A urologist who seems to be really on top of her game

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daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/3/2010 3:52 PM (GMT -6)   
Just had to share this, I went in today for my 2nd post surgical appt with a recent PSA last Thursday. Still at <0.04 (yay)

My Uro came in and just after sharing this good news and a bit of pleasantries suggested I start on statins citing some recent studies showing marked decrease in BCR at 10 years in people taking them. My jaw just about hit the floor, I was going to bring this up after the recent thread on here and some research that the thread inspired. I expected a bit of resistance due to the non-approved use of the drug. When I mentioned this she just shrugged and said she didn't argue with success and due to the low incidence of side effects from the drugs she was all for it, kind of a can't hurt and may very well help attitude.

We also discussed adjuvant rad' she is aware of the numbers from some of the recent studies but since I'm progressing well in continence and function she wanted to hold off for 3 months and discuss it at our next meeting. She did refer me to the local rad oncologist and I have an appt on Thursday just for information. She also said if PSA hit detectable at all (0.05) she would strongly suggest radiation immediately.

All in all life is good, heading to a meeting for another disease I'm lucky enough to have then to a Jeep club meeting all with a smile on my face.

Again thanks all for the information and support.
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 Dr 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, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04 06-07-10 PSA <0.04
05-03-10 1 week without pads

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/3/2010 4:01 PM (GMT -6)   
Dave,
We have a lot in common. Your Gleason is a higher grade, but I had a tad more spread. I decided to include a top line prostate cancer oncologist who over saw my during adjuvant radiation and hormone therapy. We commenced with the adjuvant therapies even though my PSA did creep down to undetectable 45 days after surgery. Some excellent studies on the use of ART after RP. They come out of institutions like Harvard, Stanford and Mayo.

3 and a half years later ~ undetectable...

Good luck to you. Stay well

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

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 8/3/2010 8:02 PM (GMT -6)   
That is good news Dave. If she is located in Durango that is even better news.
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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/3/2010 8:19 PM (GMT -6)   
Sounds like you got a good doctor and getting sound advice.
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 8/4/2010 12:46 PM (GMT -6)   
Nice to read of doctors who are on top and with it --- to many stories of things like your '08 PSA rise being kept from 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
  
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