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Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 3/11/2009 11:13 AM (GMT -6)   
My wifes uncle just had his PSA done 2 weeks ago and it was over 400. He is 63 years old and had never had one before (careless doctor). He had a bone scan done and there is cancer in alot of different spots in his body. His urinologist has told him he needs to take hormone therapy. The doctor said if he took hormone therapy it would prolong his life anywhere from 2 months to 2 years. Anyone have any advice that I could give to this man to help him. I have told him to come to our website here for some support, but he`s one of those people who never uses a computer or sees the value. Any help would be appreciated
Diagnosed Feb 08
PSA 6.3
gleason 3+3
first biopsy 1 of 10 needles positive
surgery Sept 18 08
bone scan negative
evidence of sinus histiocytosis?
involvement of the margins identified at right and left apex and right anterior surface
also perineural invasion
no extraprostatic extention
no seminal vesicle invasion
tumor cells aggressive features of moderate to severe pleomorphism
1st PSA nov 08 undectable
kept left side bundle of nerves but lost some of the right side bundle
also had laser surgery in July 2008 to save eye sight from glaucoma hospitalized twice for kidney stones  in summer of 2008

Regular Member

Date Joined Jan 2009
Total Posts : 30
   Posted 3/11/2009 11:29 AM (GMT -6)   
nono  No Stats on how long he might live - the plan would be to get him started on HT - and stop the cancer from growing in his bones and elsewhere.  The HT should give him several good years or more - after he becomes HT Resistant - there are other treatment choices.  Yes he needs to put his ducks in a row.

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 3/11/2009 3:47 PM (GMT -6)   
The urologist seems a little pessimistic mentioning a 2 month figure. As a first step he should consult with a specialist in medical oncology rather than just the uro guy. there are many cases of higher PSA cases with bone mets living for many years after diagnosis. Get him to have a look at the higher PSA men on the yananow site as linked here.
I wish him well with his treatment.
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

Veteran Member

Date Joined Oct 2008
Total Posts : 3257
   Posted 3/11/2009 5:27 PM (GMT -6)   
Hey, Check out my signature. I am almost 3 years into this crap and doing well. God is good. I stand on psalms 103. Hormone treatment can give lots of time. Todd
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months
Cat Scan 12/12/08 Prostate normal size and shape. No tumors detected. Left lung clear of all nodules right lung showing only benign scar tissue. Lymph nodes normal
Bone Scan 12/24/08. Clean!!! went off casodex January 4 2009
Current psa 2/13/09 .16

Regular Member

Date Joined Nov 2008
Total Posts : 65
   Posted 3/11/2009 6:24 PM (GMT -6)   
Hi Fred,

Although I agree that starting hormone therapy is the thing to do at this point, your wife's uncle should engage a medical oncologist, preferably one specializing in genitourinary cancer.

Urologists are by trade surgeons. A medical oncologist's training is concentrated on things at the cellular level and treatments that effect those cells. A medical oncologist is the best person to direct treatments that may include surgery, radiation, hormone therapy, or chemotherapy. At this point it is really beyond the expertise of a surgeon.

I think it's a little early to apply a time frame to longivity. I was told my prognosis was poor 10 years ago and I still call that doc an idiot.

I wish him the best,

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.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 3/11/2009 9:37 PM (GMT -6)   
Hi Fred,
A gentle reminder about the Charles Myers book is warranted here. "Beating Prostate Cancer:Hormonal Therapy and Diet"

This book has several case studies of guywith PSA's in the thousand plus range and it has some great advice to follow. We have a good few members here who have been around the block with PSA's in the hundreds. The importance of staying positive is real. I think his doctor has good intentions in recommending the use of hormonal therapy, though I wish doctors would stop putting caps on things. The fact is that I can reference several stories of guys living many years with PSA's in the hundreds or even thousands including our good friend Todd who posted above.

I hope you are well, and staying well. Time to pass it along!

Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 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  

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