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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/30/2009 4:41 PM (GMT -6)   
In another thread Waterloo said,

i have been reading i have not come across any one with a rising psa after one year of surgery to remove my hubby prostate his psa test have almost double every three month small number's ,started at .o5,.09.16 and now .24 local small town doc want to wait and test in another 3 month.going monday to tell him no more waiting we want to take the next step,but what is the next step i have been reading every site that has any prostate info on it .this site is great.i will keep reading.im not to good at this my spelling is not so good .gleason before surgery in sept 06 was 3+4=7 after 4+3 =7 psa after surgery o.oo4.

thanks for reading

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/30/2009 4:47 PM (GMT -6)   
Hi Waterloo,
Waterloo, Iowa by chance? Welcome to HealingWell. This site is one of the very best for compassionate care and support. I am a 4+3 after surgery myself, and I had a few additional issues to contend with as well. But I am back at undetectable PSA's and there is no reason to believe that your husband can't get there also. It sounds like some radiation may be next... Stay with us, and we will be happy to help.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 15, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/30/2009 4:51 PM (GMT -6)   
Welcome, waterloo, hope you can find what you are loooking for. Don't worry about eh spelling, etc. It's fine and we are all in this together anyway......I'm sure several people with much more experience with rising psa's after surgery will be along shortly.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


waterloo
Regular Member


Date Joined Jan 2009
Total Posts : 100
   Posted 1/30/2009 4:58 PM (GMT -6)   

 hard to type right now can't see through the tears thanks so much it's nice to know someone is out there hubby is not talking to much  we have been togther for almost 30 years and this has to be the worse thing yet.but we will get through it.

 thanks

waterloo in small town bc 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/30/2009 5:02 PM (GMT -6)   
Waterloo, welcome to our little corner of paradise, sorry you need to be here, but so glad you found us. It would help to know a little more about your husbands statistics, perhaps you could make a signature like you see others here with. I was gleason 4+3 before surgery, and 3+4 after, which most feel is the better combination of a gleason 7. Was your husbands post surgery pathology report "clean", or did it indicate possible future problems? After surgery, the normal recourse would be radiation, but not enough facts to know that at this point.

This is a good place to be. Good for information, for support, to help ease your pain and fears, we are here for you.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/30/2009 5:09 PM (GMT -6)   
Information and knowledge is your friend and power, from my own bizarre experiences in finding doctors and treatments and information (jungle)in treating PCa, I prefer the empowered patient concept, learn all you can, question everything, question any doc, don't be afraid to even look outside the box (with an open mind), don't be afraid to fire a doc if you have any reasons (with insurance you have choices). Always look at anything just for the heck of it, know that docs can be biased in their approach or thinking, which could therefore be skewed to their own protocol or even possible agenda. In others if you aren't happy with any particular doc, leave and find another....it is your disease to fight...not his.

Or you can sit back, even thought Joe expert is on your case and hope that all is perfect in his world for you and it might be, but keep awake on your treatments. Realize that the experts disagree on PCa about as much as we patients do too. It is imperfect science.
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 1/30/2009 5:38 PM (GMT -6)   
Hi Waterloo and welcome to the best site on the net that nobody wants to join.
If you look at my signature you will see that I too had an increase in PSA after my RRP. It went up slowly after about 18 month. After much research and reading in this forum, I decided that my best chance of dealing with this increase is early EBRT (electron beam radiation therapy). I also read and was advised by my Uro that the earlier the radiation treatment is started the better the chance of killing the cancer. I had my treatment late last year and the PSA after about 6 weeks went from .1 to .05.
Side effects were minimal and the result looks good thus far. I'm not sure if waiting to long with your numbers is a good idea.
Whatever you decide, I wish you the very best in the years to come.

Magaboo
Born Sept 1936
PSA 7.9
-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; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA on the 26 Jan., 09, =0.05. PSA tests now every 6 month


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/30/2009 5:41 PM (GMT -6)   
Magaboo, what kind of side affects did you have from the salvage RT?
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 1/30/2009 5:56 PM (GMT -6)   
Hi Purgatory,

Side effects were fairly minimal for the first few weeks, but during the last couple of week I had some anal pain and some minor bleeding. Also had to get up 3-4 times during the night in the last week or so. All these side effects corrected themselves after about 2 weeks. I never had any diarrhea or fatigue.
Wishing you all the best.

Magaboo
Born Sept 1936
PSA 7.9
-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; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA on the 26 Jan., 09, =0.05. PSA tests now every 6 month


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 1/30/2009 5:59 PM (GMT -6)   
Hi Waterloo,

I understand the tears.

The rise in PSA you are posting begining so close to the surgery indicate that another local definitive treatment may arrest the progression. The treatment options would range from another surgery if for instance the PCa (prostate cancer) is in seminal vessicles or other structures left behind (in a robotic surgery there is a lot of stuff left that used to be removed in the open anatomical approach) (which did he have). Cryo (freezing) Radiation, and some things that are not typical like HIFU. There is a clinical trial recruiting for HIFU (high intensity focused ultrasound) for persons with a recurrence of PSA for which your husband might qualify. I will place a link.

Don't give up, this PSA rise is not great nor is it fast, there may still be a good local treatment option.

Very best. Scott

www.internationalhifu.com/ (edited to add html code for link..JC

Post Edited By Moderator (James C.) : 1/30/2009 4:47:34 PM (GMT-7)


waterloo
Regular Member


Date Joined Jan 2009
Total Posts : 100
   Posted 1/30/2009 7:29 PM (GMT -6)   
great info everyone

husband's info: he is 56 years of age
3 out of 8 cores positive
contained in the capsular
clear margin.
all other info is in a box somewhere,we move and have not been able to find it yet.
i did not know what to use as a name so waterloo is the name on hubby's tool box sitting in front of me
thanks
dee in b.c.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/30/2009 7:55 PM (GMT -6)   
Waterloo, is that b.c. as in beautiful british columbia? Many long years ago, my wife and I, pre-children days, were planining on moving to Prince George. Didn't ever happen, long story. lol. sounds like a pretty good pathology report from what you stated

magaboo - thanks for the info, sounds like you did pretty well on the side affects from the salvage radiation. glad you are doing well
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4250
   Posted 1/30/2009 7:55 PM (GMT -6)   
If your husband had a clear margin after surgery you have have to assume that the psa rise may be systemic. A prostate oncologist would be a wise choice to get a 2nd opinion from. You really need to determine where the cancer is before you can come up with a plan to treat it.
MRIS or color doppler could be used to scan the prostate bed. You can't decide on radiation or salvage HIFU untill you know what you are dealing with and where it is.
JohnT

I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%

I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I most likely didn't have PC, but to keep getting biopsies every year.

in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.

2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found wis indolant and statistacally insignificant, but PSA histor was a major concern and ordered a few more tests.

Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland, currently scheduled for Feb 14.

Changed diet and takiing supplements while I wait. The location of the tumor plus the high psa make surgery an unlikely option. I'm still evaluatiing all treatment options and will make a decision once I get the results of the Combidex scan.

JohnT

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