PREAMBLE

Na...(post two days ago - Stella Day's Moonwalk London 2015 thread - in General Discussion Forum) is not where to leave it (for me, posting, that is).

Cancer at the point of diagnosis* does not define (me) - any more than death would - each are just part of the Life/ Death Trip.

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*July 2024. After the transrectal prostate biopsy, from thirteen cores, they found only 2.4mm of clinically significant Group 2 Gleason 7 (3+4), that was (and still is, my GRADING).

For the remainder of the year, I remained on Active Surveillance. I had a CT scan and an isotope bone scan, between August and October (each negative for metastases), which gave me a provisional STAGING of T2c.

In January 2025, I had a transperineal prostate biopsy (entry point through skin between the scrotum and rectum), which took another twenty nine cores. The transperineal technique enables better access to the anterior (front) of the prostate, as well as to the apex (the prostate gland is like an inverted pyramid with the base sitting on the wall of the bladder).

None exceeded the GRADING, Group 2 Gleason 7 (3+4), from July 2024. In all, ten cores from forty-two were positive and clinically significant, so I moved from 'Active Surveillance' to 'Curative Intent' On the plus side however, the quantity of Gleason Pattern 4 they found, was very low...Overall, about 14mm of Pattern 3 (clinically insignificant) and 4mm of Pattern 4 (clinically significant).

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18/06/25 update - Started hormone therapy, in mid May, with a 28 day course of tablets (one per day) and approximately half way through, had the first of four weekly analogue injections. Before I had the first of these (at 12 days into the course of tablets), I had another PSA blood test (measuring Prostate Specific Antigen). My PSA had dropped by nearly 40%! With the combination of injections and tablets this is known as Combined Androgen Blockade (CAB).

With lower testosterone, conditions are harder for the PCa (Prostate Cancer) to develop (in fact, my burden of disease is probably shrinking - though the hormone therapy alone will probably not eradicate the PCa).

A PSMA PET scan (May 2025) firmed up my STAGING at T2c - this is a relief because it confirms my disease burden is currently totally organ confined. So far so good! X....

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16/07/2025: Further update: My PSA level has now fallen by 76% since the start of my ongoing treatment! It's now at the pre-2022 level. I'm obviously delighted. Onwards...X...

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17/08/2025 update: No further improvement, as yet, on PSA reduction beyond last reported on 16/07/25. My PSA is, currently, less than twice the level considered normal for my age, when earlier this year, it was almost eight times the normal level!

I am now only receiving the LHRH (Luteinizing Hormone - Releasing Hormone) i.e. monotherapy for PCa.

Without being specific about medications or doses, for clarification:

1. The purpose of the tablets was to block the action of androgens, especially testosterone, at the cellular level. They prevent testosterone from binding to androgen receptors on prostate cancer cells, so inhibiting growth and division.

2. The purpose of the LHRH injections works to lower overall testosterone production in the body (the prostate cancer cells need testosterone to grow and proliferate), so this action effectively starves the cancer cells, resulting in a shrinking of tumours or at least holding existing disease in check, halting further growth. Over time however, in some cases, patients can develop androgen insensitive disease (the PCa can adapt).

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26/08/25

3. There is another potential explanation for the current stalling of my PSA reduction (?) In their 2010 paper, 'Hormone therapy in the management of Prostate Cancer; evidence-based approaches', Gomella et al, pointed out that LHRH analogue only reduces circulating testosterone by 90% (that produced by the testes). The other 10% is converted by the adrenal cortex.

The adrenal glands are located on the top of the kidneys. Reading this immediately captured my attention because back when I was 55 years of age, I had my first DRE (digital rectal examination) and CT scan (both following a urine infection). Whilst my PSA at that time was normal, the CT scan picked up that I had a 'bulky' left adrenal gland. Maybe more than 10% of my testosterone is still circulating? I will raise it, with my oncology and urology teams. The bulky left adrenal gland was picked up over a decade ago. I'm uncertain how digitalised the service was back then, now it is transformed.

I should also report that I have been feeling periodic hot flushes - but for me these are not lasting too long and they are infrequent. These are a common side effect of the treatment (around 70% of patients will experience them).

I have also found some interesting Japanese scientific papers on hormone therapy for prostate cancer. I'm happy the way things are going. I've got a decision to make during the first half of next month but I want to see what my next PSA reading is before I make it...I hope YOU are all well.

Tara for now...X

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21/10/25

Yeah, I'm having further LHRH (one injection every four weeks - as the five I've already had - and during that extended period I will also be having 56 days of CAB (as referred to above). Given my current low grade and early stage, I wanted to achieve a better PSA nadir (this is the lowest measurement), I wanted to see what could be achieved with HT alone, before I go ahead with radical treatment. This is a personal choice (and wouldn't be right for everyone).

There is also a possibility of remaining on hormone therapy (HT) for the rest of my life or at least longer term (c. five years) - although this seems to be less prevalent as a patient choice in Europe and the USA, but is chosen quite often in the far East, particularly Japan. The other thing to always bear in mind is that there are potential side effects with all the three main options - HT / RT / Prostatectomy. Many patients have a combination of the first two, however, a patient can't opt for RT (radiotherapy) and then later opt for a prostatectomy if the RT didn't eradicate the disease or it returned. The gland becomes too difficult to remove after RT.

If you are a male that is diagnosed with PCa, just listen to your experts in urology and prostate oncology (ask questions) and ultimately make the choice that is right for YOU.

Take care all and all the best. J.

12/11/25 - quick update. It transpires that my testosterone level is low enough for the hormone therapy to have the best chance. The periodic (further) CAB (see above) has reduced my PSA still further, to the point that my PSA level is only 1.2 billionths of a gram higher than normal (it's now below the level which would not be untypical for a 70 year old man). My PSA has fallen by 85% since March this year, so I'm delighted!

27/12/2025 - With the HT, I'm going to have to watch my testosterone getting too low, as over time, i.e. over 12 months, it can also affect bone density in a detrimental way. However, my aim for next month is to get PSA down still further, by a further 0.8 ng/ml, if possible. If that happens, the HT alone will have got it down to a level, almost as effectively as RT might (without the risks of potential toxicity associated with RT, evidentially). Fingers crossed. X

16/02/26 - Since November my LHRH injections have changed from four weekly to once every three months (at a higher dose). I picked up a cold virus at the end of last month, so I'm having to wait to see if I can get the PSA below 4 ng/ml or 4 ug/L (nanograms per millilitre or micrograms per litre, respectively). VBW, J.

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WHO'S THAT GIRL?

I mean the girl on the front and rear cover of "The Best Years Of Our Lives" (Harley) EMI Records 1975.

It's not Yvonne Keeley, Linda Lewis or Tina Charles - Yvonne, Linda and Tina, I've known by sight since the 70's of course, because of their own hits. Is it Liza Strike (I haven't yet Googled her)? Or is it a friend, a girlfriend or a model? Mick Rock designed the album sleeve, was it someone he knew? There is a narrative going on, whether real or illusory. On the back of the album cover, the two, the mystery woman and Steve, have turned away from each other - in the back of the 'limo', consumed by their own thoughts. Intriguing. Oh, by the way, the mystery woman is not Liza Strike...

That coat she had on - brings to mind - 'She's In Fashion' by Suede (on 'Head Music' I think, 1999). I don't recall seeing many of those, back in the mid 1970's, not with a metallic look - but I stand to be corrected by anyone else that does remember them.

I like the shot of Steve on the inner sleeve - the rebel. This is the final Steve Harley & Cockney Rebel that features images of other band members of Cockney Rebel (none, apart from Steve, were on Face To Face even - this seems strange). This brings me back to the later posts on my thread, ' The Human Menagerie of Cockney Rebel' (1973) (link below):

www.steveharley.com/forum/7-welcome-mat/...el-1973.html?start=6

'A Cancer Triptych';

HERE and

www.steveharley.com/forum/6-general-disc...harity.html?start=36

and

www.steveharley.com/forum/5-forum-questi...thin-the-psyche.html


Pop Trivia;

On the same stick that I listen to (I Believe) Love's A Prima Donna, Judy Teen, Beauty Queen, Conversation, Could It Happen To Me, Learning To Fly, Big Girls Cry, 5AM, Allentown, I Believe, Waves, Ziggy Stardust, many others, I listen to Who's That Girl (Madonna). Up. Punchy. Melodious, Sexy...

Some Christmas's ago, Sasha bought me a book, '1000 Record Covers' (Michael Ochs, TASHEN, 1996). 'The Best Years Of Our Lives' is featured, along with three by my other favourite band, Roxy Music. Steve and Cockney Rebel's album is on page 481.

Hi Jem, the girl on the cover was a friend of Mick Rock, called Birgit. I believe Steve once said she was married to someone who helped design some of his album covers. The silver jacket though, that belonged to Yvonne Keeley..
I'm truly sorry to read of your health issue and I hope you respond well to the treatment. Stay strong Jem, you can beat this..

For Alexa - I reciprocate and wish you and yours a healthy, happy and prosperous New Year!

For midge - Yesterday I realised, after reading Steve's Diary Entry for 11 January 2016, that Birgit was married to George Underwood, a close early friend of David Bowie - who 'gave' David his 'different coloured' eyes!

George was also in a pre-Spiders band with Bowie, before he left music to concentrate on an art and graphic design career.

So thanks to you, and Honeybadger who got me into Steve's earlier Diary entries, I can establish a Harley, Birgit, Underwood, Bowie probable connection with The Best Years Of Our Lives album cover.

All the very best...

To Jem
I hope you and your loved ones are wonderful 2026
Alexa
X