The good news, my uro/surgeon was well pleased with my greatly increased stream after the corrective laser surgery a couple of weeks ago. He was amazed that I am having so little trouble with incontinence this time around. Told him I am like 95/98% dry, just a little urge & stress issue, getting better by the day.
The bad news, he consulted with the 2 radiation oncologist that I have met with so far. He said that I was in a serious situation. He and one of the two oncologist agreed that I do not need HT nor that it would be beneficial, the other one includes it as part of his standard protocal. But what they are agree upon, was that I definitely had reaccurance, and that even though the psa is small at this point, it has tripled since surgery. He said it was classic case of the danger of high psa velocity at work, and how hard it is to stop the momentum once it gets rolling.
He said they all agreed that I need to start radiation of at least 70 grys as soon as it can be arranged. He felt it was dangerous at this point to let weeks or months go by, thus allowing the velocity to increase. He said at age 57, my "youth" was too much to gamble away, and that this was not the time to do any kind of waiting and watching.
I told him I didn't like the mannerism of the last doctor I met, and the first one who treated me with radiation 9 years ago is now out of my immediate area. So my doctor is consulting with the only woman radiation oncologist in my area, same practice, and will go over my case with her asap.
He said I should expect some more blockage issues in the future, despite two corrective surgeries, and that the radiation will no doubt cause some future problem.
I am disapointed, because I was hoping he would have said that it would be safe for me to put off a decision to go through radiation at least 6 to 12 months down the line.
We spent a good 30 minutes of quality, blunt and honest dialogue, just the way I like it when I am with a doctor.
He also agreed with something I posted recently about the perinneal invasion issue that many books and many surgeons dismiss, he believes what the rad. oncologist told me, that if there was escape, and obviously there has been, it undoubtedly went straight through some nerves that the tumor had pierced along the way.
He final thought, was that at this point, no way of knowing if it is hopefully local still in the prostate bed, where the radiation would do some good, or is long gone to who knows where, where he said, the radiation would not do a thing to stop it.
Not what I wanted to hear, but it is what it is and we say here often.
This is the same day that my mother (82) tripped and broke her ankle in her home, and I spent the bulk of the day dealing with that and her treatment, and making sure her house was safer from falls, and shopping for her ,etc. As soon as we got her out of the doctors office, we had to rush to make my appointment.
So that's it for now, I am not expecting the 3rd radiation oncologist to have much of a different view on my siituation, but one doesn't know till its over.
David in SC
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, 8/14 met with Rad Oncl, 8/18 - laser scope surgery to clear blockage, now on Cath #7, 8/26 - cath removed