My interesting PSA history

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smilinjack
New Member


Date Joined Jan 2009
Total Posts : 15
   Posted 3/23/2009 5:11 PM (GMT -6)   
10/17/06 3.2
12/3/07 3.8
9/24/08 10.3
Prostatitis was discovered and treated.
10/17/08 5.2
12/08/08 4.8
was referred to Ur. for a biopsy and another psa was done
12/19/08 4.1
Found cancer.....am now waiting for Apr. 7th wen I start at Loma Linda for proton beam.
They wanted one more psa to bring with me.....got it today.

It was 3.26 go figure.
Jack
age 67
DX 7 Jan. 09
psa 4.1
prostate size 61cc
free psa 17%
Gleason 3+3=6
14 cores 1 had cancer 5%
Going to do Proton Beam Therapy


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4237
   Posted 3/23/2009 5:30 PM (GMT -6)   
Smilin Jack,
Did you ever get a 2nd opinion? In Gleason 6 with less than 5% and a low PSA in many cases it's insignificant cancer clusters and not a tumor. Just about everyone has these and if you are biopsied a lot they will be found.
I had the same stats. The urologist said surgery and two 2nd opinions said it wasn't a tumor only clusters that didn't warrent any treatment.
You are undertaking a rather drastic expensive treatment that will affect you for the rest of your life, and you should be sure you actually have a tumor rather than indolant PC cells. Your PSA history doesn't reflect a growing tumor.
I would recommend you get a 2nd opinion from a prostate oncologist who is more familiar with this situation that either a urologist or radiologist.
JohnT

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.

JohnT


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 3/23/2009 6:25 PM (GMT -6)   

Jack...interesting questions and points from JT and Selmer.  FYI, and I have posted this before, here are the requirements for the active surveillance program run by Johns Hopkins:

1.  Age 60+.

2.  T1C, i.e. nothing felt on DRE.

3.  PSA density of .1 or less (this is PSA divided by size of prostate, e.g. PSA of 3 divided by prostate size of 35cc equals PSA density of .086 which is less than the .1 threshhold.

4.  Gleason 6 or less.

5.  2 or fewer cores of cancer.

6.  No core with more than 50% cancer involvment.

Based on what I read of your stats, it looks like you would qualify for their program...

Tudpock

 


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 3/6/09.
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