Rapid increase in PSA after radical prostatectomy: Prognosis?

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New Member

Date Joined Feb 2010
Total Posts : 2
   Posted 4/22/2010 9:05 AM (GMT -6)   
My signature line about says it all.  It seems like I have major side effects to every treatment I've tried,  including ED meds...
I can't get a straight answer from any of the three docs I've seen from M. D. Anderson to my local oncologist:
   Since I'm starting on Lupron, is it a given that I'll lose interest/ability to perform sexually?  One doc prescribed tri-mix, but my wife doesn't think it is worth getting filled if I'm going to start Lupron.
   Also, would anyone hazard a guess at the overall prognosis for lifespan or quality of life?
Thanks for any help...

Spring, 2009: PSA 6.0; Biopsy Gleason, 7
August, 2009: Radical prostatectomy including all nodes and vesicles, actual Gleason, 9; margins clear; some nerves spared
October, 2009: PSA .2,
December, 2009: PSA .5; bladder control mostly returns
January & February, 2010: after 30 days of Casodex, PSA .2; discontinued due to side effects, PSA .4 30 days later
March, 2010: radiation treatments to breasts
April, 2010: scheduled to begin Lupron; ED continues...

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 4/22/2010 9:22 AM (GMT -6)   
You didn't state your age, so was curious about that. I also had a PSA of 6 and a Gleason of 9. However my post surgery PSA has been much slower in rising. I'm now at 0.03 at 22 months post surgery.
I'm using Trimix and can state that it works extremely well. The only ED drug that has worked partially, was Levitra. But I never get more than 75% of a response and it doesn't last that long. Which is why I went to Trimix.
I'm sure other guys will respond to the issue of using Trimix with Lupron. I would go ahead and get the Rx for Trimix. 
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 4/22/2010 2:28 PM (GMT -6)   
From everything I've read from guys here who have been on HT, they had no libido during the treatment so your wife is probably correct in no filling in the trimix prescription until after you are done with the HT.
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 5 months
2 months 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 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

Veteran Member

Date Joined Oct 2008
Total Posts : 3257
   Posted 4/22/2010 3:37 PM (GMT -6)   
I was on lupron for 3 and a half years. yay... I didnt have much libido at all but my 30year old wife did. So I used the trimix which is much cheaper than other e.d.drugs and faked the climax. I'm not sure but it seems my wife and I switched roles. lolol Even without libido the trimix works extremely well and you can make it over the top if you want but once she was done 3 times I just faked it cuddled up and went to sleep.
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months
Cat Scan 12/12/08 Prostate normal size and shape. No tumors detected. Left lung clear of all nodules right lung showing only benign scar tissue. Lymph nodes normal
Bone Scan 12/24/08. Clean!!! went off casodex January 4 2009
Current psa 2/13/09 .16
Latest P.S.A. 0.05 newest P.S.A. undetectable

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 4/22/2010 5:47 PM (GMT -6)   
Glen99 you have the normal up front questions that especially worry a newly treated patient or diagnosed one. Send me an email we should talk and you should look at and compare to all other cases you can (but direct comparisons is not the same of how exactly anyone else may fair...PCa is diverse, still good to look at everything), go to www.yananow.net and see experiences/mentors and look at patients experiences and histories with fighting PCa.

Myself did the hormone therapies ADT3 for 2yrs., then went to different drug that out performed those and done very decent on it for alot of years now. My original stats were terrible and so I got actually more than 8 opinions, some were sales pitches and not totally fair to the patient. I am still here( 8 yrs.+) and doing better than I thought I would based upon original stats and total urinary blockage from PCa. Hopefully you can do very well and maybe the new things will be here for all survivors. Suggest you read the book: A Primer on Prostate Cancer-The Empowered Patients Guide- Dr. Strum & Donna Pogliano (your new bible on PCa).
Youth is wasted on the Young-(W.C. Fields)

Veteran Member

Date Joined Jan 2010
Total Posts : 1011
   Posted 4/22/2010 7:49 PM (GMT -6)   
Glenn, very sorry to about your situation. I have a rising PSA, but at least I had 9 months of undetectable PSA. Now I'm at .31. I'm currently trying to find a doctor and treatment facility that I am comfortable with and plan a course of action. I have been relatively happy with the doctors that I have seen so fair, but I have found that they tend to sugar coat things. Maybe it is because I walk intom their office with that "deer in the headlights" look. I have got to work on that. Try to find a doctor that you trust. Good luck. Frank
Dx with PC Dec 2008 at 56, PSA 3.4, Biopsy: T1c, Geason 7 (3+4)

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31

New Member

Date Joined Feb 2010
Total Posts : 2
   Posted 4/23/2010 9:02 AM (GMT -6)   
Thanks to all who responded.

I'll follow through on the suggested publication and web site... I'm amazed at the wide range of symptoms, agressiveness, responses and treatments for PC. I guess there really are too many variables to help predict the course of this illness.

I'm finding it hard to 'get on with my life' with this storm of unknown intensity hanging over me...


PS. By the way, as stated in my revised signature paragraph, I was 60 when diagnosed early last year.
Spring, 2009 at Age 60: PSA 6.0; Biopsy Gleason, 7
August, 2009: Radical prostatectomy including all nodes and vesicles, actual Gleason, 9; margins clear; some nerves spared
October, 2009: PSA .2,
December, 2009: PSA .5; bladder control gradually returns
January & February, 2010: after 30 days of Casodex, PSA .2; discontinued due to side effects, PSA .4 30 days later
March, 2010: radiation treatments to breasts to treat pain and growth
April, 2010: scheduled to begin Lupron; ED continues...

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 4/23/2010 10:43 AM (GMT -6)   
Glen , welcome to Healing Well. The guys seem to have taken you well in hand, so I hope you find your time with us informative and that you will stick around. smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

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