Surgery Next hurdle

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twotall
Regular Member


Date Joined Nov 2009
Total Posts : 38
   Posted 12/17/2009 11:48 PM (GMT -6)   
 
I had  the bone and CT scan yesterday at the Mayo in Phoenix.  My wife and I had the longest wait of our lifes in the doctors exam room this afternoon as we waited over an hour past our appointment for him to talk to us.  He finally come in and said " everything looks clear".  This was very welcome news for us!  Due to my high psa level (20) he scheduled a MRI to help determine exactly what area of the prostate is involved with cancer.  I used to think that I was a pretty calm person, but I am sore from the constant tense, try to relax cycle we were in all day.  Robotic surgery is scheduled for 1/27/09.  I would have done it the day the bio came back but he said we have to wait 6-8 weeks for the prostate to heal.  The doctor said he will have to do the surgery and check the nodes ? to have a good idea of the extent of the cancer.  Just another hurdle to clear I guess.  This site has really helped me to start to understand what my wife and I will be dealing with. 
 
age 59
2007 psa .6
Oct 2008 psa 9.4
Meds
Dec 2008 psa 11
Bio done 12 core, no cancer
Meds
July 2009 psa 16
Meds
Sept 2009 psa 20
Made appoinment at Mayo
Bio, 18 core 2 positive, gleason 3+3 =6
doctor said T2
Robotic scheduled for 1/27/09
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/18/2009 12:00 AM (GMT -6)   
Welcome -- everyone here has experienced that "hit upside the head feeling that you are having." Your PSA is high, but the biopsy suggests that treatment will have a good outcome. Look at the permanent links at the top of the form for many reading suggestions especially some good books. You may want to plug your numbers into the Sloan-Kettering nomograms.
www.mskcc.org/applications/nomograms/prostate/PostRadicalProstatectomy.aspx
to get an idea of how much the odds are in your favor.
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


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 12/18/2009 6:01 AM (GMT -6)   
Hi twotall:
 
Welcome to the forum.  You will find it very helpful.
 
Had open RRP on Oct 23 09 so a little further down the road.
 
Dealing initially with this disease after biopsy can be very stressfuld.
 
Good luck as you continue on your journey.
 
Skeener


Age:  63
 
Biopsy May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason score 3+3.
 
Considering all the controversy about whether action is needed or not (I could die with prostate cancer not from it), gave consideration to active surveillance.
 
After family considerations which I value most ("you should have this cancer out"), decided to have radical retropubic prostatectomy.
 
Operated on Oct 23/09 in London, Ontario.  Excellent surgeon.
 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
 
Nothing of concern in the pathology report. 
 
First followup PSA and visit in Feb 09.      

Post Edited (skeener) : 12/18/2009 5:05:00 AM (GMT-7)


Modelshipwright
Regular Member


Date Joined May 2009
Total Posts : 215
   Posted 12/18/2009 7:05 AM (GMT -6)   
Welcome. I had RALP on 09/29/09 and have come through it very well. See my stats below. I am now 99% continent and am using one pad per day for safety. ED remains a chalenge. My decision was made to suit my personal thoughts and the surgeon was picked as a matter of confidence and experience.

Your decisions should make you sleep well at night and feel comfortable in the outcome. Take your time and educated yourself. Maintain a sense of humour and be assured that you are in the right place here on this forum for support.

Keep well,
Regards,
Bill

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 12/18/2009 7:44 AM (GMT -6)   
TwoTall, Welcome sounds like you will fit in well here. Most of us have had that stressfull waiting period. For me that was more difficult that my open surgery. Good luck with your surgery and do keep us posted. You will probably want to read some of the post here and ask questions as you need to. You will find that many of the guys here have a great deal of knowledge about PC and treatment.

Do keep us posted on your porgress.

Jeff T
Cajun Country
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 : 25380
   Posted 12/18/2009 8:55 AM (GMT -6)   
Hello friend,

The waiting period from the biopsy to your surgery is very important. It will give your poor prostate a chance to start healing from the biopsy. 6-8 weeks is a normal waiting time for that process, mine was about 9 weeks.

Glad you are getting through the holidays first, at least you can enjoy those without being a recovering surgery patient like I was last Christmas.

You have had fast PSA velocity like I was dealing with, so I wouldn't reccomend any kind of additional waiting in your case. If you have a good, experienced surgeon before you, I would go with your decision and not look back.

Please keep us closely posted.

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
Post SRT PSA:
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4225
   Posted 12/18/2009 5:08 PM (GMT -6)   
Too tall,
Did your doctors tell you why your psa was so high? A Gleason 6 with only 2 positive cores and a normal size prostate should generate a psa of about 5. I personally wouldn't do anything until they can account for all the psa and tell me exactly what is generating it. This is basic PC 101. Without doing this you are just flying blind. There is a reason your psa is 20 instead of 5 and it may be an important reason that would impact your treatment. You also have an extremely fast psa doubling time which doesn't generally correspond to a G6 tumor. What are they saying about that? If you have not gotton a 2nd opinion from a good prostate oncologist one is surely warrented in your case.
JohnT

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


twotall
Regular Member


Date Joined Nov 2009
Total Posts : 38
   Posted 12/18/2009 8:26 PM (GMT -6)   

 

Thanks everyone for taking the time to reply to my post.  I had started reading this forum about a year ago when I had found out about the 9 psa level.  I can now relate much better to the experiences that you have spoken about.  John T, I have been told by four doctors that I have prostitias which could  be causing the  rapaid rise in psa levels.  The last doctor which found the cancer, finally did an blader scope which showed an inflamed/infected area at the lower bladder mouth.  All of the doctors reported a normal size prostate with no lumps or hardness.  The scope showed the upper part of the prostate (could not be reached by the DRE) to be enlarged enough to nearly shut the urethra off.  The doctor said he hopes that this is causing the psa levels but the bio report did not indicate prostitatis.  I would really like to know exactly what is going on but an afraid to wait much longer.

Twotall


 
age 59
2007 psa .6
Oct 2008 psa 9.4
Meds
Dec 2008 psa 11
Bio done 12 core, no cancer
Meds
July 2009 psa 16
Meds
Sept 2009 psa 20
All DRE were normal
Made appoinment at Mayo
Bio, 18 core 2 positive, gleason 3+3 =6
doctor said T2
Robotic scheduled for 1/27/10
 


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/18/2009 10:50 PM (GMT -6)   
No one else mentioned it, so I will in case its still a question.  The 'nodes' check you mentioned is that they also will usually take one or more samples of the lymph node tissue in the pelvic area near the prostate while in for the surgery.  Essentially a biopsy of the lymph tissue to see if there is any activity there.
51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/19/2009 12:43 AM (GMT -6)   
Welcome,Too tall.This forum is a very helpful tool.Best of luck.

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 nerve sparing by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-10
organ confined
extracapsular seminal vesicle involvement
lymph node involvement

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