Zero Club Renewal, please

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Date Joined Jan 2010
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   Posted 3/19/2010 10:34 AM (GMT -6)   
Yesterday was DaVinci +21 weeks.
Down to one pad a day for the last week (still a security pad for the random bad night), and got a second "undetectable" PSA from Bostwick. Yeah!
Renews the club and gives me another three month pass!
Schedule now set for 39 days of IMRT starting April 22nd, with Calypso markers being inserted next week. Sort of like a super biopsy, I'm told, but I've been there before.

Post Edited (142) : 3/19/2010 9:23:10 PM (GMT-6)

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Total Posts : 3172
   Posted 3/19/2010 10:48 AM (GMT -6)   
Hi 142,

"Undetectable" PSA (congratulations, by the way), but undergoing IMRT...?

Did you have bad margins? Sorry, I don't recall what you might have posted before. Can you refresh me?

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   Posted 3/19/2010 10:57 AM (GMT -6)   
Path. was multiple extra capsular extensions, 3 positive margins, Gleason 4+5 bilateral multifocal, pT3a, 20% total involvement.

James C.
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Date Joined Aug 2007
Total Posts : 4463
   Posted 3/19/2010 11:07 AM (GMT -6)   
142, with those stats, that is good news indeed. Thnaks for sharing with us, and keep up updated...
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man:
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

Veteran Member

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   Posted 3/19/2010 11:09 AM (GMT -6)   
"Get on it"...and you are!  (where's the 'emoticon' for "thumbs-up"?)

"Undetectable" PSA is the best starting point (as an indicator of lower probability for distant spread; spread which wouldn't even show up on scans).

May I ask; my own curiosity and continued learning: What was your PSA result history?

Post Edited (Casey59) : 3/19/2010 10:15:54 AM (GMT-6)

Regular Member

Date Joined Nov 2009
Total Posts : 206
   Posted 3/19/2010 11:09 AM (GMT -6)   
Please explain: Calypso markings. I'm starting IMRT end April but for my markings I only got three very small tattoos.
Age, only 71.
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
Christmas Day got my first hot flashes. Thanks Santa!
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
Pathology Report:
Gleason Score: cannot be determined due to hormone therapy effects. ???????
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
Additional path. findings:
high grade prostatic intraepithelial neoplasia
Pathology Stage: yp T3a NO MX
Radialogist appointment was on Friday Feb. 26 with Dr. Glenn Bauman in London.
Got another Lupron 90 day shot today and he wants to start IMRT soon. CT Scan plus measure scheduled in about 3 weeks. ( march 15)
First PSA test since surgery on March 25th.
Next appointment with the surgery Doc is April 13.
Started a Facebook page for bikers with prostate issues at:
IMRT to start approx. April 26.

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 3/19/2010 11:14 AM (GMT -6)   
Calypso is an embedded "GPS" type system. They implant the markers in the prostate bed to give the radiation a target.

I had no PSA history, and no family history of PCa. For some reason, with all the blood tests I've had over the years, there was no PSA on file. First test came back 7.4, retest 7.1, and off to the urologist a day later.
Biopsy came back 9 of 12 positive, with up to 90% positive, 7 Gleason 4+4; 2 Gleason 4+3.

Post Edited (142) : 3/19/2010 10:19:54 AM (GMT-6)

Veteran Member

Date Joined Sep 2009
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   Posted 3/19/2010 11:21 AM (GMT -6)   
Thanks for sharing; not meaning to be intrusive. So first PSA test was at age __ and the result was 7.4, then a follow-up test at 7.1, then the rest is history, so to speak? What age was your first PSA test?


Also, for JB, the Calypso is simply one brand/type of "fiducial" marker placed internally for targeting the radiation...correct 142?

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 3/19/2010 11:24 AM (GMT -6)   
Age 56, it turned out. In theory I was getting whatever tests were required yearly, but either PSA didn't get done, or the results were "lost". The nurse noticed it, and had the lab add it to a periodic test just by chance.

Correct on the Calypso.

Post Edited (142) : 3/19/2010 10:28:12 AM (GMT-6)

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Date Joined Sep 2009
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   Posted 3/19/2010 12:05 PM (GMT -6)   
Thanks, my friend. I'm simply addressing my own curiosity. Guidelines today urge doctors to begin having a dialogue with their male patients about PSA testing at age 50 (for caucasians with no PC family history; earlier for other scenarios). A lot of men are getting annual (or regular) PSA tests by that age, but still some are yourself. Today's guidelines help educate doctors, as well as patients, about the importance of firstly communicating about PC and PSA testing, and secondly about making an informed decision about testing at earlier ages. Different organizations have published different age/family history combinations, but all are focused on communicating/educating. You seem to have slipped through that crack. Thanks again for sharing.

Cajun Jeff
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Date Joined Mar 2009
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   Posted 3/19/2010 1:34 PM (GMT -6)   

142 being in the zero club before RT is a geat start I would think.  Enjoyed chatting with you Wed.

Cajun Jeff

9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 3/19/2010 2:16 PM (GMT -6)   
Congrats to you on that nice fat zero, that's news we all love to hear. Good going, man
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

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 3/19/2010 10:44 PM (GMT -6)   
Thanks for all the support. This is a good crew. Just wish I had been here before meeting Mr. DaVinci. It would not have changed my decision in perfect hindsight, but it would have given me a bit better of an initial orientation.
Yes Casey, I fell through the cracks of the system. I think testing for certain problems should be automatic, and obligated by the insurance companies. In a past life, working in a so-called socialist country, they did brutally complete physicals every year (DRE done faithfully every year in those days, on company time - fail to show up, lose your job). You failed, they sent you for treatment and early-retired you where it made sense. Here (in the US for our non-US folks) they can effectively control what doctors we see, and how often, why not add a test or two? No one thought to be sure the test was done, so it got lost. Maybe it was done and lost in the many transfers of records, or maybe it wasn't done at all. When all you see is hundreds of dollars of bills for blood tests with pages of long lists of descriptions, the tree is lost in the forest, if you can find the forest.
As a frequent international traveller, I always ask about Malaria, Hepatitis A/B/C, parasites, a long list of common problems. PCa? sure.

Veteran Member

Date Joined Sep 2009
Total Posts : 664
   Posted 3/20/2010 7:55 AM (GMT -6)   

Wow, 142 what a very interesting story! Best of luck.


Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. involving up to 75%
da Vinci at Wash U, Barnes on 11/02/09
Modified Pathology, Gleason 4 + 3 = 7. Gleason 7 present throughout Prostate.  Negative surgical margins
4 of 4 periprostatic Lymph Nodes Negative, 10 of 10 pelvic Lymph Nodes Negative. Seminal Vesicles tumor free. No prostate extension
Post-op PSA 12/10/2009, Undetectable
12/12/2009, Pad Free and Started jogging.

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 3/20/2010 3:12 PM (GMT -6)   
Glad you decided to stay in the club. I took a short break from the Zero club even though I did not resign my position as President. I think come April when I get tested again I will once again be a zero.
CONGRATS my friend that is great news

peace to you
My PSA at diagnosis was 16.3
age 47 (current)

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
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
PSA Jan 15th 2010 is .13

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

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 3/20/2010 3:51 PM (GMT -6)   
Thanks for sharing, 142. Best wishes with your IMRT in April.

Regular Member

Date Joined Feb 2010
Total Posts : 40
   Posted 3/20/2010 6:20 PM (GMT -6)   
My husband will have to have radiation for a positive margin also and I wondered how they know where to target the radiation in the prostate bed. We haven't met with the radiologist yet. Are you saying they implant something in the bed which acts as a marker, using a method similar to the biopsy? Then the radiation is attracted to those markers? Also, is the IMRT 8 weeks 5 times a week? Thanks in advance for the answers.

Husband dx 12/09
Age 60
PSA 4.5
Biopsy 8/12 cores positive; 5% - 50%
Gleason 3+3
DaVinci at UNC 3/9/10
Gleason 3+4 with tertiary 5
% of prostate involved with tumor 20%
Not confined to prostate; surgical margins positive for carcinoma, left mid prostate
Perineural invasion extensive

Regular Member

Date Joined Dec 2009
Total Posts : 347
   Posted 3/20/2010 6:29 PM (GMT -6)   
Congrats on the renewal, and progress with incontinence. Hope that rad goes uneventful.
age 45
psa 3.09
Biopsy results 12/9
Left side base 3+3=6 21% 2/2 cores positive
Left side mid  3+3=6 100% 2/2 cores positive
Left side apex 3+4=7 88% 2/2 cores positive
Right side - 0/6
CT & Bone scan negative
Davinci Feb. 5th 2010/ cath removal 2/16
Extent of tumor-Bilateral
Extraprostatic Extension-Absent
Seminal Vesicles-Negative for tumor
Surgical Margins-Rt apical margin focally positive
lymphovascular invasion-Suspicious in areas of capsular involvement
Regional lymph nodes-One node negative
Stage-T2c NO Mx

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 3/20/2010 9:18 PM (GMT -6)   
Thanks to everyone for the good wishes. I've stumbled a bit and had a two-pad day today, but it isn't seven, so...

Alice, yes the Caylpso system (seems very new and in limited use, but there is a similar system that uses gold-metal markers) is a marker that goes in to the prostate bed area just like the biopsy comes out. So I'll be having a bad day Thursday. This is a mini-gps or RFID - sort of like the new passports - exposed to a specific radio frequency, they light up and send a signal. The radiation equipment is (and here I am going on a one-hour discussion) programmed to position the impact of the beam in relation to the three markers. There is still the molded shield to protect adjacent areas. I don't know how widespread the use of this is.

The treatments are each business day (so five days a week) for 39 days, no breaks allowed. I've been at the office several times, and there is always a flow of people in and out, so it seems that they are correct that it is a fairly quick daily effort. It will probably take longer to drive up and back than the treatment time. The big complication for me is that you have to drink a couple of glasses of water 45 minutes before, and actually hold it. That is to keep the bladder pulled up out of the way. I'm trying to "train" myself to do a better job holding water :(

Link - for those interested.

Post Edited (142) : 3/21/2010 12:09:33 PM (GMT-6)

Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 3/22/2010 6:18 AM (GMT -6)   
Sounds great. Keep us posted.
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
20 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 3/22/2010 6:20 AM (GMT -6)   
142, I forgot to ask where you are from?
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
20 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

Forum Moderator

Date Joined Jan 2010
Total Posts : 7087
   Posted 3/24/2010 1:50 PM (GMT -6)   
DFW area.

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 3/24/2010 8:23 PM (GMT -6)   
Good Luck on the IMRT. I sailed through with minor side effects. Lots of guys here went through it and can offer help when and if you need it. just ask.
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
Gleason 7 (3+4)
1 positive margin (.3cm)
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

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