First visit with Radiation/Oncologist coming up soon

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Purgatory
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Date Joined Oct 2008
Total Posts : 25364
   Posted 7/2/2009 12:26 PM (GMT -6)   
My initial appointment with a radiation oncologist is coming up soon, July 13th, which happens to be my 57th birthday, what a great present!  The subject will be about whether or not I need to start salvage radiation, or wait and see.
 
I am not sure what to be asking in the form of questions this time.  You can see from my stats, that since surgery, I have had a .05, .10, and now a .11 PSA reading.  The last one was at 7 1/2 months out from surgery.
 
I don't want to rush or be pushed into this next step, unless I am totally convinced it is needed, again, due to problems with past radiation treatments.  I am also very concerned with having urethra blockages, or having to be back on a cath short or long term due to the radiation if I have to go that route.  Even my own dr/surgeon is concerned about the bladder neck if I had radiation, so he is suppose to be going in great detail to the new doctor about my surgical complications.
 
Under my circumstances, what would be some good questions?
 
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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/2/2009 2:02 PM (GMT -6)   
Ouch.

There's a line in Scardino's book (sorry, I don't have it with me) to the effect that only half (?) of men whose PSA goes above 0.2 actually have a recurrence. Also, the Mayo clinic (and some others) don't consider there to be recurrence until 0.4. Question: What's his take on the threshold?

In any case, given the 35% day-to-day variation in PSA tests, it's not clear that you're above 0.1. Questions: Do you have a recurrence? What do they think your doubling time is? All the writeups on prognosis for recurrence I've seen focus on that number (and maybe others). For example www.mayoclinicproceedings.com/content/82/4/422.full.pdf and urology.jhu.edu/newsletter/prostate_cancer52.php

If there is a recurrence, it happened in maybe 8 months. The articles I've read say that points to distant (systemic) metastasis rather than localized recurrence, i.e., prostate tissue left over in the prostate bed. Questions: What is the likelihood of local vs systemic progression? What is the role of radiation (if any) in treating metastasis?

Good luck.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


John T
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Date Joined Nov 2008
Total Posts : 4188
   Posted 7/2/2009 2:16 PM (GMT -6)   
Dave,
I think there are tumor markers that can be used to determine the probability of reoccurrance. You might want to get a 2nd opinion form a noted Prostate oncologist and run some more tests.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/2/2009 3:36 PM (GMT -6)   
Two followup points:

1) By any definition, you don't yet have a recurrence (minimum 0.2), though you may be creeping up toward it. Every month that goes by before you hit that number improves the odds that you have a local recurrence rather than systemic/metastasis.

2) One paper www.urotoday.com/browse_categories/prostate_cancer/predicting_the_outcome_of_salvage_radiation_therapy_for_recurrent_prostate_cancer_after_radical_prostatectomy.html found that those who elect salvage radiation have better outcomes if the treatment is undertaken before PSA rises to 0.5. If that's so, it would appear that you've got some time before you have to make a decision.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/2/2009 4:45 PM (GMT -6)   
Getting some good advice so far, thanks. Lots to think about, and as usual, will go with a list of questions in writing.
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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 7/2/2009 4:59 PM (GMT -6)   
In my thread Questions for your doctors from YANA, it has specific questions for Radiation Oncologists... I will bump it again...Feel free to contact me directly if you would like to talk about my experience with IMRT...

Tony
 Age 47 (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  
 
STAY POSITIVE!


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 7/2/2009 6:14 PM (GMT -6)   
Greetings, David.  Don't have a lot of help as far as questions go, just want to say good luck with the appointment and trust you will get the answers you need.  I hope you don't have to do anything else, but if you do, I'm sure you'll do great.  I am with you - if my PSA ever starts to rise, I know I'll want to try and get all the info I can as quickly as I can.  However, I do understand that the PSA is supposed to get to a certain level before they begin salvage radiation.  Keep us posted.  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/2/2009 6:31 PM (GMT -6)   
Thanks for the offer Tony. May take you up on that.

David CPA, I can't see them wanting to push a secondary treatment at this point, being .10/.11, with a Stage 2 cancer and a clean pathology report, but then I am not the doctor.


Least that is what I am hoping. My life is just now settling back down to some degree almost 8 months after surgery.

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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/3/2009 4:40 PM (GMT -6)   
Found the reference (actually an article that points to the same source).
Stephenson et al in JAMA Vol. 291 No. 11, March 17, 2004 said...
For example, one recent report demonstrated that a single PSA elevation of less than 0.4 ng/mL after radical prostatectomy is associated with subsequent stable, nonprogressing disease in up to 50% of patients.
citing www.ncbi.nlm.nih.gov/pubmed/11257657?dopt=Abstract
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/3/2009 4:42 PM (GMT -6)   
Good info Larry, wonder what it means if it stays around .10 to .15 indefinitely? Wonder then if the residual prostate tissue theory would be true?
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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/3/2009 4:56 PM (GMT -6)   
Damifino. I guess the message is that there's a lot of fuzz on the numbers. This is probability, after all. So it sounds to me like "Be alert, but not hyper."

I would guess (and with no qualifications, I can plunge ahead unhindered by facts) that a stable PSA number at just about any level is good news. But listen to your oncologist.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 7/3/2009 6:13 PM (GMT -6)   
Hi David, So very sorry to hear of this......As you know we dealt with it just the opposite....first radiation, then salvage surgery...You are much better off....I wish and pray for your good health....You are a strong survivor and a wonderful advocate for all.... Diane

"True spirituality is a mental attitude that you can practice at any time." Dali Lama
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Hip replacement total success..pain gone!!
PSA .7 2/10/09


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/3/2009 8:51 PM (GMT -6)   
Thank you Diane. I am not as strong as some think, but have survived many a medical battle over the years. Sometimes, I get tired of
the whole fight, but then I don't like the alternative, lol. So I fight some more. The meeting on July 13 for me is a pro-active step on my part
with the blessing of my doctor. I want to know what might lie ahead, and how to be prepared for it if needed.

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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/4/2009 7:18 AM (GMT -6)   

Besides asking about type of machinery used(there are many) and type of ray(s) used, delivery areas, exposure rates(dosemetrics), sessions in total, overall maximum exposure that could be safe (there are limits), his experience in years or numbers of patients, perhaps a patient you can talk to of his.  Its up to you maybe ask questions that may reveal how truthful is this doc (frankness, openess):  'in your clinical experience' how effective generally is salvage radiation for patients (25%-50%-80%-???)  Do you have a large number of patients whom appear cured, say 7-10 yrs. post salvage treatment???

Not that those answers are black and white, but listen closely to his frankness and words, does this sound like more truth or more of a sales pitch of what I would want to hear a patient???  Then you can weight everything you know and/or heard on PCa and read, etc.  Make your decision (not his decision), maybe you can wait still, maybe you can consider hormone therapy now and still do radiation later (if you wish). Maybe do hormone therapy now and wait a couple years to see what new stuff if on the horizon, it is coming (slowly) .  Maybe this is the best course to try and take at this juncture, it is always an overwhelming task for us PCa patients that are at a huge disadvantage when talking to the "experts".

It seems salvage radiation is less than 50%, so if the doc says  75% and higher....question on how he arrived at his percentages. Anyway best to you in what ever you might decide, always choices within PCa scenarios.

Bob (aka-zufus, not dufus or zufas although those are humor-ass and I like some humor, which is badly needed for us patients whom don't see alot of laughs in this jungle)

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/4/2009 8:04 AM (GMT -6)   
Bob, thanks for your advice, and some more to add to my question list. When I had radiation back in 2000, I felt like I was a sheep
being led to the slaughter. The rad dr didn't like me asking him anything, the treatment center was a little on the cold hearted
side towards their patients, it was not a good experience. After about the first 3 or 4 treatments, it was like a personal trip to hell.
At one time, my wife a seasoned nurse, begged me to drop the treatments, as she was afraid I might not make it. But I toughed it out for
all 35 sessions, only on the last 2 did I give in and let some one drive me there. Since, I have learned that throat area radiation
is some of the most physical gruelling and painful. To this day, 9 year later, I can't even spit, because my saliva glands were so
damaged by the radiation, and I have constant thirst, to where you don't see me without a water bottle, and if I am ever out of water, I
would drink from a puddle at the side of the road if I had to.

No, I don't want to have salvage radiation, not unless I am 101% certain I have reaccurance and that it is going to spread.

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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 7/4/2009 8:23 AM (GMT -6)   
Dear David,
I am about half way through 38 sessions of IMRT. In my case, I had a positive margin from the surgery. My PSA went up to about .18 in about 15 months. I realize your first bad experience with Rad and hopefully if you need IMRT the side effects will be minimal to you. It is a different area of the body. My Dr. explained all of the possible SE's in the beginning so I knew what to expect. So far I have had some loose stools on occaision and a bladder neck constriction which cleared up completely in a few days with Flomax. Other than that I feel fine. Daily exercise is really important to combat fatigue. What ever you decide, I hope this info will give you some peace of mind and take away some of your fears. Peace be with you.
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
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
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
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/4/2009 9:23 AM (GMT -6)   
The three most interesting documents I've found on salvage radiation are:

jama.ama-assn.org/cgi/content/full/299/23/2760 from which I take away the sentence "The increase in prostate cancer–specific survival associated with salvage radiotherapy was limited to men with a prostate-specific antigen doubling time of less than 6 months."

and

jama.ama-assn.org/cgi/content/full/291/11/1325 from which I see (Figure 2) that a guy with Gleason =<7 and negative margins, who gets radiation before his PSA rises above 2.0, and who (this is the big one) has slow PSA doubling time (greater than 10 months, contradicting the first article) can hope for about 70-80% chance of being progression-free in 4 years. Four years isn't very long, but it beats a poke in the eye.

and

www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17513807 which helps calculate 6-year progression-free odds and also DOES NOT find the restriction on short doubling time that the first doc did. Guess what--we don't know everything. Also, "An estimated 48% of patients who received SRT alone at PSA levels of 0.50 ng/mL or less were free of progression at 6 years, compared with 26% for those treated at higher PSA levels." Which tells me that, contrary to our experience with initial onset of PCa, treatment for recurrence may require relatively fast action. For the same assumptions as #2, their nomogram predicts something like 50% chance of being progression-free in 6 years with a PSA doubling time of 10 months, and longer doubling time is better. <Corrected percent progression free from 75 to 50%: found "erratum" which corrected nomogram>

If I were going to a serious visit with a radiation oncologist, I think I'd take those articles with me.

Good luck.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006

Post Edited (CapnLarry) : 7/4/2009 12:54:36 PM (GMT-6)


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 7/4/2009 9:51 AM (GMT -6)   
David,

Here is what I have asked or should have asked (in no particular order):

1. Probability of local v. distant recurrence with your data
2. Area of salvage treatment (prostate bed v. full pelvic)
3. Dosage
4. IMRT v. IGRT v. TomoTherapy
5. Salvage radiation v. radiation with ADT
6. If ADT, how long (6mo v. 2y)

Also, you may want to have your pathology slides re-examined by someone else. When they looked at my at MSK they found a focal EPE and two positive margines v. just one small positive margine. This made my decision easier as it makes local recurrence more likely.

From what I was told by multiple docs, the RT is really not a big deal. There are few sideeffects, they are mild and usually don't show up until last few weeks of the treatment.

Good luck!

Greg B.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

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)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, IMRT to start mid-Aug


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/4/2009 10:52 AM (GMT -6)   
Greg, thanks for some good questions to ask, I will consolidate the best answers here and be prepared. My wife wishes to go with me
for this visit, and she can ask questions from a qualified medical position, and help keep me focused.

Love this place, getting some great answers from many. If I have to use my "second gun" of treatment, i.e. radiation, I want it
to be done right, at the right time, and in the right way. We don't get second chances with PC treatments.

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, 6/9 .11, July 13 - meet with radiation oncologist
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/5/2009 10:58 AM (GMT -6)   
It's funny, I feel no anxiety about this upcoming consultation. It's not like the pressure I had before my surgery - the biopsies and the PSA
tests, nor is it like the heavy sword over my head feeling with the first 3 post surgery PSA tests. I still don't know what is going on with me
and whether or not there is reaccurance going on already, but I feel somewhat at peace, like I am doing all that I can about it. Like
everything else connected to PC, it is what it is, regardless of how I feel or think. I may not feel so relaxed about it after I have this
meeting, but then there could be good news out of it too. So for now, I simply just want to enjoy a brief period of calm, and hopefully
not a calm before a future storm. Because of the ammount of time I have spent worrying about PC, spanning now back to the summer of
2007, it gets harder over time to imagine a time in my life where I never ever thought about it, never came to my mind. Sometimes
ignorance is bliss.

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, 6/9 .11, July 13 - meet with radiation oncologist
 
 

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