What a fun group and a question

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Regular Member

Date Joined Jun 2009
Total Posts : 292
   Posted 6/2/2009 3:11 PM (GMT -6)   
I can only echo Groucho Marx, "I don't want to be a member of any club that would have someone like me for a member." Of course, I'm a member whether I like it or not.

I have my first post surgery PSA test Friday and a meeting with the doc on Monday.
I'm a tad apprehensive.

When diagnosed in January I had a PSA of 8.3.
Needle biopsy was positive 4/6 cores with one core at 90%.
Gleason as 3+4=7.

Tax season intervened. Since I was self-employed I could not shut down for half the tax season so I got a shot of Lupron to get me through the season with (hopefully) no progression.

Surgery was April 29, delayed a week so I could bury my father. (34 year prostate cancer survivor)
The most interesting(?) post surgery event was the catheter got hung up on a stitch and it couldn't be removed until the stitch dissolved a bit more. That took a couple of days and I took care of it at home.

What has me apprehensive is that the pathology report post surgery came back 3+4=7 with a tertiary 5 and I had one positive margin.

The lymph nodes where clear as were the seminal vesicles. Apparently age is in my favor; I'm 54.

The doc wants to talk about where we go from here and mentioned radiation. Oh boy.
Anyone have experience with a radical prostatectomy followed immediately by radiation?

Veteran Member

Date Joined May 2009
Total Posts : 2691
   Posted 6/2/2009 3:53 PM (GMT -6)   
I don't know how much fun this group is.
Age 58
PSA 4.47
Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09
Nerves spared
0/23 lymph nodes involved
pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.
Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Thankful for early diagnosis, and U.S. healthcare
Living the Good Life, cancer free
6 week PSA undetectable. 

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 6/2/2009 4:20 PM (GMT -6)   
Welcome STW,

Radiation following surgery is quite common when there is sufficient reason to be pro-active with the disease rather than wait until there is actual recurrence. It really depends on the protocols your urologist will follow. Some doctors will recommend adjunctive radiation if there is a high Gleason at pathology or even positive margins. Your teritary 5 means your particular gleason grade could respond more like a gleason 8 rather than a gleason 7 as there was some minor traces of gleason 5 cells found. Based on that and with positive margins I believe your doc is on target to consider some followup treatments rather than wait until later.

Radiation treatments are not benign, but well tolorated by most men. Let us know what you doc says.

Again welcome to Healingwell...where nobody wants to be, but if you have to be here, then this is the best place for information. Those that have had adjunctive radiation will chime in shortly.
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

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 6/2/2009 5:26 PM (GMT -6)   
Welcome to HealingWell. I am a proponant of proactive treatment in stage 3 and above prostate cancer especially in younger men. I am also walking that walk. After surgery I added radiation and hormone therapy before a relapse could occur. I have taken that story on the air and in magazines. Last month I also was on a panel of some of the top doctors discussing my approach. None would discount the approach and all said if it were them they would have done the same.

None the less this is a tough call and it is very personal. Good luck in whatever you decide...

I agree that this is a great group. I came here right after my bone scan in '06. This has been a great place for me, and I stayed to help others like i was helped. This is a very strong brotherhood.

Peace to you,

 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 Feb 2008
Total Posts : 655
   Posted 6/2/2009 7:09 PM (GMT -6)   
Greetings, STW. Some people will do anything to try and get out of tax season. Welcome to the group that no one wants to be a part of it but here we are. I think you are wise to explore all the options. If I had been told I had any margins or lymph node or seminal vesical involvement, I would have been right there with you. There are lots of guys here who have gone down a similar path - you are in good company. Please keep us posted as to how things go. David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

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