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Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 11/30/2009 10:55 AM (GMT -6)   
Hi All,
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)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 11/30/2009 11:07 AM (GMT -6)   
This is a duplicate of the same thread that was brought up a few threads below
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

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 11/30/2009 11:09 AM (GMT -6)   

Didn't want your post to get lost on another thread, because you are asking serious questions.

This is not an exact science. You will find a lot of opinion here about this topic. Some doctors go all the way to .5.

It is just my opinion that without a prostate to manufacture PSA antigens, once you start seeing a rise, there is some unwanted activity. When you actually choose to initiate treatment is one of cionjecture. You did have a positive margin, so there quite possibly was some escape of the cancer.

In my mind, the real question is where is it now ? After 2 years, it may not be in the old prosate bed anymore. Certainly the CT and bone scan are good, buit with the low PSA, most likely they won'y find anything.

So, you have some options. Wait a few monnts and repeat the PSA, look into HT, or do the salvage radiation.

These are tough ones. The odds for salvage radiation aren't great. The side effects of HT aren't pretty, and the nerve wracking wait on top of depression make Active Survelliance a bummer.

Good luck, and keep posting to let us know how you are doing.
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

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