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Oncas
Regular Member


Date Joined Jan 2009
Total Posts : 390
   Posted 4/29/2010 5:17 AM (GMT -6)   
Just got my PSA results one month after completing salvage radiation. So far only about a 10% drop. (Because I'm in a trial my PSA is monitored more frequently)  As you can see by my signature I'm definitely high risk so I'm kind of antsy. Has anyone else out there completed salvage IMRT (without the addition of hormone therapy)after failed surgery resulted in a pretty high PSA? What kind of response did you get? How long did it take?  Obviously every case is different, but there's comfort in comparing notes.
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
2/1/10 Samarium trial completed PSA 1.0
2/1/10 began IMRT 39 treatments 70 Gy
3/25/10 finished IMRT
4/28/10 PSA .93
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/29/2010 7:45 AM (GMT -6)   
Jim, I will give you my numbers just for the sake of comparisom:

Pre-surgery PSA 16.3

Pre-SRT PSA .16

30 days Post SRT PSA .12 down 25%

90 days Post SRT PSA .04 down 300%
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, 4/8 .04, next one:  July
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, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 4/29/2010 8:51 AM (GMT -6)   
Oncas, I would imagine any drop in PSA at the one month point is good news.

I wasn't checked at the 1 month point.

Day prior to start of SRT: 0.7
3 months later: 0.1 (86% drop)
6 months: less than 0.1

Best wishes.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 4/29/2010 9:09 AM (GMT -6)   
My post IMRT after 3 months was .18. the same as before IMRT.  I was discouraged at the time but the 6 month PSA was 0.00.  Any downward trend is good.  It takes time for the bad cells to die off.  6 weeks is a little to early to tell. I'm surprised they didn't wait until 3 months.  It could have possibly been lower and saved you some anxiety.
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


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 4/29/2010 9:45 PM (GMT -6)   
Jim,
Any decrease in PSA no matter how small is a good sign especially when the decrease happens after such a short time. Hopefully the next test will be lower.
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


chinito
Regular Member


Date Joined Dec 2008
Total Posts : 28
   Posted 7/10/2010 12:50 PM (GMT -6)   
we are considering salvage radiation even though they say there is possiblity that it is not localized. we are about an hour from where we receive radiation. will this be too much travel every day with the sideeffects of radiation. also anyone out there that has had 'less than 6 month doubling time' pointing to not localized that did radiation anyway and had success
Age 56
DOB 9/02/52
DX Prostate Cancer 12/2/08
Double Bypass Heart Surgery 8/08
Gleeson Score 3+4=7
9 out of 12 cores were postive
PSA was 7.71 rose to 12.2 week of surgery
DaVinci surgery 2/06/09
Cath out 2/17/09
Path staging PT2c Bilateral disease, stage 11
PERINEURAL INVASION, present and extensive
vENOUS (large vessel) absent
LYMPHATIC (SMALL VESSEL) invasion SUSPICIOUS FOR LYMPHOVASCULAR INCASION (C5, C10, C20) (16) no evidence of malignancy
ADDITIONAL PATHOLOGIC FINDS High grade prostatic intraepithelial neoplasia, which is extensive
3 month post op PSA undetectable
6 month post op PSA undetectable
12/29/09 post op PSA rose to .050 need to return for more testing
3/29/10 PSA .63
7/06/10 PSA .102 they called it 'less than 6 month doubling time"


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 7/10/2010 1:27 PM (GMT -6)   
Chinito,

My drive to the IGRT clinic was not a tremendous distance, but there was a lot of unpredictable construction, so it could take from 30-45 minutes. Having to allow for that meant most mornings I was terribly early, but there were a few cases of flying in the door with the therapist tapping her pencil waiting like a schoolteacher.

I got the pattern down early, knowing exactly where to start drinking the half liter of water. I had a couple of "accidents" the first weeks on the way up, as we figured out the timing.

The trip home was controlled by clearing all that water out after the treatment. The first was a stop in the restroom at the clinic, but it always seemed that I need to go again about half way home, so began to stop at a big-chain grocery store that was on the way. Since I hate to just pee and run, I got back into the "European" style of shopping - a little bit of fresh stuff every day instead of the US style mega trip. Gave me something to get my mind off the day as well.

Well into the treatments, I started feeling the fatigue that others talk about, but it hits in the afternoon, so only the last week or so it gave me some trouble with the drive. But overall, I did fine with the drive itself. Several friends advised the drive would be difficult, but they were doing more extensive radiation for different cancers.

I posted the day by day. I'll find the thread and add the link here.

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 7/10/2010 3:29 PM (GMT -6)   
I think the poster noted they did the PSA test more frequently than usual because of the trial they are in.
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 7/10/2010 6:19 PM (GMT -6)   
Chinto,
Hopkins has a nonogram that you can get on line. If you plug in your numbers you can get a good idea if salvage RT will work in your case.
JT

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


chinito
Regular Member


Date Joined Dec 2008
Total Posts : 28
   Posted 7/11/2010 3:44 PM (GMT -6)   
thanks for your response on the drive and the radiation. i thought i had put to receive the responses via email but they didnt come in and only saw these today..
Age 56
DOB 9/02/52
DX Prostate Cancer 12/2/08
Double Bypass Heart Surgery 8/08
Gleeson Score 3+4=7
9 out of 12 cores were postive
PSA was 7.71 rose to 12.2 week of surgery
DaVinci surgery 2/06/09
Cath out 2/17/09
Path staging PT2c Bilateral disease, stage 11
PERINEURAL INVASION, present and extensive
vENOUS (large vessel) absent
LYMPHATIC (SMALL VESSEL) invasion SUSPICIOUS FOR LYMPHOVASCULAR INCASION (C5, C10, C20) (16) no evidence of malignancy
ADDITIONAL PATHOLOGIC FINDS High grade prostatic intraepithelial neoplasia, which is extensive
3 month post op PSA undetectable
6 month post op PSA undetectable
12/29/09 post op PSA rose to .050 need to return for more testing
3/29/10 PSA .63
7/06/10 PSA .102 they called it 'less than 6 month doubling time"

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