Worried about my Dad

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Dadsmyhero
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Date Joined Jan 2010
Total Posts : 4
   Posted 1/7/2010 2:47 PM (GMT -6)   
I've gone back and forth as to whether or not to post my dads situation because I have been scared to read the answers and or opinions. Decided I'll just go for it and hope for the best.

My dad was diagnosed with Prostate Cancer a little over 2 years ago at age 55. He went about a year with a rising PSA from around 4 to 6. His first Biopsy was negative so we obviously kept an eye on it. At the end of 07 which was about a year later my dad decided to have another biopsy. Of course the news wasn't good this time. Came back positive in 2 out of 12 cores. Gleason score was 4+3 from local Urologist ang got 4+4 score from UCLA. Had a RP about 2 weeks later at USC Norris Center. Amazing Doc we found there. Surgery went great. It was contained to the prostate with no sv involvement or lymph node involvement. Of course he was then upgraded again to 5+4. The doctor was very happy with his results from the surgery based on his Gleason Score and so were we. A month or so later we decided to have radiation as a preventive measure because of his Gleason score. Radiation went well. It has now been 2 years since surgery with a psa of zero. about a week ago he went in for his 3 month PSA test and it came back at .1. Had it done at again to confirm it was .1 and it was. This has been a huge upset to the family because we thought he beat this! My dad is the one who holds my family together and the thought of losing him is devastating. He has worked so hard the last 2 years with his diet and supplements to keep his prostate cancer away. I know .1 is very low and virtually undetectable but it seems to all of us that it is back. The big worry here is of course his Gleason Score of 9 and the fact that he already did radiation.

Any advice or reassurance would be much appreciated.

Thanks.

Dadsmyhero
New Member


Date Joined Jan 2010
Total Posts : 4
   Posted 1/7/2010 2:55 PM (GMT -6)   
I forgot to mention that he didn't have perineural invasion or any sign of bone metastasis.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/7/2010 3:33 PM (GMT -6)   
Understand your fear and worry in your post. Any Gleason 9 situation is serious, but it doesn't mean its hopeless by any means. So he had his surgery, then you did radiation as a precaution. This would be a good approach for most men with his stats. Two years after surgery, his PSA is back to .1. Yes, it is low so to speak. What most would suggest is probably to go to Hormone Treatments. There are several people here first hand experienced with using them. They will starve out the remaining PC cells and slow things down. The dietary changes and supplements are good things for general health reasons, but there's no proof they can slow down or stop cancer growth. Nothing wrong with doing that though.

Hopefully someone well veresed with hormone therapy will come along and give you some better advice. I wish you luck, and please keep us posted closely.

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: 1/10 .12
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


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 1/7/2010 3:37 PM (GMT -6)   
Dadsmy hero,
Glad that you decided to post and hopefully get some support and feedback from others with the same type scores and situation. It seems there is good news and bad news on this, but when you conside his Gleason score he has done remarkably well. Not sure if he is at a point he has to make a choice but if so there are options. Others with much more knowledge than me will be along shortly. Take care of yourself in all of this to, and have a vision of better things to come.
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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/7/2010 3:41 PM (GMT -6)   
Hi Dad's hero,
I say that because your love and concern has you looking out for him, that makes you a hero as well! At least to me...

If it's a relapse it is very important to remember, relapses are not death sentences. it is a cause of concern because he has exhausted two local therapies in it, but this only means that it is time for a systemic approach, and likely with hormonal therapy. It is time to look into these options. I chose intermittent HT as my protocol and I have been doing well and I just entered my first "off" period. Many options remain for me and your father, but diligence will become an important factor. Has your father done any hormonal therapies yet?

Staying positive is very important. I believe in the power of a positive mind. There are multiple approaches for your father into the future, and each step will require much thought and perhaps multiple opinions...

Tony
Prostate Cancer Forum Co-Moderator


Dadsmyhero
New Member


Date Joined Jan 2010
Total Posts : 4
   Posted 1/7/2010 3:56 PM (GMT -6)   
Thanks to all of you for your quick replies!

Tony, you state "if it's a relapse" are you saying that it may or may not be? At what point would it be considered a relapse? We have an appointment with his Urologist at USC on Tuesday to go over his options. His Urologist stated on the phone with my dad to wait 3 months for another PSA test and see where it goes. We obviously are going to get a few other opinions so we haven't done any HT as of yet. Thanks for your comment above. that means a lot to me!

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 1/7/2010 4:23 PM (GMT -6)   
Dadsmyhero,
Together with input from the great members here, reading the stories of other fellas with higher Gleason scores may help to cope with your concerns. You can read quite a few here on YANANOW:

www.yananow.net/Chart-Gleasonu6.htm#8

Hope it helps and best wishes,
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
PSA December 09 <0.01

My Journey: www.yananow.net/Mentors/BillM2.htm


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/7/2010 4:44 PM (GMT -6)   
Billy, knew about that site, never really spent anytime there. I made myself go there and read all the hardest core cases. It was sobering and inspirational to say the least. Some tough birds out there. I know you didnt link it for me ,but thanks

David in SC "Lover of Wombats"
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: 1/10 .12
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


Dadsmyhero
New Member


Date Joined Jan 2010
Total Posts : 4
   Posted 1/7/2010 4:47 PM (GMT -6)   
Just read some of these. Definitely inspiring. Thanks!

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/7/2010 4:48 PM (GMT -6)   
It is likely a relapse, but i say if because you still need more information. A second test only conformed the measurement of 0.1 and we still have yet to see another increase. If you have an increase then a very important piece of information is how fast is it rising. Many doctors won't react until they see at least a doubling rate. So 0.2 and how long it takes to get there might be your doctor's protocol. We call it PSADT or PSA doubling time. Before starting hormone therapy, it may be useful to know how long it takes to double to see if HT alone is enough.

I take it your are in or close to my old stomping grounds. Beautiful Southern California. I lived there for 23 years before moving here to Las Vegas. I am down that way frequently as my family lives in Laguna Beach. In fact I was there last week.

Peace to you, and a prayer for many blessed years ahead.

Tony
Prostate Cancer Forum Co-Moderator


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 1/7/2010 6:08 PM (GMT -6)   
Thanks for that link Billy Mac, uplifting and sobering at the same time.
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

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