One Year PSA 3.0

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Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 10/22/2009 4:54 PM (GMT -6)   
 
Well after waiting for over a weekand cally my doctor 3 times today I get a call back from his PA who tell me that my PSA had gone from 1.0 in JUly to 3.0 in October.  Needless to say I felt like I was punch in the stomach.  Now what?  I certainly do not want to do back to this guy.  I am schedule for surgery in Orlando on MOnday morning to have the two clips that have made there way into my urthea removed.  I am hoping that maybe these clips have something to do with the raise in PSA.  I know I am in denial as my wife is telling me and I need to face this thing and fight.  I have contacted my surgeon and asked for his option on what are my next steps.  My wife talked to him last Thursday about the last jump in PSA and that we were waiting for my one year test and that she was very concerned.  He felt that since my Path report even from JOhn Hopkins was so good that we had nothing to worry about guess he was wrong about that but he did say if the doubling time is fast it is usually local if a year or so out it is a distant cancer.  I guess I will be going the salvage radation route but at this point just lost and shocked.  MY wife had a feeling at the last bump that something was wrong but I guess I did not want to believe it.  Sorry for vending but I know you guys are some of the few that actually understand what these tests mean and how we are tortured by doctors you take there time with the results.  I live in the West Palm Beach area if anyone knows of a good prostate oncologist the area please let me know.  Pardon the speeling a little freak out at the monent. 
 
Jerry1
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 10/22/2009 4:58 PM (GMT -6)   
 
 
Sorry guys my PSA was 0.1 in JUly and now 0.3 I guess I need to calm down.
 
Jerry1  
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 10/22/2009 5:51 PM (GMT -6)   
Jerry,

Sorry to hear your news, but don't panic yet. 0.3 a year out post surgery is likely a local recurrence. Salvage radiation is probably an appropriate alternative, so make an appointment to see a couple of the radiation docs. Also, oncologist is probably a good idea. You have a bit of time to research your options before you act. The research says SRT is best before PSA has reached 0.5.

Best of luck. Keep us posted.

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, salvage IMRT to prostate bed and pelvis. 72gy over 40 treatments finished 10/21/2009.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/22/2009 6:01 PM (GMT -6)   
Jerry,

Sorry for the news. I agree with Geebra. Salvage Radiation Treatments with or with out Hormone Treatment might very well be the next course in your journey. I am 1/3rd through SRT right now as we speak. After talking to 3 radiation oncologists in my situation, they did agree that you want to be treated before it reaches .5, where it has the best chance of being effective if it is a loca reoccurance. They said that after 1.0, it's rarely effective. Just something to think about.

I wish you the best, my brother, and hope your nerves calm down after a while. Yes, the world outside our PC world doesn't have a clue how upset and unglued post treatment PSA tests can get to you. No shame there, we are all in the same boat. Good luck and please keep posting.

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% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 10/22/2009 6:10 PM (GMT -6)   
 
 
Thanks guys no that has not waled in our shoes has any idea what it is like waiting for that dreaded PSA.  I agree about the hormone and salvage radation I just have to find the right doctor my wife does all the research and follows this website daily when we go to the doctors they think she is in the medical field because of the questions she asked and that is because of this website I do not know where we would be without the support of my brothers.  Thank you all for the support it means more then you will ever know.  I am just hoping that it is a local recurrance it is very confusing since my path report was so good but it goes to show we never know what is in store for us as I tell my wife live every day because we never know what is waiting for us.
 
Thanks again for all your support.
 
Jerry1
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 


Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 284
   Posted 10/22/2009 6:54 PM (GMT -6)   
Hi Jerry,

The news is hard especially after a clean path report (I speak from my experience) but after reading beaucoup on this site and studies... this is most likely a bump in the road even with salvage treatment. Since I live in California, I calm myself with a nice glass of Chardonnay and watch a good comedy. As a buddy always tells me... this too will pass.

Best regards,
Jake
Diagnosed 8/2008 Pre-op psa 4.2, Age 60 at dx
7 of 12 biopsies positive 3+3
DaVinci LRP 11/08
Post Op pathology clear margins, confined to prostate, absent extraprostatic extension, vascular or perineural. Gleason 3+4=7, 5-10% of 4 and location in right mid-gland.
3 month psa .1 2/09, 6 month .1 5/09, 9 month .2 8/09
broke ankle bones 6/09
9/21/09 Bone scan clear, psa still .2
next psa and chest xray 11/13/09


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 10/22/2009 6:59 PM (GMT -6)   
Sorry to hear the news my friend. I had a .11 last week and I am hoping when I get tested again in Jan that it does not double again. I do agree with everyone else SRT is usually most successful early on. Please keep us posted and know we care.

peace and 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
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%


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2457
   Posted 10/22/2009 8:15 PM (GMT -6)   
Hello Jerry,
Sorry to hear about your rising PSA. That is the news that all us fear and don't want to hear. Unfortunately we have to face head on if it comes. Don't panic, just find a good Oncologist and radiologist and finish off whatever cancer is left and you will be fine.
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


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 10/22/2009 9:01 PM (GMT -6)   
Jerry, looks like the surgery knocked it down, but not out. I've written here before of my friend who had the rising PSA after surgery and then did the radiation. That was 18 years ago and he's cancer free today.

If you need radiation may his story, be your story too.

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.    


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/23/2009 6:20 AM (GMT -6)   
Jerry, this is a scary time for those who have had surgery. My husband and I just went through the same exact situation - except that his stage after surgery was upgraded to T3a. His PSA fell to 0.0 after surgery and stayed there for 17 months. This August, his PSA came back at 0.1, and in September it was 0.3. Time to see a radiation oncologist. We met a wonderful, caring woman who walked us through the process. My husband (his name is John) went through a bone scan and CT scan of the abdomen/pelvis. In our case, it was fortunate that the bone scan found one "hot" spot in his collarbone which needed to be investigated before radiation treatment began. While we were waiting to have this test, John had his 3rd consecutive PSA test to confirm a recurrence (3 consecutive rises in PSA = recurrence). Guess what: it came back at undetectable! Urologist called us at home on a Saturday to tell us the good news and to say "do not go forward with radiation at this time" (which the radiation oncologist agreed with). The CT scan of the chest showed that the hot spot was nothing - except old age!

The morale of this story: please don't panic! We were ready to push the button on radiation even before the results of the 3rd PSA test and that would have been a very big mistake at this stage in the game. Not saying that John won't need RT down the road but he doesn't need it now.

I do hope things work out well for you. Certainly your post-op pathology looks very good. Should there be a recurrence, it's highly likely that it is local (within the prostate bed) and that radiation will knock the little buggers out of the game!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 10/23/2009 8:34 AM (GMT -6)   
Sephie,
 
My wife and I had read your story on line and were so happy to hear good news.  Thank you for the information I know when you hear the news you panic and want to do something right away.  This is basically my 2 increase but a major one seems a lot like John's 0.1 in July to 0.3 in October.  My main problem is all along the Pathologist was saying since Path report so good probably would not have a local recurrance so do I do the radiation just to be sure?  I know I need to fine a good Oncolgist that seems to be the first step. 
 
Thanks everyone for the support we both appreciate it.
 
MJ and Jerry1
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  3+3= 6 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
6/12/09 new gleason score of 4=4
Developed stone in bladder may require surgery
 


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 10/26/2009 8:49 PM (GMT -6)   
Don't let the fear mongers get the best of you. .1 to .3 - there may be reasons for this that can be better explained and it's with the specialists you shoudl be getting your advice and not well-meaning amateurs here.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0

 

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