Wednesday and I continue on my reduced steroids regime. I am not sure if I am experiencing any change or any adrenal insufficiency at the moment, all I can do is continue to monitor myself. The day is slow, by which I mean I have lazed a great deal and little of anything else. I did build a support structure for the tomato plants that were in danger of keeling over under the weight of their own foliage. My sunflowers have also been provided with additional long support canes. However my sunflowers are a source of disappointment and embarrassment. I have grown them believing that they are purple teddy bear sunflowers. I bought the seeds labelled as this over the internet. It turns out there is no such thing as a purple sunflower! I’ve been duped by Photoshoped pictures. I checked the purpleness of my sunflowers when I noticed that one of them was beginning to flower and that the colour was yellow. On investigation I find that sunflowers are genetically incapable of producing purple pigmentation. The question is whether I go into revenge mode and track down the bastard that duped me. I suspect I will not unless I see them being advertised again. I am unlikely to be trusting anything on my news feed again or indeed Esty.

So the rest of my time is filed with Commonwealth games and the final episode of STEAL. Of course the broken people somehow survive and walk off into the sunset with twenty million in bitcoin. I take my reduced night meds and go to bed.

Thursday starts with hot water and my usual check of the social media and my messages. Amongst my messages is one that includes a link to Billie Whitelaw performing Samuel Becket’s Not I. It is an amazing fifteen minute piece where all that can be seen is a mouth delivering Becketts words. Its a very strange experience watching just a mouth deliver a stream of consciousness monologue. It is a tour de force and an unexpected way to start a day.

I get up and have breakfast with my morning meds while drafting yesterdays and todays blog. Amazon deliver my new swim joggers to go with my new swim googles. These are a luxury I have given myself to take away on the upcoming Spa break. My partner returns from the physio as I continue with my drafting and watching the Commonwealth Games. Out of the blue the specialist prostate cancer nurse rings me, apparently prompted by the woman who last reviewed me. We chatted for a while and I explained what I was doing with the reduction of my steroids. She was unaware of any steroid reduction policy. We discussed my discomfort at reducing so quickly by 50% and would prefer to reduce slowly by 1mg at a time, especially at this level. She under took to find out if the tablets come in variable dosages and to talk to the consultant pharmacist about tapering off protocols and policies. The call ends and I return to watching the Commonwealth games and see our heavy weight woman weight lifter win gold with a new games record.

Eventually I find my way into the garden and the swing seat where I watch the clouds in the sky and drift around for a while until my partner returns from seeing her mother in the care home. We chat for a while and then I water the tomato plants and the sunflowers as my partner makes tea. I bring my washing in and return to drafting the blog before eating tea and settling down to watch the current drama series. The evening ends with night meds and bed.

Monday and I wake after a restless night. A brief breakfast and morning meds before I make contact with Appliance Man. Our dishwasher is full of water and clearly is not well, hence the call to Appliance Man. Fortunately he remembers Daisy Dishwasher as he has mended her before. He will come to us on Tuesday morning and will work his magic. It my eldest daughters birthday so when she emerges there are birthday greetings to do. The morning goes by with some chores and some writing until it comes time to go and have a celebratory late lunch at Pesto.

Pesto at 2pm is quiet and almost empty, an ideal eating space. The service is also quick which is a bonus. Its really relaxing to be able to eat good food in a quiet space and watch the few other dining families. There is time to chat and observe life and to reminisce. I was intrigued by a dish that was served in a twist of brown paper. Despite trying I was not able to see what was inside and in the end asked the waitress what was in the brown parcels. Calamari was the answer. After the meal we head home for presents and card time, with more singing of Happy Birthday.

The evening slides into the Commonwealth Games athletics. Its the boring early rounds so its soon on to the current drama series STEAL. Like all of the recent dramas it is beginning to get beyond what the suspension of reality can stand. Of course every major character is flawed in some way or other. In this case the bright policeman is a gambling addict owing ninety thousand, as they all do. The main woman has an alcoholic mental health nurse mother and a childhood that goes with it, plus of course her career was not what she thought her psychology degree would get her. MI5 officers are just a bunch of abducting and murdering thugs who just threaten everyone with the greater good and being able to kill people and get away with it. As for the villain there is of course the paranoid one who resorts to killing members of the gang having been worked on by the hostage that the gang has taken, where any self respecting gang would have topped him straight off as a lability. I suppose all of this is meant to give depth and dramatic effect but after a while it just becomes unbelievable and just not credible. Anyway there was some of this then medication and bed. However before bed there was bailing out the water filled dishwasher and hand washing the evenings dishes. How the ordinary can be a pain in the arse when tired. For those wondering what happened to my Japanese kneeling women who had to have her head stuck back on, I am pleased to say that she healed nicely and was returned to her spot in the garden in the morning. The operation was a success.

Tuesday and I struggle to get up early but I manage to be up and dressed by the time Appliance Man arrives and sets to work on Daisy Dishwasher. My partner and my eldest daughter go off to the gym. I oversee Appliance Man who tends to our machine and declares Daisy fit for further duty. So there is a quick exchange of real money and he leaves. I like to pay for these things in cash, I wonder if the recipient ever declares it or if there is a moral battle that takes place or if they just go “Fuck the tax man” and stick it in their pocket. I think I just like giving people the option. I always pay for petrol with cash ever since my card got cloned at my local petrol station.

Appliance Man leaves with his cash and I check my emails to find that the draft of The Cancer Years: The Rechallenge has arrived. I check it, add bits to it and and then send it onto the person who has agreed to write the Forward for it. My partner and eldest daughter return from the gym and we all go out to the café in the local garden centre for a bacon roll and a decaf coffee. The garden centre looks like it has been hit by a plague of locusts. The benches are bare save for a few straggly bedding plants as if autumn has come early this year and in many senses it has. The fields are all harvested, the trailers are stacked full of hay bails and other crops are struggling to reach full maturity. There is a lot of stunted sweet corn. I note that farmers o longer burn off their fields anymore. If they did it now there would be wild fires everywhere. We return home and I settle down to draft the blog while listening to the choral promenade concert. Our return also finds the confidential waste bags that we ordered sitting waiting for us, so over the next few days my eldest daughter and I will be filling them ready for collecting and destruction. I

I feed myself in the evening as my partner is out with a friend dining. There is athletics to watch, a guitar to play and I still have a pile of unread books to read. Of course today os the first day that I reduce my steroid intake, I have loaded my dosettes for the next two weeks with only one 2.5mg of steroid each day. Its a big reduction in relation to the 5mg prescribed. It should be slower. It should be reduced by 1mg a day for some weeks in order for my adrenal system to re-establish itself. I should be monitored for adrenal insufficiency and I should also be educated about the signs of adrenal insufficiency. As far as I can make out I should be watching for muscle weakness. The nhs Lanakshire policy states: “As steroid dosage is reduced/weaned below 5 mg daily prednisolone
Symptoms of steroid withdrawal may develop including weakness, anorexia,
dizziness, nausea, weight loss, malaise or lethargy.” Other sources suggest insomnia may occur.

Here is what one article says about Prednisolone tapering.

Does prednisone shut down your natural cortisol production? Here’s the precise answer

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group

Published: August 4, 2025Updated: August 4, 2025

Key Takeaways

Prednisone replaces the cortisol your adrenal glands normally make. A daily dose as low as 5 mg for more than two weeks signals the brain to turn off ACTH secretion, so adrenal cortisol output drops within days. Up to 60 % of patients on ≥7.5 mg for three weeks develop measurable hypothalamic-pituitary-adrenal (HPA) suppression, which can persist for months after stopping unless the drug is tapered.

How exactly does prednisone change my body’s cortisol production today?

Prednisone is converted in the liver to prednisolone, which binds glucocorticoid receptors with greater strength than your own cortisol. The brain senses this and immediately lowers ACTH release, so the adrenal glands reduce output within 24 hours.

• Brain feedback loops react within hoursACTH concentrations fall by about 80 % six hours after a single 20 mg prednisone dose.
• 5 mg daily can still suppress the adrenalsMRI studies show adrenal gland shrinkage in patients taking as little as 5 mg for 14 days.
• Even alternate-day therapy is not risk-freeHPA axis testing finds 27 % suppression in people on 15 mg every other day for eight weeks.
• One week of 60 mg daily slashes serum cortisolIn healthy adults given 60 mg prednisone each day, serum cortisol fell sharply in a dose- and time-dependent fashion, reaching only a small fraction of baseline after seven days. (BMC)
• Just 5 mg for a few weeks dims the morning peakAn expert review notes that doses as low as 5 mg prednisone daily taken for “more than a few weeks” can significantly suppress the body’s normal early-morning cortisol surge. (DrOracle)

Sources

Which warning signs tell me prednisone has suppressed my cortisol too far?

Because blood cortisol is low, stress tolerance falls. Certain symptoms require prompt medical review.

• Morning fatigue that feels worse than before treatmentIn surveys, 52 % of patients with adrenal suppression describe profound morning weakness.
• Low blood pressure when standingSystolic drops of ≥20 mm Hg suggest inadequate cortisol to maintain vascular tone.
• Nausea, abdominal pain, or fever during stressThese may herald an adrenal crisis, a medical emergency with a 6 % hospital mortality rate.
• Persistent hyponatremia on routine labsSerum sodium under 135 mmol/L occurs in one-third of suppressed patients.
• Therapy longer than three weeks can already depress the HPA axisClinical reviews note that courses of prednisone taken for more than 3 weeks are enough to measurably lower your own morning cortisol, so any dose changes should be tapered rather than stopped suddenly. (Healthline)
• Adrenal-insufficiency risk may persist up to a year after stopping steroidsHospital guidance warns that recovery of the adrenal glands can take as long as 12 months after discontinuing prednisolone, during which time extra “stress-dose” steroids may be needed for illness, surgery or trauma. (UHP)

Sources

Why do adrenal glands shrink during longer prednisone courses?

Long-term ACTH deprivation causes atrophy of the adrenal cortex, just like an unused muscle loses bulk. Recovery depends on both treatment length and dose.

• Cellular atrophy sets in after three weeksHistology shows cortical cell apoptosis after 21 days of pharmacologic glucocorticoid exposure.
• Higher doses delay recoveryPatients on >20 mg for three months average 6–9 months before ACTH and cortisol normalize.
• Children recover faster than adultsPediatric data reveal average HPA recovery in 8 weeks versus 20 weeks in adults.
• Quote from Sina Hartung, MMSC-BMI“Adrenal involution is a predictable physiologic response—what varies is how quickly we give the gland a chance to regrow by tapering doses responsibly.”
• Ultrasound confirms 13–42 % adrenal shrinkage after 5 monthsIn Beagle dogs given high-dose prednisolone for 150 days, the maximal caudal-pole diameter of both adrenal glands fell by 13–42 %, then partially rebounded by day 211 once dosing stopped. (BMC Vet Res)
• Systemic steroids reach 1–3 % of adults, magnifying atrophy riskA tapering primer notes that 1–3 % of the adult population receives glucocorticoid prescriptions, often for prolonged courses, exposing millions to potential HPA-axis suppression and adrenal involution. (NIH)

Sources

How can I taper prednisone safely to let my adrenal glands recover?

Tapering reduces the dose gradually, allowing ACTH pulses to restart without triggering inflammation withdrawal.

• Reduce by 10 % of the current dose every 1–2 weeks after you reach 20 mgClinical trials find this schedule keeps relapse rates below 5 % in most autoimmune conditions.
• Switch to morning dosing when possibleGiving prednisone at 7 am aligns with the natural cortisol peak and lessens night-time suppression.
• Use physiologic hydrocortisone during the final stretchPatients shifted to 10 mg hydrocortisone split doses experienced smoother withdrawal in 70 % of cases.
• Quote from the team at Eureka Health“A slow taper is an investment; every extra week on a lower dose buys back months of adrenal function later.”
• HPA axis recovery may take up to 12 months after stopping long-term steroidsLong-term users had documented suppression lasting “months to over a year,” so morning cortisol or ACTH stimulation tests are repeated before declaring full recovery. (DrOracle)
• High-dose courses (>20 mg for >8 weeks) should fall by 2.5–5 mg every 2–4 weeks once you reach 20 mgEndocrine taper guidelines advise stepping down to 5–10 mg at this slower pace and then by 1 mg intervals to minimise adrenal crisis risk. (EndoConsult)

Sources

Which lab tests and medications matter when monitoring adrenal suppression?

Targeted labs and adjunct drugs help clinicians judge whether tapering is safe and whether substitution is needed.

Full adrenal recovery may take up to a year after long-term steroidsEndogenous cortisol production can remain impaired for 3–12 months after stopping high-dose prednisone, so early testing may underestimate ongoing suppression. (DrOracle)

8 am serum cortisol under 5 µg/dL signals high riskValues below this threshold predicted failed rapid taper in 92 % of patients.

ACTH stimulation test confirms recoveryAn increase to >18 µg/dL 30 minutes after 250 µg cosyntropin means the axis is competent.

Fludrocortisone usually not requiredPure glucocorticoid withdrawal rarely causes mineralocorticoid deficiency, so adding fludrocortisone is reserved for marked hypotension.

Methylprednisolone may allow lower total doseIts higher receptor affinity means a 4 mg dose matches 5 mg of prednisone, reducing cumulative exposure.

Hold glucocorticoids before ACTH test to avoid false reassuranceDiscontinuing prednisone at least 24–48 hours before cosyntropin minimizes assay interference and prevents falsely normal stimulated cortisol values. (DrOracle)

Having read this you can see why I ignored the person who did my oncology review and told me to cut my dose by half for a week (at first) and to two weeks when I challenged it and then stop it altogether! I have in fact cut my dose in half and will continue that until at least the next oncology review in September unless I experience adrenal insufficiency. I suspect the inclusion of all this stuff is all about my anxiety of taking control of my steroid tapering in the face if what I perceive of as ignorance of my oncology team. when al is said and done, today I have started a process that is important.

I draft the blog and ponder on something I read on one of my news feeds. It was an article on how to know if your wife is “quietly quitting” your marriage. Their were five tell tale signs the first of which was, and I quote, “She stops laughing at your jokes”. I am amazed that this is first on the list but I’m more amazed that this is something I should be doing. Really is this my role, make her laugh, be the entertainer, the monkey on the street organ. I say I say why did the chicken cross the road? According to this article I’m screwed. Onward nevertheless. Two priest were stopped by police. The policeman says I’m looking for child molesters. The priest look at each other and say “we will do it”. You can blame David Sedaris for that one.

Sunday and its a lazy morning and one that continues to prompt me to ask “what is this?”

549

I feel becalmed,
drifting in circles,
directionless.
In this state
I see the stars rotate
and I an ever fixed mark,.
Around the ocean,
the sea life 
with its tides and currents.
Atop of it
I bob about
drifting.
Is this
what it is.

                                            549 26-07-2026

The day drifts between some clearing up and some mending. Firstly there is the soft toy tigers eye to stick back in, and then one of my Japanese kneeling women from the garden lost her head when my partner tripped over her. So I called on all my mending skills to stick the head back on and of course gaffer tape it to keep it in place until set. More trying was the time spent trying to mend my phone. The screen went black and I went into serious problem solving. Eventually I get the screen back up and running and change my display settings, it might last, it might not.

The rest of the day goes by with Commonwealth Games and in the evening the discovery of a new and reasonable drama series called Steal. I get to the end of the day, draft a brief blog, take my meds and go to bed. Tomorrow is my eldest daughter’s birthday so there will be cake and lunchtime treats at our local Pesto.

Saturday and its up for breakfast with my partner on the patio. With food and morning meds out of the way my partner and I go to the garden centre butchers to buy meats and other goodies to eat in the warm weather that is coming. Once home I sort out some things for my eldest daughters birthday on Monday. The afternoon starts with a shared lunch with my partner taken on the swing seat in the garden. A lazy time before I return to the house and prepare the cottage pie evening meal.

A friend sends me a picture of the tattoo she has had done today to celebrate her and her partners fortieth wedding anniversary. It is a really good Japanese inspired tattoo. Her partner also has a similar one. I spend my evening watching the Commonwealth Games and an interesting western where everyone apart from the two children die. I draft the blog and think abut whether I am any further forward in thinking about what stage of my cancer journey is at. I still do not really know so the “what is this?” question is still very much a live question for me. I take my meds and go to bed.

Its Friday, I’m no longer in the chemo rechallenge. After breakfast I go to the garden to think about where I am and what this time is. Being me I end up writing something like poetry.

548
Day 1, what is this?
sitting on a swing
listening to the Stones,
a whining harmonica.
My Stratocaster mute
waiting on a jack plug,
I do not know what this is.
The chemo challenge is over,
no new intervention,
no cancer weapon deployed.
I'm in the trenches
waiting for the enemy 
to advance, and advance it will.
So here I am
asking what is this?
Me time?
Quality of life time?
Palliative care?
I don't think I've been told
to fuck off and die,
I know there is a sister drug
that can toxically be tried,
so what is this?
I am bemused by this space,
this hesitation in life
as if I've developed a being stutter,
not sure of my life words,
my feelings or what to do.
This has the air of danger,
too easy to slip into
casual acceptance of sloth
and forget that this is a fight ,
its all out warfare for my life.
Is this the Christmas football game 
across the trenches?
What is this?
This started as a list,
a random jotting
to try and find 
a new name for the blog
and here I am doing poetry.
I still do not know,
what is this?

                                                             458 24-07-2026

I’m in a strange place but I listen to music, read the meters and submit their numbers. I respond to a quote, order shredding bags and a birthday cake for my eldest daughter. I start to make a shepherds pie until thwarted by the lack of viable potatoes and start to draft the blog. My new head phone jacks arrive and I await my chance to fire up the Stratocaster and the Peavey amplifier. So I slide into a Friday evening not quite sure where I am in my journey. It feels like I need a plan and all I’ve got at the moment is an inkling to start training again and tapering off my steroids. Maye that should be enough right now and the rest be played by ear.

Thursday the 23rd of July, the last day of my chemo rechallenge. Its over, done with and I enter a new era and the challenge of finding a new heading for the blog. Suggestions welcome. It means no more chemo for a while, no interventions, just blood monitoring. It also means no more children’s toothbrushes, its back to the power tool.

I finally get up after drinking my morning hot water, checking my social media and news feeds. I take my vitals, but I am not really interested, I do it for completions sake. My blood pressure is okay as is my heart rate so everything is tickety boo. I shower and then then search the pantry for muesli but find none, so its toast and marmalade for me. I take my meds but as yet I’ve not adjusted my steroids yet to start the tapering process, I intend to do that on Tuesday next when I refill my dosettes. Need to keep some routines. A friend rings as she is on her way to do the shopping prior to traveling on holiday tomorrow. She is looking forward to her family holiday and the chance to rest and recover by the seaside. Its an exciting time but there are the holiday chores to do like packing the car and organising the travel snacks. After the call I have a long conversation with my eldest daughter about the official secrets act and what that means for research. I move on to booking a Tesco slot before a guy from the house alarm calls me and discuss an upgrade to my system. I eagerly await a quote.

By now I am hungry as is my eldest daughter so its timely when my partner returns from having her hair done and I suggest we go to Pesto for a good lunch. We arrive to a quite restaurant and settle in to a prolonged late lunch. It is a celebration of doctoral completion, chemo challenge completion and successful hair artistry. Of course when it gets to the pudding menu I immediately know its Affogato for me with an additional shot of Amaretto, well why not, fuck it, what have I got to lose other than everything. I pay the bill and we drive home. My next task is to get a quote form a local shredding company to get rid of all my eldest daughters PhD notes and all my old confidential papers lurching in my “must shred” box and the boxes in the loft stuffed with old assessments and reviews. With the prosaic done I take a photo of my chemo challenge tooth brushes and start the draft of todays blog.

With the draft done I head for the garden to see how it is going and then uncase the Stratocaster and tune it up and try to remember what all the knobs do on the Peavey amplifier. I am a crap guitarist but on occasions its nice to hit a few chords and pretend I can play blues in all its distorted forms the amplifier can produce. The rest of the evening is any bodies guess but I don’t care really, tomorrow I start a new era in my Cancer Years adventure and I am not sure I can afford to care too much about the future. It all ends up in the same place, the question is which path is them most fun.

Wednesday and I wake after a reasonable nights sleep having watched the History Boys before going to bed late. My injection site from Monday is still swollen and sore so I am in discomfort when I move around. My partner brings me a hot water and I finally get up, having sent several emails. I am pleased to say that the person who wrote the Forward to the last poetry anthology has agreed to write one for the new poetry collection, which is very pleasing. I try and tidy up the growing pile of “stuff” on the lounge coffee table but I get interrupted by a phone call from the oncology team. My expected time is in the afternoon but the woman explains she is starting the phone calls early. Well that’s alright then, clearly the nhs does not expect its cancer patients to be doing anything other than hanging around waiting for the team to call. Clearly any appointment time that is sent out is now variable by at least five hours.

The conversation was quite odd. It seemed that the expectation was that I was going to go for cycle 10 and she seemed taken aback when I said that as the intervention had stopped working that I was not going to do Cycle 10. I pointed out there was no point in doing cycle 10 if the intervention had stopped working. So we talked about PSA levels and the progress that I had made but that for me the logic was in the arithmetic. She eventually agreed with me and said that she would send me blood forms and a new date for four weeks time. I raised the issue of tapering off the steroids. Her first response was to cut down to one a day for a week and then end them. when I pointed out how long I had been on them she changed it to two weeks and then stop. I have no faith whatsoever that she knew what she was talking about. I shall read more and research the tapering process and see what the literature says before I do anything else. Then it was over. So tomorrow is the last of the 21 days of the cycle 9 and will be the end of my chemo rechallenge. It will have lasted 220 days plus a 14 day holiday between cycles 7 and 8. Over that time I have reduced my PSA by 69.9%. All that matters now is the rate of rise in my PSA from here on in.

My partner makes me a fried egg sandwich to go with my orange juice and morning meds after which I start to draft the blog for the day. While doing this my eldest daughter returns home from the physio asking how many graduation day tickets we want. So if all goes well I will be seeing my eldest daughter be presented with her doctorate in early September.

The rest of my day is spent lunching with my partner and planting newly acquired plants into the garden before spending the evening watching the most appalling juvenile film until my partner retuned from the theatre. I take my night meds and go to bed. Tomorrow is officially the last day of my chemo rechallenge.

Tuesday and its been a rabid night, my injection site is very sore and tender I got up at 5am to take paracetamol again and clearly passed out till 11:15am. I came to feeling shit and sore. It takes a while for me to get up and get breakfast (more an early lunch) and take my meds. After the disappointment of the blood results last night I am feeling flat and deflated. I’m not sure where my next move is. I know that cycle 10 is out the window and that the oncologist will just want to monitor me for three months and tell me to fuck off and have a nice summer.

I spend time sending the additional poems and manuscript stuff to the editors at Rulers Wit to complete the manuscript for the new poetry collection. Later in the day I ask the person who wrote the Forward for the Man to Man anthology to write the Forward for The Rechallenge. My partner returns from the gym and has lunch after which we drive to a distant garden centre to collect a new hand bag ensemble that my partner has ordered. It is identical to the one she has and reordered one because it has been so successful and functional. Just like buying the same brand of underpants because they are comfortable. I am wearing my new Wildhearts T shirt, a gift from my eldest daughter who went to one of their gigs last night. While sipping diet coke and forking a coffee and walnut bun into my mouth we chat about my blood results and that the Chemo Rechallenge has come to an end. We both know that there will be no intervention beyond weaning me off the steroids for at least three months so we decide to investigate a short break away at a Spa. We drive home and I set about booking a Spa break. Mission complete. In early August we will be Spa ensconced and being rubbed down with oily rags and dining on, hopefully, robust food.

The evening arrives, I’m not hungry so it turns into a FFY (Fend For Yourself) evening. Apart from the Great British Sewing Bee and The History boys there is sod all on TV so I might just get the Stratocaster out and see if my fingers still work on a guitar. It all depends if I can find my Roland headphones. After my crap night last night I shall head to bed early having taken my meds knowing that tomorrow is the last of the Chemo Challenge and that my oncology review is going to be a disappointment, at least I can negotiate a tapering off of my steroids. I think I’m tottering on the brink of just saying “Fuck it”.

Monday, I am up early to make breakfast and take my morning meds as my partner goes to the gym. I take my car to he garage and run it through the car wash and check the tyres. Having topped up the tank I drive home for a quick change of clothes. At lunch time I go to the GP surgery and have my 28 day jab, a B12 jab and a set of bloods taken. The nurse had to have two goes at getting my blood with aa result that I have a hole in each arm.

A quick trip the garden centre for a bacon roll and a diet coke along with my partner and eldest daughter. Of course we came away with another plant which I planted up later in the garden. A friend rings me and we chat for a while about holiday experiences and how our families are. it was good to catch up and exchange news. Into the evening I take paracetamol to dampen the injection soreness. There is a meal and two Spiderman films before my blood results come through, which I caste up into a grid.

My PSA has risen slightly, that’s no good. There will be no Cycle 10, the logics in the arithmetic. I draft the blog and having taken my meds go to bed, disappointed and anxious. This is a set back.

Sunday and I wake up late with a headache. Once up its toast for breakfast with my morning meds and paracetamol. While I wait for the paracetamol to kick in I create a Moonpig birthday card for the eldest grandson of my youngest daughter. Hopefully it will arrive on his birthday on Tuesday. With the card on its way I start the draft of todays blog. There is little for me to do today apart from riding myself of this headache and preparing for tonights world cup final. Tomorrow is a 28 day jab, B12 and bloods day so I shall prepare for those as best I can. It is a crucial set of bloods as the PSA result will determine whether or not I get to finish the chemo rechallenge or go onto the last cycle, cycle 10. If the PSA is down by a reasonable amount the logic dictates that I should go for cycle 10, if it is not then its probably best to stop, the question is “what is a reasonable amount”. On average I have decreased my PSA score by 0.86 per cycle but the dosage used in the last two cycles has been decreased. My last PSA score was 3.1. The lowest it could get if the average of 0.86 is applied over ten cycles is 1.4. I will be disappointed if my PSA score on tomorrows bloods does not dip below 3. How much is the question, I think I will be pleased if it gets anywhere near 2.5. If it does I will be inclined to go for cycle 10. I stand by my dictum of “the logic is in the arithmetic”.

Spain beat Argentina 1-0, so its night meds and off to bed.