PSA Draw and Update

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 9:57 AM (GMT -6)   
Just got back from the Uro office.  Had my blood drawn for my 3rd post-SRT PSA test.  Should get results tommorow or Thursday, and as usual, they were instructed to call me and/or leave a message with the results.  It's almost at the point with me, that any PSA test is just now a minor blip or reminder of my PC world.  Once you have done all  the curative treatments, there's no point in sweating it out, because you have done what you can do.  I know we are all different on that point, and depends where you are at in your travels.
 
Sunday, August 1st, marked my 11th month with a continuous suprapubic catheter.  Even I find that incredible to believe.  Originally, it was expected to be in place 3 months tops.  In that department, despite having 3 corrective surgeries since the radiation ended last November, there is no real healing or improvement.  The bladder neck will still keep scarring closed within 2-3 month intervals.  I still experience moderate amounts of penile shaft, rectal, and especially bladder neck pain on a daily basis.
 
Its' been a month since my last corrective surgery, and I most say, that this one caused me the most pain and grief of the lot.  The dr. was shocked at how much radiation related damaged he can see in my lower bladder and bladder neck, both areas that the radiation clinic claimed they weren't targeting, and if IMRT is supposed to be so focused and "aimed", there shouldn't even been much if any "scattering".  So for me, my worse fears about undergoing radiation for a second time in my life came true, and something went very wrong.
 
I meet with my uro/surgeon for a consultation in 2 weeks.  I am sure we will have to have another painful SP tube swap, that will make cath #21 for those that keep score, and will be discussing what my thoughts are about having an urinary diversion surgery.
 
It's still a tough choice to make.  I don't think I want to spend the rest of my life trapped and limited by these caths, SP or Foley, and the pain and spasms related to them.  But, the next surgery is magor with a long recovery time, and another quality of life issue to consider, and that's assuming nothing goes wrong.  I am leaning toward making the decision, I have spent endless hours talking with others that have underwent the same thing at other forumns and sites, and the overhwhelming opinion is that it helped improved the quality of life for most of them.  Its a surgery, that's been done for over 50 years with low complications and risks.  But the thoughts of undergoing another major surgery spooks me a bit.
 
It may be well worth going through another phase/ordeal, especially if ultimately I can return to some semblence of a normal life again.
I was out in my outdoor shed recently, and saw the brand new bicycle that someone gave me a full year ago, and it is sad, I have never ever been able to even sit on the seat, let alone ride it.  Something has to change, my life is whittling away, a day at a time.  Tough decision ahead.
 
The PSA part, I almost don't care at this point, I knew what my percentages were going into SRT, and that will be whatever it is.  If it fails and I have recurrance for a second time, I still do not intend to go through HT, Chemo, or any other form of chemical castrations.  Just a personal thing with me, no reflection on its value for any of my brothers that use those methods every day.  Its all about choices.
 
David in SC
Age: 58, 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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 10:17 AM (GMT -6)   
P.S.

Just added the numbers up. Since my open Sugery in November of 2008, I have spent a total of 147 days on foley catheters, and 307 days without a break on the Suprapubic catheters. There is some overlap in the number of days, because some of the time, was spent with both a foley and SP catheters in at the same time, there were 38 days of having 2 caths in at the same time, an experience I would not wish on my worse enemey (if I had one, lol)

So in round numbers, that's like being on a cath for almost 15 months. So using an average of 10 bladder spasm per day, they would mean I have had to deal with over 4,500 of those nasty events, despite being on meds to help them. Trust me, a good one will still put a tear in the eye no matter how tough you think you are.

Don't mind me, just a bored accountant's mind at work thinking about facts and figures
Age: 58, 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

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 8/3/2010 10:28 AM (GMT -6)   
David,
With what you have been thru it makes me feel ashamed for having "down Days." But I still do, so that is something I am learning to handle. Hope that one day you can get on that bike and ride it straight into the wind. Keep us posted and take care.
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

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 8/3/2010 10:38 AM (GMT -6)   
Hi David,
 
I'm keeping my fingers x'd for a good PSA test result for you. Also, good luck with your next Uro appointment. Thinking of you.
 
Mag

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 days - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09 <0.04; JAN 10 <0.04; Jul 10 <.04

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 10:51 AM (GMT -6)   
Michael, I know that each man here has his own "thorns" of the flesh to deal with, and different twists and turns in their own PC journey. I wouldn't say any one is better or worse than the next guys. Depite all I had researched about PC and PC treatments, even before my dx, I never could have calculated this bizzre never ending painful world I am currently trapped in. I still just do one day at the time, its all I can handle, and still try to never give up hope of better times. Good thing I am a bit of a dreamer by nature, it helps.

Thanks, Mag, my friend
Age: 58, 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

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 8/3/2010 11:49 AM (GMT -6)   
David, you have been a great living lesson in life leadership for me, and that continues. You say "It's all about choices," and you have been able to rise above adversity and pain by making choices and then, moving on.

You are faced with another major choice now, and I have no doubt you'll make the right one. The right one for you, and your family.

I salute you, I wish you well, and I thank you for being such a positive presence in my life.

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
  

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 8/3/2010 1:01 PM (GMT -6)   
David - wishing you on the best for the upcoming PSA test results - you would think we would be through tests and grades after high school or college....
-here's to continued membership in the zero club - and contentment with whatever decision you make regarding the radiation burns and their aftermath.
sincere hugs
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 - June/2010 -have trimix - tried it twice - Aug 2010 -just lacking motivation right now
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 - August 2010 - still at one pad for day and one for night - primarily for hygiene and security - still having good and bad days due to stress and what I have consumed.
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 -
............

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 8/3/2010 3:04 PM (GMT -6)   
Hi David,

Thanks for continuing to update us on your condition and thoughts. It really helps.

You help the rest of us press on!

Here's wishing for great results on the PSA test!

I hope your bike riding days are not too far in the future.

Take care, my friend.

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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 3:13 PM (GMT -6)   
thanks to bronson, barry, and sheldon. no easy decisions in the world of pc, that's for sure
Age: 58, 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

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 8/3/2010 5:11 PM (GMT -6)   
OH PCa Bro. What can I say. I do hope the PSA is where we want it. I know this darn PC stuff has put a turn in life to most of us. Some just a bit others in a big way. Most have been adjustments and just on a positive note. PCa has allowed me to make some wonderful new friends that I now call my PC Bros. Good Luck my firend.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 8/3/2010 6:24 PM (GMT -6)   

David,

You were one of the first HW members that reached out and welcomed me when I joined. You told me I would get through my dx, my treatment choices and cheered me through my treatment and recovery. I won't forget that support.

You've had a difficult road and have some difficult choices coming up. I know you've been researching and weighing all the odds. You'll make the decision that's best for you. 

Know that you have my sincere support and best wishes.

Good luck,

 

Mike

 


-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving. ED oral meds didn't do much initially. TRIMIX was working very well. Initial dose of 0.1 mL too much. Had priapism at 0.075 mL that ended up in a humiliating ER visit. Doses recently after 50% dilution by Uro about 0.025 mL or less. Don't use Trimix anymore...I'm too sensitive to it, even at very low doses and the Alprostadil is pretty consistent in causing erection pain...had a few episodes of 3+ hour wood with pain.
-Levitra now starting to work at low doses of 5 mG to 10 mG. Sometimes the side effects like stuffy nose aren't fun...sometimes OK.
-Was supposed to see ED doc last week, but due to his schedule, will now be late August. Will discuss bimix with him.
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 6:59 PM (GMT -6)   
Thanks so much, Cajun Jeff and Canadian Mike! You are both good friends and fellow brothers of the curse.
Age: 58, 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

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 8/3/2010 7:36 PM (GMT -6)   
 
David,
 
MJ and I are praying for great results on your PSA test.
 
Jerry1
Age 70
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive 12% of sample,
Gleason Score 4+4 =8  Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Post Gleason report  4+4 = 8 Lymph nodes on both sides negative
margins Negative  Stage II (pt2a) 
Cath out on October 29th left in longer due to small leak.
11/19/08 dry no more pads
12/2/08 first PSA <0.1
 3/6/09 6 Month PSA 0.0
6/3/09 9 month  PSA 0.1
7/14/09  PSA still 0.1
10/15/09 PSA 0.3
10/26/09 surgery to remove 3 clips in bladder neck  
11/16/09 PSA 0.3
12/14/09 PSA 0.4 
12/28/09 PSA 0.5
Start salvage radiation treatments on January 18th. 
Finished IMRT
First PSA after 3 mos. 1.5 not good news


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 8:05 PM (GMT -6)   
Thank you Jerry, should know tommorow or the next day at the latest.
Age: 58, 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

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 8/3/2010 9:00 PM (GMT -6)   
David, with what you've been through the PSA would not dare to be other than undetectable. The bloody radiation has temporarily (albeit for a long time) demolished your insides so there would not be much chance of PCa cells surviving that onslaught. Although you have other important fish to fry shortly and decisions to make here is to you hearing some excellent news the next couple of days.
Take care,
Bill
Biopsy

4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007

Post-op

Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct '07 <0.1 undetectable
PSA Jan '08 <0.1 undetectable
PSA April '08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August '08 <0.001 undetectable (disregarded due to lab "misreporting"-----it is not possible for any lab to get a reading of less than .003)

Post-op pathology rechecked by new lab:

Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September '08 <0.01 (new lab)
PSA February 09 <0.01
PSA May '10 <0.01

www.yananow.net/Mentors/BillM2.htm

Never underestimate old people ............ you don't get to be old by being stupid.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/3/2010 9:22 PM (GMT -6)   
billy,

not expecting a rise, not this soon after srt, still trying to enjoy the zero phase, i have never had 2 zeros in a row since i started this journey, so looking forward to the thrill. the other part, just a lot of damage from 7 surgeries now and all that radiation, and yes, will be a tough choice, one i hope i dont have to regret one day, as usual, no guarantees no matter what we choose.

david in sc
Age: 58, 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

rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 8/4/2010 6:20 AM (GMT -6)   
Hoping you get good results today.
 
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

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 8/4/2010 6:40 AM (GMT -6)   
Good luck David. Thinking of you...
Husband's age: 52. We live in Sydney Australia.

In 2007 my husbands PSA level was 2.5.
In Feb 2008 it was 1.7
In Oct 2009 it was 3.67 with a free PSA ratio of 27
In Feb 2010 it was 4.03 with a free PSA ratio of 31.
In June 2010 it was 2.69

DRE normal.
Biopsy 28/4/2010: results, negative for a diagnosis of PC however 3 focal ASAPs on left side of prostate at base, apex and at transition resulting in the conclusion "...small acinar proliferation is suspicious but not diagnostic for prostatic adenocarcinoma."
Review of biopsy by experienced pathologist, results,
1 out of 12 core diagnosed with 10% of Gleason score 3+3 cancer (left transitional)
1 out of 12 cores with ASAP (left apex), suspicious but not diagnostic of cancer

Next steps: Nerve sparing RP on 20th August 2010.

My husband's maternal grandfather died of prostate cancer at 72. His maternal uncle died of prostate cancer at 60. Because he is the third generation to be diagnosed he has hereditary PC.

gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 8/4/2010 7:23 AM (GMT -6)   
David,

Not sure if this would be a possibility......did your doctor ever suggest/mention having a nerve block procedure done?
When my father was in the hospital and they were struggling to find the right drugs to manage the pain he was having in his penis, they considered doing a nerve block procedure of some sort. The anesthesiologist met with him to discuss it, but they ultimately decided against it, as it wasn't a really simple procedure, I guess not an exact science as to which nerves will be numbed and for how long.
But maybe an option?? Just thinking out loud..

Kevin
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.
Ended IMRT and Chemo (Taxotere) late May
Mid-July - pain finally better controlled with Fentanyl patch
Late July - Superpubic Cath. removed, peeing normal again
July 21 - PSA .21

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/4/2010 9:41 AM (GMT -6)   
Thanks you AN, Rob, and Kevin

Kevin, that was discussed once. The problem is with post-radiation damage, there are a lot of nerve endings that get "merged and melted" along with the good one, so they didnt think they could correctly do anything like that. Good idea though.

I find it interesting how the pains can rotate. Somedays, its all rectal pain. Somedays its all bladder neck. Somedays, its all penile shaft pains. And of course, there are days where any two may hurt, or all three at the same time. I usually start out fine when I first wake up. The less I am on my feet, the longer I can last. Just walking through a big store, like Wal-mart, for 10 to 15 minutes, or waiting in a long line at the grocery story, where you are standing in place for a long time, is enough to trigger all 3 pain areas big time. Also the longer I stand, the more it creates those annoying urgency feelings on both ends. Even with a full time catheter, which doesnt leak, I don't dare leave the house without a full pad on, in case I have a bad spasms, which does cause leakage through my penis, even though the cath is bypassing it. Not sure anyone else here has had to wear a pad and a cath at the same time. Been getting a lot of bowel urgency the past month (and that is 8 months past SRT). If I am out, I have to locate every restroom. Sometimes head for the "can" 4-5 times per outing, most times, its a false alarm, sometimes a minor amount of gas, and at others, a "full load". Problem is, I can't tell the difference anymore in these feelings, so to avoid a mess, I go to the bathroom just in case.

It is interesting how some post-radiation problems can take months to develop.

David in SC
Age: 58, 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

gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 8/4/2010 12:46 PM (GMT -6)   
David,

My father did wear a pad at the same time as his SP catheter, as he was getting leaking too. That was what actually prompted him to clamp off and try to pee normally again, which ended up working. He feels that since peeing normally, that has helped reduce the pain in his penis.
If you are leaking, is it worth trying clamping off to try to pee through the penis again? Or does the scar tissue in the bladder neck close it off too much?
The only other think I can think of, if you aren't already doing it, is to take a long acting pain killer, a 'contin'. Or a fentanyl patch. My father was on morphine contin for a while, then dilaudid contin, but it was the fentanyl patch that finally allowed him to get off the dilaudid and morphine, AND be pretty much fully functional and not knocked out. For example, he played 9 holes of golf yesterday!! If someone told me that a month ago, I'd say they were full of it...
Anyway, you shouldn't be sitting in pain every day. Thats what those drugs are for.
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.
Ended IMRT and Chemo (Taxotere) late May
Mid-July - pain finally better controlled with Fentanyl patch
Late July - Superpubic Cath. removed, peeing normal again
July 21 - PSA .21

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/4/2010 3:14 PM (GMT -6)   
kevin, i don't leak a drop through the penis unless i have a major spasms, and even then, its usually a dry spasm and those hurt worse. have never had a leak around the SP cath. I have tried tests, even recently, to plug the cath, and force urination the "normal" way. All it does is cause even more pain, and the effects can last for hours.

i have plenty of pain meds available. but, i live in a state where meds can count the same as a "dui". so i choose most days not to take any prescript meds until i am sure i wont be driving that day anywhere, because if pulled over, i could ruin my license. on days where the pain starts eariler, i take the meds, and just dont drive. or on the weekends when my wife is around, i may take the meds early so she can drive.

most days, fortunately, most of the pains are in the late afternoon and evenings.

as far as the bladder neck, its only been a month and 2 days since the last op, where the surgeon, among other things, re-opened it, i would bet money that it is already 1/3rd to 1/2 closed over by new scarring alreday. that has been the pattern since the start.

thanks for your imput
Age: 58, 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

MistyCoffee
Regular Member


Date Joined Oct 2010
Total Posts : 39
   Posted 10/13/2010 2:43 AM (GMT -6)   
Aloha purgatory,
We are in a somewhat similar position. Urethra EBRT/IMRT damage, severe pain, pain management plus severe nausea, urethra cath's leak badly, the damage seems to be right at the bladder urethra connection. Last week a Suprapubic cath was installed. Day of surgery the pain from the cystoscope was severe, but the next day I was off the pain management program! It is six days of OTC pain med which seems to be working. Still have that small leakage when have BM or draining the bag, bad but only 5 to 10 seconds. I suspect that I'll have the SPC a long time.
I've read a few of your posts. I also have damage to the rectum and anus. Still experimenting with Imodium, have not the right combo yet, still need toilet close by. When I travel for treatment to Oahu, I just do not eat.
My IMRT was Sept/Oct 07, the urethra damage did not show up until April this year. Since the cultures did not show anything, uro sent me to pain management, PM went back to uro and said this is your problem, fix it.
I keep looking at the attached plumbing and wondering can I continue to do this and I'm just starting this journey.
It seems as if my HMO pays the docs to screw us up, then pays the psyh's to unscrew us. Not a good combo. My wife makes a better therapist. Just facing reality is difficult.
Your consideration of corrective surgery, I just don't know. A friend of my had PCa treated by EBRT 10 years ago, 3 yrs ago he was diagnosed with bladder cancer, so now he has only one kidney. Still goes on like a trouper. I wish I had his courage. His PCa has not returned.

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 10/13/2010 5:27 AM (GMT -6)   
<<It is interesting how some post-radiation problems can take months to develop.>>
 
A radiation guy once said to me  "DON'T", it comes back to bite !
I thank God , that it has not been presented as a necessity for me, and nor has chemo..
 
A Radiation Professor, when asked what HE would do with my stats..., said "Do not have radiation - just get cut"
 
and yet - another radiation 'expert' said - it's nothing like by-gone days, when they blew all away
 
Purgatory -  My prayers are with you
 
we are all but 'Dust-of-life'
.
.
 
 
Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/13/2010 6:29 AM (GMT -6)   
David, while I've not posted much I have definitely being following your posts and the latest developments in your recovery process.

I'm not surprised that this surgery has been the toughest on you as it's been the second major operation on your "lower parts". Add to these surgeries the radiation, and you're poor innards have taken a major beating.

When we met with John's urologist right after his diagnosis and reviewed the treatment options, the doctor said you have three choices (in order of his preference): surgery, radiation, and what used to be called watchful waiting. Surgery was his first choice...yes, I now this is because he is a surgeon but knowing him for many years, we truly believe that he had John's best interests at heart. Second choice - radiation - was cited as a good option and one that works well but the long term effects are not fully known or understood. He cited concern over increased risks of certain types of cancer but did caution us that radiation methods used today are much different than what was used say 15 or 20 years ago. So-called watchful waiting was not recommended since John was young (58) and healthy, with a life expectancy of more than 10 years. John knew from the get go that he wanted the surgery, preferably robotic, but if the doctor had suggested open surgery I don't think that would have changed John's decision.

David, I totally understand your decision about further treatments should your PSA not behave. This is a very personal and very difficult decision to make and I applaud you for having the courage to say "no, this is not what I want." I truly do hope that you never again have to face this type of decision...that the radiation destroyed those pesky cancer cells.

Easier said than done but keep your chin up...we're all cheering you on (and some of us are even praying for you...LOL)!
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