Update Frank 1205

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Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 5/9/2008 8:38 PM (GMT -7)   
Hi All,
 
Good News
I just got the news yesterday via the answering machine that my PSA was not detectable <0.05.  I feel like the 700 pound Gorrila just got off my back and sat in the chair next to me. I am so very pleased with this considering the bad margin and all.
 
Bad News
I met with the oncologist today and he was also very please with the PSA but with my expected life to run another 20 or more years, he will meet with Urologist and Radiation Oncologist to discuss the use of radiation to put the gravy on the potatoes so to speak.
 
I realize that this is the first PSA and after suffering from "PSA Interval Stress Syndrome" (PISS) tongue I am displaying cautious optimism.
 
Hind sight speaking,  I feel I should have gone to a regular Oncologist with prostate experience as soon as I was diagnosed.  He seemed to provide a very different dialog in regards to course of action.  He did state he would have recomended surgery in my case but since he neither does surgery or radiates he was completely unbiased.  I loved this guy...
 
But now I have different questions...
 
The decision for radiation in mine.  Who else has made this decision with bad margins and what were your considerations?
Should I be able to keep working full time through this?
I am greatly concerned about side effects or permenant damage to the rectum, those fine little nerves that were just spared and of course all of ours second priority, continence.
 
Thank you all for being there for me.
 
Best Regards
 
Frank
Diagnosed 01-08-08 @ 53 years old 
DRE normal - High PSA for 5 or more years
2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Current PSA 6 - Bone and Ct scans negative
clinicalg Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours - Catheter out in 7 days  normaly expected leakage - Erectile funtion back on line 9 days 
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on top of prostate distal from apex. 1 positve margin at urethra and bladder.
Six week PSA < 0.05 Ya Ba Da Ba Dooooooooooo.  Put a steak on the grill Wilma!!!!
Oncologist to discuss case with Urologist and Radiation Oncologist to consider radiation.
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 5/9/2008 8:56 PM (GMT -7)   
Hey Frank,

I can't help with the radiation but I appreciate the new acronym.. I always wondered what they called that...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 5/9/2008 9:10 PM (GMT -7)   
Frank,
 
I am linking the Han Table.  I entered your post-surgery pathology results and it shows the likelihood of cancer returning.
 
Thought this might be of help to you.
 
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


Ken S
Regular Member


Date Joined Nov 2006
Total Posts : 120
   Posted 5/10/2008 8:17 AM (GMT -7)   
Frank,

You should be able to continue to work. One side effect may be fatigue but I was told that at my age it should not be a problem and it wasn't. You'll just have to take time away from work everyday for 7 weeks or so unless you can get appointments outside of your working hours.

As far as making the decision to proceed with radiation the doctors wanted to take an aggressive approach and I agreed and have had no regrets.

I was pad free for a few weeks prior to radiation but now have stress incontinence and will wear a pad, most of the time, when I leave the house. Quite often I didn't need to but occasionally I glad I did. It does seem to be improving.

The only rectal problems I had was a little rawness, while having treatments, but Preperation H took care of that. I believe damage to the rectum is rare.

My ED problems seemed to stay the same but now seem to improving ever so slightly.
Without ever using any aids at all I achieve a 60 - 70% erection. Before radiation it was probably 50%.

Ken
Age 54 (2006)
PSA: 2005 - 3.2, 2006 - 3.7
Biopsy 8/06, Gleason 6 (3+3), T1c
Radical Retropubic Prostatectomy 11/3/06
Memorial Hospital, Pawtucket, RI
Post-Op Biopsy, still Gleason 6 (3+3),
T2c, right apical margin positive
CT Scan 1/07, tumor discovered on right
kidney (unrelated to PCa)
Partial Nephrectomy 3/9/07
R.I. Hospital, Providence, RI
IMRT (37 Treatments) 4/23/07 - 6/14/07
PSA: 11/07 - less then 0.01
4/08 - 0.04


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/10/2008 9:32 AM (GMT -7)   
Good news about the PSA.  The rest of it will come into focus as you consult to see the options.  With a positive margin, it's almost accepted that 'salvage' radiation could be the next step. 

James C.  
Help support the forums so they can support you:  http://www.healingwell.com/donate  
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   (Open) Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08   Caverject started/stopped, aching.  2/24/08 .5ml Bimix started-success
5/7/08     ED- Viagra, pump, no response- Trimix .075ml continues
              Post-surgery PSA's:  3 mt:0, 6 mt:0,


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/10/2008 10:14 AM (GMT -7)   

000000000000000000000000000000000000000000000000000.

Woo~Hoo!

Great News!  Frank's a big Zero. 

I knew you didn't have it in you!!!!

000000000000000000000000000000000000000000000000000

 

God Bless and heal fast!

 

Tony


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
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


mlbsm
Regular Member


Date Joined Mar 2008
Total Posts : 85
   Posted 5/10/2008 1:31 PM (GMT -7)   
Congrats Frank, really good news.

Now you can spend a little time at the cabin.

Take care,

Billy
DIAG. 2/08
DRE POSITIVE
PSA 6.8
CONTAINED, LEFT SIDE, GLEASON 9
LUPRON, (3 MO.) 2/28
SURG, SCHED. 3/26/08
RRP, 3/26, HOME 3/31
BIOPSY REPORT:
GLEASON SCORE, 3+4
TUMOR CONFINED TO THE PROSTATE, INKED EXTERNAL SURFACE FREE OF INVOLVEMEN


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2268
   Posted 5/10/2008 4:01 PM (GMT -7)   
Good news like this always cheers me, Frank!   Hope your continued monitoring has equally negative results.  Tim

MURPHY1
New Member


Date Joined Apr 2008
Total Posts : 12
   Posted 5/12/2008 6:24 AM (GMT -7)   
Frank - who was the oncologist and was he at U of C?? our appointment is next week and I wonder if we should see him at the same time as dr. Shalhav??
 
Thanks for your help and congrats on the PSA what great news!
 
 

norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 5/12/2008 8:05 AM (GMT -7)   
Frank

Great news on the big "0" and keep em coming. As for salvage radiation it looked as through my cancer was contained with-in the prostate but did have some close margin calls in a spot or two. My first two PSA tests were undetectable but my third one saw a slight rise, so after a couple more tests over the next 4 months to validate the results and seeing it continue to rise I started salvage radiation on April 14, 2008. I have as of this morning 21 treatments completed and 15 to go and so far, knock wood, it has not affected me too badly. I work every day and keep up with kid events late in the day. There was one Friday that by the end of the day I was pretty tired but I don't know that it was just the treatments, I think everything else helped that too. The only thing I have had is my bowels got a little active but a couple half doses of over the counter medication and I have been fine and have not had any again now in over a week. I will up-date as I finish my last three weeks and see what happens from here on in. Good luck with your decision and may you never see your PSA rise again.

Norskie
norskie
Age 49, PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Surgery Pathology report 4+3=7 a couple agressive Grade 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
1st & 2nd Post PSA Blood Test .1 and less - Undetectable
3nd Post PSA Blood Test 01-17-07 .3
March 27th PSA .4 Begin Salvage Radiation April, 14 2008
Incontenence-Pad free since end of May 07 4 1/2 months post surgery 
ED back to 95% prior to surgery - no medication required.


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 5/12/2008 9:30 AM (GMT -7)   

Frank

I was one who was surprised/shocked to find out my cancer was worse than the pre surgery biopsy predicted.  At my 3 month post surgical check, even though my psa was .01, my surgeon and oncologist discussed radiation.  They mentioned that some recent studies have shown that for positive margin patients, radiation within the first year will improve your chances to avoid reoccurance.  When the 6 month psa check was .08, my mind was made up.  I really never had side effects during, or after the 32 radiation treatments.  So far, my psa continues to be 0 and I'm continuing on the hormone zoladex for a total of two years.  The radiation probably has zapped those saved nerves, and the hormones can have some side effects as well, but I haven't had a real problem.  However, I proudly escorted my daughter down the wedding isle Saturday, and living many more years to experience grand kids and all the rest of the benefits of my post retirement life is my highest priority - and my wifes as well.


Age 57 at diagnosis,  PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26 with Zoladex injection
Radiation began August 23, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 5/12/2008 8:43 PM (GMT -7)   
An excellent acronym! Great news on your first post-op PSA--------------may they continue yeah

Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable


Pelahatchie
Regular Member


Date Joined Jul 2007
Total Posts : 86
   Posted 5/13/2008 6:24 AM (GMT -7)   
I would recommend you go for the salvage radiation.  My situation is very similar to Norskies, I finished nine weeks of IMRT on March 6th with a total dose of 72gy I believe.  My PSA was .1 when I started and at my six week check a couple of weeks ago it was down to .03.  I have had very few bad side effects but radiation has caused some aches and pains in my hips and thighs that I did not have before and my rectum is still tender but this is all manegeable.  I waited 26 months before I went for the radiation and I wish I had done it sooner, so my advice is to go for it.  As far as sexual impact I have had no problems so far but the doctor said it could take up to six months before we delared victory on that front.  Good luck with your decision!

Age 45 at DX
 
DX 8/05 Gleason 5, Mayo clinic Second Opinion Gleason 6, PSA 2.8
 
Da Vinci surgery Dr. Dasari, Centennial Nashville 9/24/05
 
Pathology Report Gleason 6, 15 % on left side only very near to the edge of capsule, too close to call on margins, doc's said to watch it very closely, final decision T2A
 
PSA's have basically ranged from <.04 to .05 for two years.
 
no E.D. and no Incontinence, feel very blessed
 
PSA Nov 07 = .06
 
PSA Dec 10th 07 =.07
 
PSA Jan 4th 2008= .1
 
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes, completed on March 6th, 2008
 
PSA April 18th 2008 =.03


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 5/13/2008 8:36 AM (GMT -7)   
Thank you all for your kind and informative comments. I am awaiting my appointment to be made with the Radiation Oncologist at this time. I will do this next step if they recomend and I am pretty sure they will.

Thanks again to all of you,
Frank
Diagnosed 01-08-08 @ 53 years old 
DRE normal - High PSA for 5 or more years
2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Current PSA 6 - Bone and Ct scans negative
clinicalg Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours - Catheter out in 7 days  normaly expected leakage - Erectile funtion back on line 9 days 
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on top of prostate distal from apex. 1 positve margin at urethra and bladder.
Six week PSA < 0.05 Ya Ba Da Ba Dooooooooooo.  Put a steak on the grill Wilma!!!!
Oncologist to discuss case with Urologist and Radiation Oncologist to consider radiation.
 

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