Bad 1yr. PSA retest.

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/5/2009 9:41 AM (GMT -7)   
I posted earlier about my 1 year PSA test being .11 rising from .02 3 months earlier.  I retested at the old lab and got the results .09.  A little better but not much. I am concerned that it is rising too fast and I may need treatment in the future.  I will see my Uro the end of this month and see what he says.  Can this be just a temporary bounce or should I be concerned?
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 3/5/2009 11:09 AM (GMT -7)   
Can this be just a temporary bounce or should I be concerned?
 
I'd guess a bit of both.   As you see in my signature, I had a rising PSA after surgery,  It bounced around between .09 and .04 a couple of times, then shot up to .24.  Very nerve racking!
 
From what I gathered at the time, PSA readings can jump around and still never go too far up.  So you could be skipping around a bit and never have it go up too much higher.   In my case, I decided that .2 was my line in the sand to seek additional treatment.
 
In your case, the great thing is your initial post surg numbers were great.   THat's pretty significant.  At .11, I don't know if I would have pulled the trigger on additional treatment, but you might ask your URO for a referral to a good Radiolgist/Oncologist just to have a consultation.   For me, salvage radiation was the next step (along with HT)....and I've been clean ever since (knock on wood!)
 
Here was an instance where you wanted a positive margin, because its suggestive of residual disease in the prostate bed.  It makes sense that there might be a little cancer left behind, and that you can zap it with radiation....and I liked the ide of enhancing it with hormone therapy.  Localized cancer like that is still quite curable.  And while radiation isn't tons of fun, most guys on this board who've had it will tell you its not really that bad.   Same for HT, although the side effects are kind of sucky, very manageable.   I was only on it for six months, although I felt the effects for a year.
 
Hope you don't have to go this route, but in case you do, I was also concerned with going backwards on continence and ED.  Not really the case.   I cleared up on continence pretty well after my RP, but the radiation did set that back a little.  I'm good now -- maybe just a little leaky here and there, but nothing I need pads for.  ED was another issue, but I had non-nerve sparing surgery, so I wasn't really all that hopeful on a recovery there.  But once I hit about the one-year mark AFTER radiation (when the HT wore off)... I was surprised to find usable function with the aid of Cialis.
 
Hope this helps.   Good luck and keep us all updated. 
Sterd82
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


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/5/2009 11:30 AM (GMT -7)   
Sterd82
your reply helped greatly. I had the nerve sparing and am just about back to normal with continence and ED with the aid of Viagra. I,m hoping that radiation, if needed, won't reverse the ED.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 3/5/2009 2:07 PM (GMT -7)   
Well Bootheel...the .09 does raise an eyebrow...for the time being. I will be watching closely to see what your urologist suggests. I kinda have the feeling he is going to want a few more PSA tests before making any recommendation for further treatment. This could very easily go back to the lower ranges you experienced earlier...or could go up more. Not an easy position to be in right now...that anxiety of waiting again for the next doctor visit and PSA test...you know you would think one would get use to it...but I doubt it.

I'll keep my fingers crossed for you and let's see what the doc says later this month.
You are beating back cancer, so hold your head up with dignity
 
Les
 
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 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 3/5/2009 2:38 PM (GMT -7)   
Bootheel,
I think that what the other members have suggested makes a lot of sense. Careful watching is the order of the day. Looking at your post-op figures the PSA seems to bounce around a bit and results at the ultrasensitive level can be somewhat erratic. Here's to the next one going down again.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 3/5/2009 6:56 PM (GMT -7)   
Bootheel

Brother I was lucky this time but I coud be with you at anytime in the future. You are in my thoughts of it going down, down, down as BillyMac says.
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


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 3/5/2009 6:57 PM (GMT -7)   
Bootheel

Brother I was lucky this time but I coud be with you at anytime in the future. You are in my thoughts of it going down, down, down as BillyMac says.
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


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 3/5/2009 10:43 PM (GMT -7)   

Bootheel

I had similar numbers as you, except my PSA was .08 at  6 months.  My surgeon and oncologist recommended RT with hormones, and I agreed.  However, as my surgeon said, the radiation would probably destroy any of the nerves he spared.  I have one hormone treatment left, and have been pulling solid "0's".  I have worked hard not to let the hormones effect my life, and am looking forward to getting rid of them.  My first desire in all of this battle, is to win it by increasing my chances for a long life.  If you could have the option - 5 years with a functional sex system, or possibly more than 10 without.....  Decisions we have to make with this beast.


Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;  Dec 2008 - 0
 
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 3/5/2009 11:33 PM (GMT -7)   
Hi Bootheel,

I was also in a similar position as you late last year. As you can see by my signature, I did decide at a PSA of .09 to go via the EBRT route. PSA was at .1 at the start of EBRT. I have to date no side effects and feel perfectly well. No regrets thus far on my decision.
What ever decision we make, it will be the right one for us. Hope you're watching your PSA very carefully.
All the best to you.

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


Pelahatchie
Regular Member


Date Joined Jul 2007
Total Posts : 86
   Posted 3/6/2009 8:35 AM (GMT -7)   

Hey Boot,

I am pretty much in the boat with Mugaboo.  I completed my salvage radiation one year ago and have had no E.D. problems but i have experienced some incontince urges in the past couple of weeks and had to start doing kiegl exercises again which seem to have helped resolve the issue.  My PSA went below .01 at the six month point after radiation and my radiologist put me on a once a year schedule for PSA testing which I was fired up about but which some folks don't think is a good idea.  He seemed confident and after all I have been through I loved that so I think I am gonna go with his recommendation and see how it goes. 

The thing that you need to consider most in my opinion is that it has definetly be proven that the lower the PSA burden when you start radiation the better result you are going to get.  It is such a crap shoot as we all know and with your gleason the beast may never get you but you are young and therefore that complicates the decision.

Like Mugaboo I think I made the right call but I don't think the impact of the radiation is complete yet but on the good side of that its impact on the cancer hopefully isn't finished yet either.  From most of what I have read radiations impact goes out about two years and that is where most people see their psa nadir and the full impact of side affects.

Good luck

 


Age 45 at DX
 
DX 8/05 Gleason 5, Mayo clinic Second Opinion Gleason 6, PSA 2.8
 
Da Vinci surgery Dr. Dasari, Centennial Nashville 9/24/05
 
Pathology Report Gleason 6, 15 % on left side only very near to the edge of capsule, too close to call on margins, doc's said to watch it very closely, final decision T2A
 
PSA's have basically ranged from <.04 to .05 for two years.
 
no E.D. and no Incontinence, feel very blessed
 
PSA Nov 07 = .06
 
PSA Dec 10th 07 =.07
 
PSA Jan 4th 2008= .1
 
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes, completed on March 6th, 2008
 
PSA April 18th 2008 =.03
 
PSA August 18th 2008 = .01 or less, test only goes down to .01


LJF
New Member


Date Joined Feb 2009
Total Posts : 14
   Posted 3/7/2009 2:33 PM (GMT -7)   
Don't try to project on all the negative possibilities straight off. Wait to speak with you Urologist and see what his rec is when you see that person in a bit. If the Uro is the one that directed the re-test, fine. If not, does the Uro's office know what the latest value is and is OK with having you wait til the appt?

Unfortunately, this is Cancer with a capital "C". It doesn't play nice. Before thinking the worst, wait to see what your Uro Oncologist recommends given the current findings. That person is the expert, not you. Don't ever feel as if you have to be the expert. With only chemical treatment to date, there are a lot of other options to choose from should that be necessary. Let your specialist guide you as appropriate.
New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, February 20, 2018 1:06 AM (GMT -7)
There are a total of 2,931,105 posts in 321,598 threads.
View Active Threads


Who's Online
This forum has 160336 registered members. Please welcome our newest member, Katiehurts.
273 Guest(s), 1 Registered Member(s) are currently online.  Details
Newmommy26