New PSA back not good news

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Regular Member

Date Joined Mar 2007
Total Posts : 460
   Posted 9/3/2010 8:56 AM (GMT -6)   
Well met with the oncolgist yesterday and had my PSA done again, the  last one was July 8th and it was 1.9 well today I got a call and it is now 2.4 the doctor said my doubling time is about 3.5 months.  We discussed treatment yesterday and he knows how I feel about HT treatment but he said if it keeps rising at this level we need to look in to starting treatment in 6 to 9 months.  He said he would try intermitten treatment where I stay on for about 9 months then go off until it rises again.  I guess nothing is going to slow it at this point except a miracle but I think I am fresh out of them.  He said it is not critical at this point to make a decision but we need to watch it closely. 
Well he certainly did not make my weekend but I guess I have a lot of thinking to do over the next two months my nect PSA is scheduled for September I still feel I should wait until my PSA goes to 10 but what do I know, the way it is going that will not be long.   I still think if I feel good why make myself sick.
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

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 9/3/2010 9:11 AM (GMT -6)   
Jerry, I was saddened by your post. I am sure you were not surprised with the rise. I kind of know your feelings on the subject, so I know you have a lot of serious and deep thinking ahead of you. Hope you got a good medical oncologist that you trust and can work with. I am behind you, my friend, no matter what you choose to do, or more importantly, choose not to do.

Perhaps some kind of "mental break" or holiday to take a rest from the subject and give you a chance to clear your head for a bit.

My very best to you,

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
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 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Regular Member

Date Joined Aug 2009
Total Posts : 284
   Posted 9/3/2010 9:13 AM (GMT -6)   
Jerry, this is tough news going into the weekend but as you say, you feel good so do the best you can to push out of your mind until you need to make a decision. There are many years of tennis games in your future.

Our best to you,
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 clear margins, no extraprostatic extension, vascular or perineural. Gleason 3+4=7, 5-10% of 4.
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, SRT 01/19/10 started 39 sessions 70.2gy, psa 6 weeks into salvage IMRT up to .4
Post SRT psa at 10 weeks (5/31/2010) down to .2, @20 weeks (8/20/10) .1 (getting close)

Regular Member

Date Joined Mar 2007
Total Posts : 460
   Posted 9/3/2010 9:28 AM (GMT -6)   
Thanks David and Jake for your support.  I was not surprised by the reading, MJ is very upset but I told her it is what it is and there is nothing I can do about it.  I feel good and hope to keep feeling this way for a long time.

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 9/3/2010 2:00 PM (GMT -6)   
Jerry, Sorry about the rising PSA. At this point HT is the one option remaining, there are many who have traveled that road and who are doing well. Don't let the side effects stop you. Good luck.
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

Red Nighthawk
Regular Member

Date Joined Oct 2009
Total Posts : 289
   Posted 9/3/2010 4:21 PM (GMT -6)   
Jerry, I am sorry to read your post. I agree with Ed above. You'll get through this. Please email me. (I hope this is allowed.)
Age: 62
Pre-op PSA: 4.1
Post-op pathology:
Gleason grade: 3+4=7, present in both lobes, at least 1.1 cm, and occupying less than 5% of prostate by volume. pT2c NX MX
No lymphatic/vascular invasion present.
Seminal vesicles and extraprostatic soft tissue free of tumor.
Inked margins are free of tumor.
High grade prostatic intraepithelial neoplasia is present
Robotic RP: Sept. 15th, 2009 1 day in hospital, cath out on 9th day
Post-op PSA: at 4 weeks ---> .04
at three month intervals -> .03; .02 .05 (darn it!)
ED: Improvement is very slow but there are positive signs. Doc has NOT put me on ED drugs yet but I am starting to anyhow.

Surgery: Dr. Jim Hu. Brigham & Women's Hospital, Boston

Veteran Member

Date Joined Jan 2009
Total Posts : 2211
   Posted 9/3/2010 5:33 PM (GMT -6)   
Thanks for updating us and I know the numbers are not what you wanted. Your positive attitiude is great and keep us posted. Enjoy the heck out of Fall up there and shoot us a photo or two.
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

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 9/6/2010 7:28 AM (GMT -6)   
The one thing we all dread is the rising PSA. I to am battling that right now and get my next test Sept 24th. I agree with your doctor and you that you should wait as long as possible prior to starting HT. I do not know the number you should start so if 10 is what you think then go with it. There are so many rules of thought on this and not sure which ones are right or wrong. Stay positive my friend and please keep us posted as to how you are doing and what you decide.

peace to you
My PSA at diagnosis was 16.3
age 47 (current)

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

Regular Member

Date Joined Mar 2007
Total Posts : 460
   Posted 9/6/2010 7:41 AM (GMT -6)   
thank you all for your support and advice I have been doing a lot of reseach and it seems the only answer is HT.  My doctor told MJ that if I do nothing and the PSA continues to rise like it has been avg like span 1 year to 18 months and to her that is not acceptable. 
Has anyone had their PSA rise like mine after SRT then have it level off without HT?
Jerry 1

Regular Member

Date Joined Aug 2010
Total Posts : 154
   Posted 9/6/2010 9:02 AM (GMT -6)   
Jerry 1
I don't think you have a clear understanding of HT and how it works, and when to use it. I would recommend you obtain a copy of "A Primer on Prostate Cancer, The Empowered Patient's Guide", written by Dr. Stephen B. Strum and Donna Pogliano. Dr. Strum is one of the top Oncologist, known world wide, for his 40 years of treating PC. He is a very stong advocate for HT, when one is facing rising numbers, and clearly explains what should be done, when to start it, and why.
Rising numbers can mean only one thing, so why not put it back into remission before it gets out of hand? Its nothing to panic about, you just start a new treatment and go on with life. Personally, I would never wait for a 10 to start, especially with your DT, but I understand that one must make up ones own mind. My goals are to just suggest credable information to add to ones current knowledge of the process of PC. Good luck.......
PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. Gleason 4+5=9, Staged pT3c N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09, 0.30 4/10, 8/10 0.71. Will start ADT3 after PSA reaches 1.2.
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