Results of the dreaded Nine Month PSA test

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/12/2009 10:20 AM (GMT -6)   
I was suppose to call my dr later today for the results, but the person at the lab that read it called me directly right around 0800, kind of surprised me.  It rose over the course of 71/2 weeks from .11 to .16.   That is a rise of .05.
 
I still have an appt. I kept open till I got the results with a Dr. Duncan, the Radiation Oncologist I was suppose to meet originally some weeks back, but was unavailable at the time.  I guess the wise thing is to keep the appt with him this Friday afternoon.
 
Its looking more and more like reaccurance to me. :(
 
Until they can fix my blockage problems, can't move on ahead with radiation anyhow.
 
So, guys, give me your gut and off the cuff opinions with my post surgery psa readings.  Friday will mark 9 months to the day since my open surgery.
 
I will update my signature next.
 
David in SC, disapointed, but not totally caught by surprise
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, corrective laser surgery scheduled for 8/18
 
 


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 8/12/2009 10:32 AM (GMT -6)   
My layperson's take on it is that it looks like you're headed for just about any doc's definition of recurrence, if you're not there yet.
But you seem to have at least some time to try and get the urinary problems improved before your PSA hits any critical cutpoints.
I keep up with Andrew Stephenson's research into predicting the success of salvage radiation. His research shows that for optimal results, you want to start before PSA hits 0.5. But there are no clear cut lines where salvage is guaranteed NOT to work. Anecdotally, I started at 0.7 and it seems to have "taken" with me.
So if it were me, I'd concentrate on the urinary blockage problem. If you get it fixed and can start before PSA hits 0.5, great, but you're still doing pretty good on the odds if you could start radiation before it gets to 1.0.
Just my 2 cents. Here's the research I mentioned (free full text):
http://jco.ascopubs.org/cgi/content/full/25/15/2035 . This research is the basis of the nomogram on the MSK website: http://www.mskcc.org/applications/nomograms/prostate/SalvageRadiationTherapy.aspx

Best wishes. You deserve a break.
Galileo

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 and thereafter <0.1
http://pcabefore50.blogspot.com


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/12/2009 10:50 AM (GMT -6)   
Certainly is getting complicated, David,
But I agree with Galileo, you have time to try to get a handle on the blockage issue first. I believe that it is recurrence as well, as you have had three consecutive increases in PSA, the PSA is above undetectable levels to most Assays, and you had a positive margin. It is very probably that is it local recurrence, but since you are in a wait mode, perhaps asking if better imaging is a good idea. JohnT swears by it, and this could be a good call to see if you can get it done...

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!


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/12/2009 10:55 AM (GMT -6)   
Poor David. Like he said, an "As The Prostate Turns" moment--again. Seems like you have figured out a process, take it step by step, first the next week scheduled procedure, then address the rise. I feel for ya buddy, and am praying for you.
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 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.10ml 2X week continues
PSA's: .04 each test since surgery


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 8/12/2009 11:01 AM (GMT -6)   
David,

Your results closely approximate mine. Except for urinary complications. By the time you PSA reaches 0.2 (a most accepted definition of recurrence) you probably will be at 1 year mark. From what I read, local margin, undetectable post-op PSA and a year+ to recurrence make local recurrence very likely. That means radiation. But the longer you wait, the more chances for it to spread beyond prostate bed. So, my off the cuff non-medical advice is to slow cancer down with short term HT, especially since there is research that suggest better salvage outcomes. That buys you time to take care of your urinary issues AND improves the probability of positive outcome from salvage.

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, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/12/2009 11:43 AM (GMT -6)   
Thanks and welcome here Galieo, good advice. Thanks to Tony, James, and Greebra. I am not into denial guys, I assure you that, but I have learned over the months not to rush out into the streets and do something just because.

I will meet with the Rad Onc this Friday afternoon. See what I think of him, see what his approach is, and find out what post surgery psa rise he is comfortable treating and has experience with.

But we are all on the same page, I have to get these persistent urinary blockages resolved before tackling radiation, both types of dr
did agree on that. So, I am now on day 23 of this lovely catheter #6. Getting spasms all day long, even in the middle of the night, and I can only take so much ditropan a day. My poor bladder is swollen and sore from trying to expel the latex monster.

And to be blunt, woke up a few morns with a major wood, with the catheter on, not by choice, guess nocturnal, you talk about a touchy situation, because it hurts until it ebbs away. For any of your new surgery guys on the recovery side, don't even think about trying to get wood with your cath on, you can damage your surgeons hard work. Remember this is unsuall being on a cath nine months out from surgery, so I am healed from that point of view.

Still 6 days to the corrective surgery, can't hardly stand the thought of going thru another weekend like this, but got to. Then when I do wake up in recovery, I will find a new cath, the real #7, and would estimate that I would have it for up to 2 weeks. Then mabe I will be fixed of the problem, free of catheters, and ready to move on towards salvage radiation. Sounds like a plan, but not really a fun one.

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, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 8/12/2009 12:03 PM (GMT -6)   
David,

Not trying to put a damper on things...but just because you will get the cath out after your upcoming surgery two weeks later doesn't mean you're healed enough for radiation treatment...at least in my opinion. Ask the oncologist this Friday his take on your particular situation, because it is certainly not a normal one by any means. Geebra made a great suggestion about the HT as a temporary...something like six months maybe to keep the PCa at bay until you are healed enough for that second shot at a cure. I know it isn't any fun (HT), but going into radiation while healing could cause greater issues.

I know you hoped for better PSA reading, but it did move significantly up enough for any doctors protocol as a recurrence.

Best of luck to you in this new unexpected journey
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 Apr 2009 .06
                   9 month Jul  2009 .08


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 8/12/2009 12:33 PM (GMT -6)   

Dave, I'm sorry to read that.  A couple of things that I might want to throw out there:

According to Catalona: "Over a 20-year period, Dr. Catalona performed 3,478 RPs on prostate cancer patients. Of these, 631 (18%) had evidence of cancer progression after surgery. Of those who progressed, salvage radiation therapy (median dose 63Gy) was given to 307 patients.

For those who recurred, the median time from RP to PSA-recurrence was 23 months. There were 162 (73%) responders to radiation therapy. A response is defined as PSA less than 0.3 ng/ml after therapy.

A Gleason score of 8-10 was more common in non-responders. The median PSA at the start of radiation was higher in non-responders. The presence of seminal vesicle invasion or lymph node involvement implied a much worse outcome following radiation.

Men with a PSA less than 1.3 ng/ml at the start of radiation therapy had a significantly better outcome.

The study showed that while initial response to salvage radiation therapy to the bed of the prostate after recurrence was good (73%), a durable response out to 10 years was only maintained in 25% of patients. However, men who had an initial response to the radiation had a 35% rate of non-progression at 10 years. "

One other thing to perhaps consider (with reference to your blockage problem) is proton therapy for salvage. It could have less collateral damage than photon alone (I believe with proton treatment in salvage cases it's administered basically as a mixture of proton and photon).

Again, sorry to hear the bump in the PSA.

 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 8/12/2009 1:03 PM (GMT -6)   

Hi David:

Sorry about the PSA rise...I was hoping for better and I know you were also!  Most suggestions at this point are beyond my area of expertise so I'll just stick with support.  I'll pray for successful treatment of your blockage, a swift recovery from that and that you find the right choices as you move to the next step of this journey.

Best regards,

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 7/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 8/12/2009 1:20 PM (GMT -6)   
Greetings, David.  I know this is not the news you were hoping to receive.  Seems like job 1 right now is to get the blockage issues all taken care of.  Doesn't seem like it would hurt anything to ask your doc if HT would buy you some time to get all the other issues taken care of.  I'm certainly just a layman but wouldn't hurt to ask.  We'll continue to pray for you in these days - I know you want that catheter out of there and get back on the road to healing.  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


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 8/12/2009 1:43 PM (GMT -6)   
Hi David, Away from home and office at the moment. Just had a peek here. Sheesh...not what any of us wanted to hear. The other posters are right in saying you have time to get the urinary block under control and heal a bit from that. And I was pulling really hard for you today too!!!
 
As always, you'll be in my thoughts.
 
Talk soon.
 
Mike
-Hernia, mesh and large scar, surgery early 2006
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months 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: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Bone scan Dec 08: Negative
-Barium enema X-ray March 09: Small diverticulosis
-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)
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 8/12/2009 1:57 PM (GMT -6)   
Hi David,
 
I'm sure that all of us here are very disappointed that your PSA seams to be slowly drifting in the wrong direction. We had hoped for better numbers for you. I was in a very similar situation just a few month ago and know the horribly feeling that comes with the realization that the PSA is on the rise again. I'm not knowledgeable enough to give you any advise, but when I had a recurrence, it was decided to hit the bad cells as soon as it was clear that they were trying to stage a comeback. Thus far it seams to have worked. I just know that you will do the right thing as soon as you can and put a stop to this rising PSA.
All the best to you in the years jet 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; 17 July 09=<0.04


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 8/12/2009 2:11 PM (GMT -6)   
David,
You may want to talk to your Dr about taking Casodex while you are waiting to heal. It should stop any futher progression and the side affects are pretty mild. Loss of Libido, minor hot flashes, but mine went away after about 2 months. Also ask your Doc to give you Femera with the Casodex to prevent any breast growth. The Libido loss goes away as soon as you stop taking the drug. It should also make the radiation more effective.
with any reoccurrance I would also get an opinion from a good oncologist to see what he might. recommend. With such a low PSA I don't think a scan like an MRIS would see anything, but I could be wrong.
JohnT

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


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 8/12/2009 2:18 PM (GMT -6)   
David: Im heart sick over the results. I wish I had answers for you. All I can say is you are in my thoughts and I do hope the bladder issue can be fixed fairly qucik for you to move to the next fix.

God Bless. and Know we all care so very much about You.

Jeff T
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/12/2009 2:33 PM (GMT -6)   
les, you make a good point on the healing part, right now, there's no part of me thinking about HT, but reality may have to change my mind, i will bring the rad. oncl. dr. up to speed and see what he thinks about that

squirm, never thought of the proton thing in my case, will put that in my brain file

thanks bro tud, mike, and david/cpa - i can feel the concern

magaboo, you care and concern is good enough for me, thanks

johnt - good suggestion, but this may sound superficial on my part, i am one of the few surgery pc guys that had zero ed after surgery, and thats with only one nerve bundle, i would hate to do anything to end the little bit of sex life i have left. who knows, after radiation, i may never peform on my own again.

Thank you too, bro. jeff for your kindness.

Got lots of things to think about, but hey, another blinding bladder spasm is tearing into me even as I type. Life gets gooder and gooder.

Sure glad to know you are all out there.

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, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA
 
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 8/12/2009 5:12 PM (GMT -6)   
Dang David I was sure hoping for a zero as I know you were to. Please take care to get well so as to fight this disease. I know you are a positive spirited person so lets learn to live with this cancer.


peace and much love
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

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
Casodex
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
PSA July 28th 2009 is .01

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
92%
80%
37%
28%


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/12/2009 6:21 PM (GMT -6)   
thanks dale,

the one thing i have learned strongly in the past year of my life, is that PC doesn't play fair, and it really is an evil class of cancer, not to say that any cancer is good. but with many cancers, once its gone, its gone, and that s all there is to it. The other thing, is the infinite amount of variables when dealing wiht PC, what is normal? Is there anything normal or consistent about it? I think I met those as retorical only.

i feel like my stats are forcing me into action i really dont want to take. when it came to the dx and the primary treatment of surgery, i was enough of a number's person to think that really had a shot of knocking the PC out of the ball park on the first pass. my life has adjusted to the side effects, and that is now my new normal and reality. i sense that if i am pushed into the salvage radiation route, then the playing field is going to change once more, and then, of course, what if that doesn't work either? yes, i know i am getting ahead of the game here a bit. but being a former chess pro, i am use to thinking about things many moves ahead of where i am at, but with PC, that is grounds to drive one insane with worry, fretting, and endless what ifs.

right now, this stupid catheter hurts like the hades, i am sick of it, it annoys me endlessly. i have to make it to next week, and then really really trust my dr/surgeon with his laser skills . weird to think that after i am knocked out, they will scope me again, dialate me once again to make room, have video capabiltiy, and still have room to move in the laser surgical equip, all in a tube that fits inside my urethra which isnt large in diameter to start with. i am hoping and praying that it doesnt make me start at square one on the incontinence trail, since i have been 100% dry for some months, or worse, leave me that way. and i hope that my future pee flow will at least somewhat resemble what i had before all of this.

sorry for the rambling, but lot going on in my head right now, its surprising that i am not a drinking man or a user of illegal drugs, i deal with all this unpleasanty being completely straight. perhaps i am the fool for that standard.

but i will keep up the good fight, as long as i have the ability and mindset to do so, which i am hoping will be many more years.

david in sc, deep in thought tonight
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, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA
 
 


pa69
Regular Member


Date Joined Mar 2009
Total Posts : 260
   Posted 8/12/2009 6:33 PM (GMT -6)   
Hi David,
I waited all day to get your test results. Sure wish it was better news.

Regards,
Bob
Age 70, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin
Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative
Three PSA tests undetectable, latest July 18


down not out
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 8/12/2009 7:45 PM (GMT -6)   
David; you are in my prayers.
Open retropubic prostatectomy 12-15-2008
Catheter removed 2 weeks later, no leakage problems
Margins clear, nodes clean
Return to work 6 weeks post-op
Resumed regular workout routine 8 weeks post-op
Taking Cialis daily
Age  55
pre-surgery PSA 9.04
3 month post-op PSA 0.07


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 8/12/2009 8:05 PM (GMT -6)   
Hi David,
 
I'm so sorry for the news, but happy that you shared it with us and your follow-up feelings today.
 
All I can say is that you are working your plan.  I know that doesn't solve the problems, but it does give you direction.
 
I believe the thing to do now is focus and get your urinary system as healthy as possible.  I think that positive results from your upcoming surgery will go a long way of getting back on track with your plan. 
 
I suppose your doctor believes he's the best for this surgery.  If he does not, you may wish to ask him who is.  Your prior feedback from him sounded to me that he knows what he's doing here.
 
As far as the salvage radiation is concerned, I have read that it is most successful with people like you who had a low PSA right after surgery and minimal positive margins.
 
You may find this article interesting:
 
Here's a clip from the above article:
"Conclusions: Salvage radiotherapy administered within 2 years of biochemical recurrence was associated with a significant increase in prostate cancer–specific survival among men with a prostate-specific antigen doubling time of less than 6 months, independent of other prognostic features such as pathological stage or Gleason score. These preliminary findings should be validated in other settings, and ultimately, in a randomized controlled trial."
 
I hope that helps.
 
Our thoughts and prayers are with you!
 
Barry (Idaho)
 
 
Da Vinci LRP July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
6th PSA 06/09 still less than 0.1


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/12/2009 8:06 PM (GMT -6)   
thanks bob and down not out, every kind word helps

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, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA
 
 


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 8/12/2009 8:11 PM (GMT -6)   
David,

I'm sorry to see your PSA inching up. It seems that PC may be showing its ugly head again. As has been mentioned, you have time before it reaches a critical juncture so, take care of the urinary problems first and then deal with PC. We are all pulling for you.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
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 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 8/12/2009 8:27 PM (GMT -6)   
David,

Nothing to say that hasn't already been said. Just know that I like everyone else is pulling for you. Just reading through this forum can give us hope seeing guys who have been beating this monster back for years. Your gun is not out of bullets yet.

With my Gleason 9 I am watching your progress closely, because I fully expect to see a very similar path. I see BARR posting PSA rises after 12 years, so with my G9, I will not be surprised.

In spite of your modesty, your sincerity, and transperency really does help us all. Like all of us, there are times I am sure you just want to be alone and cry, but you continually tell us what you are feeling and thinking. Thank you !
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
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 8/12/2009 8:54 PM (GMT -6)   
Hi David, sorry the results went the wrong way, was feeling a bit down myself after meeting with the Oncologist this week, but after posting my thoughts in this wonderful support group, I, like you, can call on the strength and care of our fellow members.

All the best, Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept.
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd Augiust 09 0.6


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 8/12/2009 9:12 PM (GMT -6)   
Hello David,
 
I really do not have any advice to offer. Just wanted to say that I have been following your posts here. I sincerely hope that things turn around for you and soon. Keep your spirits up.
 
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
PSA 06/09 .36 or .30 depending on who did the test
 
 
 

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