone loss prevention, due to the potential for the small, increased risk of certain infections, including skin and urinary tract infections, seen in some clinical trials involving denosumab.

“Some patients undergoing androgen deprivation therapy may not develop enough loss of BMD to cause an increased risk of bone fracture,” explained Dr. James L. Gulley, of the Laboratory of Tumor Immunology and Biology in NCI’s Center for Cancer Research, who was a voting member on the FDA advisory committee. “And the general feeling of the committee was, until we get more safety data, let’s not recommend an indication for prevention of BMD loss,” he said.

New treatments: a) cabazitaxel: Once a cancer becomes resistant (refractory) to hormonal therapy, the standard treatment is with taxotere (docetaxel), a drug developed from the yew plant. It is in a class of compounds called the taxanes of which taxol is used in the treatment of  several cancers. Patients also become resistant to taxotere but a new experimental drug called cabazitaxel (also a taxane) has been found to extend survival for several months. (Reference: NCI Cancer Bulletin, March 9th, 2010, Vol. 7, No.5). It is being developed by U.S. Oncology.

b) Provenge: Provenge (otherwise known as sipuleucel-T)  has been discussed earlier (November 25th, 2009 entry). It has been developed by Dendreon and was approved by the FDA for treating metastatic prostate cancer. Provenge works by stimulating the immune system. It  is a vaccine consisting of autologous-antigen-presenting cells activated in vitro by the use of a recombinant fusion protein, prostate acid phosphatase (PAP)-GM-CSF). Provenge might eventually become the treatment if choice (replacing taxotere) once a cancer patient becomes refractory to hormonal therapy.

c) Nutraceuticals: Nutraceuticals are natural substances isolated or purified from food substances and used in a medical fashion. Several such as lycopene, vitamins D and E, selenium, green tea, and soy are the most promising for their roles in cancer prevention. But formal clinical trials are needed to validate such effects. Vitamin D is very important in maintaining calcium levels and bone metabolism. This is especially important when on hormonal therapy to minimize danger of fractures and bone loss. For vitamin D supplements, Vitamin D3 (cholecalciferol) is recommended over vitamin D2. Administration of 800-4000 IU per day has not shown toxicity. Personally, I take 4000 IU of Vitamin D3 daily and monitor my serum concentration of vitamin D using the 25-hydroxy assay. Thus it is important to maintain excellent levels of calcium and vitamin D.

d) Pomegranate: Pomegranate juice and extracts (rich in polyphenolic antioxidant compounds) has demonstrated an increase in PSA doubling time in men with recurrent prostate cancer. With respect to active ingredients, the seed, juice, fruit, peel, roots, bark, leaves, and flowers may all contribute. Many known anticancer compounds have been purified from the pomegranate plant, such as γ-tocopherol, catechins, anthocyanidins, flavols and flavones to name a few. A large double-blind, placebo-controlled trial is underway with two doses of pomegranate to hopefully strengthen the evidence for pomegranate juice in the treatment of prostate cancer recurrence. Unlike lycopene and other nutraceuticals, the role of pomegranate is being investigated with more poise in the form of a subsequent well-designed, placebo-controlled trial rather than a plethora of epidemiologic studies. Personally I take pomegranate juice and extract.

Reference: Nature Reviews Urology 7, 21-30 (January 2010). Nutraceuticals and prostate cancer prevention: a current review. Authors, Greg Trottier, Peter J. Boström, Nathan Lawrentschuk & Neil E. Fleshner.

March 15th, 2010:

Treatment update, side effects, new treatments, preventives. I had my 4-month appointment with my Florida urologist today. He is extremely sensitive and very knowledgeable and supportive. For a urologist who has a busy practice, he keeps up with recent developments fairly well. He is also well acquainted by name with the major researchers in the area of prostate health. Specifically in my case:

a) He was extremely pleased that my PSA was virtually zero (0.03 ng/mL). There was agreement that I should remain on hormonal therapy with Lupron every 4 months as opposed to the alternative of having periods with no Lupron (“holidays”). It seems that the “holidays” only serve to minimize the side effects of the Lupron therapy.

b) Since fractures, osteoporosis, etc. are side effects of hormonal therapy, I have bone density Dexa scans every two years as Medicare allows. My most recent one had shown some osteopenia or bone-density thinning in my lumbar spine; my left hip and forearm were still OK. We discussed the potential use of denosumab, a new antibody specifically approved for bone loss in men undergoing hormonal therapy.  But it was decided that it was too early to require this new treatment, plus we don’t know where we would get it as it is so new. Meanwhile we discussed the importance of vitamin D3 and calcium. I am currently taking 4000 units of vitamin D3 and 1,600 mg or 1.6 grams of free calcium daily. My urologist agreed that was ideal. (Note I take Prosteon which is specifically ordered and includes calcium, vitamin D3 and other ingredients). He also highly recommended that I continue with muscle building exercise as I am doing at the YMCA. I will follow up with my endocrinologist who is my resident Florida expert on vitamin D, calcium and bone issues.

c) We briefly discussed potential treatments once one becomes resistant to hormonal therapy. This is something I don’t like to dwell on. My urologist recommended standard casodex treatment as a follow up. But we discussed other alternatives such as Provenge (newly approved) or using keotconazole and leukine to continue the hormonal blockade. My urologist concluded that it was much too early to discuss these options.

d) We discussed the review I gave him about immuno-modulating treatments such as Provenge currently under development for prostate cancer. I mentioned that the major problem seems to be inhibiting the mechanisms that cancer cells have of suppressing our own immune systems. In designing such therapies, a double-pronged approach is needed, stimulate our immune mechanisms while inhibiting those of the cancer cells. Fortunately there is a lot of research in this area. One such review was just published. It’s lead author was Dr. Johannes Vieweg, who happens to be an endowed chair professor of urology and oncology at Shands Hospital in Gainesville. My urologist labeled him as “brilliant”. It is helpful to have access to such good medical help in Tampa (Moffitt) and Gainesville (UF). Hope they are not needed.

e) We discussed nutraceuticals and their use. My urologist agreed that pomegranate pills and concentrate was good (the juice as too many calories). He also mentioned that flaxseed and soy were useful. I gave him the review article I had received.

April 5th, 2010:

Why did Jesus heal people when He was on earth and why do (don’t) healings occur today? It is very natural for us who are stricken with any disease to pray that God would heal us. We know that instantaneous divine healings are rare although they certainly occur. When Jesus walked the earth, He healed multitudes of people from diverse diseases. We also know that Jesus is the same, yesterday, today and forever. So why did He heal so many 2000 years ago and why do fewer healings occur today? The answer is found in Luke 5:17-26. A group of friends had just lowered a paralyzed man through a hole in the roof so that Jesus could heal him. Jesus’ first words to them were that the man’s sins were forgiven him. This angered the Pharisees since they believed that only God could forgive sins, to which Jesus answered which was harder, to forgive sin or to make the man walk? Jesus then told the man to pick up his stretcher and walk home. The reason Jesus gave for saying this is found in Luke 5:24, where Jesus clearly says “in order that you (Pharisee witnesses) know that the Son of Man (Jesus) has authority on earth to forgive sins”, He healed the man. It seems clear that Jesus performed the healing to demonstrate that He was indeed God in the flesh, and had the authority of God Himself. Jesus healed to set Himself apart from strictly human “healers” or prophets and demonstrate Himself to be part of the Godhead. This could possibly explain why one sees many healings today in more remote areas where there are few methods such as printed Bibles, television etc. by which the divinity of Jesus is proclaimed. It would also explain why fewer such manifestations are seen in developed countries where the proclamation of the gospel is abundant. We can also adapt this to our individual situations. God (Jesus) may choose to heal us in order to demonstrate to witnesses such as medical personnel and others that Jesus is truly God in the flesh and that He has power to forgive their sins today as well. Therefore, we should always be ready to allow God to use our disease to glorify Him in any way He chooses.

A superb resource. I recently subscribed on-line to the Johns Hopkins Hospital prostate cancer resources, specifically a 116-page manuscript entitled “Advanced Prostate Cancer Treatments: Knowing your Options When Your Cancer Comes Back.” It costs $49 and contains specific sections on hormonal therapy, chemotherapy, radiation, etc. as written by the expert urologists, surgeons and oncologists from Johns Hopkins. I heartily recommend it. Go to www.HopkinsReport.com/prostate.

April 18th, 2010:

“Do not be afraid.” The Gospels list some 125 Christ-issued imperatives. Of these, 21 urge us to “not be afraid” or “not fear” or “have courage” or “take heart” or “be of good cheer.” The second most common command, to love God and neighbor, appears on only eight occasions. If quantity is any indicator, Jesus takes our fears seriously. The one statement He made more than any other was this: ‘don’t be afraid.’” (By Max Lucado as quoted in James Robison’s weekly Words of  Life e mail devotional.)

April 22nd, 2010:

A tale of two patients. “Be strong in the Lord, in the strength of His might.” (Ephesians 6:10). Charles Stanley’s In Touch daily devotional for April 22nd cites the following. “People can have very different reactions to similar circumstances. For instance, suppose two women, Jean and Barbara, from the same church are battling cancer. Both are believers, but only Jean is living peacefully, even joyfully through her ordeal-she long ago admitted her weakness and need for the Lord’s intervention. While Barbara prays for God to ‘help me get through this,’ Jean says ‘God I cannot; please carry me through.’ Jean knows that Jesus Christ is the source of her strength, but Barbara is relying mostly upon herself. Everyone has a certain amount of fortitude, but that human capacity can carry a person only so far. Some situations will sap every drop of energy we have and still demand more. Through the Holy Spirit, believers can access an endless well of supernatural power to triumph in any trial. However, the second woman is not receiving the same infusion of the Spirit’s power as Jean. Barbara wants help – which is why she desperately calls out to the Lord – but refuses to admit that she cannot fight cancer alone. In truth, we all dislike acknowledging that we are weak. Human pride is a potent force that must be uprooted before we can be filled with the Spirit’s power. Our weakness frees God to make His greatest triumphs. His power is loosed when His children admit they are not in control and can do nothing to help themselves. Only then do we find the energy, courage and peace we need to go on living for His glory.”

April 27th, 2010:

Approval of the first immune-system-boosting prostate cancer drug; Dendreon’s Provenge. Buying time. Dendreon’s application to bring the country’s first cancer-treatment vaccine to market has been approved by the Food and Drug Administration. The treatment’s benefits are modest. But as the first product of its type to emerge from decades of often-frustrating research, Provenge could help open doors for immune-based therapies against a range of cancers. Analysts estimate a course of Provenge will cost between $50,000 and $75,000. While the projected price of Provenge seems very high, it’s not out of line with other new cancer treatments. Prostate cancer mostly strikes older men, and Medicare covers all FDA-approved drugs. Insurance companies usually follow suit.  As many as 100,000 men a year develop the advanced form of prostate cancer the treatment would initially be prescribed for. Dendreon’s case rests largely on a study of more than 500 men with an advanced form of prostate cancer that spread to other parts of their bodies. Of the men who got Provenge, nearly a third were still alive in three years, compared with less than a quarter of those who got placebos. The vaccine boosted median survival time by 4 months, from 22 months in the placebo group to 26 months in the Provenge group. Vaccine developers attempt to train the immune system to respond to protein targets, called antigens, on the surface of cancer cells. The Dendreon vaccine incorporates an immune-booster to help kick the system into overdrive. The Provenge target is an antigen called PAP, which studs the surface of prostate-cancer cells. Each dose of vaccine is personalized, making the production process a laborious one. It starts with a three-hour, dialysis-like procedure that plucks from the patient’s blood potent immune cells, including the dendritic cells, immune cells that serve as messengers to stimulate other immune cells to “attack”. The cells are then “steeped” for several days in a broth rich with the PAP antigens. When they come in contact with the antigens, the dendritic and other immune cells jolt into action. They gobble up the PAP proteins and embed some of them into their own surface membranes, like warning flags. The activated immune cells are infused back into the patient in three doses, spread over a month. Once back on their home turf, they act as sentries to transmit the danger signal to T-cells, the combat troops of immunity. Relentless as terminators, the T-cells search out and destroy their target: the prostate cancer. In spite of this optimism, the outcomes in the Provenge study were far from perfect. Many of the men died from their cancer. Cancer-vaccine studies have focused mainly on the sickest patients — those whose disease has metastasized and resisted other treatments. But the real power of immune therapy may lie in treating relatively healthy people whose tumors have been cut out or knocked into remission by radiation or chemotherapy. While they may appear free of disease, a few stray cells can be enough to cause a relapse years down the road. Cancer vaccines are, in theory, ideally suited to perform mop-up duty. Trials to test that prospect are already under way with Provenge and other vaccines. But studies that measure long-term survival can take five to 10 years to reach conclusions.

May 10th, 2010:

Other factors to be considered when undergoing hormonal therapy. The Johns Hopkins Hospital in Baltimore publishes numerous pamphlets available on-line which deal with specific medical conditions. These can be found as “Johns Hopkins Health Alerts”; the e mail address being “johnshopkins@johnshopkinshealthalerts.com. From the Johns Hopkins Prostate Library, I ordered the publication entitled “Advanced Prostate Cancer Treatments” comprised of several chapters written by the Johns Hopkins team of excellent urologists and oncologists. I recommend this resource very highly. Upon reading the chapter on hormonal therapy, I learned about several important potential side effects and how to monitor for them.  For example, anemia is common among newly diagnosed prostate cancer patients with metastatic disease— approximately one-fourth of these men are anemic. Therefore, I should have my hemoglobin levels checked periodically when I have routine blood screening done. In addition, kidney functioning and potential diabetic problems should be monitored by blood screening for creatinine and glucose metabolism respectively. Vitamin D, whose importance is expanding with new studies, should be measured using the 25-hydroxyvitamin D blood test. I also plan to suggest to my Florida urologist that a bone scan be performed. The Hopkins group recommends this every six months and for me, it has been much longer since my last bone scan. We as patients, play a huge role in coordinating our treatment and bettering our condition.

May 13th, 2010:

A new medical study on intermittent hormonal therapy and its implications; but Jesus is never late. Prostate cancer patients like myself who are on hormonal therapy are given occasional “holidays” which are periods of time when the drugs such as Lupron are not administered. There is therefore no therapy being given during these “holidays” this allowing the existing prostate cancer cells affected by Lupron to multiply uncontrolled. This is called intermittent androgen deprivation therapy (ADT). A report was recently published in ProstateCancerInfoLink.net (May 9th, 2010) that addressed the length of time it takes from when the Lupron is stopped to when the PSA reappears and begins to increase from its undetectable value. The study concluded that the length of the first time-period off androgen deprivation therapy (ADT), namely the length of the “holiday”, may correlate with time to onset of castration-resistant prostate cancer (CRPC) and prostate cancer-specific mortality. In other words, the shorter the “holiday” period, there seems to be an increased risk of the cancer becoming resistant to hormonal therapy and subsequent time to death due to the cancer. The conclusion was that, “In patients who completed the first cycle of intermittent ADT, a duration of the first off-treatment interval of equal or less than 40 weeks defines a subset of patients at higher risk of CRPC and death. Conversely, patients with an off-treatment interval of  greater than 40 weeks have a significantly better long-term prognosis.” In other words, if your “holiday” is 40 weeks or less before the PSA reappears, you are at increased risk of becoming resistant to the hormonal therapy (castration-resistant prostate cancer, CRPC) and subsequent death. In my case, my first “holiday” lasted 10 months or 40 weeks. So I am on the borderline in this study.  I started to get discouraged again. I had to sincerely ask Jesus “didn’t he assure me so many times of His direct involvement in my cancer by whatever means He thinks best”? But when I look at my own prognosis, it seems no different from that of any cancer patient with whom God is not involved. So what can I expect? Within moments, the answer came. Remember Jesus’ friend Lazarus had been dead for three days before Jesus finally showed up and delivered him. At first, Lazarus’ family and friends said “if only Jesus had come sooner”. But Jesus waited for three days after Lazarus died. The bottom line is that I do not know how Jesus will address my prostate cancer, but I know He will and I do know Jesus is never late!!!!!!

May 14th, 2010:

True trust in God stays even when he is silent. We have all experienced times when God speaks to us very directly but then His Spirit is quiet for a period of time. As we see from the story of Lazarus earlier, just because God is quiet doesn’t mean He is not at work. Oswald Chambers (who wrote My Utmost for His Highest) states that God’s “silence is the sign that He is bringing you into a marvelous understanding of Himself….If God has given you a silence, praise Him. He is bringing you into the great run of His purposes”. We can trust our loving Lord, even when he is silent. “God is waiting in the silence for a heart that He can fill; He must find it cleansed and empty, with a spirit calm and still.” (From the Daily Bread, RBC Ministries, 5/14/2010). It should also be noted specially that not all life-threatening diseases are to end in death. Consider what Jesus said in John 11:4 about Lazarus’ whose death was not even permanent but was for the glorification of Jesus. This can apply to our diseases as well. The plan belongs to God Himself.

May 17th, 2010:

My wife and I are planning a 2-3 week trip to see our family and friends in Maryland in late June-early July. I am due for my next PSA test and Lupron treatment in early July. The major players in my treatment include my Florida urologist, my oncologist at Moffitt Cancer Center and my surgeon-urologist at Johns Hopkins. Since we are going to Maryland, I am trying to coordinate my upcoming PSA test in such a way that I can arrange to see the Johns Hopkins physician while in Maryland. Therefore, I will be getting the evaluation and advice of all three physicians at the same time period. As the thought of my upcoming PSA test and subsequent evaluations approached, I found myself getting tight in the stomach and, in general, a mood of nervous apprehension began to creep over me. The usual fears began to envelope me as they had in the past. I was about to spend some time in reading my Bible devotions this morning and asked God specifically for a word from Him. His answer only took a few moments. Dr. Charles Stanley’s In Touch devotional for today cited 2 Corinthians 1:8-11. In this passage, the apostle Paul mentions an “affliction” which came to him and his colleagues where they “were burdened excessively, beyond our strength, so that we despaired even of life; indeed, we had the sentence of death within ourselves” (is this not the case with cancer patients?) “in order that we should not trust in ourselves, but in God who raises the dead; who delivered us from so great a peril of death and will deliver us, He on whom we have set our hope. And He will yet deliver us.” I could immediately relate to despairing of life, having a “sentence of death” within myself; but then the glorious truth shone through the fear, like sunshine piercing the fog. I should not trust in myself (or just physicians as brilliant as they might be) but trust God for His deliverance in whatever form it may be. In verse 11, Paul also acknowledges the prayers of fellow Christians with thanks to them for helping bestow God’s favor on their afflictions. As Charles Stanley writes, “we understand divine power when we reach the limits of our own strength and feel God’s supernatural energy kick in.” God’s strength is available to all believers who confess their weakness and inadequacy. We have to “throw ourselves upon God and wait for Him to keep His promise.”

May 23rd, 2010:

Strength for the fearful; an anchor in turbulent times. Charles Stanley’s In Touch devotional has been focusing on coping with fears and anxiety. The main verse cited is Isaiah 41:10, “Do not fear, for I am with you; do not anxiously look about you, for I am your God. I will strengthen you, surely I will help you. Surely I will uphold you with My righteous right hand.” In this verse, God promises strength, help and protection. God commands us not to fear or to look anxiously about us. One of Satan’s traps is that of distraction. He knows that fear can choke faith. He wants us to focus on our unsettling circumstances. Once our attention is diverted from God, natural human tendencies take over. The remedy to dispel anxiety and doubt is prayer and worship. “Staying focused on God can be hard. The flesh prefers to seek security by thinking through the possible angles: our tendency is to weigh what we think could happen against what “experts” say will happen and then to evaluate possible ways of preventing our worst fears from coming true. Instead of becoming more confident, we begin to realize how powerless we are. Thankfully we serve an almighty God who says “surely I will help you. We can count on Him. When we focus on our circumstances, we’re actually choosing to feel anxiety and doubt. But these emotions don’t belong in a Christian believer’s daily life. Instead we should decide to trust in the promises God has given us. He’s filled His Word with scriptural anchors to keep His children steady in the faith.” (Charles Stanley, In Touch, May 20th, 2010, p.41).

July 1st, 2010:

A warm, honest and meaningful discussion of spiritual issues with my Johns Hopkins urologist-surgeon. Marie and I had driven to Maryland to visit friends, grandchildren and other family members. Since I was to be in the Baltimore area, I scheduled an appointment with my original (1995) surgeon-urologist at Johns Hopkins. I did not have any current PSA data to share but simply wanted to gain his advice on my current disease status and prospects for future treatment. En route to Baltimore, I had prayed that somehow God would anoint my appointment but I had no idea how truly uplifting and gratifying it would be. Upon entering the waiting area of the urology outpatient center, I was greeted at 11:15 by my physician as if I were his only patient that morning. His first words to me were “how’s your website coming?” This initial question was the prelude to 45 minutes of eye-to-eye, honest and open discussion of mutual spiritual issues and opinions. Our discussion included topics such as why my disease had recurred after such initial positive surgery in 1995. Though my urologist is a devout Catholic, we both agreed that in my case my cancer likely recurred in order that God be revealed and glorified in some fashion. My physician knew the story of the blind man brought to Jesus and the subsequent questions regarding whether his sin or those of his parents had led to his blindness. Jesus’ answer was that the glory of God be manifested in him. I was also asked how I came to know God personally through Jesus and was able to share my personal testimony clearly starting with my Lutheran upbringing. We both exchanged comments, questions and answers in a very respectful exchange of opinions. It was extremely warm and genuine. He seemed very interested in my website sections dealing with lessons learned from prostate cancer and spiritual Biblical medicines. I was able to share several of the lessons I have learned including that our lives should focus on people, relationships and activities which have eternal significance. I also shared significant Bible verses which had spoken to me. My physician also shared various opinions and quotes from several Catholic writers and theologians. We found several areas of common agreement. In all my years, I had rarely had such a frank and open discussion of my faith in Christ with anyone, let alone a much-respected Hopkins surgeon. Regarding my cancer, we only discussed it for five minutes or so out of a 45-minute session. He told me that I seemed to respond to the Lupron hormonal therapy very well and he predicted I would live for a good many years. He also stated that if my PSA remained undetectable for a period of a year, I could be given a Lupron “holiday” until my PSA began to rise again. He also mentioned that bone scans were unnecessary unless the PSA begins to rise. When we ended our appointment at noon, I thanked him very genuinely and sincerely for his interest in my case both from medical, spiritual and personal perspectives. Such physicians are rarely encountered these days and I thoroughly enjoy my on-going relationship with this Johns Hopkins urologist and surgeon. He asked me to send my website as soon as it is launched.

July 12th-13th, 2010:

My journey of faith continues; 4-month PSA test and follow-up; Tomorrow, I have to get my latest PSA value. I am not nearly as anxious as I have been in the past. While I do acknowledge that one day, the PSA will start to rise even when I am on hormonal therapy and I will then become hormone-refractory, I tell myself that I am totally trusting God’s schedule, treatment and His ultimate control of my situation. I have no other recourse. “Lord, I believe; help my unbelief.”

On the way to give my blood for the test, I read some of the Biblical passages I have come to call my “scriptural medicines”. The following day, my Florida urologist told me that my PSA was again undetectable (less than 0.02 ng/mL). My prayer of thanks was very sincere to say the least. I didn’t want to be like the ten lepers Jesus had healed, where only one returned to thank Him. My pastor called to say he thoroughly “enjoys witnessing my journey of faith”. Upon visiting my urologist for my 4-month Lupron shot, he gave the impression that he was somewhat surprised that my PSA remained so low. We spoke about his recent trip to Israel and he told me that if I wanted to take such a trip, I had better do it before I would need a wheelchair since so much climbing and stooping is involved. It made me feel uncomfortable as if he was soon expecting a deterioration in my case. My faith doesn’t rest in the wisdom of man, it rests in the power of God. I also shared my website contents with him and he seemed somewhat interested. In fact, my Hopkins urologist had sent him some comments from my July 1st appointment in Baltimore and his comments focused mainly on my website which seems to be generating considerable interest in the medical community. I will be meeting with my oncologist at Moffitt Cancer Center this week and intend to share it with him as well. I believe God has instructed me to assemble the website and will use it for His glory. As of today, I have 4 months of life until the next test in November. I plan to make them count. Marie and I will be leaving for Norway on July 27th to see my extended family and friends, several of which also have prostate cancer. I am grateful for every day when I can wake up with no pain and maintain a normal if not busy schedule. I am grateful that I have been given this “prostate ministry” to men.

On another front, I had been taking 4000 IU of vitamin D3 daily. My 25-hydroxy vitamin D blood test came back somewhat deficient (30 versus a desired level of 50). My family physician urged me to increase my daily intake by an additional 2,000 units daily. Apparently, vitamin D levels are being considered more important than ever before.

July 23rd, 2010:

Treatment and Vitamin D information from my visit to Moffitt Cancer Center. Today Marie and I met with my oncologist at Moffitt Cancer Center. He is probably the most knowledgeable physician I know regarding prostate cancer treatments. He always has time to answer all my questions and engage in cutting-edge scientific discussions. I have a rapidly-doubling PSA indicative of an aggressive cancer, which is being controlled by hormonal therapy. In light of this, I asked him specifically what he thought my long (or short) term prognosis would be. He said I could die of a number of conditions of which prostate cancer was a “small piece of the overall pie”. His response seemed to support the opinion of my Johns Hopkins urologist that I have a good number of years left; only God knows. We also discussed current and potential cancer treatments. In my case, if I ever became resistant to Lupron (hormone refractory), I would be treated with Casodex and ketoconazole. Casodex is not a steroid but works by blocking the cell’s receptor for hormones such as androgens, hence it works differently from Lupron which inhibits the production of testosterone in the testicles. (Technically, Leuprolide acetate or Lupron is a synthetic nonapeptide analog of naturally-occurring gonadotropin releasing hormone (GnRH or LH-RH. The analog possesses greater potency than the natural hormone). Ketoconazole is an oral broad-spectrum, anti-prostate cancer (PC) and anti-fungal agent that has testosterone lowering effects through its abilities to decrease both testicular and adrenal production of androgens by blocking various endocrine pathways. Other options would be diethylstilbestrol (DES).

As potential treatments, we discussed the potential availability of the newly-approved drug, Provenge. Its availability is limited by its manufacturer’s lack of production facilities. There is also now doubt as to whether or not Medicare would pay for the $90,000 or so price tag for the 3-step treatment. It is sad but understandable that a treatment than can extend life has to be so limited in its use.

Vitamin D3 and prostate cancer; a connection? We also discussed the need to maintain adequate vitamin D levels to combat the side effects of osteoporosis or osteopenia which accompany hormonal therapy. Vitamin D is involved in the body’s regulation of calcium. Vitamin D also modulates neuromuscular function, reduces inflammation, and influences the action of many genes that regulates proliferation , differentiation and apoptosis (death) of cells. I had been taking 4000 units of Vitamin D3 (cholecalciferol) daily which still was insufficient in providing the desired blood levels. I was advised to raise it to 6000 units daily. Since Vitamin D is a fat-soluble vitamin and has slight potential for liver toxicity, my oncologist informed me that 6000 daily units was fine. The body tolerates vitamin D much better that it does vitamin A.

One of my former colleagues at the National Cancer Institute was researching vitamin D and prostate cancer in the 1990’s so the idea of a connection between vitamin D and cancer was buried in the back of my mind. On-line, I found an interesting website at http://www.vitamindcouncil.org/cancerProstate.shtml. The site contained a comprehensive review of Vitamin D and prostate cancer. It included a presentation by researchers from the University of Toronto (presented at a National Institutes of Health symposium in November, 2004) wherein they reported that taking 2,000 units daily of vitamin D3 either “reduced or prevented further increases in PSA in the majority of men with advancing cancer.” No physician with the exception of my Moffitt oncologist was aware of this vitamin D connection. I plan to inquire further and continue my vitamin D3 regimen. There may be a bigger picture here.

Lastly, I shared the overall contents of my website with my oncologist. While we did not discuss spiritual issues in any detail, he did seem somewhat interested and commented that he could see its utility for other prostate cancer patients. He advised me to place a counter on the website so that I could verify the number of “hits”.

August 22nd, 2010:

Prayers that go un-answered; God’s tests. It has been several weeks since I have given much thought to prostate cancer. My wife and I first spent two wonderful weeks visiting friends and family in Maryland followed by a beautiful, 3-week trip to Norway to see most of my family. While in Norway I encountered several family members and friends who either had prostate cancer or had family members battling the disease. It reinforced the fact that Scandinavians in general have a higher incidence of prostate cancer. This may be due either to genetic factors or to a lesser degree that they get less sunlight and hence make less Vitamin D. But while we were away, I read a timely article which addressed the question “God, why am I not receiving answers to my prayers about my cancer?” My former pastor in Long Island had often encouraged me using the Old Testament story of Joseph’s life as an example. Joseph endured many hardships while remaining true to his faith and relationship with God. In many instances, God withheld knowledge from Joseph as to the purpose of his trials and their overall goals and outcomes. Joseph was in prison, wrongly accused of a crime. He was losing some of his faith. He had even pleaded with another inmate (a cupbearer) to put in a good word for him with Pharaoh that Joseph might be set free. But to no avail. Joseph was so close to God that he could interpret dreams and mysteries. But why did he seem to lose faith? The answer is that Joseph (like us at times) was being tried by God’s Word. God knew He would deliver Joseph eventually and make him a powerful man in Egypt. But Joseph’s faith had to be tested in order to mature. Like Joseph, we can read God’s word and its inherent promises but until it is tested in us it will not mature and become living. Others have been there as well. The writer of Lamentations 3:8 (possibly Jeremiah) writes “even when I cry and call for help, He shuts out my prayer.” The truth is that each of God’s promises to us will rise up to test us unless we rest in God’s overall plan and timing. I have prayed many times about my cancer and I am sure we all have done the same. Often we have not seen specific evidence of answers. This does not mean that God has not heard us and will not respond to our situations. We must stand on every promise, praying fervently in faith. Then we must wait on God, trusting Him to do what is right in His time and in His way. This waiting may be a difficult matter but through it all, God will not leave us nor forsake us. The writer of Lamentations came to this realization later in chapter 3 (verses 21-26 and 31-32) when he wrote that God’s compassions fail not, they are “new every morning, ….great is thy faithfulness.” He continues “the Lord is good unto them that wait for Him, to the soul that seeks Him.” God has a purpose for everything He allows and for every difficult trial, He gives special grace.

August 23rd, 2010:

Why did God allow my hut to burn down? While we were vacationing with family in Norway, I received the following e mail which addresses the question of “why did God allow this condition to happen to me?
The only survivor of a shipwreck was washed up on a small, uninhabited island. He prayed feverishly for God to rescue him. Every day he scanned the horizon for help, but none seemed forthcoming. Exhausted, he eventually managed to build a little hut out of driftwood to protect himself from the elements, and to store his few possessions. One day, after scavenging for food, he arrived home to find his little hut in flames, with smoke rolling up to the sky. He felt the worst had happened, and everything was lost. He was stunned with disbelief, grief, and anger. He cried out, ‘God! How could you do this to me?’ Early the next day, he was awakened by the sound of a ship approaching the island! It had come to rescue him! ‘How did you know I was here?’ asked the weary man of his rescuers. ‘We saw your smoke signal,’ they replied.
The Moral of This Story: It’s easy to get discouraged when things are going bad, but we shouldn’t lose heart, because God is at work in our lives, even in the midst of our pain and suffering. Remember that the next time your little hut seems to be burning to the ground.  It just may be a smoke signal that summons the grace of God.

August 24th, 2010:

One of the best on-line references for up-to-date prostate cancer developments. I have found that there is one e mail newsletter that best provides weekly capsule commentaries of the latest developments in prostate cancer diagnosis, treatment and support. It is called AWARE-the Newsletter of ZERO- the Project to End Prostate Cancer. It is published nearly every week and available at info@zerocancer.org or by phone at (202) 463-9455. This e mail newsletter often contains summaries of recent journal articles that my physicians are ofren unaware of. I most highly recommend keeping up with it.

August 30th, 2010:

Responding to tough times (from In Touch by Dr. Charles Stanley). The text is Proverbs 3:5-6, namely “Trust in the Lord with all your heart, and do not lean on your own understanding. In all  your ways acknowledge Him and He will make your paths straight.” “Tough times have a way of separating the ‘wheat’ from the ‘chaff’. That is, when two people face similar dilemmas, one grows closer to God, bears spiritual fruit, and becomes more peaceful. The other, meanwhile, becomes anxious, bitter in spirit and full of secret doubts about the Lord’s faithfulness. The difference has to do with how each one responds to hardship.

We all know that hardship is part of life. Becoming a Christian does not change that fact (John 16:33). What shifts is our understanding of God’s sovereignty-nothing touches our lives unless He permits it. The Lord allowed a murderous king to pursue David for years (1 Sam. 23). But David the fugitive responded to adversity with faith and called God his stronghold and refuge (Psalm 59:16).

We are confronted with challenges for many reasons. God intends for them to grow our faith, change our perspective or deepen our compassion. Sometimes believers reach heaven before they understand why they’ve had to endure suffering. But whatever the trial or God’s intention for it, He is available to help us in our affliction (Psalm 46:1). We can turn toward Him for comfort, guidance and support. Or we can get angry and resentful that we are not being rescued from our shadowy valley (Psalm 23:4).

When affliction strips away every crutch, one has only the Lord to depend upon. Can you think of a better position to find yourself in than to be undergirded by our faithful and sovereign God? Though some people are destroyed by that kind of situation, others are built into stalwart believers.”

September 17th, 2010:

God may not answer our prayers immediately but He acts on behalf of those who wait for Him. Philippians 4:6-7 tells us to “be anxious for nothing”. Why are we often called to wait for answers to our prayers? A chief reason is that God may be teaching us to have total confidence in Him. How would we as believers ever learn faith if our every request was immediately fulfilled? We must learn the meaning of the words “trust Me.”  Rushing ahead of God amounts to saying “I don’t trust You.” Rushing ahead may also short-circuit God’s plan. God may also delay His answers until we achieve greater maturity. For example, David waited years to become king but when he did, he was wise and strong. (From Charles Stanley’s In Touch devotional (9/17/10).

October 15th, 2010:

New results on cancer therapies and a possible nutritional benefit (from the October 13th, 2010 issue of AWARE- the Newsletter of Zero, the Project to End Prostate Cancer.)

Abiraterone demonstrating good results as a potential third new treatment for prostate cancer. Until recently, only two treatments had been shown to prolong prostate cancer survival, Jevtana, a chemotherapy agent, and Provenge, a cancer vaccine. Now abiraterone has emerged as a potential third new treatment for prostate cancer. Abiraterone, being developed by Johnson & Johnson, extended survival by an average of 3.9 months among men with cancer that had spread beyond the prostate and for whom other treatments, including chemotherapy, had failed.  The abiraterone study involved 1,195 patients whose disease was considered “castration resistant,” meaning it had progressed despite surgery or drugs to shut down production of the androgen hormone, testosterone. Androgen hormones, particularly testosterone, fuel prostate tumors. Conventional hormone therapy blocks androgens produced by the testes. Abiraterone appears to target androgens also produced elsewhere, even by the tumors themselves.  Johnson & Johnson plans to file for new-drug approval in the U.S. and Europe by year-end, raising prospects that the drug could be on the market next year. It is hoped that such treatments will lead to much longer survival when studied in patients with early-stage disease. It is possible that by giving one treatment after the other, doctors will be able to extend life beyond what’s possible with one strategy alone.

Common Prostate Cancer Treatment Linked to Bone Decay. In another study of the risk of bone decay and fractures in men undergoing androgen deprivation (hormonal) therapy (ADT), Australian researchers found evidence that the men had structural decay of cortical (hard outer shell) and trabecular (spongy inner mesh) bone. Thus, ADT therapy results in micro-architectural decay and bone fragility. The researchers used a relatively new technology — high resolution peripheral quantitative CT imaging — that enabled them to take “virtual bone biopsies.”

This technology may eventually be useful in predicting fractures in patients.

Fish-filled Diet May Cut Prostate Cancer Mortality. A new review of the medical literature by researchers at Montreal’s McGill University Health Center, found that eating fish could reduce a man’s risk of dying from prostate cancer but may not protect men from developing the disease. The study findings “suggest that the number of men who die once diagnosed is lowered by more than 50 percent among men eating lots of fish.” By analyzing 31 separate studies involving hundreds of thousands of patients, the researchers “found no link between eating lots of fish and men’s risk of developing prostate cancer. But they did find that men who ate more fish were 44 percent less likely to develop metastatic prostate cancer, meaning disease that had spread beyond the prostate gland. Higher fish consumption also was associated with a 63 percent lower risk of dying from prostate cancer.” While it is not possible to say how much fish one would need to eat in order to get a protective effect, one can conclude that eating more fish can have some benefit. Fish may reduce prostate cancer mortality by reducing men’s likelihood of developing metastatic disease. The anti-inflammatory effect of fish oils could help fight cancer progression. Several previous studies have indicated that the omega-3 fatty acids in oily fish and fish oil supplements may slow cancer progression by reducing inflammation and by a variety of other mechanisms. The current study did not include fish oil supplements in its analysis.

November 15th-16th, 2010:

When our faith falters. James 1:5 tells us that God offers wisdom to anyone who asks. But He warns that if we doubt, our prayers may not be answered. At times, all of us struggle with some degree of doubt. Some of the reasons for our disbelief include: a) the fact that faith often defies human reasoning. For example, when in financial difficulty, logic says to save every penny. But on the other hand, God says He will bless the generous giver; b) feelings of fear which can often interfere with trusting Biblical truth; c) we often focus on our circumstance rather than on the workings of God’s hand (which we often may not be able to see or comprehend at the moment); and, d) uncertainty about God’s will can lead us to doubt Him. Such wavering faith has severe consequences; mixed blessings, lack of peace and joy, and a heart that is thrown off-course when difficulty arises. When our faith falters, we should pray with the man in Mark 9 who pleaded with Jesus to heal his son. Jesus answered that “all things were possible to him who believes”, to which the father replied, “I do believe; help my unbelief.” Jesus granted the man’s request. We should also ask the Lord to increase our faith by spending time reading God’s Word and meditating on His promises (see Spiritual Medicines).  Doubt may be common but God is patient and understanding. Faith comes from God so when doubt arises, ask Him to help you to believe. (From Charles Stanley’s In Touch devotional, November 4th, 2010).

Application to my PSA test. I have been on hormone deprivation therapy (specifically Lupron) for 4 years at this point. How much longer will it remain an effective treatment before the resistant prostate cancer cells become dominant? Today was my PSA test day prior to receiving another 4-month treatment dose. While I was apprehensive, just prior to entering the hospital to have my blood drawn, I consciously read the verses in the Spiritual Medicines section. I was particularly struck by the verse from Psalm 112:6-7 which says ” he will have no fear of bad news; his heart is steadfast, trusting in the Lord.” I thought “is bad news forthcoming? Will my PSA indicate that I had become refractory (resistant) to hormonal therapy?” The repercussions of this would be unpleasant to say the least. But many of the remaining scriptural medicine verses gave me a substantial measure of peace. I now await the result. Meanwhile, our church choir (who I accompany on synthesizer) sang a song yesterday entitled “My Life is in Your Hands” written by Kirk Franklin. The words say in part:

“You don’t have to worry, and  don’t you be afraid.  Joy comes in the morning, troubles they will pass away. For there’s a friend in Jesus who will wipe your tears away and if your heart is broken, just lift your hands and say. ‘With Jesus I can make it, I know that I can stand. No matter what may come my way, my life is in Your hands.'”  As I played this song with the choir, I had to ask myself if I really believed these words. I affirmed my belief and now await my PSA result.

The phone rang at 8 A.M. from my urologist informing me that my PSA was 0.02 ng/mL. My initial response was one of extreme disappointment because it was not undetectable and cells producing PSA must still be present. But on examining my past medical history (it’s a good idea to keep a table of specific test results), I noticed the PSA was the same value that it had been in July, 2010. The sensitivity of the PSA assay must have increased over the past years. A couple of years ago, one could not measure below 0.1 ng/mL. The fact that my PSA is still at this low value seems very encouraging to me. I will consult with my urologist next week for clarification. After some hours of disappointment, I now feel more elated. I wonder how our Lord must feel about me. I sometimes feel ashamed at my own lack of trust.

Thanksgiving Day, November 25th, 2010:

What am I thankful for this year? I have an increased sense of gratitude this year. As a dedicated list-maker, a short list of items for which I am especially grateful seems appropriate. Since prostate cancer (PC) is a focus of this website, I am especially grateful for continued suppression of my PSA for over four (4) years by the application of hormonal therapy. I can almost forget at times that I even have micro-metastatic but asymptomatic prostate cancer. Almost, but I can never quite forget it.  I am especially:

a) thankful to God that He has kept me at this stage for over 15 years since my initial diagnosis and surgery;

b) thankful that I have been allowed to assemble this website in an effort to encourage other PC patients;

c) thankful for Christ’s promise that regardless of any physical problems, whenever this life ends, I will live forever in God’s presence in a new heaven and a new earth with a new, fully-restored body;

d) thankful for over ten years of marriage to a loving and fully supportive and understanding wife with whom I can share everything in my life;

e) thankful for all the attentive and gifted physicians both in Maryland and Florida who help maintain my health status;

f) thankful that I can start each morning without pain in such pleasant, sunny, Florida surroundings accompanied by a multitude of friends whom I can truly count on; and,

g) thankful that I have a meaningful and fulfilling God-given plan for my retirement life.

December 2nd, 2010:

My current status, protecting against side effects, and new therapies. Today, I had my 6-month visit with my Florida oncologist at Moffitt Cancer Institute. I have been on hormonal therapy successfully for over 4 years.  My PSA is still extremely low at 0.02 ng/mL. For me the only issue is do I stay on my therapy with its diabetic, cardiac, colorectal and bone fracture side effects or do I take periodic ‘holidays” where I go off the medication until the PSA begins to rise? For now, the consensus seems to be to remain on the medication.  If/when hormonal therapy fails and I become resistant, another form of hormonal therapy consisting of ketoconazole and hydrocortisone would be recommended. To minimize side effects of osteoporosis, I am currently taking Boniva. But my oncologist recommended Denosumab (Prolia) administered twice a year as opposed to monthly for Boniva.  To preserve bone density, he also stated that Denosumab seemed to be better than Zometa or bisphosphonates such as Fosamax. He also mentioned that since I am non-symptomatic,  I would be an excellent candidate for the new immune-modulating therapeutic Provenge. However at a cost of $93,000, in reality, this therapy is not available to me in the state of Florida. He did however mention that there are two potentially useful treatments in advanced clinical trials which represent different modes of treating prostate cancer. They are Johnson and Johnson’s drug abiraterone and MDV3100 being developed by Medivation Inc. The hope for people like myself is to continue to remain chronic or “in remission” and allow new therapies to be developed and approved thereby gaining years of quality life. I thank God for researchers and physicians developing these therapies and couple that with the fact that “my faith does not rest in the wisdom of man, it rests in the power of God” (1 Corinthians 2:4-5).

December 12th, 201o:

Biblical healing: major points.  The following notes come from a sermon preached on December 12th, 2010 by Dr. Jim McCarty, 1st Baptist Church of Port Charlotte, Florida. It is an excellent summary of Biblical teaching especially in James 5:14-16 concerning healing of our diseases.  Pertinent Biblical references are provided in parentheses. Sickness is a sad reality in this life (Luke 8:43). But the Lord is a healing God (Exodus 15:26, Matthew 4:23). When we are sick, we are to seek the Lord first (2 Chronicles 16:12, Psalm 30:2). God will eventually heal all our diseases either in this earthly life or in the eternal life to come for His children (Psalm 103:2-4, Psalm 147:3).  His healing virtue can flow through us (Acts 9:34, 1 Corinthians 12:9). Faith is key to receiving healing (Matthew 19:20-22). When God’s children pray for healing, God the Father does answer. He will either answer “yes” or “not yet”. Our faith is trusting Him for His wisdom and purposes (Matthew 20:29-34, 2 Corinthians 12:8-9).

In reference to the teaching in James 5:14-16 on being anointed with oil by the elders of the church, “P.R.A.Y” is a convenient acronym to apply under these circumstances. Christians are to “P.R.A.Y.”  when they are sick. The “P” stands for “pray”. In verses 14-16, elders or Christian leaders pray in faith and for one another. This is a key to healing. The “R” stands for “repent”. While many sicknesses are not a result of active sin, risky lifestyles or habits (some sinful) may lead to illnesses. Verses 15-16 say that if we have sinned, we are to confess and repent of our sins and they will be forgiven. The”A” represents “appeal” to the elders or spiritually-mature members of the church to pray over us (see verse 14). The “Y”  represents that I am to “yield” my heart and will to the Lord. The prayer of faith is indeed a prayer of trust (verses 14-15).  In conclusion, Jesus’ prayer in Gethsemane as recorded in Matthew 26:36-45 is our model wherein Jesus prays “not my will but Thine be done”.  The prayer of faith is not us telling God what He will or must do, it is us trusting God for however He chooses to answer our petitions.

December 28th, 2010:

Does God still care? YES! A year-end assessment. At this time of the year, many of us look back to the events of 2010. Personally, I have many reasons to look back with gratitude, but from a health perspective, I can be very thankful that I continue to respond to therapy and have had negligible PSA values throughout 2010.  But for many of us, events might not be so positive. The writer of Psalm 77, Asaph,  “chronicles the lament of a person in distress who felt as if God no longer cared.” In verses 7-9 he writes, “Has His mercy ceased forever? Has His promise failed forevermore?” But in answer to this anguishing question, verse 11 counters “I will remember the works of the Lord; surely I will remember Your wonders of old.” Focusing on past blessings from God resulted in a renewal of trust and hope as stated in verse 14, “You are the God who does wonders; You have declared your strength among the peoples.” It might be useful for us to list the significant events of the past year including positive ones as well as disappointments. Then consider all the ways God has been with us. “Difficulties in our lives give us the opportunity to experience the faithfulness of God.” (From Our Daily Bread, December 28th, 2010, published by RBC Ministries, Grand Rapids, MI; see RBC Ministries-Our Daily Bread;