Back from seeing surgeon in Orlando

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Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 7/24/2009 1:47 PM (GMT -6)   
 
Hi All,
 
Well here is another new tale not sure if anyone has had this one.  Drove 3 hours and waited for 4 hours to see the doctor the waiting room was packed with people from all over the country and some even out of the country all with Prostate Cancer and all looking to have surgery.  When I finally got in to see the surgeon he said the burning I am feeling is not a stone but a calcium buildup that is attached to a clip from the surgery.  He said the body should eventually reject the clip and I may pass it in my urine or if it comes out far enough they will try to go in with the cystascope and try to grab it.  He said they could do it now but since it is embedded in the urthra taking it out would leave a hole and then I would be leaking.  He said if I could tolerate the burning it is better to wait.  I have decided to wait and go back in 3 months to see if it is gone or if it is far enough out to grab without leaving a hole.
 
The Doctor was very encourageing about my prognoises he said even though my score is now an 8 I had a very small tumor and it was contain and margins and lymph nodes clear.  He said it is not unusal to have a slight bump to 0.1 but they still consider that undetectable and would not even consider doing radiation at this time.  He said he has a lot of patients that went to 0.1 even 0.2 and have stayed there for years.  Not sure if he is right but I sure liked what he said.
 
Jerry1
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/24/2009 2:15 PM (GMT -6)   
Sounds like guardedly good news.

On the definition of recurrence, see jco.ascopubs.org/cgi/content/full/24/24/3973 which says in part: "Recurrence defined as single PSA of at least 0.2 or PSA of at least 0.1 and rising is of questionable clinical significance in some patients, because an estimated one third was followed for 4 years without evidence of a continued rise in the serum PSA level, and the PSADT was greater than 20 months in half of the patients." In other words (if I read it right) 1/3 of guys who reached 0.2 never progressed beyond that during the 4 year followup period of this study.

Be of good cheer.
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 <0.01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/24/2009 2:20 PM (GMT -6)   
Jerry, thats the same reasoning that I am using to slow down the rush the radiaton oncologist folks were trying to do, because my last official post surgery psa went from .1 to .11. I am having another one done on August 11th, and my urlogist and the radiation boys will compare notes again at that reading.

Glad you are doing better.

David in SC
Age 57, 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
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, again
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/24/2009 10:40 PM (GMT -6)   
Yes, since you finished up as a 3 + 3 you are definitely in the lower risk category. At your (our) age you should be more worried about other things than PC. For example: heart attack and angry husbands. Be cool about those with whom you be hot.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 7/27/2009 4:18 PM (GMT -6)   
 
Just another update spoke with family friend that is a pathologist who also reviewed my slides and he agrees with Johh Hopins on the Gleason 8 he said however, that a Gleason 8 means the cancer has a greater chance of spreading out of the Prostate but mine shows no evidence of the cancer leaving the prostate he said all tissue and lymph nodes are clean.  He feels it would be unlikely to have a reacurrance locally of the cancer however, that does not mean I would not have a cancer somewhere else in the body,  Whatever that means if the cancer never left the prostate how would it get to another part of my body I forgot to ask that question.  I was just so happy that he said my tumor was small and he felt the my prognosis was excellent.   I guess time will tell.  The other news is every since I have the cystascope the burning is gone and I am not running to the bathroom not sure if I passed the clip but I will take what I can get.
 
Jerry1 
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 

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