Case Study Nine:

Joy and I decided to take a trip to Europe, during which I noticed a small amount of blood in my urine. I initially put this down to some road stress, and driving the wrong way down a one way street. Upon my return home, I made an appointment with my Doctor, to have things checked out.

I was initially given a blood test, and discovered my PSA was 49. I was then given a digital examination, and told that there were irregularities, which were likely caused by prostate cancer. A second opinion was then sought through a private practice in Epsom, which turned up the likelihood of stage T3 prostate cancer, and a biopsy was booked at North Shore Hospital by Mr Mischel Neill, where 12 cores were taken in August 2015. The results of the biopsy confirmed a Gleason score of 8 = high risk prostate cancer. Bone and CT scans were negative for metastatic disease, however showed that the cancer had invaded the seminal vesicle (stage T3B) and the bowel wall.....not good news!! I was also advised that this result made my case inoperable.

Subsequent to my clinic appointment, my case was discussed at the regional meeting of oncologists, and it was suggested that I take part in the ENZARAD trial being coordinated by Dr Chakiath Jose, out of Auckland City Hospital. The aim of the trial was to see which combinations of treatment is better for improving the survival of men in my situation. I was included in a group who would receive treatment including radiation therapy (39 treatments) combined with two years androgen deprivation therapy (hormone injection into my stomach every three months), and enzalutamide (the trial drug) for 24 months. The total treatment timeline was over two years followed by four monthly check-ups in years 3 & 4, and six monthly check-ups in years 5 & 6, dropping back to annual follow-ups in year seven. The hormone treatment and trial drug were started four months before the radiation therapy in the hopes of shrinking the tumour. Radiation began in April 2016.

Part of the trial involved the collection of blood samples for research at the start of the treatment, and at year 5, along with PSA and testosterone blood tests prior to each consultation.

I have now completed five years on the trial, and my last PSA count, taken in July 2020, was 0.20 and testosterone 13.8, which is all in the normal range.

The ENZARAD trial study was to include 800 participants from Australia, New Zealand, Canada, Ireland, United Kingdom, and other countries. Twenty participants were to be enrolled at Auckland Hospital.

My next appointment with Dr Jose is in January 2021.