PSA is not an airline! what if on the third try she spikes

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flippin out
Regular Member

Date Joined Mar 2006
Total Posts : 137
   Posted 2/26/2009 7:17 PM (GMT -6)   
After Surgery,After Radiation - what and why would one take it further. What might one on the third try expect as a procedure?
50 Diagnosed as type II Diabetic
54 Cancer Detected
55 Da Vinci City Of Hope California
57 Cancer rise in successive PSA's
57 Radiation Loma Linda Medical Center California

Veteran Member

Date Joined Jul 2008
Total Posts : 637
   Posted 2/26/2009 8:08 PM (GMT -6)   
Hello mjr....Turn that around, and say "After radiation, after surgery, what and why would one take it further.....We are at that point. Who can say?

Let's see what the people say....... Diane
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and 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 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Hip replacement total success..pain gone!!
PSA .7 2/10/09

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/26/2009 8:38 PM (GMT -6)   
It might become the drug protocol therapies realm, which can and do work for many patients for possibly many, many years it varies tremendously, in small cell PCa (variant) prognosis it horrible and hormone therapies are short or non-existent for useage. Drug therapies not considered cures but it could even be possible for an anectdotol cure to happen, probably very rare of course. One abstract I have seen is from 1955 which claimed anectdotal cured patients(over longer time period), hard to prove in hindsight it was prior to the psa era to measure for possible distant mets or micro mets, etc. But, they did not die of PCa and had total normalcy and without known mets, which sure looks decent.

Here is one from Paact Newletter only a couple months ago: 2 identical twins both had similar prostate cancer, both had different treatments. One died and the other is living on, it will be interesting to know the parameters and walks of both of them for comparison sake, I don't have that or I would have posted the known information. You can get the Newsletter by contacting them

There are abstracts that either suggest or show improvement for folks whom do certain drug protocols compared to others that do nothing but wait. There are drugs that seem to slow progression times, cause temporary remissions (months and sometimes years). The onco-docs for PCa have seen all kinds of bizzare patient levels of PCa and variant strains of this disease and have had reasonable success in prolonging survival it appears, some PCa onco-docs have mentioned some patients did way better than they would have assessed them to do.

How long is longer survival???? No data maybe, I am not sure on that might be abstract or patient data in some places to be found. Ask the person whom is with psa of 3000+ or near it and has mets, if he might want to try various drug protocols, there is a guy on whom is over 10 yrs. with psa level started at 3000+ and high enough gleasons etc....I doubt he would be living without these drug protocols. He may fail at anytime, but already has out done most patients diagnosed with the same parameters.

So, whom wants to judge the world of PCa in general????

FLHW(David E)
Regular Member

Date Joined Nov 2007
Total Posts : 201
   Posted 2/26/2009 10:08 PM (GMT -6)   
"After Surgery,After Radiation - what and why would one take it further. What might one on the third try expect as a procedure?"

How about the expectation of one more day, week, year or more? Why give up after three, four, five......procedures?
Dx'd 2/18/05
PSA 271, bone mets, lymph node involvement
Gleason Score: 7
Current (2-16-09)
PSA: 38.16
Treatment: Lupron
Taxotere + Prednisone + Atrasentan
[12th Treatment on January 26th]
Clinical Trial:
Personal Blog:

Regular Member

Date Joined Sep 2006
Total Posts : 187
   Posted 2/26/2009 11:54 PM (GMT -6)   
That's the biggie, isn't it?...having gone thru surgery, PSA rise, radiation....I wonder that every time I get my PSA checked.....
THe way I understand it, the next stop, IF there's a rise in PSA, is hormone treatment - I think I would opt for intermittent HT if my PSA rises again. Not considered curative, but as zufus pointed out, there CAN be anecdotal cures from HT at that point --- my oncologist has seen it--- although its rare.

THe idea would be to keep the cancer in check as long as possible on HT (in many cases, many, many years)...then if that runs its course, there are other protocols out there...more important, if we can delay progression long enough, there may be treatments...even cures...we don't have now.

Of course, like you, I surely hope and pray I'm cured now....and don't have to find out the other protocols first hand!
Age 48 - pre-surgery PSA 39 (at age 45)
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
PSA as of November 25, 2008 undetectable

New Member

Date Joined Feb 2009
Total Posts : 14
   Posted 3/7/2009 11:54 PM (GMT -6)   
The next step could be hormonal, could be clincial trials if necessary. Could be a lotta things. Only you can decide when enough is enough.

Regular Member

Date Joined Jul 2008
Total Posts : 50
   Posted 3/8/2009 1:02 AM (GMT -6)   
zufus said...
It might become the drug protocol therapies realm, which can and do work for many patients for possibly many, many years it varies tremendously, in small cell PCa (variant) prognosis it horrible and hormone therapies are short or non-existent for useage. Drug therapies not considered cures but it could even be possible for an anectdotol cure to happen, probably very rare of course.


     Zufus, when you write "small cell PCa" what do you mean by small cell?  Is this something that can be seen in the biopsy?
Name: Tony  Born: 1951
Diagnosed PCA 7/23/2008;  Prostate Volume 19 grams
Cancer Location: Right Mid and Right Apex 2 of 12 cores positive
Percentage of tissue involves 14%  Gleason 3+4=7 4+4=8
PSA levels  6/08/08 7.7;  6/30/08 6.8
Began HT Zoladex 8/26/2008
As of 9/11/08 I am waiting to start IMRT IGRT
September 23, 2008 after one month of Zoladex PSA 2.83
Testosterone 16.
October 22, 2008: First day of IMRT.  I am receiving 1.8 grays per day over a period of 43 days.
December 24th, 2008 Completed my Radiation treatment

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 3/8/2009 7:51 AM (GMT -6)   
Tony I posted once herein about the known 18 variant types of PCa's defined by Pathologist (experts, variants were likely identified by guys like Bostwick, Oppenheimer, Epstein and a select few others, whom have literally 'seen it all' over time.
They have special names for these variants for identification/classification reasons: signet ring, squamous cell, small cell, etc. Perhaps the small cell variant,actually looks likely smaller than normal PCa cells and thus the name. Small cell PCa is amongest the worst one to be found with, hormone therapies either don't work or work for such a short time frame that is it pathetic. I saw a women post that her husband was diagnosed with small cell PCa (as she just posted it on a forum-this was years ago now), two weeks later he was gone...surely it was caught late...and his drug therapy started was apparently useless. This one is very rare but occassionally we see a patient diagnosed with such. Another reason why expert pathology is worthy in finding out do you have a rare variant of PCa. Some PCa onco-docs have treated some of these rarer presentations of patients and thus have some clinical experiences on what drug protocols might give better results...otherwise it is more of the Twlight Zone.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 3/8/2009 12:45 PM (GMT -6)   
Bob, I understand your point on this post too well. The other cancer I have dealt with 3 times in my life is so ultra rare, that it doesn't even show up in most cancer groups or sites. In fact, the American Cancer Society doesn't even list it. An ultra rare disease is usually defined as having less then 10,000 cases world wide. I have had porocarcinoma the three times. The first time in my scalp, they removed it. In less then a year, it came back with a vengenge, huge, ugly, bleeding all the time. This time, involved major plastic surgery to the scalp, long ugly story there (still have an ugly red triangular sunken scar on the top of my head). Two years later, while about to shave my neck, was scratching it, felt a weird rectangular lump right below the skin. Two surgeries to remove it. Came back with the same porocarcinoma in my lymph nodes. Two more operations to remove lumps in my thigh and groin, to be safe. Then I began the 35 days of radiation treatments, covered me from about my nipples to my nostrils. Was rough as hell, side effects were terrible, to this day, have constant thirst, can't really spit anymore, still suffer chronic fatigue, and that ended 9 years ago!

At that time, I was one of only 38 known cases in American medical history with such a cancer, and in the whole world, less than 300 known cases. My dr. had one other patient, a female, little older than me, she has since died of it. With 2 patients, my oncologist was considered the "expert".

Yes, there are weird little cancer variants that the pros just don't know a thing about.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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 .05, 6 month on 5/9

Regular Member

Date Joined Dec 2008
Total Posts : 194
   Posted 3/8/2009 6:41 PM (GMT -6)   
Just adding this for reference since most of us have the book, "Guide to Surviving Prostate Cancer by Dr. Patrick Walsh, MD": 'small-cell carcenoma' is referenced on pages 187, 487, and 513 in the second edition that I have.

This is really a must have book for anyone just diagnosed with PCa and availible in the HealingWell
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA 2-17-09   0.00

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