PSA Number Back - Moving the Wrong Way

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/6/2010 11:12 AM (GMT -6)   
Just got my PSA back, it took  them an extra day, because they wanted to re-test the sample.  This is my 3rd post SRT, and was taken 8 months after radiation ended.  It went from .04 to .06.  The re-test showed the same number each time.  I know the number is still small at this point, but that's still a 50% increase since my last test.  Too early to confirm recurrance again, next test is in early November.  If it has moved up still again, then the SRT failed. 
 
I did not expect an increase at all this time, I figured I would get a grace period of a year or so, before it failed.  I am a big believe in the current thinking about the danger and high risk factor of rapid PSA velocity prior to treatment.  The odds of beating the cancer long term really decrease with PSA velocity working against you.
 
SRT is generally considered effective in 30-40% of patients.  My radiation oncologist, because of the velocity issue, reduced mine to 20-30% effective.  I just thought that I might get a year or two of zero's before seeing any future rise.  Very disapointed, and I know there is nothing I can do until my next test period.  Can hope it will drop again, but I think most folks would realize that's not a likely outcome.
 
I am still weighing out the urinary diversion surgery ahead.  My wife and I had a good talk about it today again.  The pluses still out weigh the negatives.  But, if the cancer is on its way to returning without any curative means left, what's the point in a lot of ways?  So I am still thinking through all my options.
 
I know this remark doesn't win popularity points, but even with this increase, and assuming it ultimately means recurrance again, I still do not have any interest in going the HT route.  Again, my blessings on any brother here who does.  It's just not me, and I can't get it out of my head that its just an expensvie stalling tactic (perhaps I am dead wrong), but that's how I feel.  Just not very good at faking myself out, never have been.
 
I have already spent nearly 2 years with bad quality of life issues with all this catheter nonsense, and the rigors of the radiation I went through, just wouldn't want to make my life even more miserable if its not going to prove anything.
 
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

Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 665
   Posted 8/6/2010 11:26 AM (GMT -6)   
David, I'm sorry that there might be a trend there... but on the bright side, there might not just yet. I figure there is at least a +/-0.03 inaccuracy in the readings (at least I tell myself that).
I believe that you still have admission into the zero club. I'm hoping you're still there when I stroll back in and ask for my bar seat back.
Jeff
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09: 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2
CT scan, bone scan Feb 10 both clear
PSA after, 2010: March, 0.17; April, 0.17; May, 0.24; June, 0.31; July, 0.29; Aug, 0.41
Started salvage IGRT on August 4, plan 72Gy total, 40 doses

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/6/2010 11:29 AM (GMT -6)   
Bounce?
Hang in there...I hate those ultra sensitive tests. You only have what's called "maybe information", at this point...

Again, hang in there...

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

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 8/6/2010 11:46 AM (GMT -6)   
David and Peg, Read you post today at 12:30 PM my time. Called Pat over and we read the post again. No words can experss how dissapointed we are for the two of you today. I know it is a low blow. You already have so many things on your mind. Know that Pat and I are in your corner and if there is anything we can do to help, please let us know.

Your Cajun Friends
Jeff and Pat
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%

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 8/6/2010 11:47 AM (GMT -6)   
David,
I'd hoped you would get better numbers. I would have to fall back to the (mental) defensive position that <0.1 is good if I saw that, but I know an increase is an increase.

I agree on the HT thoughts - had many discussions about it with my Uro/surgeon and the Rad. oncologist, and I was never even close to convinced that the side effects could be anything good for me. The PSA anxiety for me, where I allow it to exist, is to wonder what will happen if I have to face that choice. It would also be my next challenge.

As to the bladder surgery, I could see doing something radical regardless of the PCa prospects. Fix what you can fix, and get some good from it. The PSA is seeing a cloud on the horizon, without knowing in which direction you are looking. There is no way to know which way it will pass.

Hang in there. We're here.

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 8/6/2010 12:04 PM (GMT -6)   
David, this bounce may be statiscial blip, but you of all people don't need this hassle. I'm truly sorry.

You characterize HT as an expensive stalling tactic. So, what's wrong with stalling? One day is one thing, one decade another.

My dad was about three years older than you when he was diagnosed with prostate cancer. (He went to Mayo for dry skin and came back with prostate cancer --- he always loved that story.) He was too far advanced for surgery. He did HT and had his testicles removed. ("What good they are to me at my age, I can't say," he said, "but I gotta tell you it makes me wince!) And, he had many, many great years --- until, in the end, his heart got him. If his heart hadn't got him his uro said he'd have had to live to 130 before the PCa was an issue.

I can understand how, after trying so many things, and again seeming to be faced with a treatment that didn't deliver as hoped, that you'd be inclined to not be keen on yet another which could also give you misery. However, it may also be the answer and the stalling could be 50 years.

You say you're not very good at faking yourself. And, from what I know of you here, I'd say that was an accurate assessment. However, this same 'by the book' honesty also means that when the disappointment and dust settles on this PSA you'll need to keep an open mind on HT for now and if in November HT is really on the table, you'll need to do a full review of not just the minuses, but also the pluses, of HT. HT gave my dad some of the best years of his life. While on HT he traveled the world, was chancellor of the University here, ran his law practice, grew corn and potatoes at his farm, and best of all played endlessly with his grandchildren. For him, stalling was a huge success.

In the meantime you're still an upstanding member of the zero club.

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
  

Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 285
   Posted 8/6/2010 12:05 PM (GMT -6)   
David, sorry you didn't get a conclusive reconfirmation of killing this devil. My RO has mentioned the kill cycle can continue for a year and lower grades take the longest due to being not as abnormal (and therefore doesn't split/die cycle as frequent).

Sure wish we could deal with devils in a serial fashion instead of them ganging up. My impression still is there is a long way from where we are to the possibility of a PCa death.

Our best to you and the rest of the gang,
Jake
Diagnosed 8/2008 Pre-op psa 4.2, Age 60 at dx
7 of 12 biopsies positive 3+3
DaVinci LRP 11/08
Post Op pathology clear margins, confined to prostate, absent extraprostatic extension, vascular or perineural. Gleason 3+4=7, 5-10% of 4 and location in right mid-gland.
3 month psa .1 2/09, 6 month .1 5/09, 9 month .2 8/09
broke ankle bones 6/09
9/21/09 Bone scan clear, psa still .2
11/12/09 chest xray was clear, psa however up to .3,
01/05/10 psa still .3, radiation setup done with tats, 01/19/10 started 39 sessions 70.2gy, psa at 6th week salvage IMRT up to .4
Post SRT psa at 10 weeks (5/31/2010) down to .2

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/6/2010 12:26 PM (GMT -6)   
IM - thanks, still in the zero club, first time I have ever been in more than one reading, so will milk that for whats its worth, lol

Tony - fully realize one number doesnt make a trend, just not a good early sign. what is your opinion on the psa velocity risk factor? not sure i have ever heard you talk about it. in november, the next reading will tell more than this one. no way to draw a conclusion.

cajun jeff - i know without a doubt that you and pat have my back, appreciate you guys always. peggy was most disapointed.

142 - yeah, i am a side effect person, if there is some remote chance of a weird one, i always end up in that group, lol. so if HT comes with a lot of potential side effects, i would probably get them all. yes, the urinary fix could still get me off the caths and allow me to do a lot of physical things that i havent been able to do. i am keeping that decision seperate from the PSA situation.

sheldon, thanks as usual. your post was a good read. will keep the tone of it in the back of my mind for future reference. i am coming up on the 2 year mark of my original PC dx. I would have never believed that almost 2 years later, I would have had open surgery, 6 corrective surgeries, and 2 months of radiation, and being on my 20th catheter still needing prescription pain meds every single day, with an appearent still rising psa number. would not have believed my entire life would come to a standstill, and being out of work all this time too. its a lot to take in, brother.

jake, thanks, and dont worry, not picking out my casket yet or burial site. just was very disapointing news
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, 8/6 .06 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

rhb47
Regular Member


Date Joined Mar 2010
Total Posts : 208
   Posted 8/6/2010 12:34 PM (GMT -6)   
Hi David,

I'm really sorry to see one of my favorite people on the forum going thru so much! I also agree with 142 about the bladder surgery-why not fix what you can and hopefully achieve a better quality of life. I'm in the last few days frenzie before my husband, Geoff's surgery but I'll be sending lots of positive thoughts your way.

Renee
Husband diagnosed 3/10
Age 56, PSA 4.7, free 7.6%
Biopsy 5 of 10 cores positve-all right side-25% to 57%
Gleason 6
DaVinci surgery with Dr. Vip Patel scheduled 8/9/10
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/6/2010 1:03 PM (GMT -6)   
Thanks much, Renee
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, 8/6 .06 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

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 8/6/2010 1:10 PM (GMT -6)   
Hi David,
 
Sorry to see this news. Also sorry to see that you will not consider the HT. I agree with Sheldon on this. I was on lupron for two years. Expense roughly $900 per shot X 6 = $5400 over two years. I admit I got a break from my oncologist as these shots typically cost $3000. (no insurance in my case) Quality of life. HT did not keep me from doing anything I would normally do. Hot flashes, body hair loss, no libido, (sex is overrated) and weight gain. It helped me beat this crap back and now is the time to be decisive while it is at low point. Sorry if I come across as preachy or pushy but I would hate to see you let something pass without first trying it. If you find it too much to bear you can always stop.
 
David, I sincerely hope that things turn around for you. I will keep you in my thoughts.
 
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?
PSA 07/14/2010 0.1

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 8/6/2010 1:12 PM (GMT -6)   
 
David,
 
Very sorry to hear your numbers are not where we would like them to be but you are still in the zero club and there is still a chance it could be beause of all the inflamtion from your other procedures.  Mine went from .5 to 1.5 in 4 months and the Doctors were not that excited.  Even though I feel mine cancer is definitely back I still plan on living and fighting for a lot more years.  You know how I feel about HT but you are a young man with a lot of living to do and a family that loves you.  I plan on waiting to consider HT until they find something on a scan then I will deal with it.  Live each day as a gift.
 
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


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 8/6/2010 1:38 PM (GMT -6)   
David

Sorry to hear of the results. Don't blame you one bit for being down about it. In a few days you will feel better and get back onto the more pressing issues. For what it is worth, do consider the HT if and when it becomes necessary. I am sure you have read stories of the pain involved with mets and believe me that is much worse than the side effects of HT. To be honest, I am contiplating skipping the SRT and just wait it out and then go the HT route later on.

Stay strong...it's a battle, just don't give up and lose the war.
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

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 8/6/2010 1:47 PM (GMT -6)   
David,
I'm really sorry that your PSA test didn't come out the way we all hoped it will. There is always the chance that this is just a bounce. Hopefully your next test will show a reduction. As far as the HT, you may want to rethink that if things don't improve.
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

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5828
   Posted 8/6/2010 2:09 PM (GMT -6)   
Just me, I don't see it as bad news, sure it would be better, I suppose if it was the same or lower. I know the whole thing about srt better by .05 and all that according to studies. None of all this take your time before treatment but hurry up after sits well with me. I just don't like to see people suffer QOL issues, that originate in the mind especially on issues that are quite arguable. Perception really isn't reallity, reality is reality, unfortunately we al have troubles defining it. Read Walt Whitman, Ralph waldo emerson. The human Being is quite the powerful force in all things, including cancer, draw your own implications, I have mine and thats the way it should be. Am I going to die of PCA, maybe, am I going to die of something, no maybe's about that. We have to get on top of our own fears and trust God, if you don't believe in God, then trust that inner part of you, that defines your humaness, only the individual knows what that is. I don't mean to ramble. Bottom line, and this does not mean that I don't struggle with this, is I refuse to let forces out side of my control define me. Maybe I AM a Pollyanna!! Aloha!!!
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 8/6/2010 2:38 PM (GMT -6)   

David,

Sorry to hear about the blip upwards as that wasnt something else that you needed on your plate at this time. Not sure how I feel about HT and will cross that bridge when I come to it. Keep us posted. Are you up to a lunch sometime in late August? I go to bed too early to take you to dinner.

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 : 1210
   Posted 8/6/2010 2:41 PM (GMT -6)   
Hi David,
 
I just read the news about your latest PSA test and could hardly believe it. The disappointment is echoing throughout the whole forum. We had all hoped for a somewhat better number. There is still a hope that it maybe just a bounce; the last gasp of the cancer. Should it become necessary in the future to go the HT route, I hope that you will consider that. As you know, several brothers here have gone that way and have been doing well for a long time. As always, the decision of cause is yours and I will respect whatever you choose.
My thoughts are with you.
Wishing you all the best.
 
Your friend,
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

Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 8/6/2010 2:45 PM (GMT -6)   
David, the hits just keep coming don't they. All things considered though, you should just file this one away as still undetectable for a while and spend you energies getting out from under the urinary issues. You need the break and QoL has to take front stage at this point.

You and I have spoken at great length about HT, so I know where you are coming from on that.

Bless you brother,

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
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 -performed
5/20/10 PSA test 1.2 Holding off on future tests for 3 months- single lytic lesion found and scheduling radiation.
7/22/10 PSA test 1.3 - Begin radiation for MET on leg

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 8/6/2010 2:48 PM (GMT -6)   

Hi David,

Maybe it is just a post-RT bounce as a few have suggested. Hope that's what it is and that the next will be lower. There's been a lot written and posted about the more sensitive PSA tests and their value. I don't know enough about that subject yet and I'm not going to try and interpret that here except to ask if maybe the increase is within the realm of measurement error and/or normal fluctuations at those sensitivity levels?

I'm sure you were looking for a lower or unchanged number from the last one...I hope the next test brings that.

Good luck and know you have my best wishes.

Mike

PS: Does chocolate affect PSA? 

 


-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.
 

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/6/2010 2:56 PM (GMT -6)   
David,
Sorry to hear the news. I would urge you take each day as it comes and to keep an open mind. I agree QOL is huge and I will join our other members in supporting you in any decision you make.
Cheers
Dave in Durango CO
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..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/6/2010 3:01 PM (GMT -6)   
Don and Jerry - thanks for your insight on it

Les, I dont disagree with you, but would be nice to see a break in the pattern once in a while

thanks EdC and logo too

michael, on a good day, could be up to lunch for sure, i forgot you were in ATL

thanks mag, appreciate you

sonny, yeah, quality issues right now are worth more to me, sick and tired of being confined to these endless caths

mike, there isnt any bounce with SRT, my rad oncologist made that clear, that only happens to men that use radiation as a primary treatment, and the prostate is left behind, still attempting to produce psa. with srt. it may take a while for the number to go down, but it goes down to a certain lowest level, and should never raise above that if the cancer is gone. chocolate helps my attitude, screw the PSA, lol
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, 8/6 .06 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 : 1131
   Posted 8/6/2010 3:04 PM (GMT -6)   
I have been waiting on your post and wondering why it was taking so long. I am sorry to hear about your #'s and know you have had a tough two years. I have followed your successes and disappointments and know you will make the right call as to next steps. We are here to support you.
 
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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 8/6/2010 3:05 PM (GMT -6)   
"My dad was about three years older than you when he was diagnosed with prostate cancer. (He went to Mayo for dry skin and came back with prostate cancer --- he always loved that story.) He was too far advanced for surgery. He did HT and had his testicles removed. ("What good they are to me at my age, I can't say," he said, "but I gotta tell you it makes me wince!) And, he had many, many great years --- until, in the end, his heart got him. If his heart hadn't got him his uro said he'd have had to live to 130 before the PCa was an issue.

I can understand how, after trying so many things, and again seeming to be faced with a treatment that didn't deliver as hoped, that you'd be inclined to not be keen on yet another which could also give you misery. However, it may also be the answer and the stalling could be 50 years. " <Sleepless>

Dave, don't give up the ship.. Get the plumbing straightened out regardless..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/6/2010 3:15 PM (GMT -6)   
fairwind,

not really giving up the ship. life is about choices, and quality of life issues are very personal and subjective, and you would have to include a person's lifetime of experiences to factor in to.

the plumbing part needs fixing. if this present cath were removed, the pain in urination would be so intense (testing that has shown me that), and my flow would not be good, it and it would only be days or weeks before the bladder neck would swell close and scar back over. this is the results after 6 corrective surgeries, definitely a chronic condition, perhaps in around 2% of prostate surgery guys, and i was the lucky one.

regardless of my long term future, i dont want to spend endless more months with caths, pain, and spasms. so in my mind, its two seperate issues

as far as the HT part, there are guys here (wouldnt be polite to mention names) that have similar feelings about not going down the HT path. i would never encourage or discourage anyone's choice on that. but they understand where i am coming from. and i have equal respect to the brothers that are on that path, and extending their lives on it.

if i were 10-15 years older, i would have a different opinion about it, some of the quality of life issues would be differnt to me. right now, i am one of the fortunate few that didn't even get ED from all I have been through. It's the one thing that works right for me, lol, though i usually am fighting too much pain in the region to enjoy the big "S".
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, 8/6 .06 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

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/6/2010 3:29 PM (GMT -6)   
Dave, somehow chill alittle until you know factually with psa history combined with velocities (plural) and cross the threshold. Other factors could be going on that are only scaring you at this point.
Youth is wasted on the Young-(W.C. Fields)
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