PSA still rising quickly, 2 weeks to surgery

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/1/2008 9:06 AM (GMT -6)   
Looking for some imput here, please.  You can from my signature what has been going on with my psa.  Just had a final psa test down (always the same lab).  Was 12.3 in July, rose to 14.9 in Sept, and now, it's jumped again to 16.4.  Based on all my posted stats, can it be assumed that I am dealing with an aggresively fast case of PC, or am I just being justifibly paranoid?
 
The current thinking is that with psa velocity of 2 or more in the year before pc is diagnosed is indicative of a very aggressive pc, and a worse change of long term cure.  Do you agree with that thinking?
 
Worried and waiting, I really don't want to deal with cancer again. mad
David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
Biopsy 2007 Negative
Biopsy 8-2008 Neg, some PIN, 4 "Suspicious Areas"
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal PIN noted
 
Open RP surgery scheduled for Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC


6071
Regular Member


Date Joined Jul 2008
Total Posts : 113
   Posted 11/1/2008 12:01 PM (GMT -6)   
Hi Purgatory
I did post a reply about my surgery
I think you should get you self ready for the surgery and wait and see
I know it not easy on the nerves
Two weeks before my surgery my urologist told me to level it to then to do there job so i stop reading about
The Psa and think about getting the surgery over with
The waiting is the worse on psa tests and then Pathology report is a killer for me
If i was a drinker i would be drunk all the time
Because it very hard to put it out of your head and think of something else
i hope you do well with your surgery and i wish you all the best
Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
 
 


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 11/1/2008 1:01 PM (GMT -6)   
I really think each case is different....as our doctor told us. Two men with the same statistics could have the same treatment and it would react differently...You have made a good choice....for one thing, if it does come back, you can have salvage radiation... Try not to worry...As I saw somewhere: "Worry pretends to be necessary"... Good luck to you and let us know when your surgery is over. 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
Activated Oct 28th Dr. Sandhu..MSK


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 11/1/2008 3:35 PM (GMT -6)   
Purgatory,

A couple of points up may or may not mean more aggressive disease, but even if it did, you're pretty much doing everything you can at this point --- so adding extra worry to the equation probably won't help.

You're getting the "gold standardard" treatment. The pathology will tell you a lot more about the true nature of the disease, and after that, its all about the PSA post-surg. At least now you're really tuned in to your condition and will be willing to take on more treatment down the road if you need it. My PSA jumped from 28 to 39 the month before my surgury. My signature tells the rest of the story --- but I'm doing just fine now (knock on wood - next PSA is coming up!)

Good luck and keep us all updated --- we're all rooting for you here!
Sterd82
Age 47 - pre-surgery PSA 39
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
PSA as of November 29, 2007 undetectable
PSA as of May 14, 2008 undetectable
Next PSA November of 2008


Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 202
   Posted 11/2/2008 10:47 AM (GMT -6)   

Purgatory,

I also had a rapidly increasing PSA prior to surgery.  It went from 3.1 in November 2005, to 3.9 in December, to 5.6 in May 2006.  So mine was doubling about every 6 months.

From what I have read, the PSA velocity is something that is indicative of the aggressiveness of the cancer.  But, it seems you have caught it at an early stage and you have selected the gold standard.  My bible through all this is a book by Dr. Patrick Walsh, entitled "Guide to Surviving Prostate Cancer".  It has a wealth of information in it which I have found to be incredibly helpful as I encounter the various issues and questions that have arisen in dealing with this thing.

Dr Walsh  says that having PSA tests taken within a short period of time can be misleading as the differences in their readings could be a result of normal variations.

Another thing Dr Walsh says is "perineural invasion has no long-term impact on whether or not a man can be cured.  For this reason, some noted pathologists have suggested that it should not even be commented on when found in a biopsy, becaues it's not worth worrying about".

You are doing everything you can and your biopsy results are not bad.  If you have a partner, try to enjoy some quality sex prior to the surgery.  I was out of commission for 11 months post surgery, not knowing whether it would come back or not.  So, try to enjoy what you currently have. (One ironic thing for me is I started developing ED problems prior to surgery because I was worried about losing it post surgery.

Sorry I got off topic.  I guess my point is that this is an ongoing situation. Try not to worry about the future and try to enjoy the present, which I know can be easier said then done.

Good luck with the surgery.  I hope it goes well and your pathology report comes back with encouraging news.

Dave


Age:54
PSA 5/22/06: 5.6
Divinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 11/2/2008 10:19 PM (GMT -6)   
You are in good hands and scheduled for surgery. the only advice I can give you is to get ready for surgery. I had surgery 6 months ago. When I was diagnosed, I spent all my time on google searching for the same things you are doing now. I lost 20 pounds before surgery due to stress and worry. It didn't help. Trust me, you have enough to think about just getting to surgery and the recovery. I wouldn't cross bridges until after the surgery and pathology report. It isn't like you are ignoring the pc. You have been tested and scheduled for surgery. I recently posted here asking for advice on how not to worry about upcoming psa tests. I was given a lot of good advice and trying not to consume my life in worry and stress. I know it is EASIER said than done but hang in there.
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
4 week and 6 week PSA >.04 (undetectible)
12 week PSA <.04
continent at 10 weeks (no pads!)
kegel's twice a day 20 reps


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/3/2008 1:20 AM (GMT -6)   
Hang in there,
Your case may be a call for more thourough biopsies, but that's moot now. There is still time for good results, so stay positive! We'll be watching for your results. And we'll be here when you get back from surgery, 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 (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/3/2008 8:31 AM (GMT -6)   

Thanks from all of you for the words of comfort and reason.  I know you are right, but like the rest of the men here, we all have to fight our own fears and demons as we deal with PC.  I have total faith in my doctor(s), the surgeons ahead and the hospital itself.  My wife of 34 years is a well qualified nurse and I know she will take good home care of me when needed.

The other positive factors are that I have never experienced ED in my entire life, honest, not bragging.  I seem to have a remarkable immune system, I don't think I have even had a simple cold in over 5 years, a flu in more then 10.  I also am oblivious to seasonal allergies, not even a sniffle.

So I am hoping all of the above will give me an edge in what lies ahead.  Most of the time I try to stay positive, but I am but flesh too.  And this is my 4th bout of cancer since age 45, so I am starting to feel like a cancer magnet.

Sorry for rambling, but I do appreciate the comments, and can feel the care from all of you, and your spouses, in the Great Brotherhood of Prostate Cancer.  Best wishes to all.

David in SC


Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
Biopsy 2007 Negative
Biopsy 8-2008 Neg, some PIN, 4 "Suspicious Areas"
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal PIN noted
 
Open RP surgery scheduled for Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 11/3/2008 7:58 PM (GMT -6)   
David, You will do well. You allready sound more positive...and that is what is important....Be aware of what you are thinking about, and then, if you don't like what you are thinking about, ... choose to change your thoughts...It really works...! Good luck to you! Diane
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
Activated Oct 28th Dr. Sandhu..MSK


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/4/2008 10:16 AM (GMT -6)   

Thanks Diane for the kind words.  My doctor/surgeon called me this morning out of the clear blue just to see if I had any other questions or concerns about the upcoming surgery, I really appreciated that.

I went and voted this AM, the election has been a good distraction for me the past few weeks.  Was in and out in 20 minutes, not bad at all.

David in SC


Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
Biopsy 2007 Negative
Biopsy 8-2008 Neg, some PIN, 4 "Suspicious Areas"
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal PIN noted
 
Open RP surgery scheduled for Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC

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