Roller Coaster

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Regular Member

Date Joined Sep 2008
Total Posts : 143
   Posted 10/22/2008 10:33 AM (GMT -6)   
I know everyone who gets prostate cancer immediately finds himself (along with caregiver, family and friends) on a huge emotional roller coaster. My roller coaster took me on another lunge yesterday.
After having Retrobubic Radical Prostatectomy on 9-15, I have done remarkably well. I was back at work three weeks, am 95% continent, and had what I thought was a good pathology (siganture below).
I discovered each of my great physicians has a little different interpretation. That's why it is important to have a team (urlogist, oncologist and radiologist). I am so fortunate to have the best doctors in my area.
After doing so well during and after surgery, convincing myself that "they got it all" and my first PSA was <0.1, my radiologist forced me to  accept the fact that the disputed positive distal margin and perineral invasion are too risky to leave to chance (watch and wait). He pointed out that since I had hormone treatments, the first post op PSA is irrelevant. Bummer.
So, on December 1, I start a seven week regiment of EBRT as adjuvant radiation therapy. Side effects may undo soime of the great progress I have made since surgery.
I am very aware that many of my fellow HW travelers would gladly trade places with me. My outlook is very positive.
So please, kick me in the rear and tell me to get over it! Just had to get it off my chest. I am working at staying positive. I can only imagine what the roller coaster is like for those with a more advance diagnosis than mine must be going through.
Bill in San Diego

Age 59 at diagnosis (Now 60)
PSA 4.4
05/15/2008 – Biopsy
Gleason 3+3=6
Most cores positive 40% or more, some 100%
Bone scan and pelvic/abdomen CT show no visible metastasis
06/15/2008 – Began two months Casodex 50 mg
07/01/2008 – Trelstar shot (3 month dose)
09/15/2008 – Retropubic Radical Prostatectomy
Pathology: Staging pT2c pN0 MX
Gleason post op: 3+4=7
No discrete tumor mass
Bilateral involvement
No capsular penetration (carcinoma extends into but not through capsule bilaterally)
Perineural tumor invasion: present
Perineural margin: Free of carcinoma
Bladder neck: Free of carcinoma
Distal (Urethral) Margin: Carcinoma present
Seminal Vesical: None present
Lymph Nodes: 18 nodes free of metastatic carcinoma
10/13/2008 - PSA <0.1 - disclaimer: I had HT, so...
12/01/08 - Begin 35 treatments EBRT (adjuvant radiation because of concern for positive distal margin and PNI)

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 10/22/2008 11:17 AM (GMT -6)   
Ewww...Bill...hmmm what a roller coaster ride indeed. Your doctors concerns are founded by much research and unfortunately are dispelled by other doctors at the same time. Does radiation therapy begin adjuvantly or as salvage...guess it's best to follow the doctors recommendation on this. But the good news or at least from what I have seen posted here is that the issue you mentioned usually isn't a problem as it is with radiation as primary treatment. I could be wrong on some of the others that have been down your path will give you the pros and cons based on their experience.

Stay positive and I bet things will work out just as planned for the best.

Best part...the first PSA was that's a club you want to join!
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
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 

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