PSA result in and not good

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Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 12/18/2009 11:17 AM (GMT -6)   
 
 
Well Guys,
 
I did not get the Christmas present I was looking for but I guess it could be worse.  PSA went up to 0.4 in 4 weeks.  Uriolgist recommends radiation even though my Path report was good he feels there is still a good chance it is local.  Bottom line its the only way we will know they do not have anything else.  Said he does not advise hormones at this time should try for a cure first.  He recommend the Lynn Cancer Center in Boca Raton it is brand new and they have all the latest equipment and are affilated with MD Anderson and Sloan.  Doctors are all experienced and I have a consultation on Tuesday with the radiation oncologist.  Also since MJ (my reseacher) and I had so many questions regarding whether this the right thing for me at my age and with my Path,  etc.  They are also setting up me up for a consulation with this thing called a Disciplinary Council  apparently they have a medical oncologist, radiation oncologist and uriolgist the present my case and discuss and then give their opinion of the best treatment.  Anyone ever hear of this?  At this point very confused knew it was coming but was still like a punch in the stomach when I got the news.  They are setting me up for all the scans to be sure there are no tumors and then said they would like to start treatment in 3 weeks.  Will know more next week still having my sister in Houston who works at Methodist hospital checking out the facility and doctor.  The location is convenient and the bests news they take my insurance.
 
Jerry1
Age 70
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. 
11/16/09 PSA 0.3
 


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/18/2009 11:25 AM (GMT -6)   
sad mad  Sorry Jerry. 
 
But I'm glad they have some reason to believe its still local.  Best wishes for a smooth and successful salvage radiation course. 
Time to kick the remaining mutinous little critters out!  Good luck.
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.
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/18/2009 11:47 AM (GMT -6)   
Jerry,

Sorry to hear the news, wish it were different for you. You and I were on similar surgery schedules. Salvage radiation at this point sounds sensible, you sure don't want that PSA a chance to rise any more.

I just completed that and will get my first post radiation PSA next week.

I wish you well on that, and please keep us 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


Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 288
   Posted 12/18/2009 11:55 AM (GMT -6)   
Jerry, sorry the reading didn't drop. Seems like we being given almost identical advice. Please keep us in the loop. You've got decades of good tennis ahead of you and the Florida weather to get you out there playing.
Our best,
Jake
Diagnosed 8/2008 Pre-op psa 4.2, Age 60 at dx
7 of 12 biopsies positive 3+3
DaVinci LRP 11/08
Post Op pathology clear margins, confined to prostate, absent extraprostatic extension, vascular or perineural. Gleason 3+4=7, 5-10% of 4 and location in right mid-gland.
3 month psa .1 2/09, 6 month .1 5/09, 9 month .2 8/09
broke ankle bones 6/09
9/21/09 Bone scan clear, psa still .2
11/12/09 chest xray was clear, psa however up to .3,
radiation setup scheduled 01/05/10, 35 sessions follow


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/18/2009 12:34 PM (GMT -6)   
Not good news but it sounds like your medical team is taking your desire for information very seriously. A tribute in part to you self education.

You mention your age as a factor and I see that you are 70, which is, of course, old. In three years when I am seventy that will be middle aged.

However by that time you will be 73 and looking back on the time when once you had PC (and got weird messages from the "kids" on the board)
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


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 12/18/2009 12:41 PM (GMT -6)   
Hi Jerry,
 
I'm sorry to read that your PSA is on the rise again. I know first hand how discouraging that can be. RT is, of cause, your next logical step in attacking the beast. I had my SRT about a year ago and it seams to have been successful thus far with few side effects. I'm going for my 2nd 6 monthly test early in Jan.
Wishing for a successful outcome for both of us and for every other brother.
Please stay in touch.
 
Magaboo

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09, = 0.05; July 09, <0.04


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 12/18/2009 1:45 PM (GMT -6)   
<<They are also setting up me up for a consulation with this thing called a Disciplinary Council  apparently they have a medical oncologist, radiation oncologist and uriolgist the present my case and discuss and then give their opinion of the best treatment.  Anyone ever hear of this?>>
 
 
These are not uncommon, partciularly at academic medical centers (teaching hospitals), and in my view are an excellent idea.   It helps to avoid a situation where the patient hears opposing views from different specialists -- all of which seem to make sense -- and then has no idea what to do.   The term "Disciplinary Council" is unusual -- makes it sound like someone did something wrong.  Maybe "multidisciplinary council."  But the name does not matter.  The approach is a good one.  
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 12/18/2009 1:45 PM (GMT -6)   
Jerry, So very sorry about the PSA. Sounds like you have a good Dr that has a good plan of action to knock this PC out for good. Do keep us informed.


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.


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 12/18/2009 1:51 PM (GMT -6)   

Jerry,

Just wanted to add that we are all pulling for you.  This is one of those things where we are basically bystanders, watching a bunch of folks in white coats work on us.

Best of luck, and be sure and keep us in the loop, even if all you want to do is scream.  We're listening.

Goodlife


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


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 12/18/2009 1:56 PM (GMT -6)   
 
 
Thank you all for your comments it is great to be able to talk to people who know what you are going through and can tell it like it is.  Not sure the doctors are always completely honest about side effects.  I am being told that since I currently have no incontinence problems that should be the case after surgery and that the side effects are mild more frequency and some rectal bleeding from what you all have experience is this the case?
 
David, good luck on the PSA next week I will be thinking of you.
Jakester, you are right we are getting the same advice good luck on your treatments.
Magaboo, Thanks for the information and encouraging words on the treatments and side effects.
geezer99, I hope you are right I would love to look back in 3 years and have a good laugh with the kid.
Rolerbe, I definitely will try to take on this monster.
 
Jerry1
Age 70
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  
11/16/09 PSA 0.3
12/14/09 PSA 0.4 


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 314
   Posted 12/18/2009 2:28 PM (GMT -6)   
Jerry1,
 
Remember what Dr. Peter Scardino said in his recent presentation to the New York Section of the American Urological Association (discussed earlier this week in another thread on this board) - in patients with locally advanced prostate cancer, the combination of first-line surgery followed by second-line radiation is associated with good prostate cancer-specific survival rates and in particular carries with it a much lower risk for prostate cancer-specific mortality than the reverse (radiation-surgery) combination.
 
You may feel like you are walking a tightrope, but it sounds like you have already gone a long way and you haven't put a foot wrong yet!
 
Zen9  
 
 
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 12/18/2009 2:55 PM (GMT -6)   
Zen that was a very good post. I'm in the same boat Jerry so it's good to have this cheering section rooting for us.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 12/18/2009 4:20 PM (GMT -6)   
 
 
Thank you all again for your support I do not know what I would do without this board.  Things are moving fast I am scheduled for a bone scan on Monday morning and the council conference on Jan 8th.  I will let you know after I meet with the radiation oncologist on
Tuesday how it went.
 
Thanks again to all of you for comments and great information.
 
Jerry1
Age 70
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  
11/16/09 PSA 0.3
12/14/09 PSA 0.4 

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