My Dad - help Pls?

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New Member

Date Joined Sep 2009
Total Posts : 14
   Posted 9/2/2009 9:01 PM (GMT -6)   
Hi Everyone,

My Dad currently 56 was diagnosed with PC back in 2007. Gleason Score =7 (4+3) He has since then had the operation (RP) to remove the prostate and since the PSA did not drop as much as the Dr's would have liked, he then had to have radiotherapy, which he has finished a bit over year ago. Since then he has been having the 3 monthly PSA tests and the last one we found out recently is at 0.75. Last test it was 0.25? Dr says to go back in another 3 months for another test - but he said Dad will have to have some more treatment.Does that mean the cancer has spread outside of the prostate bed, but I guess they are not sure where? I guess the radiotherapy was unsuccessful then?

What would be the next treatment plan for him?  I am assuming the next step would be Hormone Therapy?

Why do we have to wait another 3 months when we know the PSA is going to go up? Any chance it could come down again? I don't understand why they haven't done any scans on him to find out where the cancer has spread to?

Can someone please shed some light on this for me...I'm very worried again. Ever since he was diagnosed in 2007, it just doesnt seem to be going away. confused

Any feedback would be very much appreciated!


DS Can
Regular Member

Date Joined May 2009
Total Posts : 195
   Posted 9/2/2009 9:18 PM (GMT -6)   

Welcome to healingwell, Roxy1980.

It is great that you are so concerned about your Dad's treatment.  I am not educated in the advanced treatments of PC but I am sure that others will be along very soon to offer support. 

I know that this is a difficult time for you and your Dad.  Don't panic. Just be there for your Dad if he needs your help and support.  That will go a long way toward making him feel better.




PSA 01/07 1.2, PSA 01/08 1.9, PSA 01/09 2.5
BIOPSY 02/24/09  PCa DX age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP 04/09/09 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter out 04/17,1st no-pad day 05/03
25 mg Viagra nightly;100 mg:not ready for prime time
Followup PSA 05/28/09, 08/20/09 <0.1

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 9/2/2009 9:28 PM (GMT -6)   
I'm not an expert, just another daughter who is worried about her father. Sorry to hear that you father's situation is what it is. You father will most likely need to start Hormone Therapy and you might want to have him discuss with his doctor what the threshold is for beginning HT. Most doctors seem to wait until the PSA hits a certain level and then they begin HT. Often times the scans won't pick up exactly where the cancer is until it is more advanced. My father had negative CT and MRI results and after his surgery his pathology came back with lymph node involvement. We were devastated, but quickly came to learn, that the cancer doesn't play fair. With that being said, many men do extremely well for years and years on HT. Please keep us posted on your father!
Father's Age DX 62 (now 64)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 9/3/2009 10:18 AM (GMT -6)   
Hi Roxy,
I extend that welcome to HealinWell as well. You father and I have a lot in common. I have after surgery in 2007 a Gleason of 4+3=7...My surgery was not enough to sit alone with. I had Radiation...and I am about to complete 2 and a half years on Hormone Therapy. I was 44 when I started this in 2006.

The reason to wait on the next PSA is sound advice from his doctors. You want to see what the doubling rate is over a period of 3 consecutive rises. Hormone therapy is a likely next choice, and chemo might also be a good decision to go along with it if the doubling rate is fast enough.

You need to stay hopeful. There are some good things on the horizon with prostate cancer. HT can provide many years of success, allowing for some of these things to hit the streets. My #1 mantra is ~ Stay Positive. I do believe in the power of positive thinking. And after nearly three years I have an undetectable PSA. Your father can do very well. And with you there looking out for him, he is on the right track...

 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 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 9/3/2009 12:41 PM (GMT -6)   

Greetings, Roxy.  I am your dad's age and also have a daughter who has been very supportive of me.  I am very grateful to have tremendous support from my wife and both my children.  Fortunately, surgery seems to have done what it was intended for me so I am not as familiar with next steps after both surgery and radiation as some of the good folks on this board.  I'm sure you will be hearing from them, but it seems as if Hormone Therapy and possibly chemo are both options. 

Welcome to the forum and thanks for being a supportive daughter.  All of us dad's are grateful!  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

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 9/3/2009 1:57 PM (GMT -6)   

Welcome to HW. As others said, don't panic. Looks like your questions were mostly anwered above, so I'll just say this: I had chemo, then surgery; I have started HT about three months ago and I am two weeks into radiation. None of these treatments were pleasant, but they are also not nearly as bad as many people picture them. I continued to work full time at a demanding job during chemo and I feel fine now on HT. So, while those are among possible treatments they are not life altering.


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

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 9/3/2009 2:50 PM (GMT -6)   
Sorry about the rising PSA. As a father of 4, I admire your love and concerns about your Dad. Your support will allow him to keep a positive attitude. I think Tony (TC-LasVegas) recommendation is probably what the doctors will do and hopefully he will have the same result as Tony.
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

New Member

Date Joined Sep 2009
Total Posts : 14
   Posted 9/3/2009 11:50 PM (GMT -6)   
Hi Everyone,

I just wanted to say a big thank you on all your advice and help - it is very much appreciated at a time like!

I will stay positive for Dad and just hope & pray for the very best for him!!
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