Ultrasensitive PSA results

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orickster
Regular Member


Date Joined Dec 2009
Total Posts : 22
   Posted 12/31/2009 8:04 AM (GMT -6)   
Not exactly the results we were hoping to see, 0.13. Next step PET/CT scan, 1/7/2010.  Happy New Year to all of you.
Rick
Texas

59 Year/Male
Needle Biopsy Surgical Pathology Report  7/30/2009
Source of Specimen:  1. Right Prostate
                                    2. Left Prostate BX
Pre-Op Diagnosis:        Elevated PSA
Post-Op Diagnosis:      None Given
Operative Procedure:  Right and Left Prostate Biopsy
 
DESCRIPTIVE DIAGNOSIS:
 
1. Right Prostate Biopsy:
       Benign Prostate Tissue showing Adenomatous Hypertrophy.
2. Left Prostate Biopsy:
       Prostatic Adenocarcinoma, Gleason score 5, involving approximately 25%
of the submitted specimen. Also seen are numerous areas of high grade PIN and
a focus of perineural invasion.
 
MICROSCOPIC DESCRIPTION:
 
1.  Sections of the specimen show benign fragments of prostate tissue with adenomatous hyperplasia.
No evidence of carcinoma is identified.
2.  Sections of the specimen show fragments of prostate tissue with a dysplastic glandular proliferation
corresponding to Gleason patterns 2,3, score 5, involving approximately 25% of the submitted specimen.
Also identified are mumerous areas of high grade PIN and perineural invasion.
 
ROBOTIC SURGERY 9/30/2009
 
SURGICAL PATHOLOGY REPORT DIAGNOSIS:
  PROSTATE AND SEMINAL VESICLES (RADICAL PROSTATECTOMY):
 
Histologic Type:                      Prostatic adenocarcinoma.
Histologic Grade:                    Gleason Grade 3+4=7 
Laterality:                               Bilateral, involving approximately 35% of left prostate and less than 5% of right prostate. 
Margins:                                  Focal involvement of peripheral surgical margin measuring 3mm in greatest dimension.
Extraprostatic Extension:       Focally present.
Seminal Vesicle Invasion:      Not identified.
Perineural Invasion:               Present.
Angiolymphatic Invasion:       Not identified.
Lymph Nodes:                         Not identified.
Stage (AJCC, 2002):              pT3A, NX,MX.
 
Eight week follow-up: 12/01/2009
PSA  0.15 Requested another PSA in hopes of a false reading.
12/15/2009  PSA 0.12  Dr. suggested to see a Radiation Oncologist
12/18/2009  Saw urologist for referral
12/28/2009  Consultation with Radiation Oncologist  ordered PET/CT scan to be done 1/7/2010 in Abilene, Tx.
12/30/2009  ULTRASENSITIVE PSA REPORT  0.13
 
 
 
   


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 12/31/2009 8:14 AM (GMT -6)   
Rick, sorry to hear that your PSA is not where you and your doctor would like it to be. While disappointing, the chances of RT knocking out the rest of those pesky cancer cells is excellent so please don't give up hope.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 12/31/2009 8:55 AM (GMT -6)   
Rick,

Well the results are not what you wanted, but don't throw in the towel yet. If you have seen any of my posts, you know that you and I are just about in the same place. Except maybe for the fact that I am about 25 treatments ahead of you on the Radiation.

There have been plenty of studies and research articles lately about the advantages of following surgery with radiation even when not called for immediately by rising PSA results. In fact they have a fancy medical name for it, Adjuvant Therapy. I like that a lot better that Salvage Therapy anyway.

I did not approach the rad with doom and gloom, but rather with the positive outlook that I am being a little more pro-active rather than waiting down the road, in killing this crap off so I can get on with enjoying my "EVERY DAY IS A BONUS" philosophy.

I know it's tough to take right now, but try to put the positive spin on it. Find the silver lining in the cloud. Trust in your faith and your medical team. 2010 is going to be the year of wonderful things, I just know it.

Sonny
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
Stage: T3a
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)


orickster
Regular Member


Date Joined Dec 2009
Total Posts : 22
   Posted 12/31/2009 9:30 AM (GMT -6)   
Thanks Sephie and Sonny. No towel thrown in here. Sonny are you doing IMRT?
59 Year/Male
Needle Biopsy Surgical Pathology Report  7/30/2009
Source of Specimen:  1. Right Prostate
                                    2. Left Prostate BX
Pre-Op Diagnosis:        Elevated PSA
Post-Op Diagnosis:      None Given
Operative Procedure:  Right and Left Prostate Biopsy
 
DESCRIPTIVE DIAGNOSIS:
 
1. Right Prostate Biopsy:
       Benign Prostate Tissue showing Adenomatous Hypertrophy.
2. Left Prostate Biopsy:
       Prostatic Adenocarcinoma, Gleason score 5, involving approximately 25%
of the submitted specimen. Also seen are numerous areas of high grade PIN and
a focus of perineural invasion.
 
MICROSCOPIC DESCRIPTION:
 
1.  Sections of the specimen show benign fragments of prostate tissue with adenomatous hyperplasia.
No evidence of carcinoma is identified.
2.  Sections of the specimen show fragments of prostate tissue with a dysplastic glandular proliferation
corresponding to Gleason patterns 2,3, score 5, involving approximately 25% of the submitted specimen.
Also identified are mumerous areas of high grade PIN and perineural invasion.
 
ROBOTIC SURGERY 9/30/2009
 
SURGICAL PATHOLOGY REPORT DIAGNOSIS:
  PROSTATE AND SEMINAL VESICLES (RADICAL PROSTATECTOMY):
 
Histologic Type:                      Prostatic adenocarcinoma.
Histologic Grade:                    Gleason Grade 3+4=7 
Laterality:                               Bilateral, involving approximately 35% of left prostate and less than 5% of right prostate. 
Margins:                                  Focal involvement of peripheral surgical margin measuring 3mm in greatest dimension.
Extraprostatic Extension:       Focally present.
Seminal Vesicle Invasion:      Not identified.
Perineural Invasion:               Present.
Angiolymphatic Invasion:       Not identified.
Lymph Nodes:                         Not identified.
Stage (AJCC, 2002):              pT3A, NX,MX.
 
Eight week follow-up: 12/01/2009
PSA  0.15 Requested another PSA in hopes of a false reading.
12/15/2009  PSA 0.12  Dr. suggested to see a Radiation Oncologist
12/18/2009  Saw urologist for referral
12/28/2009  Consultation with Radiation Oncologist  ordered PET/CT scan to be done 1/7/2010 in Abilene, Tx.
12/30/2009  ULTRASENSITIVE PSA REPORT  0.13
 
 
 
   


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 12/31/2009 10:06 AM (GMT -6)   
Rick,

Yep!! IG/IMRT for me. Using a machine and method called TOMO (tomography). Does the CT scan, alignment and rad treatment all at the same time. Two passes through the machine, 1 for aligning and 1 for the rad. Takes about 14 minutes.

So far so good. No real side effects. A little more frequency in going to the john, but I don't think it's the rad. We bought a new coffee making system (Oh! it's sooo good) and I have been enjoying a few more cups than usual.

If you want to talk in a little more detail, shoot me and email. Mine is active on the side bar.

Good luck with it all,

Sonny
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
Stage: T3a
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)


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 1/1/2010 10:14 AM (GMT -6)   
Rick:  Most of us who have done SRT, IMRT haven't had TOMO therapy like Sonny.  There aren't that many TOMO machines around.  I just finished SRT and basically you'll be on a table with the machine rotating from one side to the other stopping ususally in 7dfferent locations for a 15-30 second burst when delivering the radiation.  A CT will be done before hand to make sure you are properly aligned.  I believe most of us had a cast made of the lower body and it is slipped into place before the treatment begins.  All in all it took about 10-12 minutes from start to finish.  I had to drink 8 oz. of water every day 1 hour before the treatment to have the bladder at the same level each treatment.  The amount of water that you drink seems to be a little different from establishment to establishment.  I believe Sonny wasn't told to drink any, that may be because it was a TOMO machine.
 
David 
 
 
 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 1/1/2010 10:22 AM (GMT -6)   

Rick:  One other thing, the people who are dissing the PET scan are probably wrong about you having it done.  I read where they have said it won't be of any help.  That is probably incorrect if the scan is a PET/ Bone scan which it probably is.  That is one of the newer techniques and machines out there, it combines PET scans with full body CT scans to give you a much better evaluation than just the bone scan.  I had a PET/Bone scan and then went down to MD Anderson for a second opinion and the prostate onc. actually told me that he wished that is what they had at M.D.Anderson and when they changed machines it would probably be to a PET/Bone machine.

You can Google it andyou'll find plenty of info. on them.

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/1/2010 10:23 AM (GMT -6)   
Hello there,

I just completed 39 sessions of IMRT for SRT myself. My experience was documented here in a day by day log if you are interested. I had a lot of side effect problems and pain, but that is not the normal. I had experienced radiation problems 10 years ago in another cancer event in my life. I had this done on a Novalis machine, as described above, it indexed into 7 posiition with each session. Due to either operator problems and/or alignment problems, each session for me ranged from 20 minutes to 55 minutes. I don't think that was normal either. I did not have to drink water, because I was wearing a catheter the entire time going through radiation, in fact, still on a catheter a month after ending radiation. But that's another story.

I started my SRT with a PSA a little higher than yours, but mine was the 3rd increase in a row, comfirming recurrance.

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

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