how long can i wait until i get radiation

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gregory m helman
New Member


Date Joined Oct 2009
Total Posts : 16
   Posted 11/5/2009 5:06 PM (GMT -6)   
my last psa score was 0.45 and oncologist does not  want it to goe  to 1.0.
he says if it stays around 0.45 ,  i can wait after the holidays and get it done in january .
its been over 3 months now since prostate surgery.
i will see another oncologist soon for second opinion.
it was 0.97 before surgery , it dropped to 0.55 , and then to 0.39 and now up again.
i am afraid of missing work , if i get  alot of side effects. but my health is more important.
i need to get this beast out before it climbs any higher
 
  age 52
had rectal exam and found prostrate nodule detected.
psa was .097 before exam.
referred to urologist and also rectal exam , but couldn't feel anything.
we discussed about biopsy to be on safe side.
Final   Diagnosis of biopsy
specimen  is received in formalin in 8 parts labeled A-H.
 
 
 
A-G ------ no atypia or malignancy found.
H---- prostrate needle biopsy, left anterior horn:   Adenocarcarcinoma,
gleason score 3 + 4= 7,    4 mm in greatest linear dimension, involving approximately 20% of tissue from this site. less than 1ml cancer and less 1% of gland involved.
 
 
prostrate surgery done 7/29/2009 -- radical perineal surgery.
robotic was out of the question due to previous surgeries, hernia repair,gall bladder,had mesh put in.
 before surgery , psa was at 0.97.
09/2009 psa ---- 0.55
10/2009 ----- 0.39
11/2009 ------- 0.45
10 days with foley  cathereter
drain tube for 2  days
hospital stay--- 2 1/2 days
 had trouble with bowl movements constipated due to pain meds .
on stool softners
 
 
 
 
 
 
 
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/5/2009 5:55 PM (GMT -6)   
Your stats are not typical of most guys here so it is hard to say. You should get a copy of the post operative pathology report. That may help explain why your post surgical PSA is high.

A second opinion is definitely a good thing. If your oncologists think that radiation is the right direction, then sooner is probably better than later. At your age you need to think long term and if your cancer needs further treatment then I would say you should go at it aggressively now for best results later.
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
6 mo. PSA 0.00 -- 1 light pad/day


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 11/5/2009 6:01 PM (GMT -6)   
I know nothing about radiation but if Geezer says go for it aggressively now for best results later, I'm honored to second the motion.

Let us know what you decide, Gregory,

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  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/5/2009 6:22 PM (GMT -6)   
gregory,

think you were answering your own post at the bottom part of your post. if the cancer is back, and already that high, then waiting to watch it get worse isn't going to be a good game plan. i would agree with others above and get ready for your next step in trying to eradicate whats left of the PC in your body.

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 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 11/5/2009 7:41 PM (GMT -6)   
I to concur. i know there are proponents of waiting and in some cases it is good, however in your case i think at least a second opinion is in store. I had 44 IMRT's as I am sure many here have had. There are side effects but none that I think would keep you from most work. I was able to work through my radiation. The only problem I experienced was fatigue.
Please keep us posted as to what you do.

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%


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 11/5/2009 8:25 PM (GMT -6)   
I would say sooner than later. The rate of change is disturbing to me. I also would recommend a second opinion, maybe even a third.

Did you have a CT scan or bone scan before the surgery ?

Good luck. We are here to help however we can .
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/6/2009 3:46 PM (GMT -6)   
I would second geezer...low psa before surgery...after surgery still higher than expected. Definitely get a copy of the surgical path report. The 1% involvement should show a much lower psa than 0.45 Absolutely get a second opinion on the path report. Something is very wrong here in my opinion.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/6/2009 3:48 PM (GMT -6)   
Something either way off on the data, or way off on whats being suggested
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 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

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