At what point do you see a medical oncologist

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted Yesterday 3:45 PM (GMT -6)   
This has been an ongoing, interesting discussion on HW. I have been thinking about consulting with a medical oncologist who specializes in PC. But, right now, my situation has been pretty cut and dry. I've had the surgery and I'm doing the PSA monitoring. But I would prefer to be able to think things through and anticipate events with a plan in place. Right now, the plan is that is the PSA goes up (say 3 increases or above 1.0 confirmed with a subsequent PSA test) I do SRT (obviously I would consult with a radiation oncologist before that time).
 
But... is it really cut and dry. Is that for sure the next step.
 
I get the sense that I should consult the oncologist when and if SRT appears to be failed. But, it would seem an earlier meeting would be useful. For example, I am reading of studies advocating HT (perhaps) with SRT (or just before it). Or...whatever. My point is I think some expertise could be useful BEFORE deciding to do only srt.
 
Anyway, I hope that is not in the near future, but I come back to the subject question.
 
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.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted Yesterday 4:31 PM (GMT -6)   
Mel,
My opinon is that you should see an oncologist immediately upon being diagnosed. If only I knew this simple fact 10 years ago I would have saved myself a lot of grief.
PC is the only cancer that an oncologist specialist is not involved in at day one, and I feel that this is the primary reason for so many reoccurrances and misdiagnosis.
In your case, a good oncologist can guide you concerning a reoccurrance. If you want to get a good idea of how an oncologist works go to prostate pointers p2p and look at the archieves of Dr Strum's posts and ask "was my doctor this through?"
The sad fact is there are only a handful of oncologists that specialize in PC and you may have to travel to see one.
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


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted Yesterday 4:35 PM (GMT -6)   
Mel, when I was diagnosed with cancer, my urologist (surgeon) wouldn't operate on me until I met with an oncologist. My uro said I needed all options and he was a surgeon and was biased toward surgery but I needed to have all the information needed to make a decision. Long story short, I ended up with surgery but was very impressed with the oncologist. If my cancer were to return, I would go straight back to the oncologist. I was very impressed with him and he scared the xxxx out of me. He told me to have surgery because with all the cancer I had I would need to "mop up" the rest with radiation. Well, two years out I am still <.04 and have not needed to pay him a visit. To answer your question, if you want to see an oncologist, you may be in a better frame of mind to talk one now. You do not have a recurrence at this point (and may never). As some have said on this site, knowledge is power.
 
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted Yesterday 5:37 PM (GMT -6)   
Interesting responses. When I first got dx., I went to the Umich Comprehensive Cancer Center, They had me scheduled to see a surgeon, radiation oncologist, and a medical oncologist. I researched all of them and they all seemed to have stellar reputations.
 
After spending most of the day seeing the first two, the secretary for the third came out to see us. She said Dr. Hassein would be pleased to see us, but if you have no further questions and you know what you are going to do, you don't have to see her.
 
Well, at that time I had spent a month getting information. We were tired an on information overload. It was also extremely clear that for me with my biopsy results, the best move would be the robotic surgery. We chose to go home at that point. In all honesty, I don't regret that decision. Our focus was on what treatment to utilize and we had that decision made.
 
But I think at this juncture, I probably should consult with a medical oncologist. I'm sure if my PSA taken today is bad news, that will give me a new sense of urgency. If it is good news, it might have the reverse effect.
 
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.


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted Today 12:02 AM (GMT 0)   

Mel, I hope you don't take this the wrong way but this thread reminds me a little of when you first arrived at HW...in what looked to most of us as total panic mode...  I think you're just freaking a bit since your PSA test is due...maybe not and if this is offensive I apologize.

Specifically in answer to your question, I agree with JT.  The first time to visit an oncologist is BEFORE any treatment.  I didn't do that because I hadn't been educated properly by HW!  Hopefully I chose the right treatment plan but if I had it to do over again I would see a PROSTATE oncology specialist pre treatment, not just any medical oncologist.

Having said that I can see no reason for you to see an oncologist now.  If your PSA rises then that's another story but I just don't see the gain on a what-if basis when you're rolling out .01 readings...  But, if you see a significant rise, I would certainly agree that going to a PROSTATE oncologist is the best bet...before getting any additional treatment.

Best of luck and I'm guess you're gonna score another .01 so this will all be academic...LOL...

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted Yesterday 7:12 PM (GMT -6)   
I was obligated by my uro (later surgeon) to see the oncologists before I made a decision. As bad as my biopsy was, the statistics the radiation folks could offer as first line were not what I wanted, and I suspect he knew that already. The rest was the same, if not worse.

It was a $1000 per interview exercise, but at least I knew the paths and the odds.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted Yesterday 7:17 PM (GMT -6)   
Mel, I was hesitant too to answer this thread, but would have to say I feel along the lines of Tud above. You have only had a single post surgery psa, and your reading was good, you just had your second one, and of course, until you get the reading you have no idea. But even if it bumped up a tiny amount, you would still not be in a recurrance situation. I believe in researching, planning ahead, trying to stay a step ahead in the PC game, especially after all my difficulties, but on the other hand, I don't think seeing one now would prove a lot. You have no evidence of recurance, and if you are fortunate, you never will. And if you do, then you will have to deal with making a secondary treatment choice, which in most likely hood, have to be some form of radiation. Not quite sure where you are really going with this.

And no disrespect intended with my answer here. Been a rough and painful day for me, so a bit on edge. There's a time and place for proper worry in our journeys, in my opinion, I don't think right now you need to be thinking along these lines.

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 - 31 days, 5/24 put in Cath #17


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted Yesterday 10:06 PM (GMT -6)   
Tud and Purg:
 
No offense taken whatsoever. I'm sure my nervousness is fueling these posts, although I think the subject question is a good one.
 
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.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted Today 5:31 AM (GMT -6)   
Mel, as always, you ask good questions (albeit a bit early in the game for you). As John T stated, seeing a prostate oncologist at diagnosis - as well as a surgeon and radiation oncologist - should be part of the decision-making process for all PCa patients. Unfortunately, prostate oncologists are not all that easy to come by.

I guess no one can really answer your question since your situation does not warrant an oncologist. However, if you feel that there are questions you need answers to that could only come from a PCa oncologist, then make the appointment and go as long as you're willing to accept the possibilility that speaking with an oncologist might just create more anxiety (e.g., more questions than there are answers to).

You are still at the beginning of your journey ... PSA anxiety will be part of your life from now on. But, at least in my case, it gets easier to deal with with every "zero" that comes in. None of us is immune from the worry about what the next test might tell us.
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!


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted Today 11:02 AM (GMT -6)   
I was able to talk with an oncologist in his kitchen after he pulled up my info on-line from the clinic using his wife's lap top. It was interesting to get his perspective as sort of an after dinner what do you think. Not being a surgeon and not specializing in PC his recommendation was radiation. I chose differently which he as grudgingly come to accept. I hope I never have to see him officially.
Diagnosed at 54
PSA 8.7 Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7 Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09 Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5 T3b
Catheter out at 2 weeks no nighttime incontinence Pad free week 5
PSA 6/6/09 <0.1; 9/10/09 <0.1; 3/11/10 <0.1


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted Today 3:34 PM (GMT -6)   
I am a bit confused, you want to see an oncologist as a proactive step "in case" you need him/her in the future ?

I suppose you could ask them "what if" questions, but then again you can do that with any specialist for any part of ones body, not sure what peace of mind that gives you
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted Today 3:37 PM (GMT -6)   
Mel,
 
Thanks for asking the question ... it had been going through my mind too! (Whats the next step and who do I see if my PSA rises?)
 
Nothing wrong with being prepared.
 
I've learned from the responses ... very informative.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy -  Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
70 gram prostate.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


midi
Regular Member


Date Joined Apr 2010
Total Posts : 122
   Posted Today 4:45 PM (GMT -6)   
I saw a Medical Onocologist yesterday and he really put my mind at ease regarding my chances for the future. I am of couse so far gone that I am on HT and was having a lot of pain over the weekend but he said that means the medicine is working and shrinking the bone mets and the prostate. Mentioned pain should go away soon and I do feel less today.

Funny thing is I still have to self-cath but going on my own some but last night at 4 am was surprised and woke up with an erection and tried to have sex but was unable to orgasm - thought maybe any kind of sex at all was impossible while on the Lupron treatment but thought I would try it anyways.

Well I woke up this morning having to pee real bad but just got dribbles sitting on the toilet (before I had an OK but not great stream). Had to self-cath then and already 4 times today. Did I mess something up by trying to have sex? Or will the Casodex & Lupron treatment help me get back to where I was?

I'm trying to have to aviod a Turp but the Uro says that still might be a possibilty down the road some....thanks guys!


White Male 55 otherwise healthy until this year :-(
 
January PSA: 17.4
March PSA: 36.8
 
Cipro: three weeks
Macrobid: one week
Levaquin: 10 days
 
Cystoscopy: April 19th 2010
 
Self-cath still 4-6 times a day
 
PCa Biopsy performed May 17th 2010 100% positive
 
Size: 54 grams
 
Gleason Score 4+5
 
Hospitalized May 30th - June 4th for severe pain/fever & infection.
 
Bone scan on May 31st showed its spread to pelvic area, ribs & sternum.
 
Stage: T4M+
 
Taking 50mg Casodex daily, 5mg Percoset as needed, 1st Eligard shot June 14th!
 
Will I still be a man afterwards? :-(

Post Edited (midi) : 6/22/2010 5:45:11 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted Today 5:01 PM (GMT -6)   
midi, sorry about your continued troubles too, and the need to self cath. My uro decided early on, that I was not a good candidate to do self caths.
As far as your surprise errection, never look a gift boner in the mouth, I think that is the correct expression, certainly shouldn't have harmed anything in trying to work with it. hope things improve for 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 - 31 days, 5/24 put in Cath #17


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted Today 6:52 PM (GMT -6)   
Midi- I had total urinary blockage and drove to emergency room with it all caused by having a $H*#$& load of PCa and terrible stats, diagnosed right after that visit (2002-March), the pain of not be able to rid yourself, is unbearable pressure. Well I must say the FLOMAX worked very well in my case, I cut off the catheter thing myself at home about 8-9 days later even though doc wanted it in longer, I could see I had results. Been good ever since, coupled also with all my treatments and protocols. Don't know if it works that well on everyone, but if needed I would buy it in heart beat (Rx-needed). Oh I drove a stickshift car with this catheter thingy on too, I would say do that at your own risk...not fun. (LOL)

Best to you. Hey midi-aren't you the piano man, I talked to you before and caught the midi thing (midi synthesizer), I  love music and creativity with it. So, give me a little bass with those 88's  (88 keys-on std. piano)
 
Mel, do whatever makes you feel more comfortable right now.  You may do better than you guess.


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 6/22/2010 6:59:34 PM (GMT-6)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted Today 8:09 PM (GMT -6)   

Midi:

 

Nice to hear from you. I was wondering how you were doing! Glad you got some hopeful news.

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.

Second post-op PSA on 6/21/10--0.02--


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 6/23/2010 6:46 AM (GMT -6)   
May I just say to sit back and enjoy life. I made a news years resolution two years ago to STOP watching the news and reading the news paper. I started training for a marathon, reading positive books and listening to postive CD's and Mel I am loving life now more than ever. I still have PCa, it is still a gleason 9, but I refuse to give it any control what so ever over me.
Thanks for writing my friend and please know I care about you and your well being

peace and joy
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

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
Casodex
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
PSA April 16th of 2010 is .16
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
92%
80%
37%
28%

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