A trip to my new urologist and I can't believe what I was told

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fredlp
New Member


Date Joined Jan 2007
Total Posts : 14
   Posted 4/18/2008 7:12 PM (GMT -6)   
I had Proton/Photon radiation therapy at Loma Linda April May and June of 2007.  I also had 5 months of Lupron before and during the treatment.  44 treatments in all.  My pre-treatment PSA was 15.6, gleason 3x4=7, stage T1C.  Two cores positive out of 12 @ 30%.  I had my first post treatment PSA in September 3 months after last Hormone shot (1 month shot)  Still feeling effects of Lupron, hot flashes, etc.  PSA came back 0.1.  Urologist said great, next PSA in 6 months.  Just took the test and had my appointment today.  The Urologist said PSA now 0.3.  He said I need to go back on Lupron right away because the cancer is probably active due to doubling time estimates.  I am devistated.  This seems contrary to everything I have read regarding post radiation PSA readings.  I could sure use some advise here.  Maybe PC Dave and some of you guys can provide some input.  Regards to all, FredLp

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/18/2008 8:13 PM (GMT -6)   
Even though the PSA is still relatively low the doubling time would be a concern. From my limited experience I find it odd that you were only on Lupron for 5 months. Most men that I have contacted stay on it for a minimum of two years. Go back on the Lupron like the doctor says, and try hard to stay mentally, emotionally, and spiritually strong. I believe you will find the results to be better than you may expect right now. Thanks for sharing with us and may God's peace be with you.
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
 


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 4/18/2008 10:22 PM (GMT -6)   

Fred:

I'm so sorry to hear that you are going thru a rough time right now.  I don't know much about HT, so can't answer to your first PSA result.  Hope that Tony (TCVegas) will see your post tomorrow and be able to give you some insight - he has alot of very valuable knowledge.  Please try to stay positive and know that we are here for you. 

Dutch


Diagnosed Feb 2001  (Age 65)  Currently 72
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - 2001 - No side effects.  My journey is at: http://www.healingwell.com/community/default.aspx?f=35&m=727565
7yr PSA - 0.2
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 
 


Jayadub
Regular Member


Date Joined May 2007
Total Posts : 89
   Posted 4/18/2008 11:20 PM (GMT -6)   
Fred

I don't think your urologist is correct that the cancer is active, but I am not a doctor. There has been no real doubling. Your 1st PSA was obviously suppressed by the HT. The 0.3 that you are getting now is your true PSA. If I were you I would contact Loma Linda and have them discuss this with your urologist. I would do this ASAP so you do not have to undergo another Lupron shot and wait 6 months for the effects to wear off.

54 years old

PSA 5.6 on 3/20/07

DRE: Negative

Biopsy on 4/20/07 

Results 4/25/07:

3 out of 12 cores positive, 2 on the right lobe with 5% adenocarcinoma Gleason 3+3, 1 on the left lobe 10% adenocarcinoma Gleason 3+4, overall Gleason graded 7 Cancer T1C.  After web research discovered Proton Beam Therapy and called Loma Linda. Completed consultation with Dr. Luu on 7/5/2007 and started treatment at Loma Linda on 7/26/07. Completed treatment 44 on 9/28/07. 0 treatments remain. Side Effects remain minimal. 1st PSA result on January 28th is 1.1.


fredlp
New Member


Date Joined Jan 2007
Total Posts : 14
   Posted 4/19/2008 8:41 AM (GMT -6)   
Jayadub - I agree with your assessment. I was having hot flashes from the 5 months of Lupron until Nov/Dec. The PSA in September must have reflected some supression from the drug. I contacted Loma Linda yesterday and they will get back to me next week. Thanks for your support. Those of you who have responded, thanks much, Fred

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/19/2008 10:39 AM (GMT -6)   
Fred,
I have always understood that you need more than one test to rise consecutively before reacting to the rise. Especially when radiation was the primary treatment. PSA bounce is a natural occurance for radiation patients. AND I was surprised that you acheived an undetectable PSA so soon after proton therapy. I agree with Jayadub, that was not an accurate reading because of the HT. I don't like a treatment plan involving HT with radiation. I know there are studies that show by shriking the cancer the radiation can be made more effective, but none of those studies talk about the fluctuations after treatment and after HT. That sets up a nerve racking time when you see fluctuation. You need a second opinion before using HT again. Loma Linda has greater experience when using this treatment plan. I believe you will be instructed to watch for a while. Get more tests to show a trend instead of a single rise. Good luck. Take is easy, this just may be part of the treatment plan and not bad news.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


fredlp
New Member


Date Joined Jan 2007
Total Posts : 14
   Posted 4/19/2008 10:52 AM (GMT -6)   
TC- Las Vegas - Thanks for your input. That's exactly what I felt. It's very hard when you are talking to a medical professional and totally disagree with what he is telling you. One thing I have learned here is to be your own advocate and take charge of your own circumstances. Thanks again, Fredlp

gustaf
New Member


Date Joined Apr 2008
Total Posts : 1
   Posted 4/20/2008 8:46 PM (GMT -6)   

Fred,

Sorry to hear what is happening here! I had post operative radiation treatment last year June and July (34 total) at The Center for Radiation Therapy (malignant neoplasm of prostate (active)). I was treated with a brand new concept 3 dimensional 3mm colimeter beam. No hormone treatment at all. My PSA since (after 3 tests so far) is zero. No side effects at all. If you wish - I put you in touch with Dr.Christopher Rose (who by the way) is the nicest, most humble and knowlegeable Oncologist you'll ever know. Otherwise call 310-205-5777.

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