PSA recurrence and additional treatment recommended

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pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 448
   Posted 11/11/2009 12:27 AM (GMT -6)   
 
Jeesh,    I thought I was over PCa....   Had DaVinci in 2007,  not a bad path with Gleason 3+3 = 6...  First few PSA tests low...  .01, .02...  Then at 31 months I had one come back at 0.13 and a retest at 0.11....
 
Just had a followup appt with my DaVinci doc and hew thinks there may be a few cells left in the localized area and same day had me talk to one on their oncoloogists.   Even though the levels are still somewhat low,  the oncologist says recent studies show that treatment now would be in my best interest...
 
I was certainly not ready for this bump in the road.   He did say that is was also OK if I decided to postpone things for awhile, but basically the sooner the better.   He would reccommend a 7 week treatment regime (5 days/week) of lesser doses for minimal side effects...
 
It is early and besides being totally freaked out and depresssed right now,  I will start doing some more research on this...   I wish I would have waited til spring to get my psa test until things were more settled in our lives and moving!   
 
Any comments or links on a recurrence such as this would be greatly appreciated as my wife and I digest and determine our next steps...
 
Thanks
 
pasayten
After 3-4 years of annual PSA 4-6, biopsy recommended
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/11/2009 12:59 AM (GMT -6)   
Hello, Pasayten,
Ray, this just means there is a little mop up requirements and I know you will do well with it. I have seen a lot here and I know you have too. My motto is stay positive. You know it well, so get that stuff zapped and get back to livin' well. :-)

Peace, my good brother...we are with you here in the bleachers...

As far as links go with salvage radiation, I am getting ready for bed and I will supply some studies tomorrow...

Tony
Prostate Cancer Forum Co-Moderator


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 11/11/2009 7:04 AM (GMT -6)   
pasayten, What a shock...Sounds like your Dr has the spin on this that will have the least side effects. I have a friend that did the rt and he found it to be a breeze for him that is.

As Tony commented. Mop that sucker us and lets get going again...

Stay positive. Attitude is so very important.

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
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/11/2009 7:51 AM (GMT -6)   
I am going through right now, what you are about to do. The sooner the better, to catch the re-occurance while it is still low, as opposed to sitting back and watching it grow. My daily travel through 39 rounds of radiation treatments are on-going here.

It's time to bring out and use your second big gun and radiate the hades out of what is left.

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


dsmc
Regular Member


Date Joined Jul 2008
Total Posts : 150
   Posted 11/11/2009 7:56 AM (GMT -6)   
Hi pasayten, Been there done that. It is quite a shock as I was at the 3 yr mark. As you can see in my bio my numbers started to climb at the rate of .01 every 3 months. I started my SRT a year ago and finished in Jan. of this year. I worked nearly every day as I had my appointments early. A little tiredness but other than that not a problem. I am now due my 6 month psa draw and I must admit there is a little anxiety which I guess goes with this. Good luck and go ahead and check on this. Now is the best time for a cure!

David
Age 54
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!
05/14/09
1st PSA after Salvage RT <0.04..... Another YEA!


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 11/11/2009 8:06 AM (GMT -6)   
Pasayten, sorry to hear that you're facing a second round but take heart in the good news: your PSA is still quite low and you're more than 2 years from surgery. You've done very well considering that one small positive margin, and I've no doubt that the radiation will zap those little buggers once and for all.

You will hear from many on this forum who have been or are going through salvage RT.

Good luck, and please keep us posted.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4 SA. PSA: 0.0 til July 2009. August 2009 PSA was 0.1, in September it was 0.3 Met with radiation oncologist, CT scan and bone scan clean. Third PSA on October 16 - PSA BACK TO UNDETECTABLE! Next PSA scheduled for early December. No radiation treatment at this time!


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 11/11/2009 11:04 AM (GMT -6)   
While I agree with others that SRT is fairly easy procedure (just had mine completed a couple of weeks ago), let me be a devil's advocate and ask why you need to jump into SRT when your PSA is still so low. Give it a bit of time and see what the next test will show. The textbook definition of recurrence is two consecutive rises above 0.2. You are not there yet and may not ever get there (God willing).
<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Father died from poorly differentiated PCa @ 78 - normal PSA and DRE<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">5 biopsies over 4 years negative while PSA going from 3.8 to 28<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">PSA prior to treatment<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"> on <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">1/8/2008 is <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">33.90, bounced on 1/31/2008 to <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">38.20, and down at the end of the treatment (4/24/2008) to <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">20.60

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'"><SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">RRP at Duke (Dr. Moul) on 6/16/2008, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Gleason downgraded 4+3=7, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">T3a N0MX, focal extraprostatic extension, two small positive margins<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">PSA undetectable for 8 months, then <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">2/6/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.10, 4<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">/26/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">0.17, 5/22/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.20, <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'">6/11/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">-<SPAN style="COLOR: black">0.27<o:p></o:p>

<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009<SPAN style="FONT-FAMILY: 'Garamond', 'serif'; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, 10/21/2009-<0.05, T<10, salvage <SPAN style="FONT-FAMILY: 'Garamond', 'serif'; COLOR: black; FONT-SIZE: 10pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'">IMRT to prostate bed and pelvis. 72gy over 40 treatments finished 10/21/2009.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/11/2009 11:48 AM (GMT -6)   
Geebra, never heard of it as being rises above .2. It's usually defined as 3 consecutive rises period.
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


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/11/2009 1:39 PM (GMT -6)   
Lots of us are worried about if the other shoe will drop and we're sorry that it had to drop for you. Radiation has a high potential for success so try to stay positive.

Should you go for radiation now or wait? Waiting probably doesn't hurt your chances much, but why take a chance? With two labs and you doctor saying go why give the little devil more time to dig in?

I can't find the link now, but a recent ten year follow-up study suggested that immediate treatment could lead to longer survival.
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


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/11/2009 2:05 PM (GMT -6)   
David...I heard from my uro the same thing Geebra said about the .2 mark as a definite recurrance point after surgery. If you note, most studies label recurrance at that mark. The rise to .1 or detectable limits can occur in several steps (such as in the three increases you mention) and not necessary mean recurrance of cancer. There are many men that will hover around that .1 mark for years without additional treatment and some won't need treatment at all.

I believe that the success rate with SRT at the .1, .2 , .3 are all nearly identical. So why not wait until it is above the .2 to be certain that it is a recurrance. Oh and the arguement that it might allow time for the cancer to spread according to my uro is not likely at those low levels and shouldn't be considered in the decision process. I really think that how quickly the detectable psa rises is the base key for decision. Such as yourself with a very rapid rise, it wouldn't have been prudent to wait. People like me...meh..it might take a few more years to reach that .2 mark, so what would be the rush to SRT ? Besides, it could also mean newer therapies will be available while waiting.
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 


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 11/11/2009 3:16 PM (GMT -6)   
I think my views are pretty much middle of the road with the other guys. No need to rush at that level, but you should probably get prepared now to take action. If you are going to have salvage radiation, optimally you want to start before you hit 0.5, and if you happen to miss that mark, before 1.0. That's based on my understanding of Andrew Stephenson's research, which is the basis of the prediction tool on the Memorial Sloan Kettering website.
Immediate radiation, meaning adjuvant, does seem to have an edge over salvage, where you wait until you're declared in recurrence. The literature has gone back and forth over this, but I think the most recent studies are in favor of adjuvant.
You can weigh for yourself whether or not the slight edge in going straight for radiation outweighs the risk of radiating unnecessarily, IMHO. Just don't get too relaxed about this.
My PSA dropped below 0.1 after my Da Vinci, but then on the second followup, it rose to 0.2, and from there started doubling quickly. At 0.2 my uro was not alarmed, and didn't have me come back for 4 months, when it was now at 0.6 and now I was sweating. Christmas, New Year's, etc. were all coming up and I needed appointments.
I managed to get SRT started when it was at 0.7. Afterwards it fell to less than 0.1 and has remained there (now approaching 3 years post-radiation). I had a problem with proctitis as a side effect, but it was treatable and resolved itself. My blog goes into all of this, probably in too much detail for most people.
Best wishes.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/11/2009 3:49 PM (GMT -6)   
Galieleo, glad that worked for you, in my case, never could have stood by and watched it climb well over .5 like you did. Hope your stay zero forever.

Les, my remark was based on the opinion of the 3 local radiation oncologists i spoke with. So like eveyrthing else with PC, different answer from different areas from different doctors.
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


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 11/11/2009 4:01 PM (GMT -6)   
Passayten,
 
As was mentioned earlier, many of us have gone through the same thing.  As you can see by my profile, just a raise to .08 for me was enough to go for the additional treatment.  However, I did have positive margins.  I was really fortunate not to have bad side effects during treatment.  I keep very active as a high school sports official, so the hormone treatments didn't seem to cause a lot of fatigue.  Minimum hot (warm) flashes were an annoyance, and I still have a few as the hormones work their way out of my system.  The one thing my surgeon stated, was that the radiation would probably destroy the nerves he saved.  Can't say he was wrong, but that's an issue with surgery as well.  My driving thoughts throughout all of this were to kill any of those pesky PC cells before they had a chance to go anywhere else.  Final thought, my PSA is still 0 6 months after my last hormone treatment.
 
Good luck in your decision.
Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;  Dec 2008 - 0;  March 2009 - 0;  Final Zoladex injection!
 
 


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 448
   Posted 11/11/2009 10:27 PM (GMT -6)   
Thanks all for you replies, insights, and words of encouragement.
 
Some of the biggest issues we are struggling with right know are my current mind frame as this did slide me into a relapse of depression...  But that will resolve itself in awhile as I am back on meds for it.  
 
The second is also figuring out the logistics of when and where...  We have actually moved to the east side of the state nowhere near any facility.  We still have not sold our old home yet and it is still a ways away from the Seattle facility...    the 7 weeks treatments would be at a facility 40 miles away with a terrible commute....   especially bad in winter rains...     Wait for spring?  Find a temp location to stay near the facility?    
 
Going to take a lttle while for my currently handicapped brain processes to figure this out...   Wish I would have waited til after the holidays to get my test...   mentally that is...
 
Thanks all...
 
pasayten 
After 3-4 years of annual PSA 4-6, biopsy recommended
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 11/12/2009 8:38 PM (GMT -6)   
Best to you nobody wants to see psa rises and especially post surgery. There are different ways of mopping up PCa, residuals. Get further opinions is in your best interests, see an onco doc too wouldn't hurt. Why make a full plunge without more data, contrast and comparison....salvage radiation even though can be good with results...also can be total gamble or in vain in some PCa scenarios, you might have to make that gamble, and that is hopefully the patients full choice and not because you are told 'you have to' by whomever.
Because PCa is the jungle it actually is....question everything...every test...every proceedure...every choice, or go to Margaritaville and drink xyz and forget 'bout it! How's that for choices???

gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 11/12/2009 10:35 PM (GMT -6)   

sorry to hear about psa going up,but it is still very low,my father had radiation and about two years after he uses to bleed every time he used the bathroom.I will wait acouple of month test again the if it is up,it will be maybe .28 then radiation.

you did not have any positve marging and end everything else was clear you will be ok just wait for one more test good luck.

 

 


DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 

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