We are midway between oncology appointments so there is nothing to report on that front other than to mention a Radio 4 programme – Inside Out – that a fellow pc-blogger drew to my attention. It discussed the grey areas in the diagnosis and treatment of prostate cancer – it may be over-diagnosed and over-treated or the opposite (and in particular not identified early enough). It’s a bit like spending money on marketing – you know that half the money is wasted but the trouble is that you don’t know which half. The programme also argued for MRI scans before prostate biopsies so that they could be targeted better. Interestingly it mentioned prostatectomies and radiotherapy as treatments but nothing about chemotherapy.
However I can report progress on a different front – I saw a Haematology consultant on Monday. I had stopped taking prednisolone a week ago Friday and had had a blood test last Friday. So I had been a week steroid-free. We were waiting with baited breath to see whether the platelet count was still in the mid-40’s or whether it had dropped. To our amazement it had gone up – to 72. This is a much more comfortable level (although still well below the normal level of 150-450) and should mean that I am not at risk of bleeding or bruising.
So what is likely to happen next? It seems that there are three options with an equal chance of each. It could pootle along at the current OK but below normal level; it could drop back to a level where there might be cause for concern (and intervention); or it might climb back towards the normal level. We will just have to wait and see, so it is another blood test in four weeks’ time, but should I show signs of bleeding or bruising I should get back in touch with Haematology (rather than A&E which is where this ITP journey started). As the consultant said idiopathic describes it well. It used to be that ITP stood for Idiopathic thrombocytopenia while the preference now is for it to stand for Immune thrombocytopenia. In fact both are appropriate since it is idiopathic (its cause is a mystery) and it is an auto-immune disease (the immune system is confused and is attacking the platelets when it should be making friends with them).
The only dampener on the good news on the platelet front is that my blood glucose levels are still too high. The HbA1c figure which gives a three month average was a little higher than the last reading in October. It probably hasn’t had time for my stopping steroids (prednisolone) to have any significant impact. There is a bit of a challenge here.