The following was posted as a reply on my thread about my upcoming IMRT. I am starting a new thread so that the folks at HW can answer the questions posed. I thought it would get lost if left where it was. He has some good questions and is looking for some guidance.
Looks like I an in a similar situation as after my davinci removal, psa loooked ok for a year or 2... Now at month 31, it climbed to 0.13 (checked at another lab at 0.11) and visit with uro doctor, he suggested salvage radiation. Talked with their oncologist and he wants to progress on treatment. I never did have a ct scan/bone test and that is what they would like to schedule that soon (guess I did not have one as I was a gleason 6) and then start a 7 week radiation treatment.
My question is recurrence is not defined til 0.2... I am not there yet...
But is the need for speed required for best outcome? Best chance to be localized...
And how are the psa doubling times calculated? After you reach 0.2? or any of the ones before also count in figuring doubling times...
Also, I am figuring if I am in the 0-3 year period... or the greater than 3 yr period for recurrence... it might not hit 0.2 til after the 36 month period.
My stats have more info... but this has really freaked me out as I had thought I had beat this thing... I am 62 y/o now... and currently severely depressed... this on top of other building new house/selling old house factors pushed me over the edge.... and thinking about the 7 week treatment each day requiring a 1 1/2 hr commute each way...
On the positive side, I have a great understanding wife and she assures me that thru the doctors and our faith in Jesus we will get thru this...
Thanks for letting me vent and ask a few questions... I know there are many that are in a much more serious situation than I am...
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)
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative
da Vinci 9/17/09
Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Tumor Volume 12.5%
NERVES SPARED-positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT scheduled to begin Nov 30,2009 (74 days post surgery)