1985-2004
A ‘summary’ of a long but revealing period of time!
In 1985/86 I spent hundreds of hours in my car researching a French Autoroute Guide. I remember having the urge to void my bladder too often every day. My Amersham doctor explained that this was a symptom of the ‘prostate gland’. (I left him convinced he had said ‘prostrate’ gland; like most men that was all I knew about the thing!)
In 1989 I had the first of several urine ‘retentions’ (the inability to pass any urine at all; the answer was to have a catheter inserted). Always after a drug had been used, except once when I had drunk over half-a-bottle of Chianti red wine! The first drug was an anti-cholinergic medication, used as a pre-med for my detached retinas eye surgery. I found that out for myself months and months later. Another was an anti-histamine, promethazine hydrochloride, used in ‘Night Nurse’. The non-drug was excessive natural tyramine found in Chianti (in drug form tyramine is used in anti-depressive medications). I found out all the above myself! Whatever the causes my prostate gland closed tight too easily, stopping the bladder voiding. I made sure I knew all the foods/medicines that could cause problems – and to avoid them.
In 1993/94 I again spent hundreds of hours sitting in my car researching Mapaholics’ France. This time, without initially realising it – cutting down on fluid input to avoid constant voiding of urine – I must have had a series of infections in my bladder and prostate gland.
After an especially nasty infection in 1995 I was referred to an urologist at Warwick Hospital. I had, for my first ever PSA reading, a very high score of 29. However after a DRE (up the rectum!) the consultant concluded he had found no sign of cancer (in the ‘focus’ sample he had removed from the gland); and he made no mention of an enlarged prostate size.
Now, looking back, I conclude that my prostate gland ‘troubles’ probably first went nasty on me during 1985/86 and 1993/94: I reckon that was when the cancer started.
From 1995 to 1999 I saw the urologist every six months.. Some raised PSA scores were high, but always below the first 29; ‘prostatisis’ was the diagnosis each time. However, after passing a spot of blood in my urine in September 1999, I was given a cystoscopy; access to my bladder and prostate via the penis. Seven ‘samples’ were taken from the prostate, with just one showing signs of cancer; and a Gleason rating (the cancer’s aggressiveness) of 6 (not too aggressive). Now my prostate was reckoned to be about 140gms – the normal size for a man of my age was 40gms (early 60s).
I had already started delving into research material: on prostate cancer, treatments and diet. Zoladex was the initial drug prescribed – but after 13 months my gland had not reduced one iota in size. Normally the gland reduces by least half in 13 weeks.
So, alas, the reality of my health outlook was that I had a massive gland (which continued to grow!) – the size of the thing effectively prevented me from having all the radical treatments available to me: prostatectomy (removal of the gland), radiotherapy (even conformal – that was a blow), freezing, radioactive pellets; and, later, the remarkable HIFUS (high intensity focused ultrasound). Yes, I could have gone ahead – but with the 100% certainty of chronic morbidity, seriously prejudicing my quality of life.
I was stuck with Zoladex (and being a eunuch), replaced by Casodex after 15 months (less spiteful side-effects but still almost 100% castrated!). I started to see, in turn, an oncologist and urologist every three months. From 2000 to 2004 my PSA readings stayed low, from about 3 to 9 (the size of the prostate ensures higher readings compared with a normal-sized gland).
In 2002 I had my second-ever ultrasound; this showed a breach in the hardish capsule which surrounds the gland – but the medics decided that presented no problems. Note: prostate cancer does not kill if it is contained within the gland!
Now, with me looking back, and you about to read what followed in 2005 onwards, I conclude I was let down badly. As a matter of course patients should have six-monthly ultrasounds; and, in cases similar to mine, a cystoscopy every six months. To check what’s going on in the prostate gland.
Question: is it not amazing within a few weeks of the end of 2004 I was to discover that my prostate size was in excess of 160gms; that my gland was massively vascular; and that, right out of the blue (with PSA always under 10 since 1999), my Gleason score was a top pf the scale 9 (as aggressive as hell). Worst of all, the TURP operation to come was to release myriad nasty cancer cells into my body. Now read on.

Early January 2005
   Since I put the 'December 2004' (early in the month) notes up on the website there has been a worrying deterioration in my voiding. Daily voidings have risen to double figures; actual output, per voiding, has plummeted - usually not much more than 100ml; 220ml is an exception. Worse still, on more than a handful of nights, I couldn't pass any urine and I found myself sitting in three inches of hot bath water - relaxing the prostate - or, several times, taking an emergency Doralese tablet (at 20mg this acts like a tap full-on; better to 'try' to slice the thing into thirds; say 7mg each). I hadn't had to do this to pass water since 1998, my last Chianti-driven total retention saga - a catheter job in the end.
   In a further letter to my urologist I made a telling, controversial point - of interest to every GP. Read the 7th para in the 'Dec 2004' notes. If the last sentence is right then my prostate is growing significantly because, not only is there a 'lower amount of testosterone available' (remember only about 10% of the 'circulating' variety can be absorbed), but Casodex blocks off the stuff completely. So the gland works harder and harder for nowt. I'm sure you see what my conclusion is: no wonder then that my prostate must be even larger then the last ultrasound count at 140gm.
   Two days ago I asked my GP to prescribe Cardura (which my younger brother Keith uses with some success). Instead he prescribed Doxazosin. Doralese, plus the latter two, are all derived from 'prazosin hydrochloride' - an alpha-blocker to reduce blood pressure. (The notes with the pills say nothing at all about BPH!)
   I've elected to have 4mg capsules. To start with I cut a tablet into two: and took 2mg a time. I've taken one as I go to bed (to avoid the mid-nightly worries expressed earlier; and the other 2mg at about 6.00 a.m. - the start of the usual four-hour whoosh of passing water (a pattern with me for some years). No point in taking any more of the drug between lunch and evening meal time as my norm has always been to pass water at lunchtime, evening meal time and before going to bed.
   So far the results have been very pleasing. Two 200ml voidings during the night; and 3 to 4 from getting-up to lunchtime. You certainly realise it is a blood pressure drug. My blood pressure is/has been bog standard for yonks. My two-steps-at-a-time run up two floors to my flat will have to be watched: slight dizziness! Shame: that, several times a day, helps me to keep very fit. Maybe it will go. Likewise: you feel almost a laid-back 'malaise' after taking 2mg; maybe that will go in time.
   I must get my prostate size reduced - always my bête noire. So, I'm putting pressure on my oncologists to do the following:
      a) another ultrasound to determine my prostate size;
      b) a blood test for oestrogen and testosterone levels;
      c) to consider prescribing, as a guinea pig male, Anastrozole (a friend of mine, of the same age, had a recent mastectomy; then Tamoxifen which proved too onerous; and is about to use the newish drug).'New' here, in use five years ago at the Mayo Clinic (their detailed notes are an eye-opener; see what follows).
   Many cancer tumours (BPH too) grow in response to oestrogen. Anastrozole does better than just blocking oestrogen; it has an effect earlier in the chain of events by stopping the production of oestrogen (a BHP bonus too). The amount of oestrogen that the tumour is exposed to is reduced, limiting the growth of the tumour (for prostate cancer too). Can you fault my logic? If so please tell me.

February and March 2005
   The final two sentences above: no need to tell me; I solved the 'logic' myself! The answer was found in the Mayo Clinic notes: among the many side-effects are 'urinary difficulties' and 'increase in blood pressure'. Both an absolute no-no for prostates. Tamoxifen, in reality, is much too toxic and unpredictable for prostate cancer treatment.
   Anyway, all the events listed above in early January, came to a grinding halt on the 18th of that month: 'retention with overflow' forcing catheterisation. Read the chapter 'Prostate Problems' (click-on in the drop-down menu under the 'Author' button).

What now follows are the contents of three emails:

Email 1 to Dr. Desmond Tivy (11 Feb)
   Tuesday 1 Feb proved to be a bad day: the planned removal of the catheter. Plan A was to see if I'd manage on my own (I had taken Flomax for four days to prepare for that possibility). But no way: back to the hospital in under an hour, and after drinking plenty of water, to be re-catheterised. Back home once more, did some work, again drank plenty of water - but, no, no urine getting through even with the catheter! Back to the hospital in a real state; nowt quite like a vary full bladder unable to empty.
   I was then 'Dyna-rodded'. My word. What relief: water, plus gas, equals aerated water - which pushed everything in the bladder out. Litres of it into a vast beaker. The most stunning sight was the bottom two inches - like a blackcurrant 'soup': literally hundreds of small pieces of dark clotted blood - all caused by a catheter in just two weeks! (I had seen a few during the original catheterisation.) No wonder I couldn't pass anything with or without a catheter. I had been utterly clogged-up. This is called Prostate trauma.
   Since 1 Feb I have only seen two bags of light rosé urine ('bag' attached to my lower right leg); otherwise all light yellow. I'm drinking gallons of water. Plan B is now in motion. I'm paying to have a TURP on 3 March - to ensure the surgeon has plenty of time to be careful and skilful and to able to cauterise blood vessels. What is now certain is that I have an awfully 'vascular' prostate. BAD NEWS.
   The ultrasound I paid for at the end of Jan showed my prostate size at 160+gm. I've got to do something drastic as the prostate is pushing up into the bladder, the latter looking more like a Lac Léman shape. Maybe I should have given Floxmax another chance? One thing is certain: I didn't drink enough water after the first catheterisation (an out of hours emergency with a nurse doing the job); I continued with my normal daily input of about 1.7L fluid. Not enough: the hospital staff didn't ram it home as they did on 1 Feb (urology experts this time). I didn't stand a chance on my own on 1 Feb, after that sensational clogging-up over the period since 18 January.
   Finally, one odd sensation continues. I regularly get the urge to urinate, even with the catheter in place. I have to go to the toilet: often nothing comes down outside the catheter; but sometimes it's a teaspoon worth; and on other occasions as much as 50-100ml. For the latter if you don't get to the toilet in time you have a real mess on your hands. So, even with a catheter, I cannot be too far away from a toilet - just in case. So much for 'spasms' and 'Urgency'! (The latter two problems were still with me pre-Easter in March - when I put the set of three emails up on the website.)

Email to readers, friends and my family (9 March)
   Back home now after the TURP operation and all appears to be going well with the 'flow' (alas two litres voided during the night, every night).
   The immediate hours after the two-hour brought a very serious crisis. My 160gm vascular prostate (four times the normal size if blokes my age; now no more jokes about the Guinness Book of Records please Liz) and its wretchedly high number blood vessels proved to be real sod. Pints of 'heated' blood were needed (haemoglobin levels fell dramatically, by over 60%); also plasma; and, over 36 hours, 50 litres of saline were pushed though my bladder. Plus other things two; into various inlets into my body!
   A 'real sod'? That was a gross understatement.. Even now though I can see the funny side of some 'happenings': being tethered, dinghy-like, to eight points around the bed, either taking readings or feeding me with a handful of essential musts. I couldn't escape that's for sure! Other laughs followed when just three attachments meant I could get up but go no further than my bedside: in the main to cope with sudden 'spasms', coupled with 'urgency' voidings of urine (plus blood) outside the three-way catheter (hope that makes you wince Brian) I had been wearing for three days. (I had got used to those 'spasms' in the weeks before the op.) One spasm at the hospital produced 400ml in no time at all - like Niagara Falls. If I had remained in the bed I would have floated away to the nearby River Avon.
   One 'benefit' of the op (what follows would never have won any 'sales order' in past decades) is that there's a mass of tissue available for 'histology': that means in a few days I shall be given an up-date of how many cancer cells are in the prostate and, most importantly, the Gleason 'Score', or 'Rating', which tells you the 'aggressiveness' of the things. Anyway, whatever, I shall have to continue keeping all battened down as best I can.
   Final chuckle: I have restarted Pelvic Floor Exercises (what are they? asks Jim: tell him Jane). First the 'Lift' - 'tighten as hard as you can for as long as you can'; followed by the 'Wink' - 'only held for a second and repeated quickly 5-10 times'. Finally, the 'Trick': do a couple before you cough, sneeze or laugh'. All you blokes must be mystified: ask the lady in your life. Real reason for this 'exercises'? To take control of both 'urgency' and to ensure 'no lack of control'. So there!
   Keep smiling! Enjoy life! Keep your fingers crossed or anything else that's handy: the latter is called the 'Pump' exercise (no, I'm not going to explain Maril).

Email to readers, friends and my family (18 March)
   Progressing well at home. Pelvic Floor Exercises are still a priority. 'Urgency' is still a problem. Winning but lots more 'Lifts', 'Winks' and 'Tricks' needed over the coming weeks before I can get a secure, regular royal 'flush' every time.
   The 'histology'? Alas, bad news. The Gleason 'Rating' or 'Score' couldn't have been much worse. On a scale of 2-10 my score is 9. I'll not go into detail but a summary would be: two of the most prominent cell patterns extracted in the recent bore-out have been examined by a pathologist and, in my case, a score of 4+5=9 emerged. In 1999, when the original cystoscopy was done, the biopsy then gave a score of 3+3=6. Both 4 and 5 are 'poorly differentiated' cells. QED: as aggressive as they come.
   The most disappointing aspect of the last two months is the out-of-the-blue 'vascularity' of my prostate (excessive blood supply). This is the last thing you want in the gland when you know cancer cells are about. How, when and why this has happened is now neither here nor there. It's a fait accompli! I'm convinced it is all to do with the body's immune system and the vital Th1 and Th2 cells and the two different jobs they do. (Thymus-derived helper cell type 1 and type 2.) In my case prostate gland inflammation, infection and damage, both long and short-term, prompts the body into healing mode, lowering Th1 levels to allow 'repairs' to take place. If cancer cells are lurking this is bad news, particularly as Th2 cells proliferate, creating new blood vessels around damaged tissue. They allow the cancer cells to grow and spread. That's why I've been taking a 300mg dissolvable aspirin every day for some time. Now I'm taking three; I wish I had earlier. (If any of you are interested refer to the article called 'Cancer's Missing Link' in this section of my site, under Author).
   Anyway, let's be positive. My urologist and oncologist, with my agreement, are undertaking the following treatment 'plan'. Immediately after Easter I start a 'Maximum Androgen Blockade' for three months. I continue with Casodex (which blocks testosterone from the prostate) and I start again with Zoladex (a monthly implant which prevents the body from making testosterone and other 'androgens'). QED: the blockade keeps testosterone from both the prostate and the cancer cells.
   The aim is to try to reduce the size of my prostate even further over three months (April to June). The gland has already lost a big part of its 'interior': 100gm were removed in the recent op, leaving 60+gm. Then the 'plan' is to use 'conformal radiotherapy' to see if we can kill-off the remaining cancer cells. I explained all this some years ago on this website: see the very start of this now long chapter.
   Keep fingers crossed! Be sure that I will be like the 'frog' in the 'Don't Ever Give Up!' Cartoon. (I've sent hundreds of copies to my readers over the years.)

Three important observations
      1) The 'vascularity' (copious blood vessels) of my prostate came as a shock: for me and all the medics providing advice and care. PSA readings gave no clue. What should be standard treatment is constant monitoring of the condition, especially for large prostates: for example the use of endoscopy investigations in the prostate; or more detailed ultrasounds perhaps (you'll not be surprised to read that I, eventually, had to pay privately for an ultrasound to be done; the pressure, and backlog, on NHS equipment is huge). Does anyone have ideas how this could be done? E-mail Richard

A copious blood supply is the LAST thing cancer cells need! What the latter need is a supply of angio genesis inhibitors (agi: which stop the creation of new blood vessels). See Soya Isoflavones in 'My Diet' (in this drop-down menu list). The latter have come too late to really help me during the last year or two - but, over a lifetime, they have benefited, massively, all Far Eastern men and women with cancers of the prostate and breast. I know work is being done in trying to create 'agi' drugs. At the moment Thalidomide, a very potent 'agi'(the cause of all the terrible deformed limbs in children during the early 60s) is being used but only for advanced cancers.

      2) Taking the gamble to stop Casodex in August 2003 (see earlier) for six months was a big mistake on my part, but supported by the medics looking after me. All we had in mind were the cancer cells; no account was taken of the impact in providing testosterone to the prostate - which allowed the gland to grow even bigger.

      3) Somewhere along the line all the above links back to the Th1/Th2 cells mentioned earlier. Th2 cells must have created the steep increase in 'vascularity' and, QED, the stepped-up aggressiveness of the cancer cells. (I've had a long history of inflammation and infection in the prostate over 25 years, ever since I started sitting for such long periods in a car carrying out all the myriad research I've been doing!)

End May 2005
First, the humdrum news. The TURP operation has been a success. Two weeks after the op I stopped taking Oxybutynin (to help the urgency problems). Bleeding eventually stopped 10 weeks after the op. By then waterworks 'performance' was hugely improved - more like one's younger days. For so long, from mid-January when the first catheter was put in place, proper exercise was a pipe-dream; but after the bleeding stopped I was able to work hard at restoring muscle power. At the end of May I felt 100% fit again; and looked it too. The Zoladex/Casodex combination continues. One major caveat: has the major loss of blood from the prostate gland, starting in mid-January, carried the aggressive cells to other parts of my body?
End June 2005
Now the news I've been apprehensive about since the end of January
I've had three 'scans' in the last few weeks: first a 'CT scan', followed by an 'Ultrasound scan', both at Warwick Hospital; and finally a 'Gamma camera' bone scan' at Coventry's Walsgrave Hospital.
The CT scan confirmed the need for a bone scan. The Ultrasound confirmed that the overall size of the prostate gland remained big, despite the 100gm removed during the TURP op, 7cm at the widest diameter; and the prostate 'capsule' had been breached by a 'tumour'. The bone scan, as you have guessed, brought the worst news of all.
The cancer cells had indeed escaped: significant 'spots' could be seen on ribs; much larger areas had developed on the bottom of the spine; and a bigger amount of cancer had taken hold in a corner of the pelvic area.
How can I relate the eventual outcome of this hammer-blow news? A reader friend, like so many of you, on hearing from me in early June of this possibility, sent me an email: 'I am sad to read that the prostate cancer is moving towards your bones. All the very best for 17/6/05 and I hope the Good Lord will reject any indication that you wish to have an appointment with him!!'
Well, the 'appointment' looks likely to come sooner or later - but certainly much earlier than anyone would ever want to meet 'the Good Lord'. I shall have to be the 'frog' in the cartoon: fighting like a dervish to stop the heron swallowing me! Radiotherapy, conformal or otherwise, is pointless; that is a non-starter. Zoladex, with or without Casodex, initially remains the only treatment to keep the bone cancer quiet.
I shall have monthly PSA blood tests to determine the progress of the ongoing hormone therapy (on 17 June my PSA was 6.6; not much lower than the 8.7 last November). Some time soon I shall meet Prof. Nick James at the Queen Elizabeth Hospital in Brum to determine if any other 'novel' treatments, at the clinical trial stage, may be able to help (like e-coli). Chemotherapy will be another toxic possibility. As will Thalidomide, the ultimate and strongest possible angiogenesis inhibitor; Prof. Stewart at Leicester Hospital uses this for advanced cancers.
I shall continue to keep fighting fit: and I shall continue with my régime - with absolutely no dairy produce these days.
My greatest sadness is the burden my dear Carol has already had to carry and will increasingly have to continue to do so in the months to come. She does not deserve such massive misfortune. Sadness, too, for my family - and especially Keith, a real Rock of Gibraltar brother. All of you I know will continue to be 'seconds' in the ring, encouraging and ensuring this frog scraps to the bitter end. Please do not feel unhappy: be positive; keep well; and continue to enjoy life. Carol and I will do so, that's for sure. More reports, at the end of every two months, will follow.
Observations: these cannot change past events but will interest you nevertheless.
This month I read the following on the Mayo Clinic website: 'A small percentage of prostate cancers don't lead to elevated PSA. In these cases PSA level may be normal or even low, despite the prostate cancer. Some scientists believe these have more genetic mutations than others and allow this form of prostate cancer to grow and spread more quickly. One group of researchers found that PSA helps slow the growth of prostate cancer in laboratory studies by slowing the growth of new blood vessels (angiogenesis) that cancer needs to survive. This may explain why prostate cancers that don 't produce PSA tend to grow and spread more rapidly than prostate cancers that do produce PSA. More research is needed to determine prognosis and treatment.' The above fits my 'case' over the last few years to a tee: 100% spot-on!
The NHS. In July 2002 I asked for an Ultrasound scan, to check the gland size. A three-line letter confirmed the 'volume is graded at 139mls' (gm). The letter continued: 'In one spot in the right lateral lobe, there is a swelling which breaks the capsule. This will be discussed at the next Multi Disciplinary Meeting.' It was and no undue concern was expressed. At the time my PSA was a low 3.6.
Despite the fact that I have seen consultants, consecutively a urologist and oncologist, every three months for the last six years, nothing was done post July 2002 to assess prostate gland - until I pressed hard for a further Ultrasound test in January 2005.
The NHS is a '10-minute service'. Pressures, stress and sheer volume of work (three incoming phone calls came when my oncologist broke the bone scan's 'very bad news'; and the meeting started an hour late!) prevent consultants diligently managing their patients problems and constantly reviewing the treatments needed.
Now it's pretty obvious that further Ultrasounds should have followed in both 2003 and 2004; plus the use of endoscopy, which would have shown how vascular the gland was becoming (excessive blood vessels, the single worst situation as blood provides the essential oxygen for cancer cells to thrive and become ultra aggressive).
No wonder then that Japanese men, for example, with their life-long diet of soya (Nature's weak but best angiogenesis inhibitor), tend to have far fewer aggressive prostate cancers (they certainly have the same number of cells; autopsies prove that). My two to three years on a similar régime is like spitting into the wind - but I shall continue it with a vengeance, especially the elimination of all dairy produce.
End August 2005
I’ve had four ‘rewarding’ consultations during July and August: first in Coventry with my oncologist Dr Caroline Humber; followed by two with Professor Will Steward at University Hospital in Leicester and Professor Nick James at University Hospital in Birmingham; and then a final ‘recap’ meeting with Dr Humber.
The encouraging news is that I have several optional treatments - all legally and currently available as prescription drugs. However, first, let me describe two important medical terms.
A. Hormone-related therapy Cancer of the prostate depends on testosterone for its growth. Androgen drugs (also called pituitary down-regulators), such as Zoladex or Prostap, act directly on the pituitary gland and prevent a signal reaching the testes, which manufacture testosterone.
Casodex and Cyproterone are anti-androgen drugs which stop (or block) testosterone from reaching the cancer cells in the prostate. Note: testosterone is still made. (I’ve had both Zoladex, in 1999/2000 and the last five months, and Casodex in 2001-2004.)
Hormonal drugs like Stilboestrol release man-made oestrogen which prevents a signal from the pituitary reaching the testes.
B. Hormone-refractory prostate cancer This can occur some years after successful use of the above drugs. The cancer sells eventually find ways (refraction) of growing and spreading, helped by the blood supply, without the need for testosterone. Often the cancer spreads to the bones: as a result patients are then left with fewer treatment options for the disease. ‘Hormone-refractory’ makes any drug, on its own, ineffective.
Available treatments for my bone cancer are (in the order I would use them):
1. Combined ‘androgen’ drugs like Zoladex and Casodex, both at maximum doses.
2. Alternative hormone therapy - changed to make the cancer cells ‘think’ again. One example would be Stilboestrol combined with a steroid like Prednisolene or Hydrocortisone (both corticosteroids).
3 Chemotherapy where several drugs and minerals are used: think of the mix like a cocktail - the contents and quantities put in the ‘shaker’ depend on the patient’s needs. An example: the toxic Docetaxel or Taxotere drugs mixed with the likes of Tetracycline, Thalidomide, Vitamin D, Melatonin and many others.
4. Bone-targeted therapies: Bisphosphonates (to strengthen bones) or Radio-isotopes.
5 The new Tyrosine Kinases Inhibitors (angiogenesis inhibitors) which, though they cannot kill cancer cells, do stop blood vessels forming, the latter needed for the cells to flourish and spread. These now replace Thalidomide. Three years ago Prof Steward gave me the details of TKIs when they were at the phase II stage of a ‘clinical trial’.
The last two words give you a clue to the treatment I have chosen instead of those listed above. Professor James has suggested, and I have accepted, that I join a current phase II ‘clinical trial’ of an AztraZenica product - ZD4054 (no name yet).
What is ZD4054? ‘Many cancers make substances that help their growth. ZD4054 is an investigational new drug that blocks one of these substances called endothelin-1. Experiments have shown that blocking endothelin-1 reduces the spread of cancer to bone and for the cancers that have already spread to the bone, reduce bone pain.’
By coincidence I already know of Abbott Laboratories’ Xinlay drug - which has just been given permission by the U.S. Food and Drug Administration to make the drug available to men with late-stage prostate cancer (in the bones) which does not respond to hormone therapy (like me) - even though the drug is not yet fully approved.
The drug is akin to ZD4054. Indeed I wonder is there is some link between the two drugs , though not yet official and out in the open! Abbott say their drug is: ‘a critical step in our goal of making new therapies that are less toxic.’ The same seems to apply to ZD4054.. Abbott continue by claiming ‘Xinlay is an investigational, oral, once daily, non-hormonal, non-chemotherapy, anti-cancer agent that belongs to a class of compounds known as endothelin-A receptor antagonists. They antagonise (block) the effect of endothelin-1 (ET-1), one of the proteins thought to be involved in the stimulation of the spread of cancer cells.’ All those words apply equally to ZD4054!
( Apparently clinical trials for use of the drug earlier in the disease are underway in the States. Also work is being done to measure the drug’s effectiveness with other cancers. No wonder then that the Bank of America Securities team believe that, once the drug is approved in late 2005, Xinlay sales will reach $300 million in 2006 and ultimately  $1.5-2.0 billion annually.)
So, all good news - if the two drugs prove to be that effective! I have two months of tests, scans and other pre-treatment examinations before I start the trial at the end of October. The sole debit is that one in three of the patients taking part in the UK trial, just 42 of them, will be taking daily placebo pills!
Abbott also say ‘For patients where prostate cancer spreads to other organs (including the bones), it remains incurable.’ That may well be but there are plenty of ways of fighting the beast.
Some of you have seen me recently. You already know that ‘my contribution’ to the scrap is two-fold: to keep super fit and to stick like a limpet to my terrific food régime. The fact is I look and feel fitter than I’ve been at any time since 1960! Keep your fingers crossed for mr.
Expect the next update at the end of the year.
End January 2006
I started the clinical trial of ZD4054 on 21 October 2005. The seven week delay came as a result of waiting for scans and blood tests to be carried out. In addition three PSA readings had to be done, each of which entailed a three-week gap before the next. One of the conditions for acceptance on the trial was that PSA readings were ‘rising’ – to prove hormone refraction was taking place (i.e. the body twigs how to circumvent the monthly Zoladex injection started in mid 2005). You guessed right: the scores rose!
A CT scan was done at the trial start (21/10/05). A further CT scan followed at week 12 (12/01/06). At weeks 4 and 8 further blood tests were carried out.
Sadly, I had to abandon the trial following the CT scan at week 12. In the words of Professor James: “the disease has progressed.” Comparing the two CT scans proved the point. Specifically thee lymph nodes had grown in size (one from three cm to four). So much for trying to guess if I was on a placebo or the real thing.
For the record the PSA scores had risen from 6.6 last summer to 61 at week 8; as yet I’ve not had the week 12 score but my guess is that it will be in excess of 100.
(Incidentally, earlier bad news came in a press release from the U.S. Food and Drug Administration: they stopped Abbott using its version of the trial drug in the U.S.)
I have now started ‘Available treatment’ number 1 – as described in the End August 2005 update (already sent to you by email/letter; and also on my website*). This is tagged the maximum androgen blockade – Zoladex and Casodex taken together.
*) www.richard-binns.co.uk Mouse on ‘Author’. Click-on ’My health’. Scroll down.
I continue to look and feel well; and to be ‘Tiger Frog Positive’. I’ll be in touch again in early summer.

1 August 2006
There have been some serious developments since I wrote the above, click here for details