Still Undetectable...but...

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/14/2009 2:20 PM (GMT -6)   
My blog has been updated...

My T levels one month after stopping Casodex and skipping my 4 month Lupron injection was ...well still minute. It was 21. I was kinda disappointed as I was hoping for a noticeable increase. Didn't happen.

More of a worry is my lipids. They were sky high. My doc believes that we need to intervene with better dietary control, exercise, and medication. Simply put my body is not metabolizing they way it used to so it needs to be addressed.

Also, there were early signs of gynocomastia. I have breast tenderness and it is related to the HT. We need the T levels to get going...

My PSA History
October 3, 2006 19.8
October 10, 2006 18.9
November 27, 2006 13.9
Surgery February 16, 2007
February 28, 2007 0.9
March 12, 2007 0.1
March 23, 2007 <0.1
May 16, 2007 <0.1
July 18, 2007 <0.1
September 19, 2007 <0.1
January 29, 2008 <0.1
May 9, 2008 <0.1
September 17, 2008 <0.1
January 13, 2009 <0.1
May 11, 2009 <0.1 T=50
October 7, 2009 <0.1 T=21

We'll get it right...

Rm 5:1-5

Amen!


Tony
 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  
 
STAY POSITIVE!


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 10/14/2009 2:32 PM (GMT -6)   
Fabulous news on the undetectable. I already left a note, but wanted to congratulate you again and let you know that the family and I will be thinking of you and believe 100% things will turn around with the T soon:)
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
Oct. 9, 09 PSA <.01 Last Lupron Shot
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/14/2009 2:35 PM (GMT -6)   
Tony, how does one increase the "T" number in your situation? I am clueless. And why is it bad if it is low?

David
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% cancer, 1 pos margin
Post Surgery  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, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4225
   Posted 10/14/2009 2:47 PM (GMT -6)   
Tony,
Great on the PSA. Did you take Femera while on Casodex to stop the breast growth?
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/14/2009 2:52 PM (GMT -6)   
David,
Testosterone keeps a man strong, it protects bones, and it makes us feel "normal"... Without testosterone my bones are brittle, osteoperosis can permanently set in. In addition my body metabolizes differently than before. I have increased cholesterol counts and even blood pressure increases. Not to mention hot flashes and "being in touch with my emotions". I also have been having breast tenderness but i have not experienced any growth.

Low T levels have been associated with depression, but I have that one under control...

Tony
 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  
 
STAY POSITIVE!


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 10/14/2009 3:22 PM (GMT -6)   
I like the others wish you well I unlike the others have History with you and I do feel a kinship with your plight and I know I would not be the same without the gifted surgeon we had shared. Your numbers are and your outlook is positive in nature I do wish you well. I was just informed by LLU my new PSA was slightly different than the last and was to continue to fluctuate, the Radiation has seemed to control the beast as it were for now for that i am grateful. Stay well my friend.
50 Diagnosed as type II Diabetic
54 Cancer Detected
PSA 8.+ Gleason 7
55 DaVinci City Of Hope California
57 Cancer rise in successive PSA's
57 Proton Radiation Loma Linda Medical Center California
Aug 09 PSA 0.06


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/14/2009 5:00 PM (GMT -6)   
John we did take Letrozole but it caused nausea. I don't have growth yet, just the tenderness. Hopefully it won't be an issue with the rising T levels. I think if I go back on I will look at the radiation option if it's not too late.


mjr,
Thanks buddy! We are in this together. May your healing continue...

Tony
 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  
 
STAY POSITIVE!


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 10/14/2009 6:40 PM (GMT -6)   
Tony,
The good news is that your PSA remains undetectable. All other issues can be dealt with because you are in the drivers seat. I know you can do whatever it takes to get things back to normal.
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/14/2009 6:45 PM (GMT -6)   
Tony,

Thanks for the explanations. Makes sense, just something I never had to think about before.
You are still doing great, with even a better attitude.

David
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% cancer, 1 pos margin
Post Surgery  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, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 10/14/2009 7:01 PM (GMT -6)   
Tony,
Your report gives me great pause, but I am glad you posted it. I am going to do a lot more research and soul searching before I commit to the HT/RT.
All the best.
Roger

 

 Age 67 at diagnosis. Treated for coronary artery disease (CAD) since 1998, and under control with medications.

2/6/09              Routine physical, with DRE and PSA Test. PSA 4.02. Referred to Uro

4/20/09            TRUS  w/needle biopsy

4/23/09            Diagnosis PCa with Gleason 4+3 in 2/2 cores, Gleason 3+3 in 5/10 cores.

                        CT scan and Bone Scan both negative. Stage T2C.

8/27/09            DaVinci RP at WakeMed Cary NC with Dr. Tortora. Discharged 8/28.

9/8/09              Catheder removed. Path post-surgery confirms PCa, with Gleason 3+3 with scattering of 4. Positive margins in L & R posterior, R and L seminal vesicles, with perineural invasion.  Stage T3b.

9/30/09            PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Prostate Oncologist and Radiation Oncologist. Appointments set for 10/8.

10/8/09            Met w/ both oncologists. Adjunct Combination Therapy to begin ASAP.

 

Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradually getting better, with dramatic reduction in leakage around 9/20. Currently on 1 pad during the day and one at night (for security). Actually totally dry at night. (Pressure off the bladder neck?)

 

“I’d rather die while I’m living, than live while I’m dead.” (Jimmy Buffett. Changes in Latitude, Changes in Attitude.)

 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/14/2009 7:13 PM (GMT -6)   
Roger,
I believe it was the right plan for me. I am doing very well attitude wise and the cancer is in remission. If I had to do this again, and have success, I would do it.

But you should not do it without fully understanding the goals...and the SE's. I have had them.

Tony
 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  
 
STAY POSITIVE!


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 10/14/2009 7:21 PM (GMT -6)   
Great news on the undetectable. I know you will work the other issues.
 
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


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 10/14/2009 8:50 PM (GMT -6)   
Tony, all that noise you hear from up north is me cheering you on!

Thanks for the report. Love the PSA and good luck with the "T"

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week.    


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 10/15/2009 4:49 AM (GMT -6)   
Greetings, Tony.  Great news on the undetectable.  Keep those zero's coming in.  On the other issues, I'm sure you and your doc's can find a plan of attack.  Before my surgery I took one pill - now I take a handful everyday.  I think I have the opposite problem regarding cholesterol - mine is too low (they are mainly concerned about the good kind being too low).  Keep up the good attitute - you are a great role model for those of us who have not had to face as much as you have.  We appreciate your leadership.  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


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 10/15/2009 6:14 AM (GMT -6)   
Hey Tony, congrats on the PSA number. ......Like many others here I have followed your personal journey and thank you for your tireless efforts in combatting PC on behalf of all of us...........Relative to your low testosterone levels and classic accompanying symtoms, you mentioned you have the depression symptoms "under control". Are you taking an anti-depressant? My "T" levels have been low post-surgery (certainly not as low as yours due to HT you underwent), but low enough to produce all the low T symptoms. Of course my MD's are following protocol of not supplementing or having discussion of such until I reach at least one year of PSA's of <0.1. So I agreed to try a mild anti-depressant (Wellbutrin) which in 6 weeks time has taken away some of the foggy brain, fatigue and irritability, but I still have stength issues and zero libido.........Wondering what relief you have experienced re: depression and how you addressed it.
                         Arnie in DE
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point.
3 month PSA--<0.1
6 month PSA--<0.1


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/16/2009 9:38 AM (GMT -6)   
Arnie I addressed depression with a conscious effort. I knew that when I felt down that I needed to recognize it and change the mind set somehow. Many times it was to get busy living instead of dwelling. It did not take long at all to forget about feeling down. I got through depression without medical intervention. I still get those mood swings but I know it's the meds. So I attribute it to it and move on.

Tony
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)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My Journal is at
My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 10/16/2009 12:10 PM (GMT -6)   
Thanks Tony..........I'm sending you an email,
                        Arnie
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point.
3 month PSA--<0.1
6 month PSA--<0.1


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 10/16/2009 1:09 PM (GMT -6)   
Tony,
The only part I understood in your first post was the "undetectable". Congratulatins. I'm honored to stand next to you. Since I am still a mere babe in the woods about this issue the rest of your post was white-noise. Hopefully they can be addressed by people much more intelligent and informed than I.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/05 10 weeks, Still no activity
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/17 2 months: Still 3 pads per day.
10/5 10 weeks: Still 3 pads per day. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.004 undetectable.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/16/2009 1:14 PM (GMT -6)   
Jeff,
I am still experiencing the side effects of hormone therapy. Having been off a month I was hopeful that my testosterone was rising back up. No such luck. But I am very happy about the undetectable PSA. Overall a good day.

Tony
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)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My Journal is at
My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 10/16/2009 9:13 PM (GMT -6)   
you are the man Tony and glad your numbers are still great. I think I will make plans to come to Vegas someday soon and sit in on an RCIA class. Heck you might even let me teach one.

love you brother

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
PSA OCt 15th 2009 is .11

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%


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/16/2009 9:40 PM (GMT -6)   
Hey man,
You get out here, I hand the class over to you. Count on it.

Tony
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)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My Journal is at
My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

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