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Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 11/30/2009 8:49 AM (GMT -6)   
Just got my 3 months PSA results after 37 treatments of IMRT.  Not what I had hoped for.  It stayed the same as before the treatments. (.18)  Does it take longer than 3 months to decrease?  There are a couple of guys out there that have maintained the same PSA level after IMRT for several years.  I am having a consultation with a radiation oncologist in a few weeks.  I really don't want to rush into HT.  The Rad Onc doc wouldn't comment about the results. He just scheduled me for another test in February.   At this point I am very confused about whats going on.  Any suggestions would be appreciated. 
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 11/30/2009 9:02 AM (GMT -6)   
Bootheel,

I just completed my 39 IMRT treatments this past Friday. My radiation oncologist said that its possible the first 2-3 post PSA tests may not show much if any decrease at all. She said it can take a while to kill off the remaining cancer cells. I will have my first number in
about a month, and I don't even have a guess at what to expect at this point.

Hoping the best for you. Some men hover for years at some trace level, despite having the radiation.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4186
   Posted 11/30/2009 11:13 AM (GMT -6)   
A reoccurrance is defined as three consecutive increases in PSA. There have been numerous posts on the ERBT prostate pointers of men not seeing a decrease for 4 or 5 years, then a sudden plummet in their psa. Everyone is different, but I would wait until your psa starts to go up at least three times before pulling the trigger on another treatment.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT

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