Noose is tightening

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Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 9/22/2010 2:14 PM (GMT -6)   
Got a bummer of a PSA result:  0.06.
That's worse than I expected. I am also worried about the increasing velocity. See my signature below. At this point, the Ford doctors still maintain:  look at it carefully after 0.10 and consider 0.20 a definite reoccurrence. My next test will be in 3 months.
I have a call in to see if I can get in to see Dr. Hussein, a medical oncologist at Umich. I may also consult again with a radiation oncologist there and our local radiation oncologist.
Some might consider this panicking and/or jumping the gun. That may be the case.
This is very upsetting.
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 2:18 PM (GMT -6)   
Mel, you seem to be one test behind me, as mine is slowly increasing, yet not high enough to trip any alarms. You are getting the same advice as me, wait and see if it hits .10 and .20. I have decided to take that approach, however, I am gonna be getting a Rad oncologist consult set up when I go back to my Urologist Oct. 4, just to talk to them as see what their take is on the whole matter and maybe preplan stuff if I need to . a year ago, before mine started rising slightly, I would have said that you still have statistical zero's, and no really trend upwards, rather it could be lab variance, change in diet, or many other things and not to worry. Now I will just say, there's a possibility you might need to worry, but I still would wait until you see a definite multi-results charting to get too rattled. You have had .01,.02,.06 so far, so there's nothing yet that you can hang your hat on, as far as statistically proving it. I suppose we will both just have to wait for a few more data points and try to not worry too much----yet... smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

Post Edited (James C.) : 9/22/2010 2:24:17 PM (GMT-6)

Veteran Member

Date Joined Jan 2010
Total Posts : 2832
   Posted 9/22/2010 2:24 PM (GMT -6)   
mel -
-sorry that the numbers are upsetting you - it is my understanding that an increase like yours is not a definite reoccurance - but part of how the body readjusts after the fact - and to be concerned when it gets past 0.1 and definitely past 0.2.
-hang in there ....

Age: 55 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: Sept 23, 2010 -TBA

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 9/22/2010 2:43 PM (GMT -6)   
I noticed you seem to be getting a PSA every 5 months? That seems strange as most of us are at 3 or 6 months.
Yeah, I know it's technically not a BCR, but the mathematician in me kind of sees where this is going!
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06

Veteran Member

Date Joined May 2009
Total Posts : 2691
   Posted 9/22/2010 2:45 PM (GMT -6)   

That is why I do ultrasensitive. I want to know long before the .2.

I would bet that Dr. Hussein will recommend adjuvant/salvage therapy. She cites a study partially done at Umich that shows better results the sooner it is started. Her data showed within 4 months of surgery as a key number.

I know how disconcerting this is. I know how I felt when it went from <.01 to .01.

All I can offer is that statistically you still have some favorable odds.

Good luck on the next steps. You know that we are all here with you.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 9/22/2010 2:45 PM (GMT -6)   
I got the local rad. consultation set up for 10/6.
It gets more cumbersome seeing Dr. Hussein as I have to go through some hoops at Umich.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 9/22/2010 2:47 PM (GMT -6)   
Ultra sensitive psa tests can spot reoccurrances 1 or 2 years before the standard test reaches the "magic .2". If 3 or 4 psa tests all have serial increases this is a significant indicator of reoccurrance and you may not want to wait until it reaches .2


64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Veteran Member

Date Joined Jan 2010
Total Posts : 1011
   Posted 9/22/2010 2:48 PM (GMT -6)   
Mel, I very much hope that this is a temporary blip. I believe that it is best to be prepared. I don't think you are jumping the gun with the rad and medical oncologist consults. I think it is the right thing to do at this point. I also would not go 3 months before your next PSA. It is probably due to my own bad experience, which I believe is very unusual. I went from .07 to .28 in 3 months, and then to .5 before I got a shot of Lupron to stop the advance while I waited for SRT to start. Doesn't hurt to be careful. BB
Dx with PC Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
One night in hospital, back to work in 3 weeks

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 9/22/2010 3:18 PM (GMT -6)   
Mel...I had a .06 reading 3 months out from surgery (for comparison) 18 months it was at .19. 24 month test is in a couple of weeks.

So I agree with others, that this is maybe a glimpse of what may be in store for you in the months ahead. You have plenty of time to do you research and get comfortable with what you want to do.

And then again...could be like one of our other members that his PSA went as high as 0.3 and then dropped back below 0.1 a few months later.
This disease is strange and has it's quirks.
You are beating back cancer, so hold your head up with dignity


Signature details in Sticky Post above - page 2

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 9/22/2010 3:40 PM (GMT -6)   
John T:
Well,so far 3 PSA tests. The last 2 are increases. I think if the next one (I probably will wait 3 months but I'm not sure -- if I get to see Dr. Hussein at Umich they may do one at that time) is an increase, that will seal my fate-- on to SRT (although maybe they would do a confirming one a month later).

Regular Member

Date Joined Dec 2009
Total Posts : 345
   Posted 9/22/2010 4:20 PM (GMT -6)   
Sorry to hear about the numbers, I hope it's just a blip for you.
Good luck,

Regular Member

Date Joined Jan 2010
Total Posts : 26
   Posted 9/22/2010 4:20 PM (GMT -6)   
Mel, sorry to see the increase. The engineer in me sees that you are not panicking. Use the early indicators to review your options, see what the docs say, and see how things look with work, scheduling and insurance. Being a couple weeks behind you , I think about this too much. All the best!

Age 59 PSA: 8/09 - 5.7, 10/09 - 6.4, 12/09- 7.2, 2/10 - 7.4
12/09 FreePSA 10%
Biopsy 12/09 3/12 cores positive for 3+3  (10%, 20%, 20%)
Multi-focal Adenocarcinoma 4th core Hi PIN (bonus!)
DREs negative
daVinci  2/9/10 only in Hospital for 25 hrs
Cath out 2/16/10
Path report:
Gleason still 3+3
Benign Margins
Benign Seminal Vesicles
No Extra-Prostatic Ext
No Vascular Invasion
Adenocarcinoma < 5% of Prostate
99.5 % dry at 6 weeks
pills and pump regularly but ED still an issue
Post op PSAs
3/19/10    0.01
4/21/10   <0.01
7/14/10   0.01

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 9/22/2010 6:12 PM (GMT -6)   
mel, sorry to read the news.

remember on your other thread, i said i made my own calculation of what this psa would be, but i wouldn't tell you ahead of time, as i didn't want to jinx you? i had written down .06.

in my experience, i feel that you are on your way to recurrance. you are not there yet, officially, but you are wise to start planning out a course of action, and its not too soon if you can find a good oncologist to at least talk and do some early planning with.

if you keep rising, over the next couple of test periods, and just my opinion, i wouldn't wait for it to even get to .20. with my psa velocity issues, i was told firmly that there would be no gain to waiting, once I moved 3x above .10. Some will be happy to argue that reference point.

good luck, i was hoping to be dead wrong, and hoping you would get a surprising reprieve like Sephie's husband John got that time.

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.

Veteran Member

Date Joined Jan 2010
Total Posts : 2832
   Posted 9/22/2010 6:16 PM (GMT -6)   
MEL - this PSA results was supposed to be in October (bloodwork in Sept) - but I was becoming anxious - so I moved it up a bit and had the bloodwork done last month.
- I don't think PCa has a calendar ...

hang in there
Age: 55 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: Sept 23, 2010 -TBA

Veteran Member

Date Joined Jun 2007
Total Posts : 784
   Posted 9/22/2010 6:21 PM (GMT -6)   
Hi mel, sorry about the rise, it may be just a bump, and the next one may be lower, this sure is a funny disease, how can you explain my psa record? as below, it's a puzzle.

All the best. Mal
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd August 09 0.6
PSA 25th November 09 0.6 (I am now 69)
PSA 18th Jan 10 0.6
PSA 27th July 10 0.6

Veteran Member

Date Joined Sep 2009
Total Posts : 5469
   Posted 9/22/2010 6:57 PM (GMT -6)   
Hope it stabalizes for you, as it seems to be doing for Maldugs, stuff happens all the time both positive and negative. In the big scheme of things,IMO, they are both imposters that swing us this way and that. Its difficult, but transcendable. Its poetry, just let the art wash over you. intentions honorable!!
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

Old Sailor
Regular Member

Date Joined Aug 2009
Total Posts : 207
   Posted 9/22/2010 7:06 PM (GMT -6)   
Mel, I hear you and feel for you because I went through exactly the same thing. Felt like the air taken out of my sails as my psa kept going up after RRP.   My Docs at Mayo said start SRT at .2, NLT .9 for best results.  Don't know if it is any consolation to you but I have read numerous articles saying that positive margins actually gives a better chance of successful SRT because the cancer cells causing the PSA rise are very likely still in the prostate bed. One of those bad news good news things.  Hang in there and try to stay positive.  The Old Sailor
Dx 07/09 Age 67 - 28 core saturation biopsy w/5 positive (2 gleason 8, 2 gleason 7, 1 gleason 6)
RRP 8/13/09 Mayo Clinic Jacksonville

Path report upgraded gleason to 4+5=9

Negative margins/extraprostatic extension/seminal vessicles/ lymph nodes but perineural invasion present.

Two month post surgery PSA 0.022

Five month post surgery PSA 0.081

Seven month post surgery PSA 0.190

Eight month post surgery PSA 0.217

Started 38 sessions IMRT at Mayo Jacksonville on 4/12/10, completed 6/4/10. Few side effects except urinary urgency and frequency during the day and some rectal discomfort near the end of therapy.

Veteran Member

Date Joined Apr 2008
Total Posts : 1131
   Posted 9/22/2010 7:08 PM (GMT -6)   
I am sorry to hear the news. I am in the camp that does not believe you are jumping the gun. You are receiving good information and hope you have a good meeting with the doctor.
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

Veteran Member

Date Joined Oct 2006
Total Posts : 1210
   Posted 9/22/2010 8:15 PM (GMT -6)   
Hi Mel. Sorry to hear that your PSA is misbehaving a bit. I went through
the same thing about 2 years ago, so I know that horrible feeling. Perhaps it's
just a bump in the reading, but it is probably not a bad idea to consult with a
radiation pro so that you are prepared should the need arise. I guess I'm one of he few guys here that believes to hit the bad cells early (I had SRT at PSA=.1
after 3 consecutive increases), had few side effects and the result thus far
looks promissing.
Anyway, Mel, hope your last PSA reading was only a bump and that the next one will be lower again.
All the best to you.

Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 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; at SRT Start=0.1, Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jul 10) <.04

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 9/22/2010 9:05 PM (GMT -6)   
Does proton radiation have any advantages over photon radiation for potential recurrence?

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 9/23/2010 8:17 AM (GMT -6)   
Sorry about the higher PSA reading. I'm glad you are seeing and Oncologist and taking charge early rather than late.
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 9/23/2010 8:21 AM (GMT -6)   
Mel, you certainly had a good intuition about this situation. Have you considered high dose vitamin C rather than radiation? This may be a good window to cleanse the body and blitize yourself with super foods. It can't hurt.

Still waiting on my PSA done Sept. 15th.

Regular Member

Date Joined Dec 2008
Total Posts : 235
   Posted 9/23/2010 9:17 AM (GMT -6)   

The whole zero-club is behind you. Come back. We want you back.

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 9/23/2010 11:12 AM (GMT -6)   
Technically, I'm still in the zero club-- but we know better!
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