Latest PSA (not good)

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Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 5/13/2009 7:16 PM (GMT -6)   
I just got a call from my Uro.  Latest PSA .18.  Not good.  Last was .09.  about a 3 month doubling time.  Will setup IMRT with the Rad oncologist tomorrow and see what happens.  Any advice or info from someone who has ben there? We are totally shaken by this latest news.
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
Gleason 7 (3+4)
1 positive margin (.3cm)
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

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 5/13/2009 7:22 PM (GMT -6)   
I am sorry for your news. A 3 month PSADT is indicating it's those grade 4 cells. RT sounds right but you also may want to bite the bullet and also engage a prostate cancer oncology specialist. I have been down the road of Surgery/HT/RT though I chose to do the latter two before a PSA rise and because of extensive spreading. Radiation will be a breeze. But ADT isn't so fun but a regemin on it might be in order as well.

Remember to stay positive. Don't let this keep you down. You still can do very well.

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 (May 11, 2009): <0.1
My Journal is at Tony's Blog  

Veteran Member

Date Joined Nov 2008
Total Posts : 697
   Posted 5/13/2009 7:31 PM (GMT -6)   
Bootheel, my situation was similar to yours, the main difference being age. I'm in my 40's. Positive margins, Gleason 3+4, robotic prostatectomy. First PSA was okay, and then it started to rise, with a doubling time of about 3 months.

I had IMRT. It was no big deal. I had some mild effects that are now gone. The best thing is, it seems to have worked. I'm now just over 2 years out from the end of IMRT, and my PSA is (knock on wood) less than 0.1.

My complete story is on my blog, .

Have you put your numbers into the nomogram on the Memorial Sloan Kettering site?

Salvage radiation is always a bit of a gamble, but at least the nomogram gives you some idea of where you stand in terms of probable outcome. For me, there wasn't much of downside risk, and I had everything to gain.

Best wishes.

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 5/13/2009 7:35 PM (GMT -6)   
Thanks for sharing the news Bootheel. As bad as it seems on the surface I, like Tony believes there are still plenty of weapons to throw at this. Stay positive explore your options and then defeat the demon. In the meantime love life my friend it is a precious gift so often taken for granted.

peace and love
My PSA at diagnosis was 16.3
age 47 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
Testosterone keeps rising, the current number is 156, up from 57 in May
T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 5/14/2009 8:21 AM (GMT -6)   
Oh Bootheel...I am sorry to hear of the news. Dang seems like lots of members lately are seeing increases in their PSA tests...must be the spring weather..gotta blame something. Your decision at this point is a wise one, and like Tony mentioned...with the fast doubling time, at least consider including the HT.

Best of luck...and update your journey often for others to follow with the salvage radiation process and thoughts.
You are beating back cancer, so hold your head up with dignity
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

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 5/14/2009 9:14 AM (GMT -6)   
I am sorry to hear this news.

I had a similar experience just a couple of weeks ago. After a period of time with a good news (undetectable PSA) I came to believe I was out of the woods. Then bam! The PSA is doubling every 3 months. Just like the first time - I had five negative biopsies and began to believe it was nothing when I was diagnosed. The reaction to the news is similar - a shok at first, then you get used to the idea... the life goes on.

Hang in there - your positive margin is actually a good news. The latest research shows that those of us with high risk (Gleason 7+, positive margin) have a much higher probability of good results from IMRT. ( ). I plugged my numbers into Sloan Kettering calculator and got 64% chance of regression free at 6 years. I believe your numbers are similar.

Previous 5 biopsies over 4 years negative

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)















followed by surgery at Duke (Dr. Moul) on 6/15/2008

Gleason downgraded 4+3=7, T2b N0M0, one small positive margin

PSA undetectable for 8 months, then






James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 5/14/2009 3:35 PM (GMT -6)   
Darn, that's a disappointment. I hope your plan of treatment will kill the sucker for good....Our thoughts will be with you in this stage...
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

Regular Member

Date Joined Feb 2007
Total Posts : 122
   Posted 5/15/2009 5:51 AM (GMT -6)   

Sorry to hear that you may have radiation, I went through the same situation and had 37 treatments, Radiation wasn't bad  for myself, The only thing is you have to go to the radiation center everyday, mine only took 30 minutes or so.

I didn't have any real side effects except a sore rectum  at first and they gave me something for that. I sure you will do fine

good luck to you


50 years old
gleason 3+4=7 psa5.8 clinical stageT3a
Da vinci surgery April10 2007 Mayo clinic Rochester, Mn.
extraprostatic extension Gleason -same
pelvic lymph nodes -negative
Catheter out April 19
psa aug 2007 0.28
37 treatments IMRT ended 10/26/07
psa Jan 29 2008 0.10
psa april 30 0.14
psa aug 21, 0.16
psa dec 17 o8 , 0.16

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 5/15/2009 11:31 PM (GMT -6)   
I am disappointed I missed your thread earlier. I am sorry to hear the news, but as the others have said, the war is not over and you have got plenty of guns to blaze. Just wanted to let you know that I will be thinking of you and wishing you peace and strength for the next leg of the race.

In regards to radiation, my father tolerated it quite well. The hardest part was mental, but once you wrap your mind around round two, I think it helps. He did get diarrhea for a couple of weeks, but otherwise, it wasn't bad for him. Keep us posted!!
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

Veteran Member

Date Joined Nov 2006
Total Posts : 1464
   Posted 5/16/2009 10:31 AM (GMT -6)   
Hey Bootheel,

Your news is devastating buddy. But as you know, lots of guys here have gone through adjuvant therapy and had excellent results. Your attitude is excellent and you should expect the same outcome.

All the best...

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
"Patience is essential, attitude is everything."

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