Waiting for PSA results

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Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/17/2009 8:55 AM (GMT -6)   
 
 
Hi All,
 
Well I am waiting for my PSA results from my doctor in Orlando.  My last PSA numbers were 0.3 in Oct up from 0.1 in July.  I know if they have not gone down I will be joining some of my other brothers for radiation treatments.  My surgeon seems to feel hormone treatment is the way to go because of my good path but do I take that gamble and not do radiation?  I think the waiting for the results is the worse these last 4 weeks have been very hard on us both.
 
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  4+4 = 8 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
10/15/09 PSA 0.3
10/26/09 surgery to remove 3 clips in bladder neck that formed stones and caused burning and pressure for 9 months.  Finally relief but may now be looking at radation.
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 11/17/2009 9:01 AM (GMT -6)   
I personally think that radiation is the best next route. In my opinion, HT will reduce the PSA, but will not necessarily destroy the cancer cells.

I also think the Gleason 8 dictates a cannon shot, not a slingshot.

Good luck !
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/17/2009 9:04 AM (GMT -6)   
Jerry, we all know how horrible the waiting game is on a critical PSA test.

If your results bump you up from the .3, obviously you would need to start your next treatment path. We can still hope the .3 was a testing blip and that this one will be back at .1, some men hover at .1 for long periods of time, perhaps that will be your fortune.

You mention HT. Did you meant the doctors wanted you to do both HT and SRT at the same time as a secondary treatment, or just HT alone? Wasn't clear in your post. In my case, 2 Radiation dr. said I needed strong SRT alone, 1 Radiation dr. said he wanted me to have HT and SRT combined. When I grilled my own radiation dr. about the subject, the one I decided to go with, she thought adding the HT was overkill in my case at this point, and that she thought it would be best to save HT for the future, for whatever reason the SRT were to fail. My uro/surgeon and my GP agreed with this line of thinking too.

Let's just hope your test at least drops back to .1. If it rises, brother, then I wouldn't waste a lot of time deciding and I would get into action while you still have a good window of opportunity for a cure. Just my advice. Wishing you well.

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


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/17/2009 9:11 AM (GMT -6)   
 
Thank you Goodlife and David for your support.  My surgeon is suggesting HT alone he feels that since I had no positive margins and organ contained it was not a local recurrance.  The radiation doctor I spoke with at Methodist Hosp in Huston felt that with a Gleason 8 no matter what the Path report says it is possible cells got out to the prostate bed especially since I had the surgical clips left in my bladder.  He also said if radiation does not work HT can still be done later.  I guess it is all a crapshoot.  We do what we can and hope for the best.
 
Jerry 1    
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  4+4 = 8 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
10/15/09 PSA 0.3
10/26/09 surgery to remove 3 clips in bladder neck that formed stones and caused burning and pressure for 9 months.  Finally relief but may now be looking at radation.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/17/2009 9:45 AM (GMT -6)   
Jerry, that makes a bit more sense to me now. My rad. dr. said that in my case, having a positive margin was a good thing, confused me at first, but she said it added more credence that some PC cells were left on the other side of the margin, and while she couldnt guarantee that there is also distant escape at this point, it was more hopeful that it is still local in the prostate bed, and that's why she is giving me a heavy dose there.

The nature of Gleason 8 does add another dimension to your situation, but certainly not without hope or answers. Here for you.

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

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