My ongoing struggle

Mottie Feldman

I was diagnosed in early 1997 at age 60. I had little knowledge about prostate cancer and my GP never spoke about the PSA (prostate-specific antigen) test. As my prostate grew substantially, he finally referred me to a urologist, which is how I met Dr. Chris Morash.

By then my PSA was 30, Gleason 7 or 8, and all six biopsies were positive. Dr. Morash gave me the news in his office—“you have prostate cancer”—and my blood ran cold! He was reluctant to attempt surgery and referred me to Dr. Juanita Crook for radiation. I started on hormone treatment (Zoladex and Casodex) immediately bridge the time gap until I was scheduled for treatment.

Dr Crook took the opportunity to add me to a clinical trial, looking at the effect of length of time of hormone treatment before radiation. Later, I was treated by external beam, conformal radiation being pioneered by Dr. Crook (shortly thereafter, she moved to Toronto.).

Radiation was minimally successful. Back in the hands of Dr. Morash, I was treated with Zoladex and Casodex, and even tried some “intermittent” treatment. I experienced a number of the classical side effects of the “hormone” treatment.

This was also a time to join the Ottawa support group, meet great people and learn a lot more about prostate cancer. I joined the executive and got involved with the volunteer work.

In 2002, I moved to Toronto for family reasons and was fortunate to have Dr. Morash refer me to his Sloan-Kettering classmate, the well-known Dr. Neil Fleshner. I continued the hormone treatment, but by autumn 2008, my cancer was becoming refractory. Dr. Fleshner referred me to oncology, where I am under the care of Dr. Anthony Joshua.

I have had a variety of treatments, sometimes stopping the progress of the metastasis, then it progresses again. CT and bone scans show metastasis mainly to the spine. A tumor in vertebrae L-2 is pressing on nerves causing back and groin pain.

Here is a description of recent treatments. I took prednisone. It worked for a year and I still take it with other treatments. I tried a clinical trial for Aberaterone with prednisone, but it didn’t help. I do not know if I was on the placebo, and there is no way to find out. (By the way, after about three years, prednisone caused sudden worsening of cataracts, leading to cataract surgery on both eyes this fall.).

Radiation to L-2, resulted in severe pain, and had no effect, contrary to common practice.

Ten chemo treatments with Taxotere reduced the PSA and considerably reduced pain, with tolerable side effects.

Next, I participated in a clinical trial from February to August 2011, using Torisel (Temsirolimus). Scans and an MRI show mixed results, and eventually PSA and pain are increasing again. I am back on Taxotere, controlling PSA but not pain.

So here I am at another decision point, and again my blood runs cold.

[Mottie Feldman died in 2012, 15 years after being diagnosed.]

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