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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 8:43 AM (GMT -6)   
Just got back from my uro/surgeon's office in Greenville.  Had my wife come with me in case they were going to do a major sedation, but that didn't happen.  First thing he did, was a "super" flush on the existing catheter.  Tested some of the fluid, and said there was a raging UTI going on.  He flushed a few more times and found no further evidence that anything was actually wrong with the catheter.  He said it will be difficult switching it out to a larger one, and he wants to delay that till the 24th of the month, when it would be time for a normal swap for sanitary reasons.  He put me on strong antibiotics to start on the UTI, while they send out for a major culture on the sample.  He said additional meds may be needed.
 
Then he surprised me.  Like all of my current medical team, he is not generally in favor of vitamins or supplements, but he wants me to start taking 1000mg of Vitamin C a day, he said to take 500 in the morning, 500 in the afternoon.  He said that vitamin C will break apart with water and when it enters the bladder, it makes a very hostile environment for an UTI to grow or thrive.  One of the problems of long term catheter use is fighting off UTI's.
 
He gave us a bunch of new irragation supplies for free, in case there are any other blockages over the weekend.  And he said, if it becomes too big a problem, I can go to my local office  (he is there on Mondays) on Monday without an appointment or phone call, and he will have to go ahead and replace the tube a week earlier.
 
He didn't find any evidence of any serious healing taking place since my last visit, so it will be at least to the end of June before we can discuss and further fixes to the real problem.  Catheter #17 just got delayed today.
 
Hoping the meds and vitamin C might tone down some of the pain issues in between. 
 
To show you the kind of doctor he is, he had a surgical procedure scheduled for the exact time they told me to come in.  He delayed the surgery and saw me first, and as usual, spent a goodly amount of time talking to me and getting him up to speed with me from my last visit.
 
That's the latest, btw, despite a lot of bladder pressure pains last night, did not block up over night as I had feared.
 
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, 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


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 5/14/2010 8:50 AM (GMT -6)   
Sounds like a good Doc David, and sometimes I guess there are no easy answers. I saw where Kiwi fruit has more vitamin c than oranges, so have been eating one or two a week during this pollen season. Not a big fan of vitamins but my wife takes them daily. Good luck.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 5/14/2010 8:56 AM (GMT -6)   
Good news David. I hope the infection gets taken care of and you can continue healing.
Cheers
Dave


Come to think of it this is a strange world we live in where a raging infection is GOOD news.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04
05-03-10 1 week without pads


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/14/2010 9:42 AM (GMT -6)   
Dave, hope you are now on the upswing. Really helps to know that you are in good hands. Your Doctor sounds great and your wife is a saint. Best of luck. BB
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
Aril 10 MRI and Bone Scan show lesion on lower spine, no SRT


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/14/2010 12:06 PM (GMT -6)   
David, I don't always post a reply, but I always read your postings and I always send best wishes your way. I look forward to the happy ending to this story that IS coming.
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


spottydog10
Regular Member


Date Joined Dec 2009
Total Posts : 348
   Posted 5/14/2010 12:22 PM (GMT -6)   
David, good luck mate, hope it works.
The VitC may stave off colds and and flu as well!

Cheers
Mike
Age 51
PSA 5.5  june 09
biopsy july 09 gleason 3+3 = 6   5% and 50% in 2 of 12 cores
robotic prostatectomy nov 7 prostate weight 45gm
path report due 8 jan 10
post op psa 22/12/09, 0.04
no incontinence after 7 days
total ed

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 12:53 PM (GMT -6)   
Thank you Michael and Dave. The trouble with a bad UTI I am learning, is if you are peeing normally through your penis, you would feel burning and discomfort if it were bad enough. Being on an indwelling catheter for so long, I don't feel it in the normal sense. After the culture comes back, the Dr said he made need to adjust the antibiotic even stronger.

Thanks too, BB and Galileo.

Mike, its kind of weird with me. I don't drink any juices, take no vitamins or supplements ever, rarely eat fruit, and yet I seem immune to colds, coughs, sore throats, flu's, etc. Part of my natural immune system must be real strong, I was worried going through SRT in the winter, as its a known fact that radiation really weakens your immune system, but never even had a sniffle the whole winter, and was surrounded at times by sick family. So hopefully, the Vit C will do me some good, and if it helps to stave off any future UTI's, that will be a good thing.
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


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 5/14/2010 1:02 PM (GMT -6)   
Sounds like you have a good plan for this crisis. I am happy you were able to get flushed and have some medication before the weekend. I hope it eases your mind some and you get some good rest.
 
Age 48 at diagnosis
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
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 1:09 PM (GMT -6)   
It should Rob, hoping for a less painful and edgy weekend, still pretty darn sored - covers my entire pelvic/hip area, and all the parts in between from front to back, lol
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


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/14/2010 1:12 PM (GMT -6)   
David, glad your doctor figured out the current problem. Hope you get better soon. My stricture surgery still effective. Strong stream and incontinence is almost gone. Hang in there, Squid.
*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.
*03/15 - Cath #4 out. Great urine stream. Unfortunately, incontinence back to post surgery level.
*04/14 - Six month PSA - .21.
*04/28 - Will start IGRT week of 5/24.


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/14/2010 1:44 PM (GMT -6)   
David, thanks for bringing us up to date. Cheering you on, bro,

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02
PSA on April 9 less than 0.02 
 
  


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 1:50 PM (GMT -6)   
Squid, you sure sound like your fix "fixed" your stricture issues. What is considered normal for small group of men that endure strictures, is that it can take 1 - 3 fixes to get things normal again. I hope you stay in that group, I am selfish and don't want to share this miserable spot with anyone else, lol

Thanks Bro. Sheldon
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 5/14/2010 1:51 PM (GMT -6)   

David:

 

Thank you so much for keeping us up to date. I really appreciate your honest factual reporting. You do a great job of that.

I never heard of vit. C for UTI. I know I've done the cranberry juice routine (it seems to help when things aren't too bad). So, that's interesting.

Just curious -- what specific antibiotic was prescribed (cipro? augmentin? bactrim? septra? zithromax? erythromyacin? -- I've been on most of those over my lifetime).

I hope the culture shows something. I am sure I had one awhile back. You may recall I was pretty miserable: pain, burning, no energy, chills, very low-grade fever. They found blood and white cells in my urine, but nothing grew in the culture. They put me on cipro and things cleared up in 3 days. They had me stop it immediately when nothing showed up in the culture. I would still bet that I had a UTI.

 

In fact, the symptoms returned a week later (but not as bad). That time, the urine was clear. I did not resume the antibiotics and eventually things resolved.

 

Mel

 

Mel

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 5/14/2010 2:00 PM (GMT -6)   
David,
I'm glad to see that at least for now, things are improving. I hope that this forward movement continues on the road to full recovery. I appreciate you keeping us up to date on your journey. My wife is always asking me about your progress, at least for now, I have some positive news to tell her.
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 2:01 PM (GMT -6)   
Mel, from what you previously described in detail about your own symptons, I too, believed you had some kind of UTI going on as well, I am glad that yours has cleared up.

This time, it was an antibiotic I have never been on before, must not be used as often, as it was way more expensive at Wal-mart then the usual. It's called NITROFUR, I am to take one 100 mg capsule twice a day, 12 hours apart. Being a Friday, the lab won't have a culture result until next Monday at the earliest. He said depending on that outcome, he may increase, add, or change meds.

Since I never drink juices, or eat much if any fruit, etc, don't have all that much exposure to Vitamin C. If I had to eat fruit, I like bananas and every variety of berries known to 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, 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


Heavy Leaker
Regular Member


Date Joined Feb 2010
Total Posts : 63
   Posted 5/14/2010 2:05 PM (GMT -6)   
David,

I am very thankful when I read your posts that so far the only issue I have had since my robotic surgery has been pretty severe incontinence. Often when I feel sorry for myself I think about guys lie you who have been through so much. Lately, the incontinece is improving. I have a question for you based upon a prior post you amde concerning salvage radiation. I believe that you stated that you would not go through the radiation if you had to make the choice today. The reason that I ask this question is that my 6 month post op PSA went from <.1 six weeks after surgery to .1 at 6 months. Now my surgeon says that if the PSA rises to .3 I will need radiation. He would postpone it by giving me hormones until I am 1 year post op to give my incontinence time to continue to improve. I am hesitant about radiation & that has been reinforced by your severe problems since your radiation. Do you have any advice about this for me? How often does a man have the problems you have had since your radiation? Thank you & I am so sorry you are going through this living hell with your catheters!
4 biopsies over 4 years starting in 2006, 4th biopsy showed 5% of one core Gleason 3+3=6.  PSA in 2005 6.0, rose to PSA 18 shortly before surgery.  Chose surgery over radiation due to conflicts in PSA versus biopsies.  PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09  T2B Tumor 30% of prostate  involving left & right lobes  NOMX Gleason 3+4=7  Urethral Resection margins &  resection surface clean Seminal vessicles clean.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 2:32 PM (GMT -6)   
Thanks, heavy leaker, how about a first name, hate calling you that. For all my troubles, I feel for every brother who has the opposite problem ,that of incontinence. After a few months, that would get really old, really fast.

For starters, if you need salvage radiation, that is for you to choose, and you alone, along with the advice of your own pesonal medical team. That is most important for you to remember.

The .3 line in the sand is safe enough to keep, as advised by your dr. he/she will probably want to see (3) rises above .1 before declaring recurrance anyhow, so you have plenty of time to think through it. Dr. also correct in wanting to use HT to slow things down while you are continuing to go dry, as a general rule, the SRT will end your attempts going dry at that point, but not always. Still can vary man to man, case by case.

What I am going through, and this is important to consider, is very rare and unusual. Having chronic strictures after prostate surgery is only in the 3-5% range of surgery guys, depending on the source you read. Most guys are fixed after an attempt or two, i.e. Subicsquid here is a good example. It was also very unusual to go through SRT like I did with an indwelling catheter the entire 39 zaps, I did not have the water in my bladder to protect it like most men do. I was told at the time since I was getting IMRT, it was safe to do it that way, but I am having my doubts now about that decision. My clinic had never done one with a catheter in place before, and I reported burning pains the very first week.

It might explain how much collateral damage I have received since radiation ended. My bladder, bladder neck, rectal parts, are all heavily "burned" so to speak, if nothing else, by scattering from the radiation. My radiation ended nearly 6 months ago, and I still have a lot of pain and damaged areas, and this is why I am still on a catheter after all these months.

So, I should not be used as a typical example. Most men here at HW, that have SRT, go through their treatments fine, without incidents, and at worse, experience some fatigue and perhaps some minor urgency or rectal issues, and those side effects usually go away in a few weeks.

Also, I went through a terrible throat/neck radiation treatment back in the "old days" 10 years ago. It was to finish off my 3rd bout of an ultra rare but deadly cancer. Went through 35 or so treatments, and it did a lot of damage to me. I still dont need to shave on the left side of my face or chin, I have a constant burning feeling (like from thirst) in my throat, and chronic fatique that has never improved since year 2000. So you can see why I was so negative about radiation for me again.

Even though I dreaded this SRT for my PC recurrance, in the end, it may save my life from PC. I got my first "zero" number at the last reading, the next (3) 90 readings will be critical for my situation, and then I may be able to sigh some relief. If I didn't take the SRT, all my doctors, both urology and radiation, were convinced that the PC would be back with an agressive vengence and would spread quickly. In the end, it was that thought that pushed me to do something I was so against.

Listen to your doctors, think hard and long, and then choose wisely what is best for you.

Hope some of this drivel helps you.

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, 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


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/14/2010 2:34 PM (GMT -6)   
David, your doctor sounds like a very compassionate person - good for you! Glad you got to see him and that there's an answer to your problem. Hopefully the new, stronger antibiotics will help you heal - and the vitamin C won't hurt either. Interesting what vitamin supplements can do for us (other than empty out our wallets). Hope you have a painfree, peaceful and flowing (urine-wise) weekend!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 2:40 PM (GMT -6)   
PS to Mel:

http://womenshealth.about.com/od/urinarytractinfections/a/preventuti.htm

This link is about women's health with UTI's, but it does mention the use of Vitamin C, and it matches what my doctor told me today.
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


keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 347
   Posted 5/14/2010 2:49 PM (GMT -6)   
I'm glad things seem better for now, hopefully these meds will help. i'm traveling but still check in.
 
 
Neal
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
 
Gleason-3+4=7
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
Incontinence-yes/ Down to 1 pad at 6 weeks out
11 weeks pad free
PSA 3/29/10 <0.01


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 3:06 PM (GMT -6)   
Sephie, thank you. The reccomendation of the Vit C didn't change my doctor's atititude about Vits in general, he said that it can neutralize the acidity in the urine, which a UTI feeds upon. Did some research since I got back, and it seems to be true.

Neal, thanks for checking in
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


Heavy Leaker
Regular Member


Date Joined Feb 2010
Total Posts : 63
   Posted 5/14/2010 3:26 PM (GMT -6)   
David,

Thanks for your reply. My name is Ray and although I am a native of Georgia, I have been in southern New Jersey for almost 40 years. I do make it home to Georgia every year for my family reunion so I am sort of a neighjbor of yours. South Carol.ina, like Georgia is a beautiful state. I also appreciate the explanation about the circumstances of your radiation. I would imagine that your bladder being empty could definitely be a big negative. I hope that my PSA will remain at .1!

Ray
4 biopsies over 4 years starting in 2006, 4th biopsy showed 5% of one core Gleason 3+3=6.  PSA in 2005 6.0, rose to PSA 18 shortly before surgery.  Chose surgery over radiation due to conflicts in PSA versus biopsies.  PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09  T2B Tumor 30% of prostate  involving left & right lobes  NOMX Gleason 3+4=7  Urethral Resection margins &  resection surface clean Seminal vessicles clean.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 5/14/2010 3:54 PM (GMT -6)   

David et. al.:

The SRT discussion brings up another question. I think Ford Hospital said they would be concerned if my PSA goes above 0.1. In fact, if it does that and is confirmed with a test 4 weeks later, I think SRT would be in the cards.

 

But I also understand that 3 rises in a row is a cause for further treatment. But suppose I go from:  .01 to .02 to .03 to .04.

Would that also indicate that it is back and time for SRT?

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 3:58 PM (GMT -6)   
Ray, pleased to know you by name now. I live in Easley, SC, 10 miles west of Greenville, SC, not far off of Interstate 85, about 40 miles north of the GA border. I like the NW corner of GA, where it joins the mtns in NC/SC. A lot of people don't even know that there is a public ski resort in GA!

I hope your number stays low too. You had the same problem I did, you had a rapid rise in PSA prior to your surgery, and I see that you were upgraded to a Gleason 7 case like me. So keeping an eye on that PSA at this point is very, very critical, because with your velocity, just like in my case, if you ever had recurrance of the cancer, it could multiply quickly, which is why your dr. doesnt want you to go over .3

Hopefully, it will level off, or even drop again, giving you some breathing room. Hope it goes well for you.

David in SC

PS I am the opposite of you. I am a you-know-what-yankee carpet bagger from NH, but I have lived the past almost 22 years here 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, 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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/14/2010 4:03 PM (GMT -6)   
Mel, you would think so, but most dr. wouldn't agree on that. Because all those lower numbers you quoted are still under .1, and can still be in the range of test tolerances/allowances etc. In my opinion, the first time a person gets a true .1 or higher, its time to start paying close attention.
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

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