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livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 7/22/2010 11:07 AM (GMT -6)   
Well i went in for my PSA this morning and it came back at .71 which is up from .17 in March just three months ago. Needless to see my doctor was concerned as was I. I suppose the good news is that I stopped HT one year ago before I was resistant which should mean I can go back to that. I have opted to have another PSA test done in 60 days before deciding on treatment. My question to my friends is this, do you think I am making the right decision?
 
peace to all
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%


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 7/22/2010 11:24 AM (GMT -6)   
Dale - sorry to hear the numbers rose for you -I don't know if to expect the rate to continue exponentially - or maybe it is just a blip? - so a two month wait doesn't look too much of a risk -
-maybe a second opinion on the time delay for the next PSA test?
-wishing you all the best.
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night - May 25 - 1 pad during day - 1 pad at night for security (barely needed at all) - stress incontinence at work - lifting trees and shrubs...
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
Next PSA - October 8, 2010 - TBA -
............


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 7/22/2010 11:31 AM (GMT -6)   
Dale I don't know much about the HT, but I remember reading awhile back that Tony said he was going to wait until the PSA reached the 2.0 mark before going back on HT. Based on that only, seems like waiting for another test would be reasonable.

Hang in there Prez....
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009     .06
                   6 month Apr 2009     .06
                   9 month Jul  2009     .08
                 12 month Oct 2009     .09 
                 18 month April 2010   .19


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 7/22/2010 12:03 PM (GMT -6)   
Dale, my only personal experience with HT is the discussions I had with my Onco about my PSA after the IMRT. It was jumping around up to 1.5. Tests showed they found a MET and I am addressing that with the RO today. But in that last meeting with my Onco he said we would hold off discussing the HT scenario for three months and in fact didn't want to do any PSA tests for 3 months.

Good luck man. I guess my only question is "What is your comfort and experience level with your Dr?" Sounds like you guys have a long relationship and if the comfort level is in place, maybe you go with his direction and try not to stress for the next 60 days.

Blessings upon you brother,

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.0---CARRRP --waiting for the next test.
3/22/10 Second Post RAD PSA 1.5 Dammmmnnn stubborn son of a gun
4/19/10 YAHOO PSA dropped to 1.2 Moving in the right direction.
5/7/10 PSA test 1.3 Sodium Fluoride PET Scan & CT SCAN -scheduled
5/20/10 PSA test 1.2 Holding off on future tests for 3 months- single lytic lesion found and scheduling radiation.


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 7/22/2010 1:19 PM (GMT -6)   
Dale, sorry about the rise. Thanks for the update.

The wait, from what little I know, sounds okay ---- but, I'm the last person you'd want to take advice on this from. I'll be watching for an update. Good on you!

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, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 7/22/2010 3:57 PM (GMT -6)   
Thanks for the responses
Sonny you ask if I was comfortable with my doctor and yes I am. I feel lucky to have a doctor that I have such a good relationship with. His advice was to wait and get one more reading under our belt before any major decisions were made. I am happy with that right now.
Les, I have kinda made my personal marker around the 1.5 to 2 range however I was hoping to not have such a huge jump at once. At this rate I will hit that number in Sept. Oh yes I plan on staying the PREZ haha
Bronson you are always a pleasure to hear from thanks for the response
Sheldon your advice is better than you think so don't cut yourself so short.

You guys are awesome

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%


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 7/22/2010 4:03 PM (GMT -6)   
Dale,
Sorry about the rise n your PSA. I don't much about HT but from everything I have read, waiting 2 month for another test sounds like a good idea. I wish you the best.
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
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


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4235
   Posted 7/22/2010 4:12 PM (GMT -6)   
Dale,
Sorry about the rise. I think you are doing the right thing. Please read "A Primer on Prostate Cancer", by Dr Stephen Strum. There is a lot more monitoring and testing to see if the HT is working or it is the right combination. Most doctors give you a shot of Lupron with out any futher evaluation except PSA .
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


Kongo
Regular Member


Date Joined May 2010
Total Posts : 36
   Posted 7/22/2010 4:35 PM (GMT -6)   
Dream,
 
Has your doctor considered the possibility that the Lupron you're on now may have failed to control the generation of testosterone and that he should consider another drug?  For many men, some HT drugs just don't seem to work while others are very effective.  It's not surprising to me that your PSA is rising if your testosterone is going up so quickly.  A rapid rise in testosterone levels could be an indication of a more aggressive form of cancer.  Does your doctor measure dihydrotestosterone?  It is much more powerful in stimulating prostate growth than testosterone but many doctors don't routinely measure it and and it may well be rising too.  From what you have described, the rapid rise in your testosterone level may be a strong indicator that Lupron isn't working for you.
 
It would be interesting to plot the times you started and stopped Casodex and Lupron against your testosterone levels and PSA.  From the data in your signature, it looks as if you reached the lowest PSA about 12-15 months after your IMRT which is reasonable.  Frequently following radiation there is a PSA bounce at about this point before PSA levels decline again to some low level nadir.   If you stopped taking Casodex about that time and switched to Lupron and your testosterone and PSAs began to rise it would make me very suspicious about the efficacy of the Lupron in your situation.   You may wish to discuss with your medical team an alternative mix of drugs in your androgen therapy.
 
I'm certainly not an expert in this area but I studied it during my research before treatment.  Hope you get some answers soon.


============================
Age:  59
Dx:  March 2010
PSA @ Dx:  4.3 (Latest PSA = 2.8 after elimination of dairy)
Gleason:  3+3=6 (confirmed by second pathologist)
Biopsy:  1 of 12 cores contained adenocarcinoma at 15% involvement and no evidence of perineural invasion
DRE: Normal
Stage:  T1c
Bone scan and chest x-rays:  Negative
Prostate Volume: 47 cc
PSA Velocity:  0.19 ng/ml/yr
PSA Density:  0.092 ng/ml/ccm
PSA Doubling Time:  > 10 Years
Treatment Decision:  CyberKnife radiation treatment in June 2010
 
 
 

Post Edited (Kongo) : 7/22/2010 3:38:43 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 7/22/2010 5:17 PM (GMT -6)   
Dale, my friend, I am disapointed for you with this rise, and I think waiting for another reading is sound advice, before re-activating the HT path. No easy answers in your particular journey, so being comfortable enough with your doctor is important at this juncture. I wish you peace of mind and soul in between the PSA readings, I know, easier said than done. We are all here for you. Strength in numbers.

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: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 663
   Posted 7/22/2010 9:05 PM (GMT -6)   
Livin,
I wish you all the best.

Hero

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 7/23/2010 12:40 AM (GMT -6)   
Hi Dale,

I'll kick in my support as well. I like your plan to get one more reading to know where you're at before making big plans.

All the best to you.

Barry
Surgery: Da Vinci; July 31, 2007; 54 on surgery day;
Pathology: PSA: 4.3; Gleason: 3+3=6; T2a; Confined to Prostate;
Post RP PSAs: 09/'07 <0.04; 12/'07 <0.04; 03/'08 <0.04;
06/'08 <0.04; 12/'08 <0.04; 06/'09 =0.06; 09/'09 <0.04; 12/'09 =0.05;
3/'10 <0.04; Latest PSA 6/'10 <0.01


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 7/23/2010 1:03 AM (GMT -6)   
Dale, thanks for the nice comment about my advice, but I know so many here are so much better informed than I when it comes to medical matters I want people, especially new people, to not give my advice, or thoughts, when it comes to medical decisions much weight --- especially when compared to so many others here. This is being realistic. Not modest. I assure you my ego ( Edging God Out) is intact and I'm normally a pretty arrogant know it all.

But still, thanks.

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, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/23/2010 2:02 AM (GMT -6)   
Hi Dale,
You have done remarkably well and I think you have a great path, buddy. .7 is still within range of monitoring. Have you decided what may be the next step? Lot's to choose from. It's been a good year so far with the new options for PCa treatment. We have to take this all one step at a time, but their are so many steps.

I love you buddy, and may the good Lord keep you close. Call anytime if you want to chat...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 7/23/2010 2:33:24 AM (GMT-6)


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 7/23/2010 1:29 PM (GMT -6)   
Tony
I have not considered what to do next, however let's say my PSA goes up in 60 days again I think I will go back to ADT3. It worked in the past and I am sure it will work again. Might be work as long. Honestly I have been so focused on training for a triathlon that I am not up to date on the latest treatment protocols. May I ask what your thoughts would be? The down side to ADT3 is the darn side effects that I now know. Oh well it was not bad being a girl haha.

peace and love to you all
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
I was on Lupron, Casodex, and Avodart for two years with my last shot March 2009. I am currently (7-22-2010) not on any medication.
My Oncology hospital is The Cancer Treatment Center of America in Zion IL
PSA July of 2007 was 16.4
PSA May of 2008 was.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
PSA July 22nd of 2010 is .71
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%


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/23/2010 5:17 PM (GMT -6)   
Dale,
Talk to Zufus about his approach. You may be able to avoid the LHRH downer in the second round. Bob is very familiar with the DES protocol and you can't argue with his success with it. I know it doesn't work for everybody, but you are in terrific shape physically and can do just about anything in the protocols. If I fail, I might go that way. My oncologist, Nick Vogelzang, isn't against it but he said he would like to look at other options too. The good news is that you have lot's of options.

Now that my T levels are back up, it sure is nice being unreasonable again...lol

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 7/23/2010 6:56 PM (GMT -6)   
Hi Dale,

Sorry about the rise. If I have read your dates right you are about three years out from radiation. You may be seeing a "bounce". What did your RO tell you was a good number to stabilize at after radiation? Mine said something around a 1.0 and to expect the PSA to rise after coming off the lupron.

I am researching alternatives to going back on HT and, as Tony recommended, I am looking at DES also. Just seems that all I can find is for vetrinary use. I guess I should bark next time I see the doc. :)

Dale, best to you and keep us informed of progress.
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?

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