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