A detectable level of prostate-specific antigen (PSA) is the first indicator of recurrent prostate cancer after radical prostatectomy. In a new Mayo Clinic study, the concept of PSA doubling time (DT) is found to be a reliable tool to distinguish which patients have prolonged innocuous PSA levels after therapy from those who are at great risk for disease recurrence and death from prostate cancer. Doubling time is defined as the duration for PSA levels in the blood to increase by 100 percent.
Mayo's study, published in the April issue of Mayo Clinic Proceedings, concludes that patients with a PSA doubling time of less than three months after therapy are at imminent risk of death from prostate cancer. Patients with a doubling time of three to 12 months are at a significant risk for the development of systematic disease and cancer-specific death.
According to the authors, the new findings should prompt physicians whose patients have doubling times of less than one year to treat them with systematic therapies. Patients with PSA doubling times of one to 10 years are more likely to have a local rather than systematic recurrence, and patients with a PSA doubling time of greater than 10 years are at a low risk of recurrence.
Recurring PC After Radiation
Post Edited (pcdave) : 4/26/2007 5:35:17 PM (GMT-6)
Terrific posting!! I visit my cancer "team" tomorrow. Besides the information that has been tested - positive margins, gleason 3+4, post surgical PSA 0.01 - I want all the information I can prior to talking to them. I just printed out that article you referenced, and will have it with me. My thoughts are now that I'll wait and see what my PSA is in three months, etc. and make decisions on further threatment if things change. According to Dr. Walsh's book, with my gleason score - 7 - it won't change my survival statistics to delay any radiation unless I get my PSA rising above .2, or a high double rate. I'll put another posting up late tomorrow about what my doctors tell me. (Again, another shameless plug for Virginia Mason in Seattle. They have a prostate cancer clinic director who sets patients up with a board of 4 specialists in one day to review their specific treatment options. I cringe when I read about forum members who have had to search out these on their own. Expect for the fact that my initial biopsy showed much less cancer that what was there, I have been very pleased.)
Post Edited (aloha dave) : 3/28/2007 7:47:46 AM (GMT-6)
Post Edited (pcdave) : 3/14/2007 11:58:13 AM (GMT-6)
Post Edited (pcdave) : 3/14/2007 8:00:29 PM (GMT-6)
You have to remember that ultra sensitive PSA tests are very touchy things. My .01 may be .03 tomorrow, and .02 in a few days. What one of my doctors mentioned yesterday, was to look if it rose to .05, and that would be significant. A lot of the information I've read says that reoccurance is when it reaches .2 The main thing is not to get upset if a 0 goes to .01, etc...
PSA from 3.2 to 4.3 in one yr
4 of 12 cores positive, one lobe, less than 10%
Inflammation only second lobe
Stage T1C Clinical Dx
PSA prior to surgery: 3.9
Da Vinci Prostatectomy 2/27/07:
PCa in BOTH lobes 5-10% of gland
Negative tissue margins
Bladder, seminal ves, vas deferntia negative
Two inguinal hernia repairs
Catheter removed 1 wk after surgery
Full continence (no pad needed) 1 wk after surgery
54 years old
PSA = First ever was 9.8 in late Oct. ‘06, two weeks later, 10.1
Biopsy results 11/22/06 (6 out of 8 cores positive), both lobes, Gleason 3+3 = 6
Da Vinci Robotic RP surgery, City of Hope, Jan 12, 2007
Post surgery pathology – Organ confined, Gleason still 6, margins clear.
First post-surgery PSA -- Undetectable, 2/20/07
Post Edited (pcdave) : 4/26/2007 12:50:54 PM (GMT-6)
Post Edited (pcdave) : 3/16/2007 5:21:24 PM (GMT-6)
Sorry for the late post. We are On The Road and sometimes don't have access to the internet. I think that newsletter is on my home PC. Darn. I'll do some research and see if I can find it elsewhere.
Dave & All,
Could not find the Newsletter that mentioned the Proton Beam Salvage Treatments, but I did find 2 testimonials on the www.protonbob.com website. I'll paste them here and they also can be found on the website under Testimonials.
I'll start a new topic also as this might be missed.
David Leighton - Foresthill, California
When David Leighton’s radical prostatectomy failed, he chose Proton treatment to go after the cancer cells the surgery had missed. That was 5 years ago. Today things are looking great! Following David’s brief testimonial, he relates an inspirational story about his brave friend, “TC.”
Proud to be aboard the Brotherhood. This is an outstanding program. I am a solid believer in the "Proton," and your organization is right on track getting the message out to all those in need. Keep up the good work! Early detection and Proton treatment is the way to go!
10-17-95, the prostate biopsy came back hot in the upper left quadrant of the prostate.
12-12-95. my prostate was removed.
Two years later, the PSA began to climb again.
11-20-97, ProstaScint - UCLA - indicated cancer in the prostrate bed.
1-26-98, City of Hope, consulted with Dr. Wawachi regarding regular or Proton radiation. PSA 7.
4-98, Started Proton radiation - Proton all the way.
Completed Proton, 2nd week of June 98.
So far, PSA is Non Detectable, as of Feb. 2003.
Had no radiation side effects, whatsoever.
That's my history.
Thanks so much, Bob for having me aboard. Looking forward to communicating with all members!
Steven Hodgdon - Hatley, WI
Like many of our members, Steve’s initial treatment for prostate cancer was surgery. When his cancer returned, he chose proton therapy for salvage treatment.
Following is an email sent to me by Steven Hodgdon, a former surgery patient whose cancer had returned. He chose proton therapy at Loma Linda for salvage treatment.
I just finished reading the Proton Bob newsletter from June where you were speaking at Loma Linda's Wed. meeting. I was a post prostate surgery guest at Loma Linda starting in January 2006 and finishing up there on March 10th.
Four years after having my prostate removed my psa began to climb and when it reached 0.20 my urologist advised traditional radiation as the next step. I wasn't too keen on getting that done after hearing about the possible damage to good tissues that conventional radiation can have. After pressing my oncology radiation doctor about other treatments he then told me about proton radiation treatment at Loma Linda and mentioned that he had graduated from there some time ago and that his son now is going to Loma Linda. He said that if he were me and could afford the time and expenses, he would go to Loma Linda. After this fine recommendation, and some research and correspondence with Loma Linda the decision was made to go.
The experience as others have testified to, is almost indescribable. Being treated as a guest and with respect at every turn, the opportunity to socialize with other guests, and the professionalism by all the staff is overwhelming. My wife and I came home with many new friends and a very positive outlook on my recovery. Dr. Rossi is indeed an expert in proton treatments and is confident in his practice.
I had my first follow-up treatment after two months (standard for post surgery treatment), and am so elated to say that my PSA was non-detectable. Also, my friend Rex from N.M. who had post-surgery proton treatment at the same time, reported to me that he had the same results.
So anyone out there with ‘returning’ prostate cancer absolutely needs to check out Loma Linda. Bob, when I first contacted you to join your group I was surprised to get a personal e-mail back from you outlining the success of other Proton Bob members who had post-sugery proton treatment. That little note of yours really helped build up my hopes. Thank you. I hope this makes your testimonial pages so that others having similar cases will know that proton treatments for post-surgery returning prostate cancer really are effective. Best Regards, Steven Hodgdon, Hatley, WI. Keep up the great work!”
Hope this helps.
Post Edited (pcdave) : 3/20/2007 6:23:17 PM (GMT-6)
Hope your treatment is going well with little side effects.
You are correct as far as the seriousness of the reoccurence. With Protons the area would have to be a Targetable area. They do both Proton and Photon if there is any question about the extent of the spread.
Each Patient is unique and a consultation with a knowledgeable Urologist would be the best way to go. Knowledgeable is the Key Word. Some are not even aware of all the possibilities. Sad to say.
Time is the most important issue with a reoccurence. Catching it quickly is the key ,whether it is Salvage Treatment or your 1st treatment.
At long last I am hearing from you! I think of you and Don often and have been wondering what progress you and Don have been making in pursuing the continuing treatment needed for him because of the most unfortunate failed surgery. I am glad to hear that you are communicating with Loma Linda--it gives you hope. Not being a doctor, I have no idea about the cancer in the distant nodes. I don't know how often that happens. Usually the nodes in the pelvic area are removed at the time of prostate surgery. If they can identify where those distant nodes are, why couldn't they be removed surgically. In many other types of cancer operations, it is common to remove nodes elsewhere in the body. Has this possibility been discussed with any of your doctors? I would hope that Don would agree to any further treatment that gives him a good chance of wiping out the remaining cancer. I know it has not been easy for both of you, but don't give up the fight. Please keep us informed of the progress you are making. What a wonderful wife Don has! Fighting for her man all the way! God Bless!
Post Edited (myman) : 3/30/2007 3:41:25 PM (GMT-6)