This beast is one persistent S.O.B.

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Ralph Alfalfa
Regular Member

Date Joined Nov 2008
Total Posts : 469
   Posted 9/12/2009 7:58 PM (GMT -6)   
Hello guys and gals,
Had my 9 month post-op on Thursday and my Psa was .2.  That's double from the 6 month.  I thought I was doing all the right things, with exercise, eating properly, etc.  Things were good and I felt great.  Doc said he doesn't normally see this number 9 mos. out.  He has seen it at 2 yrs. out.  So, next month I meet with the radiation oncologist.  Had a handle on ED, no continence problems, and my reaction was, "Well, S..T!"  He agreed.
My wife did not take it well, nor did the rest of the family.  So, we'll see the man next month and figure out the procedure.  I am so pissed right now that I find it hard to concentrate on other things than "will this darn pestilence just go away and leave me alone!"
Sorry to vent , but what better place.  PC has been mostly pushed to the back of my mind for quite some time and that was fine. Now it has come front and center and it's time to deal with this once again.  So what do I do?  Well, playing 18 holes with my sons and son-in-law today helped.  Knocked the dickens out of the ball today and addressed the ball as "YOU S.O.B.!"  Whew.  That helped.
One quick question,please.  I will do the research later but how many treatments am I probablly looking at, and what are the most probable side effects?  I know everyone is different.  I'm looking for a baseline.  Thanks in advance for the insight.
Have a lovely evening. 
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
Fully continent...ED progressing as expected.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 9/12/2009 8:14 PM (GMT -6)   
Bob, I know how you are feeling. I did my surgery about 2 months ahead of you, you can see I am on a similar reaccurance path as you. Monday I will be meeting with the 3rd radiation oncologist, and so far, all are reccomending salvage radiation asap, including my own surgeon/uro and the first 2 rad. oncologists. I just want to be left alone with this PC too, know what you mean.

Have no incontinence, not even my two post surgery corrective surgeries due to my blockages, and never had ED from day one, I too am worry what the radiation will mess up with me, and obviously, do I really need it ,and do I really need it now.

Talking to the radiation oncologist will be a good next step for you. Please keep us posted. I will post late Monday about the visit with the 3rd one. Running out of choices in my more limited area, and not in a position to travel far for other specialists. So I am hoping the 3rd time is the charm with this doctor.

Good luck to you, don't let it get your completely down. You got good reason to be pissed. My family was so disapointed, not mad, when they fully realized and comprehended my new situation. But they are onboard now, and ready for whatever must be.

Keep the faith, brother, and your chin up.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out after 38 days

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 9/12/2009 8:35 PM (GMT -6)   
Ralph, I'm so sorry you're facing this "beast" again ... and so soon after surgery.

As the wife of a PCa guy, I know how your wife feels. Husband has his next PSA next week to see if his last reading of 0.1 has changed (hopefully it has - DOWNWARD!). All of his readings have been 0.0 so we're watching the PSA very closely. Hubbie is 17 months post op. Margins were clear but there was a single microscopic extraprostectic extension in the posterior.

Wishing you and your wife well...and keeping everyone on this board in my prayers.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a due to minuscule extraprostectic extension in posterior left. Margins, bladder neck and SV clean. Gleason 3+4 (no change from biopsy). PSA of 0.0 every 3 months since surgery. In August 2009, PSA reading of 0.1 - urologist will retest in 4 weeks. Hoping this is a blip. Incontinence good to excellent but still having issues with leakage. ED is a work in progress (with the help of Viagra).

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 9/12/2009 8:35 PM (GMT -6)   
Bob, can't answer your questions as I have no experience but am glad you came here to dump your emotions. That's one of the main purposes of this place...
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
24 mts: ED- 50 mg Viagra 3X week, pump daily,
Bimix-30/1/20-.20ml 2X most weeks continues using plump and ring technique
PSA's: .04 each test since surgery

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2460
   Posted 9/12/2009 9:01 PM (GMT -6)   
I had my robotic surgery 3 weeks after yours. SO far I've had to <.1 PSA but I'm afraid that my next one be like yours. I also work out and play golf and feel great. It seems that PCa is such a stubborn S.O.B that doesn't want to let go. Hang in there, you still have a lot of options to fight with.
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

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 9/12/2009 9:17 PM (GMT -6)   
I would add some more four letter words to your reaction, but they would just get bleeped, and besides,
I'm sure that you have already used them.

Well, as we tell newcomers, take a deep breath. Just when you thought that life would go back to normal, you have this. I doubt that it is any comfort, but the nomograms don't improve your odds until three years of zeros -- which is to say your situation is not unusual even though you seem to have drawn a short straw.

I can't comment on what lies ahead -- probably a bunch of tests and then perhaps radiation. Frightening, but those who have had to walk this path before can give us hope and courage. The beast can still be beaten.

My prayers are with you and your family.
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 - now light pads

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 9/12/2009 10:46 PM (GMT -6)   
I'm guessing probably radition will be suggested, with or without hormone treatment.

Regular Member

Date Joined Jul 2009
Total Posts : 40
   Posted 9/13/2009 12:18 AM (GMT -6)   
What were your 3 and 6 month results?
48 yrs old
Robotic RP
6-15 2009 Da Vinci surgery
8-10 2009 almost dry big step
Still ED
Recovery is a process not a switch to turn on and off.
Using support groups like this and in person to make it through

Regular Member

Date Joined Jul 2009
Total Posts : 384
   Posted 9/13/2009 7:56 AM (GMT -6)   
Sorry to hear your latest news. Take that Gulf club and pretend you are swinging at those cancer cells knocking the **** out of them clear out of your body.

Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex

Regular Member

Date Joined Aug 2009
Total Posts : 152
   Posted 9/13/2009 9:35 AM (GMT -6)   
I'm getting my 22nd Rad on Monday, out of 36. I barely met one of four crtieria for radiation after my February RP. So, it's probably 'prophylactic' in nature, I hope. There have been no side efects to speak of yet, a bit tired after the Thurs and Friday tx's, some mild bowel irritation at times, usually also late in the week. They treat Monday-Friday, giving the weekend to recover. It's no big deal. But I'll see how I feel in three weeks when it's over!

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 9/13/2009 9:48 AM (GMT -6)   

Sorry to hear of your situation. As others said, your most likely next step is radiation. I am getting 40 treatments. I am three weeks into the eight week course. No significant side effects. The docs say that the salvage radiation will stop progress on continence and ED front, but usually does not reverse it.

My thought about your situation is that with PSA jumping this fast, you don't want to wait a month to take action.


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

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 9/13/2009 3:32 PM (GMT -6)   
I am so sorry to hear about your latest PSA results. My father had a poor path report come back after his surgery and the entire family was devastated. I felt more devastated by the pathology report than I had his dx with PC. So, I completely understand where your family is coming from. The good news is that you have had time to heal from surgery and regain strength and piece of mind. I have no doubts that you will sail through radiation. My father had an easy time with radiation and did not suffer any major side effects. Granted....he had radiation immediately following his RP, so he didn't have much time for recovery on the incontinence or ED front. However, he is pad free now. He had a little diarrhea caused by the Radiation but it was controlled with Immodium and Metamucil. He also had more fatigue, but was able to work. Good luck and please keep us posted!!
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

Regular Member

Date Joined Jul 2008
Total Posts : 76
   Posted 9/13/2009 5:53 PM (GMT -6)   
  I start radiation on 9/22.  Golf does help.  I finished playing about an hour ago.
age:  46
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
3 month psa  0.11, 11/08
6 month psa 0.12,  2/09/0
9 month psa 0.13, 5/01/09
1 year psa 0.20, 8/17/2009

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 9/13/2009 6:10 PM (GMT -6)   
Greetings, Bob.  Sorry to hear your news.  You know you are always welcome to come here and vent - anytime.  Trust you will do well with your follow up treatment and whatever treatment you have will knock the cancer out of there once and for all!  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

Veteran Member

Date Joined Jul 2008
Total Posts : 637
   Posted 9/13/2009 7:13 PM (GMT -6)   
Bob, I wouldn't worry about it. We have been fighting this beast for eight years...Pete's PSA just came back at .9 ....well up from before Feb 2009 , AND after all of the treatments the
doctors offered...I don't kow whether Pete's Pca is virulent or a docile one, but , here we are also...What I know for sure is this: No one ( even the doctors) knows for sure what to do....Just enjoy each day....Dont try to second guess yourself and your options..Each day that you are angry or pissed is a wasted day, Please, just force yourself to smile and enjoy your life. We have been in this for eight years...We were where you were years ago, and it did not help anything. Just enjoy your life and FORGET about the Pca... My advice to you is to :Go on a vacation with your wife....Di
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
PSA .9 8/29/09
waiting for new PSA 7/09

Ralph Alfalfa
Regular Member

Date Joined Nov 2008
Total Posts : 469
   Posted 9/13/2009 8:17 PM (GMT -6)   
Thanks, everyone. I've cooled off now and have accepted that it is what it is. The odd thing about this is that the pathology looked great. No lymph node involvement, all margins were clear, no invasion anywhere as the scans were all clear. But going from undetectable at the 3 montth to .1 to .2 was a little disconcerting, to say the least. But you're right, Di. I need to file this is in my noggin somewhere far in the back. Will start doing the research tomorrow and take what comes . Sigh.

Thanks all,

 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2

Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 9/13/2009 8:26 PM (GMT -6)   
I think Di said it all. Enjoy the day. That is great advice and it is very hard to not let fear, stress and other events take over. It still xxxxes me off when people say, oh you had prostate cancer you will be fine. If only everyone knew what this disease is capable of. One thing for sure, you are following up with doctor's and doing everything you need to be doing so take peace in the fact you are and will fight this cancer.
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 9/13/2009 8:27 PM (GMT -6)   
Ralph, I hate what this darn illenss does to us!!!!. Hang in there know that you can always vent here. Many of us have.

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

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 9/14/2009 6:57 PM (GMT -6)   
Hi Bob, it's a real pain when things go the wrong way, I felt bad the first week when my oncologist said that it looked like the radiation was not successful and my PSA was on the upwards trend, then I realized all I can do is go along under the care of my doctors, and hope we can keep this thing under control, and being down all the time was having a negative effect on me and my wife, so I am just now trying to live my life as normally as possible.

Best wishes to you. 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

Ralph Alfalfa
Regular Member

Date Joined Nov 2008
Total Posts : 469
   Posted 9/14/2009 7:44 PM (GMT -6)   
Thanks for the thoughts, ROb, Jeff and Mal.
You know my folks, their folks, and their folks all lived well into their eighties (Pop is still hanging in there at 83). And with all the advances in medicine and research you'd think that we all had a shot at least at 90. But, things being what they are, I guess we just take it one day at a time and try not to get hit by a bus, or shot by a jealous husband as we're hurrying out the bedroom window trying to get our pants on.

So life goes on...and as my sister in law says, "No one gets out of here alive."

My best to you all,
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 9/15/2009 11:33 AM (GMT -6)   
Hey Bob,
You'll do fine, just stay positive. Don't let this stupid disease ruin a nice day. Di says it very well. Keep on keepin' on is the only way to move ahead...

 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  

Regular Member

Date Joined May 2008
Total Posts : 260
   Posted 9/15/2009 12:40 PM (GMT -6)   


 ...Hang tuff Bob, keep the head held high, stay on the positive side and keep moving'll do great!

  age: 53 @ Dx, Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  6.23.09 1yr Post-op PSA Still a zero..
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 9/16/2009 7:33 AM (GMT -6)   
Rob2, I agree with your statement! When my husband's August PSA came in at 0.1 (after being 0.0 since March 2008), my sister in law said to me "we have to get you to calm one dies from prostate cancer." I wanted to go through the phone and throttle her!! People tend to pooh-pooh PCa because of its reputation as a slow-growing "non-threatening" cancer. My response is cancer is cancer and while there are certainly types that are more curable/manageable than others, it is still a serious illness.

I try to educate people as best I can but find that sympathy for PCa patients and what they (and their family) can go through is just not there. I have even found doctors who tell me not to worry so much ... prostate cancer is curable. Wonder what some of these guys would say if it was them going through it.

Take care everyone.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a due to minuscule extraprostectic extension in posterior left. Margins, bladder neck and SV clean. Gleason 3+4 (no change from biopsy). PSA of 0.0 every 3 months since surgery. In August 2009, PSA reading of 0.1 - urologist will retest in 4 weeks. Hoping this is a blip. Incontinence good to excellent but still having issues with leakage. ED is a work in progress (with the help of Viagra).

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