PSA rise after RRP

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Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/11/2008 5:35 PM (GMT -6)   
Hi,
I had my RRP in Nov., 2006 and my PSA was ok for just about 2 years (see below). Now is has increased to .08.
My next step is probably RT or ?. I'll see an Oncologist in the next week to discuss the situation. Has anyone gone thru a similar scenario? I'm a little uncertain as to how to proceed and a little concerned about what's to come. Perhaps your story would be helpful if you care to share.
Wishing all of you the best of health.
 
Magaboo


Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?

Post Edited (Magaboo) : 9/11/2008 6:26:11 PM (GMT-6)


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 9/11/2008 5:55 PM (GMT -6)   
Hello Mugaboo,
While looking at the numbers does show an increase the amount you are looking at (.04ng) is really slight. It could well be just a blip in the testing procedure........same equipment? same assay test? even a different technician running the test can produce a slightly different result. The oncologist consultation is a wise move but I would suspect he would want to monitor the results for a while longer in order to clarify things before deciding if further treatment is warranted. Here's hoping it's just a blip on the radar.
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 <0.001 undetectable
PSA August 08 <.001 undetectable


Every time I see an adult on a bicycle I no longer despair for the human race.
H.G.Wells


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/11/2008 7:09 PM (GMT -6)   
Magaboo,
Dang it! I hate this disease. You have done so well until now. But for now you probably need to stay in watchful waiting, probably until 0.4, and just keep enjoying life. That seems to be a gold standard before starting RT from the experts I talk to. You know my mantra ~ Stay positive! It just means you have to keep managing this. It's probably not a bad idea to review the different radiation options and be prepared. You are a good man, and a good friend. Thank you so much for being here when I came to this great site. And we'll be here for you again, too.

Tony
Age 46 (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, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/11/2008 7:18 PM (GMT -6)   
I hate this disease too! Sorry to hear about the slight rise, but I am with Bill and Tony. Hopefully it is a blip on the radar. My father has done radiation and HT, so we are pretty familiar with the process. Wishing you nothing but the best and undetectable PSA's!
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 9/11/2008 7:42 PM (GMT -6)   
Magaboo

I echo the above responses as well, your numbers still look good but you need to stay on top of them. My PSA stayed away until about 10 months post surgery and then it was .2, a check 3 months later and it was .3 so yet another appointment date set for 2 months later but also appointments were made to see the radiation experts. Long story short the next test was .4 and on to radiation which I started in April and finished in June. My first follow up PSA test and was hoping for any kind of a decrease in the reading. Both to me and my doctor was great results all the way back down to .09 and thier device only goes as low as .06 so he said see you in 6 months. I will stay on top of it but I am very hopeful that the salvage radiation was sucessful. Here's hoping it's just a blimp in the reading but never lose faith.

Good Luck
Norskie
norskie
Current age 50, Age at Dx-48 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 .422 Begin Salvage Radiation April, 14 2008
Radiation Complete June 4, 2008 36 treatments
August 5, 2008 PSA .09 or < .1 again
Incontenence-Pad free since end of May 07 4 1/2 months post surgery 
ED back to 95% prior to surgery - no medication required.


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/11/2008 9:33 PM (GMT -6)   
Hi to all my friends,
Thanks for your encouraging comments and postings, but the way the PSA is going, we all know deep down that this is not a good sign. I'll see what the Oncologist has to say, but I'm pretty sure that RT is most likely my next battle ground for this scourge on  mankind.
Thanks again for all your comments, concerns and interest.
All the best to all of you.
 
Magaboo

Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?


Pelahatchie
Regular Member


Date Joined Jul 2007
Total Posts : 86
   Posted 9/12/2008 7:43 AM (GMT -6)   
As you can see from my profile our situation is very similar.  I did not wait around long before going after the enemy and I respectufully disagree with others on hear suggesting a wait and see approach, however, with your age and gleason score you would probably be ok with watchful waiting.  These decisions are truly one of the most difficult aspects of this disease.  It really boils down to a personal decision, one that you are comfortable with.
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
 
PSA August 18th 2008 = .01 or less, test only goes down to .01


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/12/2008 9:54 AM (GMT -6)   
Pelehatchie,
If it were me I would have radiated right after surgery with Magaboo's numbers. Adjuvant treatment is better than salvage treatment in the long run. But it is a difficult decision for anyone to radiate before biochemical relapse. Watchful waiting is a normal part of treatment course for those who decide to not to have RT adjuvantly. Keep in mind anything below 0.1 is considered undetectable.  But you can see what I did. I fired all of the torpedoes immediately after surgery, save Taxotere. Which I wonder if I should have bit the bullet there, too. It's good to see you are back to undetectable numbers. I am certain Magaboo can get there if he starts now, or at 0.4. And waiting will reveal a doubling rate, which might indicate he also needs HT. Better to know what that rate is now.

All my best to both of you,

Tony


Age 46 (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, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 9/12/2008 10:12:51 AM (GMT-6)


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/12/2008 10:56 AM (GMT -6)   
Hi chas036
To answer your question about +ve margins. The path report stated among other things: T3a, which, I believe, means +ve margins. Seminal vesicles and lymph nodes (2) -ve for malignancy.  

Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/12/2008 12:44 PM (GMT -6)   
Mugaboo, my husband's pathology report staged him at T3a with negative surgical margins, seminal vesicles, etc.  I believe the T3a designation means that the cancer was no longer "organ confined" or localized.  My husband's pathology report stated that a very small extension into the prostate capsule but not through it (whew) with clean surgical margins.
 
Hope all goes well for you.

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 9/12/2008 4:01 PM (GMT -6)   
Magaboo...read somewhere this analogy....

T3-the horse stuck its head between the barbed wire on the fence and is eating the grass between the fence and the road. The road is the margin and the fence is the prostate capsule. So in your case you could have had capsule penetration but not far enough into the margins like Sephie stated.

T4- the horse jumped the fence and is on the other side of the road!
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
Robotic Surgery scheduled Sept 18, 2008


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/12/2008 4:32 PM (GMT -6)   
Interesting discussion. My cancer had spread into carcinoma of the muscle tissue all the way to the pelvic bone. 4 positive margins, bilateral SVI, and the doctor was sure that he did not get it all near the rectum. I am pT3b on the pathology report. Go figure. The full TNM is in my signature. But we acheived undetectable! Amen. This much I know. I have plenty of livin' to do. So I don't worry about this stuff. I'm headed back into the mountains this week ~ to ride along the wild horses...(Pics at my website!)

Magaboo, keep on keepin' on, brother!

Tony
Age 46 (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, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/12/2008 5:13 PM (GMT -6)   
Our urologist knew from the biopsy that one core was very close to the outside edge of the prostate. Ten samples were taken at biopsy, and 2 came back positive (all on the left side). Gleason for core 1 was 3+3 and core 2 was 3+4. After the prostatectomy (March 18), the surgeon told me that he cut a wider margin than he needed to to ensure a clean margin.

Magaboo, we were told to obtain a copy of my husband's pathology report - which we got about 9 days after surgery when the catheter was taken out. Gleason was 7 (3+4) so no change there. My husband's clinical stage based on PSA (6.3) and DRE (normal) was a T1c, so when I saw the T3a on his path report, I "freaked out." The urologist calmed me down alot by walking me through the path report and explaining that the stage is often upgraded based on the surgical specimen vs. the biopsy which is only a sample of the tissue. He also pointed out that the key words were "into the capsule" rather than "through the capsule" and "no evidence of tumor at margin, seminal vesicles or bladder neck."

FYI: Hubbie's PSA went from 6.3 at surgery to 0.1 4 weeks post op; at 8 weeks post op, his PSA hit zero and has stayed there.

My suggestion, if you're so inclined, is to get a copy of your path report so that you know exactly what the situation is - surgical margin and SV status. This is really the only way you can make an educated decision about your next steps.

Good luck ... and God bless.

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/12/2008 6:04 PM (GMT -6)   
Hi Sephie,
I do have the pathology report and it contains, among other things, 2 items which I don't fully understand, but resulted (I believe) in the T3a rating:
1. Capsular proliferation identified.
2. Malignancy continuous with distal right and left resection margins.
 
I'm not to sure how to intrepid these 2 items in plain English. Perhaps some more knowledgeable person could help?
The rest of the report is quite clear and leaves no room for guesswork.
I thoroughly enjoyed LV-TX's analogy regarding the difference between T3a and T4 :-). --- Well done!
Best of health to all of you.
 
Magaboo

Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 9/13/2008 12:14 AM (GMT -6)   

Magaboo,

I had the adjuvant therapy within the first year following surgery when my PSA went up to .08.  Together with hormone therapy, studies show that this will decrease the chance of biochemical relapse.  I had no problems with the radiation, and my insurance picked up almost all of it.  The hormones along with the radiation help increase your percentages.  Hot flashes seem to be my only side effects, and they aren't overly bothersome.  I keep physically active and work on the weight - well, at least I try - and that seems to counter any fatigue issues with the hormones.

Bottom line, listen to your doctors, but don't be fearful of additional therapy.  Like others, I've attacked this beast with both my six guns firing!  Also check out the University of Arizona clinical trials on phone counseling.  Keeping that spirit strong is as important as the other stuff.


Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
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, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;
 
 


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/13/2008 6:15 AM (GMT -6)   
To Magaboo, sorry I missed the part in your original email about having the path report.

Lets focus on the positive things in your path report: seminal vesicles and lymph nodes are clean (excellent).

As to the "capsular proliferation", you first need to understand the anatomy of the prostate. There's the gland itself, which is surrounded by a thin membrane called the capsule. When PC is found only in the gland, it's considered localized. When the PC is found in the capsule, it's considered regionally localized (also called invasive because it has invaded tissue around the gland). Extraprostatic extension means the cancer has extended outside the gland into the capsule; extracapsular extension means the cancer has broken through the capsule into surrounding tissue.

When cancer extends into the capsule, it is usually identified as single foci (one area) or established (several areas). I would assume that capsular proliferation means that more than one area of cancer was found in the prostate capsule.

With cancer surgery, the intent is to remove the tumor as well as any stray cells. This is called the surgical margin, and the goal is to obtain a clean surgical margin. Sometimes the surgeon has to cut a wider margin than usual because the cancer is very close to the outer edge of the gland - this was the case with my husband.

The pathologist examines all tissue removed. If cancer cells are found in the "extra" tissue removed by the surgeon in an attempt to achieve a clean margin, you have not achieved a clean surgical margin. I believe this is what your path report is telling you.

If cancer cells are left behind, they will generate PSA hence the importance of regular monitoring of PSA levels post surgery. Generally, PSA is checked every 3 months for the first year, then every 6 months up to year 5. If you still have an undetectable PSA in year 5, the PSA is then checked every year.

My husband's surgeon wants to check his PSA every 3 months for the first 2 years because of his T3a status even though the surgical margins and seminal vesicles were clean.

If you can, chat with your surgeon to get a very clear understanding of the capsular proliferation and margin status. T3a is not an uncommon stage for prostatectomy patients.

divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 9/13/2008 7:54 AM (GMT -6)   
Mugaboo,,, The good news for you is: ( if you decide on RT...after watching for awhile) It is much easier to have salvage RT than salvage Prostectomy....We went that way. You should get through the RT easily....nothing like the SEs after salvage Prostectomy... Di
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Waiting for activation October 21 2008


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 9/14/2008 11:39 AM (GMT -6)   

Hi, Mugaboo.  I logged onto the forum this morning to report almost the exact same experience and to ask the very same question you have.  I had DaVinci surgery in June 07.  In Sept 07, my PSA was undetectable at <.01.  In March 08, it was .02, and dr said nothing to worry about.  Last Friday, the latest report came in at .07.  Dr again says he is not overly concerned and that people with my profile have only a 6-8% chance of recurrence.  My post-surgery path was clear margins and Gleason was 3+3=6, a non-aggressive form of cancer confined to the prostate, and final stage of T1c.  He told me that other tissue can create PSA -- including the pelvic bed where prostate was, the penis itself, even the pancreas, and that any inflammatory process involving those sites can result in a minimal spike.  He told me to wait another 6 months to check again.  I requested three months, so I will try again in mid-December.  I'm trying to remain "unconcerned" and positive, but it is a bit difficult to put this out of my mind completely. 

I appreciate the information you all have provided.  My dr didn't say anything about .4 being a threshhold, but did say that unless and until the level rises to .1, he will remain unconcerned.  ('Course that's not too far from .07!)  At that point, he will consider radiation.  I guess we're on a similar journey, Mug!  Let's keep each other positive.

I'm off on a two-2week vacation out of the country. I'm going to take the dr's advice and put this out of my head -- at least for that long!  

 


Puget
61 years old (60 at surgery)
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)
Second Post-PSA March 08 = 0.02
98% continent
ED seemed endless, but after 10 months definite improvement


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/14/2008 2:26 PM (GMT -6)   
Hi puget,
Although our initial numbers are a bit different, the stage that we are in right now seams to be similar. I think that your request for a 3 month checkup was appropriate. Things can change quite a bit in 6 month. I'll see an Oncologist hopefully this week and will see what he suggests. I don't like the idea of  'wait and see', so I hope that he will suggest either RT or HT or possibly both. Waiting and not worrying is easier said than done at least for me, but we all do the best we can.
Anyway, hope your PSA increase is just a 'blip on the radar' as suggested by others.
All the best to you.
 
Magaboo


Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?

Post Edited (Magaboo) : 9/14/2008 6:00:53 PM (GMT-6)


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 9/14/2008 3:01 PM (GMT -6)   
Hi Mag,
 
I hope you don't mind my thought but, why would a Doc want to do more than just radiation at this stage? With all that I've read both in the journals and of your bio, a recurrence is local probably local and early radiation may be all that is required. Your PSA isn't screaming systemic. A scan of the porstate bed perhaps???? A prostascint? I'm not sure what tests might tell a clearer story.
 
Good luck to you :>)
 
Swim
 


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 9/14/2008 3:57 PM (GMT -6)   
Reading Swim's comment, at my dr visit last week, he didn't give any hint of HT, only possibly radiation.

Puget
61 years old (60 at surgery)
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)
Second Post-PSA March 08 = 0.02
Third Post-PSA Sept 08 = .07 -- now watchful waiting
98% continent
ED seemed endless, but after 15 months definite improvement and almost normal with viagra, occasionally without


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/14/2008 4:24 PM (GMT -6)   
I am amazed when an oncologist does NOT provide all the options. Even though HT is a systemic treatment, it also helps shrink tumors so that they can be better radiated. And there are studies that show using HT when doing radiation has a better result than radiation alone. It is a tough call, though, to put yourself through what HT does. I have lived on it 18 months and will get another blast from the harpoon Wednesday. Even though my "odds" are only improved by 11% preventing biochemical relapse according to the Harvard and Stanford studies (as much as 35% in the RTOG 94-13 study) I still am hopeful that we have knocked it down enough to stay away a long time.

I think age is also a factor as to whether to decide to start HT or not. Whatever you decide, you know we will be here to support you.

Tony
Age 46 (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, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/14/2008 6:20 PM (GMT -6)   
Hi friends,
Thanks again for your comments and interests. Swimom, I never mind anyone's thoughts or opinions, I only appreciate them. I will see the Oncologist hopefully next week (my Urologist is making the appointment- that's the way they do things here in Canada). I have no idea what he will suggest after examining me and all the paper woks from the Urologist and the biopsy. I will most likely follow his suggestion, although I have also (like TC-LasVegas) read that RT and HT together will improve the odds of beating the cancer and that is my main objective in this battle. I'll just have to wait until I meet with the Oncologist. It sure seams that I'm spending half my life these years just waiting.
Best of health to all of you.
Magaboo

Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 9/15/2008 9:43 AM (GMT -6)   
Good luck, Magaboo.  I'll be thinking about you this week, wishing you the best.

Puget
61 years old (60 at surgery)
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)
Second Post-PSA March 08 = 0.02
Third Post-PSA Sept 08 = .07 -- now watchful waiting
98% continent
ED seemed endless, but after 15 months definite improvement and almost normal with viagra, occasionally without


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 9/15/2008 10:36 AM (GMT -6)   
Thanks pudget and all the best to you. Stay in touch and share your journey with the rest of us.
Magaboo
 
Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
open RP 28 Nov 06
Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08
Next step: RT?

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