Six-month PSA results - bad news

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 8:54 AM (GMT -6)   
Just got back from my dr. appt.  Wasn't good news.  My PSA doubled from .05 to .10 in just 3 months, and this was the six-month post surgery test.  He did a DRE, which I didn't think I would ever have again, and found nothing.  He's 99% we have reaccurance already, but he's scheduled another PSA in 6 weeks, if there is any movement upward, he wants me to hook up with the Oncologist and Radiation people.  He will use my former Oncologist, one of the best in the state, who took care of me ten years ago.
 
My dr. did comment, that is the trouble with Gleason 7, and why men shouldn't play around with them.  Even though my post surgery pathology was "clean", doesn't take many cells to have escaped to start all over again. I am proof of that.
 
He told me some utter horror stories of salvage surgeries he had to help perform when he was a resident, one reason he said he would never do one himself.  He still feels strongly, despite today's news, that I am doing things in the correct order.
 
If we have to do salvate RT, then he said without the prostate in the way, they can really do a focused and targeted attack on the prostate bed, and in most cases, that will finish off the cancer for good.
 
Now I have to let this bad news settle in.  Shows that some of the pre-surgery info is accurate, about PSA velocity and doubling times can give you stronger chances of reaccurance, even after having surgery.
 
All for now, this will just add to my depression.
 
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
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/11/2009 9:11 AM (GMT -6)   
Not good news, David, but not the end of the world just yet, also. Salvage radiation has been successful in stopping a reoccurance in 2 of my friends. Your course of treatment plan is good and nothing shows now to alter it, in my opinion. Other guys who have been there will have more info for you. Just remember, this is just one more step in the route.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 672
   Posted 5/11/2009 9:13 AM (GMT -6)   

Hi David,

Sorry to hear the news. I hope your oncologist can get you on a treatment plan soon. You are in my thoughts and I'm rooting for you.

Mike


Lower left groin hernia: mesh and large scar: surgery early 2006
Nov/Dec 07 and March 08 and now Dec 08: Severe perineal pain (between scrotum and rectum). Septra/Bactrim for 8 months (Nov 07-Jun 08) for diagnosed prostatitis.
PSA start of 2008: 5.3..... PSA June of 2008: 7.3
14 DRE all benign or nothing felt
TRUS Biopsy Nov 08: Got copy of pathology (see below). Prostate about 40 cm sq.
General Health: pretty good, 5' 10", 180 lbs, slim.
Bone scan Dec 08: Negative
Barium enema X-ray (March 09 due to several days of blood in stool)
MRI with endorectal coil (April 09 as part of a study)
3D advanced TRUS (April 09 as part of a study)
CT (April 09 as part of a study)
Biopsy Pathology: 5 of 8 cores positive, adenocarinoma in both lobes. 30%-65%. One core perineural invasion. 2 cores "foamy" and suspicious. All +ve cores, 3+3 GS 6.
Open RP surgery: 1st week of May 09.
Physical State: 10 miles brisk walking per week (border collies), 20 minutes/day hard weights plus 5 minutes per day elliptical trainer (target before surgery is 20).
Mental State: Mostly good. Sometimes questionable. 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 9:29 AM (GMT -6)   
Yeah, I can always find myself in the minority percentage groups. If only 1% of people turn purple on leap year, I would turn purple.
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
 
 


KeyWestPirate
Regular Member


Date Joined May 2009
Total Posts : 60
   Posted 5/11/2009 9:31 AM (GMT -6)   

Purgatory:

There's a relativly recent VA study that talks about "small and fluctuating" PSA levels caused NOT by PC, but just by small amounts of benign prostatic tissue

left behind.  I coudn't put my fingers on the study, but it's out there somewhere.  It was a small study, 750 men who had undergone RP.  If I find the link I'll post it.
 
Good luck.  Hope for the best, but plan for the worst.  It's bad enough to have to go through this once.
 
Can the Proton Beam be used for the salvage radiation, to avoid the side effects of conventional radiation?

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/11/2009 9:36 AM (GMT -6)   
Hi David,
It sounds like we are more alike than we would have hoped. You doctor should have ordered another test right away as well. This to discount lab error. But it is what it is. And yes a Gleason 7 can be as bad as some Gleason 9's in progression, I knew this and was proactive in selecting adjuvant therapies before a relapse. Still won't know if we accomplished anything until after the fact. My tests are tomorrow, and oncology is on Wednesday. Nervous time again for both of us. But I will stay positive. You should as well.

Peace brother. Keep your Faith, Love and Hope.

Tony
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  
 
STAY POSITIVE!


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 5/11/2009 9:45 AM (GMT -6)   
David-
I am so sorry to hear the news. It's not that there are not options, because we both know there are. Unfortunately, my family knows all too well the feeling of accepting the diagnosis, preparing mentally and physically for the surgery and recovery and starting to feel like life can get back to normal and then getting a bad report. It definitely takes the wind out of the sails. However, it sounds like your dr has a great plan and you will get through this. Take a day or two to be down if you need, but know that you have the support of many and we will be the wind in your sails if you need us. You can still knock this out, it just might take two rounds. Thinking of you.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 5/11/2009 9:51 AM (GMT -6)   
Sorry to hear about this.
 
But there is one thing that I just don't understand, and that is with pathology reports for prostate cancer and maybe someone can help explain it. It just seems that when the report says "clear margins" that doesn't mean that a recurrence cannot happen. If the margins are clear, to me that means that all the cancer was removed with the prostate gland. So where and how is the prostate cancer growing again?

JdKick
New Member


Date Joined Apr 2009
Total Posts : 11
   Posted 5/11/2009 10:03 AM (GMT -6)   

Hi David,

Sorry to hear about the new PSA levels, I hope that this new schedule of treatment will help.  From reading your message I know that you are a fighter and I hope to send you my wishes that you fight as well this time as you have done in the past.  I once again wish to thank you for your messages to me, I will be here for you as well.

 

Joseph age 46

CT Scan: clear for now

Bone Scan: clear for now

Chest X-ray: Compressed fractures in Thoracic Vertebrae

 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 5/11/2009 10:25 AM (GMT -6)   
David,
Sorry to hear the bad news. Hang in there. Have you considered ADT along with salvage radiation? If any cells have escaped and are growing ADT could kill them.
It also makes radiation more effective.
JT

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.

As of April 10 and 7 weeks on Casodex and Proscar PSA has gone from 30 to 0.62 and protate from 60mm to 32mm. Very minor side affects. Doc says all this indicates tumor is not aggessive

Awaiting schedule for seed impants

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 10:32 AM (GMT -6)   
Thanks TC, Doting, and Pirate, just hard right now trying to put a positive spin on bad and unexpected news.

Squirm - despite surgery, microscopic cancer cells could have already escaped, too small to be detected by any scans. With a PSA above 12 and a Gleason of 7, plus strong PSA velocity, I knew all along that I was in a much higher risk group for reaccurance after surgery, just didnt expect it this soon.

Joseph, kind of tired of being a fighter, that's all I have done the past 10-12 years of my life with one medical crisis after the next, that's why I already look 65-70 instead of my natural age of 56.

I had such a terrible time of going through radiation in the year 2000, I fear the thought of having salvage radiation for the PC if needed. This is why I wanted surgery over radiation in the first place.

If I didn't have a good wife, kids, and family, I would know just how to end this nonsense and save everybody a lot of trouble and money being wasted.

David
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
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/11/2009 10:37 AM (GMT -6)   
David,
Radiation was a breeze for me. By far the easiest of my therapies. But don't get ahead of yourself yet. Get that next PSA and look at it when you get there.

Tony
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  
 
STAY POSITIVE!


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4087
   Posted 5/11/2009 10:39 AM (GMT -6)   

Dear David:

I am SO sorry to about your latest results...it seems that you just can't catch a break and that seems very unfair.  Having, said that, I know your story includes many issues over the years that you have overcome and I pray that you will overcome this problem as well.

Now...I am going to give you some advice that I think you would give someone else with these issues.  That is, to immediately seek another opinion from another urologist.  I know that you have a lot of faith in your current doc, that he is convenient, etc, etc.  However, let's examine the facts as you have presented them over the past months: 

1.  Major catether issues that were finally fixed after you asked about treatments you learned about on this forum.

2.  First he said he had not spared the nerves then, oops, I guess they must have been spared after all.

3.  Everything was clear post-surgery but, oops, PSA is up...guess we didn't get it after all.

Maybe this latest jump is residual per KeyWestPirate...maybe not.  But, don't you owe it to yourself not to wait 6 weeks?  I'm not trying to be a doc-basher, just trying to honestly help you consider your options.

Good luck and please keep us posted,

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 5/1/09.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 12:05 PM (GMT -6)   
Tud,
I apreciate your sentiments, but not sure they all fit the facts. My surgeon is very, very good, he can't be held responsible for a few cancer cells that may or may not be on the other side of the fence. He warned us after surgery about the extreme difficulty with the bladder neck reconstruction, he kept hoping not to put me through a corrective surgery to fix the catheter problem, but in the end, that is what it took. The nerve bundle thing, still a puzzle to me, he did originaly tell my wife after surgery that he wasn't able to spare either side, but later, admitted that the right side was left alone entirely. BTW, even today, he is totally amazed that I don't have any ED problem, this is from a guy that has been doing this for 30 years.

I am not blaming anyone. Luck of the draw. This is what can happen when pre-surgery you are higher psa, high velocity and at least a Gleason 7 to start with. I have to hope and pray the next six weeks that the psa number either freezes in places, or if by some miracle, goes down a little. My logic says that's not likely to happen, if anything, may go up even more, which will force the next course of treatment.

Thanks for caring,

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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


dsmc
Regular Member


Date Joined Jul 2008
Total Posts : 149
   Posted 5/11/2009 12:19 PM (GMT -6)   
Hi David,
I am sorry to hear this for you. Maybe it will be lab error or residual tissue. I am glad you and your Doc are proactive in wanting to get things lined up. As my signature says I had to go this route and the radiation was not that big of a thing other than just getting there everyday and trying to work at the same time. Now there is the waiting to see whats up. I am going to have a PSA drawn next week for an appointment with my URO/Surgeon on the 20th. My last PSA reading was in September and was 0.1. I did cheat a bit and had blood drawn a couple of weeks ago at a health fair and was glad to see it come back at 0.0. It wasn't an ultra sensitive test but I will take it. I wish you the best and you will be in our thoughts and prayers.


David
Age 53
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 5/11/2009 12:21 PM (GMT -6)   
David, man I am so sorry to hear the news. After reading through several comments here, I think you are spot on in the direction you will need to go. I don't see where this as a small fluctuation given the ultra-sensative test that was used. If it had been a small amount of rise I would agree. Having that said, I think you will most likely need to begin planning on how best to enter the fight again. You have some time to think about it from this point forward. I personally would really weigh in the options for your next step. Regardless of the direction you go...just remember the end result is the idea of getting rid of the cancer, your family needs you around. But always work on the emotional side of this roller coaster and not let it get you down any longer than necessary. Right now it is a terrible depression to think about this, but this too will soon pass. Look into that which is inside you for that strength...your passion and devotion.

Good luck my friend, and I will watch your progress closely.
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
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 12:30 PM (GMT -6)   
dsmc - hope your results match what you found out early, hoping the best for you too.

les - today's experience is why I hate PC so much, its too unpredictable, too uncertain of its paths and turns, too mean and can be too agressive as you well know. Sometimes, I and I know this is not logical even saying it, I swear I feel I am being punished for something. I don't know what, I am not a bad person, I am a sinner as much as the next man, but I try to live a clean decent life, and treat others fairly as I would like to be treated. I don't see it as a flucuation, and not a flaw in the test. The original post surgery psa of .05 was actually on the high side to start with, so I have been nervous all along. If I were 75 years old, I would probably take this more in stride (no offense to our elder brothers), but I am only 56. It is what it is, so all the wishing in the world won't make this go away. Going to be a long 6 weeks to the next test.

If I go the salvage rad route, I already know my oncologist, and he is the best of the best. If I hadn't had such a terrible time with previous radiation, wouldn't be as worried or concerned, but it really did a number on me.

Thanks for your care and concern, that I know is real, and I can feel it from SC

David
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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4825
   Posted 5/11/2009 12:31 PM (GMT -6)   
darn David….Guess you’ll need to make some lemon aid with all them lemons you’ve been thrown.................. or learn to duck tongue
 
Of all the people here, you’re one of the winners and you’ll get through this.

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4087
   Posted 5/11/2009 12:37 PM (GMT -6)   

Hi David:

OK...this is my last post on your doc.  I'm not blaming him for the recent PSA rise.  I'm just saying, from a totally objective party who has read almost all of your posts, that I would get another opinion.  Maybe he is ""very, very good" but, leaving everything else aside,  how in the world can he not know whether he spared nerves or not?  C'mon...

If you were my brother, son, best friend...all I'm saying is that, after objectively reading your posts, I would advise seeking another opinion and not waiting 6 weeks.  But, your body, your decision and now I'll shut up...except to say that I feel horrible about what you are going through and really hope for the best.

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 5/1/09.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/11/2009 1:16 PM (GMT -6)   
One thing for sure David,
If this is recurrent disease then you do need that strong prostate oncologist consultation prior to any further treatment. If the plumming is working, and it is, your urologist was successful even if it took a few rounds. But now to line up the the next steps and careful calculation. You have been a terrific read here with your case. Keep up the good work.

Tony
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  
 
STAY POSITIVE!


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2457
   Posted 5/11/2009 1:55 PM (GMT -6)   
Sorry to hear the bad news Dave, I hope your next step will kill what ever cancer is left there. RT after surgery seems to get good results and that is what I will pray for you. Hang in there.
Age: 67
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09
Surgeon: Dr. Randy Fagin, Austin TX.
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
seminal vesicles clean
Lymph nodes: not dissected
1st PSA test 4/7/09 result <0.1


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/11/2009 2:20 PM (GMT -6)   
David
Even though it says Regular Member, I’m a relative newbie here, but I certainly recognize the Purgatory handle. When you hear us saying things like fight on or think positive it is because those are things you have taught us. You may feel like crawling into a hole and never coming out and you have every right to feel that way except for one – that is not what you stand for.
Age at diagnosis 67, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/11/2009 2:21 PM (GMT -6)   
Words fail me, Purgatory. I assure you that you will be in our prayers tonight and that all will be well.

Please don't feel you're being punished for something - I know this is much easier said than done. You are a strong and extremely kind man who has done so much for so many. You will get through this.

You are not walking this path alone - we are all with you, every step of the way!

Hugs and kisses from The Big Apple!

Joanne and John
Husband diagnosed in February 2008 (age 57). Cancer discovered during routine annual physical. Clinical Stage T1c, Gleason 7 (3+4), with 2 out of 10 cores testing positive. Perineural invasion identified on biopsy. DRE was negative.

Robotic surgery in March 2008. Pathological stage upgraded to T3a, Gleason still 7 (3+4). Miniscule invasion into prostate capsule but no cancer found outside capsule (surgical margins and seminal vesicles were clean).

1st PSA 3 weeks post op: 0.1; 2nd PSA 7 weeks post op: 0.0. PSA remains at 0.0, and will continue to be checked every 3 months for the first 2 years due to capsular penetration.

Currently on Enablex to control frequency of urination (tried Vesicare but stopped due to heart palpitations) and on Viagara 2 - 3 times a week. Recuperation from surgery was uneventful.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 5/11/2009 3:04 PM (GMT -6)   
steve in dallas - thanks for the kindness

tudpock - didnt read any ill feelins in your post(s), i know you care, a 2nd opinion is needed at this juncture.

tony - i agree completely with you

edc - thanks for your kindness

geezer - we are all friends here equally, i dont mind that you are fairly new, i haven't been here forever, just seems that way

sephie- thanks, felt that hug all the way from NYC!!!! Needed that.

To show one and all, that good and bad news can follow one another, after todays set back with the dr, I have two quality level job interviews tommorow, one at 130 and the other at 430, after been in an interview draught since February.

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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 5/11/2009 3:16 PM (GMT -6)   
Hi David,
 
First let me tell you how sorry I am about your increasing PSA. I know exactly how you feel because a few short month ago I was in a similar situation as you. My timeline was a little different, but I had a recurrence and opted for salvage radiation as soon as I felt sure that the cancer had returned. I had very little difficulty with the RT and my PSA dropped by 50% only 6 weeks after completion. My 6 month checkup is in July and I'm hoping for the best.
Life is not always fair, but like it or not, we have to deal with it as it unfolds.
I'm wishing and hoping that we will both be around for many years to come.
 
Magaboo

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), 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

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