Rising PSA after RP and RT

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bingo
New Member


Date Joined Jan 2010
Total Posts : 1
   Posted 1/10/2010 5:16 PM (GMT -6)   
My husband is 63. Had RP in August of 2006. Gleason 9, T3a. No positive margins, no seminal vessicle invasion. PSA stayed at 0.1 for almost a year after RP. In Nov 2007 rose to 0.2 and he had salvage radiation. It never dropped after that but has risen slowly from 2007 to 20010--0.3 to 0.4 to 1 to 2 and most recently to 4. (The doubling time has obviously increased in the past 4-5 months. He is in great shape, swims, exercises, has a healthy libido--but it's pretty obvious his cancer has recurred. Anyone know of options other than ADT which seems to really impact QOL for someone like him.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/10/2010 5:47 PM (GMT -6)   
hello and welcome bingo, to you and your husband. glad you found us here, sorry you have a need.

with what you described, the normal approach would be Hormone Treatments. We have a few advanced case guys here very experienced in a variety of HT that should be able to help you. So sorry that his surgery and salvage radiation didnt hold for long.

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: 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


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 1/10/2010 7:06 PM (GMT -6)   
Hello,
Sorry about your husband's rising PSA after surgery and salvage radiation. At this junction, I think that HT is the next step. I can't speak about the QOL with HT but several here may be able to discuss. Good luck.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/10/2010 7:33 PM (GMT -6)   
Suggest you read about immuno-therapies, that are not hormone therapy and not those side effects, should have no side effects and literally plays pac-man on the PCa cells with the help of dendretic cells...you have to read it...it gets complicated, but it works. You will have to search for the info on it.
 
Using Leukine is another  type of therapies, you'll need insurance and a cutting edge oncologist whom knows about it.  Dr. Scholz in California is doing this with a patient I know whom is 12 yrs. post diagnosis and looking for alternative for control, he claims no side effects other than his insurance company feeling the pain at $8,000 for 3 mos. worth of injections to him after seeing onco doc intitially. Not saying cure, but works when other therapies are done, it looks like the future in this area is brightening.
This can be an intermittent treatment or on and off, it appears.
 
Other guys are doing a lesser side effect hormone treatment like estradiol patches or DES, maybe even emcyt.  Getting good responses on it and low cost, little side effects, cancels hot flashes and other negative when Lupron is still in your system...I know because I have done this. Used it for years and it is way superior to ADT3 hormone drugs, outperformed them(no profits to made on these either-fyi).  You feel much closer to normal on such, especially compared to the Lupron, Zoladex, casodex and ADT3 combos.
 
You could also use Ketoconazole and other protocols drugs therapies. Search www.prostate-help.org   or  www.hormonerefractoryPCa.org    perhaps and find other methods, you will need an onco-doc whom knows PCa, hopefully. Lots of ways to fight PCa, but you might have to work at finding the information and the doc whom will help you.
 
Best to you.


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 1/10/2010 5:43:28 PM (GMT-7)


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 1/11/2010 8:35 PM (GMT -6)   
from vantage point ADT3 is a viable option however i would certainly explore what Zufus had to say. I was ADT3 for two years and had the normal side effects of zero libido, lack of energy, etc. I did find that exercise helped offset the energy problem but nothing helped with the libido. Now that I have been off of HT for several months my libido is back and my energy is great. Unfortunately my PSA is rising. Please keep us posted as to how you are doing and what you do.
peace to you
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11

PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


Reinardo
Regular Member


Date Joined Jan 2010
Total Posts : 23
   Posted 1/15/2010 9:18 AM (GMT -6)   
Hello, bingo. PSA staying above zero or starting to rise soon after RP suggests recurrence at distant sites. So, salvage radiation had little chance of success right from the beginning. Hormone therapy which would be standard choice in such cases will initially work well but, apart from its side effects, will not last very long due to high gleason. It appears to me that your husband should try to find out where in his body the recurrence is located (preferably in the bones). This would allow for some targeted therapy. Otherwise or in addition to this a combination of hormone therapy and early chemotherapy might be considered. Such therapy could be intermittent to allow for recovery from side effects.
By now much time has elapsed and it is about high time for you and your husband to get worried and look out for a good doctor able to respond to your - hopefully - critical questions. Best wishes to both of you. Reinardo
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