PSA following salvage

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Oncas
Regular Member


Date Joined Jan 2009
Total Posts : 390
   Posted 3/31/2010 3:58 PM (GMT -6)   
Not sure if I posted this correctly.  Forgive me if I've duplicated a post.
 
Just completed my salvage radiation as part of a clinical trial. My PSA was pretty high going in. Went from .6 post surg up to about 1.0 now. I'm definitely high risk with two positive nodes but a prostascint showed activity might still be confined to the bed. I'm concerned however about no downtrend in my PSA yet. How long does it usually take to see results with salvage?
 
Jim

Age 61
Northeastern Penna.
11/08/08 annual checkup (3 yrs late) PSA 8.04 from previously 2.7 in 11/05
1/23/09 biopsy 12 cores positive, 10 cores Gleason 7, 2 cores Gleason 8 70% tumor
2/06/09 cat +bone scans clean ..
3/26/09 RRP surgery Post op path .. upgraded to Gleason 9 (5+4), seminal vesicles involved, several positive margins, 2 of 9 lymph nodes positive.
80% involved
4/4/09 Dr. advising wait for significant rise in PSA and initate hormonal treatment.
1st post op at 4 weeks PSA  .6  urologist concerned
will retest in one month
8/15/09  bone and pelvic scans redone .. clean   PSA .65
onc/radiologist recommending starting radiation treatments and 6 month shot of Lupron
9/11/09  consulting with med/onc today
Prostascint test done at U of Penna indicates cancer still confined to prostate bed.
PSA at .7
10/21/09  Rad onc suggesting clinical trial of samarium 153
 


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 3/31/2010 4:04 PM (GMT -6)   
Jim: I don't know the answer to your question but I think others have posted that there is an amount of time that must pass. I am sure someone will jump in with an answer to your question. Good luck Jim. If you get a chance to join us in Chat tonight someone will probably be able to help you.

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%


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 4/1/2010 3:11 PM (GMT -6)   
My two Cents :
after Proton Radiation I had an immediate Drop from .2 to .09 within two months,
after my two year anniversary Ive had slight upturns .06- .07 -0.08 I'm hoping its not a trend
good luck
54Yr Cancer Detected
PSA 8.0+ Gleason 7
55Yr DaVinci City Of Hope California
57Yr Cancer rise in successive PSA's
57Yr Proton Radiation Loma Linda Medical Center California
Feb. 10 0.08 Rise showing up in sucksive PSA's ) :


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4228
   Posted 4/1/2010 7:32 PM (GMT -6)   
Jim,
A couple of points:
Prostascint is practically worthless and making any decisions based on a negative scans is not prudent escpeially with lymphnode involvement and seminal vesicle invasion.
If you had two lymphnodes positive did you have radiation to the pelvic area along with the prostate?
What was your psa after salvage radiation? It should have dropped.
You said you were also on Lupron. are you still on it? PSA should have dropped to 0.05 or less on Lupron. Was your testestorne tested while on Lupron?
Psa should decline immediately after salvage radiation, not increase, escecially if you were on Lupron.
If I were in your position I would be getting an opinion from Dr Myers in Earlysville Va. There are just too many open areas about your treatments.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 4/2/2010 10:18 AM (GMT -6)   
My PSA was .18 going into IMRT.  It was still .18 on the 3 month PSA.  It finally went down to 0.00 on the 6 month PSA.  Give it some time.  It takes time to kill off the cancer cells.

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

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