KICKED OUT OF ZERO CLUB

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Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 3/15/2010 9:56 AM (GMT -6)   
 
  I was unceremoniously kicked out of the zero club this week.  RRP on 8/13, first PSA 10/13 was 0.022.  On 12/31 it was 0.081 and on 3/10 is at 0.190.  Will have another PSA in 2 weeks to confirm if rising etc.  Docs said IMRT is next step.  I asked for an estimate on how many years of good quality life I would have if I decided not to have any follow up therapy and was told  "probably 5 years."
 
  I can't say I am totally surprised about the PSA.  Depressed and disappointed, absolutely.  I had a gleason 4+5=9 however path report totally negative with transition zone organ confined tumor.  Only negative was perineural invasion, pre RRP PSA was 5.6.  Docs say gleason 8-10 are game changers regardless of path report.
 
I'm beginning to think that if the path report has 4 or 5 as a primary pattern, and regardless of how positive the path report,  the chances of a cure through surgery are not as good as what we might be told.  Of course, you don't know what the real gleason score is until the prostate is removed. 
 
In my case, knowing what I know now, I would have gone with the seeds but it is what it is.
 
The Old Sailor
 
 

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/15/2010 10:06 AM (GMT -6)   
Old Sailor, yep, maybe not the best news, but you still have many options for fighting any possible reoccurance. Just know that there's a great gang of guys here to help you with support. wanted and unwanted advice and best wishes and prayers for you. smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 3/15/2010 10:14 AM (GMT -6)   
Just turn it into the wind and hunker down for the ride.

Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 3/15/2010 10:55 AM (GMT -6)   
Old sailor,
Sorry to hear about the rising PSA, but Old Sailors never give up and they dont spit into the wind. Keep us posted and hope that you have many more good years to give to 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
Starting IMRT on 1/18/10
Great family and friends
Michael


Gmike
Regular Member


Date Joined Jan 2009
Total Posts : 48
   Posted 3/15/2010 11:15 AM (GMT -6)   
Old Sailor,
Just a few minutes ago I was talking to my neighbor over the back yard fence. He had open prostate surgery and then a recurrence. For the last 15 years has been taking "shots". He is 75 years old and said he feels "great." I can attest that he at this moment is atop his house vigorously sealing his roof.

What I see is that a rising PSA test is by no means end of the world.

Good luck
Mike
Dx: 05/21/2009 (age 58)
1 core of 12 positive (10%), Gleason 6, Stage T1c, PSA 5.2 (21% Free)
Family history: Grandfather had PCa, died at age 79 of other causes, Father had PCa still living at age 80 cancer free (11 years)
07/15/2009 TUMT (Transurethral Microwave Therapy) for BPH
08/29/2009 Started on Casodex
10/5/2009 Color Flow Doppler at Dattoli upgraded stage to T3a, started Avodart
10/12/2009 to 11/20/2009 IMRT at Dattoli Clinic in Sarasota
12/03/2009 Brachytherapy performed by Dr. Dattoli


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/15/2010 11:46 AM (GMT -6)   
Sorry to hear that sailor, been there done that myself. It's disapointing, but like you said, with your numbers, not totally unexpected. I only got to stay a zero for my original post surgery reading, then up and up.

Good luck as you consider your next choice.

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, no problem post SRT
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 3/15/2010 12:38 PM (GMT -6)   
Sorry about the being tossed overboard, but you do have options.

Hopefully once you get over the shock, dissapointment, and depression, you will set sail for the best possible cure, and go for it.

Best of luck !
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 injection
No pads, 1/1/10,  9 month PSA < .01


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 3/15/2010 2:46 PM (GMT -6)   
Sailer,
Keep your head above water. You may have lost a battle but you can still win the war. You have options available to you and you have all of us here cheering for you. God Bless you.
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 in circumference.
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
11.5 months test 1/21/10 result 0.004


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 3/15/2010 3:17 PM (GMT -6)   
Old Sailor,

Hang in there. At least you still have IMRT available if you so chose it. Good luck. SubicSquid
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.


Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 3/15/2010 4:03 PM (GMT -6)   
 
Old Sailor,
 
Hang in there guy I have a simlar story, had robtic surgery, organ confined, etc., Gleason 8,
At nine months PSA started going up I just finished IMRT and did well.  Will find out if it worked sometime in June I am not that anixous to know.
 
Jerry 
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 
12/28/09 PSA 0.5
Start salvage radiation treatments on January 18th. 


Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 3/15/2010 10:11 PM (GMT -6)   
Old Sailor,
 
I agree with previous folks - you still have a lot of options, including IMRT.  You mentioned that the only negative component in your pathology report was perineural invasion.  Did they explain to you meaning of it?
 
I wish you speedy recovery!
 
Sharp

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 3/15/2010 11:21 PM (GMT -6)   
Hi Old Sailor,

So sorry to hear about the report.

Those of us who don't have perfect PSAs are in a similar ship. It seems the ship rocks back and forth and sometimes and wakes us up when we want to be settled.

You have been riding a wave since October and want to get back to calm waters. I'm really hoping you'll find a course that will lead you there with all the options you have available to you!

Hang in there, buddy.

Barry
Surgery: Da Vinci; July 31, 2007; 54 on surgery day;
Pathology: PSA: 4.3; Gleason: 3+3=6; T2a; Confined to Prostate;
Post RP PSAs: 09/07 <0.04; 12/07 <0.04; 03/08 <0.04;
06/08 <0.04; 12/08 <0.04; 06/09 =0.06; 09/09 <0.04;
Latest PSA 12/09 =0.05


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 3/16/2010 9:03 AM (GMT -6)   

I want to thank all of my brothers for your words of encouragement and support.  HW is the "bomb."  I guess we'll now turn into the wind and launch em (IMRT). 

Sharp, doc only said perineural invasion called a secondary consideration in containment of pc to the organ and most men have it on pathology - he didn't seem too concerned.

Subic Squid - I have many fond memories of the PI and Olongapo.  "Fair winds and following seas" to you shipmate.

The Old Sailor 


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 3/16/2010 9:05 AM (GMT -6)   
Old Sailor, Comming about, Man the sails. Will be thinking of you. Do keep us posted.

Cajun Jeff
AGE:58, 57dx. PSA 5.4
Biopsy: 9/08 Gleason 3+4=7
open RP: 10?08 Nerve sparing. Path Report : GS 3+3=6 Stg pt2c margins clear
Cath for 10 day. Dry day after removal of Cath
PSA @ 3 months <0.1
6 months <0.1
9 months <0.1
12 months <0.1
16 months <0.1

ED Started VED at 3 months, pills followed VCL none did much, tried MUSE at 9 months (YUCK) Hated it. 15 months out injections Caveject (succecc)


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 3/16/2010 10:03 AM (GMT -6)   
Old Sailor-
Sorry to hear the news. My father needed IMRT and tolerated it very well. Here's hoping the next stage will be smooth sailing for you too! All the best!
Father's Age DX 62 (now 64)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Oct. 9, 09 PSA <.01 Last Lupron Shot
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/16/2010 10:05 AM (GMT -6)   
Hang in there Sailor. A lot of us had rising PSA's after RP including myself. There are still options for you. I chose IMRT and am finally at zero. Like you I was very discouraged. Good luck and take care.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)
11/23/09 Post IMRT PSA .18
2/12/10   Post IMRT PSA 0.00


Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 3/16/2010 1:27 PM (GMT -6)   
Good Luck Sailor.....I guess you'll be traveling to Mayo again...........
1996, Age 48, Stage III Colon Ca, Colon Resection followed by 18 chemo treatments.
 
2000, Colon Ca Metastasis to upper left lung lobe.  Lung lobe surgically removed.  24 chemo treatments scheduled.  Took 1, declined the rest.
 
9/08 PSA is 2.8, 12/08 PSA is 4.56??  Chalk it up to prostatitis due to urinary retention after Nissen Fundo Surgery.  VA docs prescribe 30 days of Septra.  Prostate feels normal.  PSA hovers around 4.1.  VA docs want prostate biopsy but can't seem to get me into the schedule.  Continue through Spring and Fall of 2009 thinking I have prostatitis.  Bacteria cultures are always neg.  PSA drops to 3.1 10/09.
 
12/09 Prostate Biopsy performed
3 of 10 cores positive, 5%, 25%, & 35%, 3 + 3= Gleason Six with perineural invasion.
 
Doc wants CT Scan due to prior Colon Ca. Findings: "The seminal vesicles are irregular & there is nodularity in the periprostatic fat such that local extension cannot be excluded.  Shotty lymph nodes in both groin measuring 2.3 cm."
 
Doc wants Endo-rectal MRI (OUCH!) Findings: Mild central zone BPH, no discrete focus of carcinoma is identified, no evidience of invasion into the periprostatic fat or seminal vesicles.  Normal size iliac chain lymph nodes.
 
2/08/10 Open RP surgery.  Findings: Gleason Six upgraded to Seven.  3 + 4, Stage pT2c, Bilateral w/perineural invasion, No pos lymph nodes,  margins uninvolved, no extraprostatic extension, no seminal vesicle extension,  39 grams, blood loss 1200 ml (didn't want a transfusion & didn't get one) nerve bundles spared bilaterally.  current age-61

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