Oncologist Follow-up

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GarthK
Regular Member


Date Joined Feb 2009
Total Posts : 74
   Posted 3/1/2009 11:42 AM (GMT -7)   
As can be seen in my profile below the surgery is past and the pathology was good. I go in for my first post-op PSA this week with the appt with my urologist the following week. My wife had lung cancer seven years ago which was most fortunately surgically curable. Even so, she has been under the watchful care of a medical oncologist ever since starting with a checkup (CAT, MRI...) every three months and finally going to once a year as we are now. She has not required any further treatment but even so still goes once a year for some sort of scan/blood work.

I am going to ask my urologist this but I thought I'd ask y'all (remember, I live in Huntsville, AL:-) what your thoughts were on the subject of follow-up care by an oncologist even after supposedly successful surgery.

Thoughts welcome.

Thanx,
Garth
Vitae:
DOB: Q4'46, HT: 5'9", WT: 180
PC:
Biopsy: 12/08
Cores: 4 of 12+ positive
PSA: <2.5
DRE: Slight enlargement, one node
Gleason: 3+3
Surgery: RRP on 1/21/09
Catheter: 15 days
Pathology:
Adenocarcinoma occupying 5% of prostatic volume (right posterior aspect)
Gleason: 3+2
No extraprostatic extensions
Perineural invasion within prostate only
No angiolymphatic invasion
No seminal vesicle invasion
Clear margins
AJCC: pT2a


stxdave
Regular Member


Date Joined Nov 2008
Total Posts : 65
   Posted 3/1/2009 2:30 PM (GMT -7)   
Obviously it's your call Garth, but if your post-surgical PSA's continue to come back good, I wouldn't bother. If there is an increase, a medical oncologist who specializes in genitourinary medicine is the next physician on the call list.

Dave
Dx'd 1999, Age 60, PSA 43, Gleason (3+4=7), T3c
42-3d EBRT w/Lupron/Casodex for 24 months and PSA remaining to be <0.1 for the entire 24 month period.
July 2001 - 2nd opinion required to go intermittent ADT.
MDAnderson biopsy revised Gleason (4+5=9).
Intermittent ADT, Lupron only, with PSA threshhold established at 1.0.
March 2007 - Diminishing returns with Lupron, conferred with MDA urologist for bilateral orchiectomy. Uro asked for biopsy of prostate again. Biopsy resulted in tumors found with Gleason (5+4=9).
August 2007 - RRP and bilateral orchiectomy. PSA <0.1
99% continent immediately
September 2008 - PSA 0.45
November 2008 - PSA 0.67
December 2008 - Resume Casodex
December 2008 - Stricture in bladder neck requiring surgical removal. 99% incontinent immediately.


Life is not waiting for the storm to pass, it's learning to dance in the rain.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 3/1/2009 3:53 PM (GMT -7)   
Garth,

I'd say you probably would benefit from one or 2 visits to a your minister or other support person. There is some stress going on...for valid reasons. None the less, wouldn't hurt to find new coping methods when the usual ways aren't working as well as before. Best of continued good health to you and your wife :>)

Swim
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 3/1/2009 4:03 PM (GMT -7)   
Hey Garth,

I have both prostate and lung cancer. My story is in my signature below. Like you wife I go for CT scans every 3 months and PSA tests every 6 months. If my PSA goes above .1 I will go to an oncologist. My scans are read by an oncologist.

I think a person can get too involved in cancer and lose out on life. For me, these two simple tests are all I am going to do until one or the other shows something is amiss. My doc gave me good advice when I first got cancer. He said don't worry about it until we tell you to.

Jim
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06. Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + .04 cc Trimix = Excellent Results
PSAs from 1/3/07 - 7/17/08 0.00.
PSA on 1/28/09 - 0.02
Lung cancer dxed on 5/16/08. Surgery on 6/25/08 T1N1M0 - Stage IIA Finished 4 cycles of chemo on 11/7/08.
CT scans on 12/2/08 & 2/25/09 - in remission!!!
Next scan in May 09.
Biker90's Journey
Jim's Space
"Patience is essential, attitude is everything."


GarthK
Regular Member


Date Joined Feb 2009
Total Posts : 74
   Posted 3/2/2009 4:03 AM (GMT -7)   
What I thought was a pretty straight-forward question yielded quite a variety of responses. I thank you all for the feedback and, in particular to you Jim, I've been following your courageous and inspiring threads and personal web site and you are in our always thoughts. My wife is living proof that even really difficult cancers can be defeated so you hang tough!

As to my question, I am not particularly anxious nor am I losing any sleep over this so not to worry. I thought the question was very much in line with one of the overriding concepts expressed in this forum which is that we all need to take charge of our own treatments, to a certain degree, since every case of PC is different. One of the reasons I chose RRP was so that I would have other options available in case there ever were a recurrence and the best way to know if that ever happens, IMHO, would be to have an oncologist doing regular checkups in addition to my urologist. This was the course recommended for my wife and what's good enough for her... :-) I don't want to be getting poked and prodded by too many doctors, each having their own axe to grind, but due diligence seems to be in order here. This is, after all, the Big C we're talking about and is why such excitement is generated whenever someone in this group gets to report another zero from their last PSA test.

So, Thanx again for the responses. I'll talk to my urologist next week and maybe my wife's oncologist during her next visit later this month and see what they think. Then I'll mull it over, with maybe a little more feedback from y'all, and decide what my best course of action is.

See ya,
Garth
Vitae:
DOB: Q4'46, HT: 5'9", WT: 180
PC:
Biopsy: 12/08
Cores: 4 of 12+ positive
PSA: <2.5
DRE: Slight enlargement, one node
Gleason: 3+3
Surgery: RRP on 1/21/09
Catheter: 15 days
Pathology:
Adenocarcinoma occupying 5% of prostatic volume (right posterior aspect)
Gleason: 3+2
No extraprostatic extensions
Perineural invasion within prostate only
No angiolymphatic invasion
No seminal vesicle invasion
Clear margins
AJCC: pT2a

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