Prostate Cancer Growth Rates

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BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 9/26/2010 5:09 AM (GMT -6)   
Jan-2010 - TRUS Bx DX - AdenoCarcinoma T1c - Geeson(3+3)=6 , 5 & 45% max., Left MidZone
May-2010 - Post Op. Gleeson(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
 
How does one go from a healthy position to one of having  CANCER ?
This is clearly the $64,000 question.
 
In an article that I read just days ago, there was the claim of the critical damage caused by CT scans.
In another article, I read that every body has cancer cells in it, but the immune system is systematically controlling those cells, however, should that immune system collapse for any reason, then the cancer can get a foot hold and advance to where a functioning immune system can no longer cope.
 
In late 2008 I developed undiagnosed Rhinitis after a respiratory virus, and I cycled through a three month process of lungs being infected, to technical pneumonia, followed by treatment with the strongest anti-biotic (Augmentum-Duo-Forte).
Days after stopping the AB's, the symptoms would restart and the treatment would again commence.
No expert could tell me what was happening, but after 5 cycles of this treatment, the AB's stopped working (surprise, surprise)
In hospital, even more CT Scans and Xrays and even stronger AB's.
Eventually, the true "cause" of the problem was found, and once treated, all the nasty secondary problems disappeared.  I was 'cured'.... rolleyes    So , for a period of three months, I was drowned with the strongest of AB's and irradiated with Xrays.
( 3 CT-Scans and one XRay )

Nine months later, thanks to a random event, I discover that I had PC..  and I start to question "WHY?"
From the clinical information at diagnosis and post-operative, could it be   idea that this cancer developed and got a foot-hold, as a result of the destroyed immune system and the abnormally large number of CT-Scans etc. and all in a period of nine months?
..
.

Nov 09 = First-PSA 5.0 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-2010 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May25-2010 = RRP- Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED-85%, Incont-5%
+17W First 'DRY' day

Post Edited (BuiDoi) : 10/5/2010 2:45:28 PM (GMT-6)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 9/26/2010 6:34 AM (GMT -6)   
I think many of us if not most of us had higher Post Op gleason scores then we did on the initial biopsies. Getting more and different samples is much easier post op. I too went from a 6 to a 7.
Age 55 - 5'11" 215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6
06/25/08 - Da Vinci robotic laparoscopy
05/14/09 - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
Growing old is mandatory; growing up is optional..

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/26/2010 7:00 AM (GMT -6)   
Bui, as Steve mentioned, it is very common for the Gleason score and stage to be upgraded after surgery. Since a biopsy is just a sampling of the tissue, it's not a definitive test and sometimes is just a best guess at what's going on.

Your stage at biopsy - T1c - is pretty standard (that's what my husband's PCa was staged at). After surgery, he was upstaged to a T3a due to extraprostectic extension (all margins and seminal vesicles were clean).

Your signature doesn't state your PSA history...you mention a PSA of 5.0 leading to a biopsy. Was your PSA tested before and was it trending upward?

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 9/26/2010 11:20 AM (GMT -6)   
Prostate cancer takes about 10 years to grow from a cell to a visible tumor. It is very improbable that the CT scans caused or made your cance grow faster. The most probable reason is that your biopsy missed the higher grade and this happens about 30-35% of the time. The imune system does a very good job controlling the small population of cancer cells that are roaming in your blood stream. It is when the population gets high that it overwhelms the imune system and gets a foothold somewhere and continues to grow.
JT

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.

JohnT


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 9/26/2010 11:58 AM (GMT -6)   
Your PSA was 5.0 a year before your respiratory problem..Chances are, the PC was already there, in it's very beginning stages, years earlier..

Yes, CT scans are not without risk...That risk usually manifests itself 15 or 20 years later if at all...All medical treatment has it's side-effects and trade-offs..

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 9/26/2010 4:58 PM (GMT -6)   

<Your signature doesn't state your PSA history...you mention a PSA of 5.0 leading to a biopsy. Was your PSA tested before and was it trending upward?>

That is another story -- I am unaware of any previous PSA tests during blood tests ! 

I trusted my doctor skull   and never questioned his comments "All's Fine !"

After my doctor retired, I discovered that he only asked for PSA test in regular 'blood tests', when patients displayed symptoms of concern..   No symptom=No PSA = Neanderthal Doctor

It was only the change to a younger doctor, that resulted in a complete blood test and a reading of 5 and a thought that it should be investigated 'just in case'.
So I went from totally unknowing, to a PSA reading of 5 in Nov2009, to a Dx of a T1C, to a radical removal in June2010..

<Prostate cancer takes about 10 years to grow from a cell to a visible tumor.>

I guess that I was hoping for a comment that might suggest that cancer COULD develop to a serious state in (say) 9 Months...   Needless to say, I am fully clear now and we pray that I and all here on HW, can remain that way..!

<Bui, as Steve mentioned, it is very common for the Gleason score and stage to be upgraded after surgery>
Yes - I have noted that it is more common than not...  I am not concerned on that point and thanks..
 
Thanks to all, for your comments..  I suppose that we ALL ask the question  "Buy-Why" ?
If we can put a finger on a possible reason, then we can warn others of possible risks... nono
 
If anyone knows of a range of (PC) cancer growth-rates - it would be still interesting.. 
We all know of those poor souls who have gone from being apparently-healthy to fully dead within six months.
We know that most men will die 'with' PC , but not from it, and then we hear of the 35yo who is dead within 6mths of feeling a twinge..  So, it is clearly evident that PC does not necassarily develop over tens of years.
I suppose that if one could answer my question, then chances are that a wealthy life, would lay ahead for that person!
 
It is just so interesting that my 62yo brother had a PSA-test within months of my Dx, and having had regular PSA's, observed a sudden jump to 5.
With the doctor knowing that kid-brother had been Dx'ed and RRP'ed only weeks previous, he too was TRUS-Bx'ed, and DX'ed with PC and is now, just out of hospital after his RRP.
 
Sydney's Dr. Paul Cozzi is one of the best  !... turn ..
.
 
 

Post Edited (BuiDoi) : 10/5/2010 2:49:45 PM (GMT-6)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 9/26/2010 6:57 PM (GMT -6)   
BuoDoi.
It takes a doubling of 40 times for cancer to go from a cell to death. This is true for prostate cancer as well as other cancers. Except that most other cancers have a doubling time of weeks and PC is usually measured in years. There is no recorded case of its going from zero to death in a year. PSA doubling time is genetically connected to the cancer which means it is determined by the individual characterists of the tumor and does not usually change. High grade aggressive tumors have a doubling time of months and low grade tumors have a doubling time greater than 3 years. That's why a tumor with the characteristics of a 7 year doubling time will never hurt you in your lifetime.
JT

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.

JohnT


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 9/26/2010 6:59 PM (GMT -6)   
Take a look at my PSA history..It still took them three tries to find it, 36 cores total..

Now I also had a touch of BPH which muddies the water and makes the U-docs job more difficult.

You can read HUNDREDS of PC case histories. No two are exactly the same. Most are very different, different numbers, different time frames, different outcomes.
Age 68.
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 age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 9/28/2010 8:34 PM (GMT -6)   

<It takes a doubling of 40 times for cancer to go from a cell to death.>

Not sure about the comment, but fortunately, 'death' is not part of the equation..  Do I assume that this implies  40 lots of doubling (times) to falling of the old twig.. skull

<PSA doubling time is genetically connected to the cancer which means it is determined by the individual characterists of the tumor and does not usually change. High grade aggressive tumors have a doubling time of months...>

I recall the Onc commenting "High Grade", in one discussion, so I presume that it is vaguely possible that at the time of RRP, 14 mths had elapsed from the severe immune-supression, and CT-Scans..

Thanks for your comments, guys.  I am just technically 'interested' in WHY, but not paranoid about it.

.

 

Post Edited (BuiDoi) : 10/5/2010 2:47:58 PM (GMT-6)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 9/29/2010 12:10 PM (GMT -6)   
PCa is caused by an influence to the normal DNA cell structures, problems with the chain maybe a receptor pickups something and alters part of one or more DNA structures. There are actually many receptors to PCa and that is why manipulations with drugs and such can be used at different stages. Your PCa cells DNA ploidy analysis, in its original cancerous DNA may start out as diploid (equal numbers of DNA strands in pairs, just like normal cells...two sets of 23 strands), it can however morph or drop something within a DNA strand and become now an uneven number paired of cells (growthing more out of control)=aneuploid, or further it could get worse to complete random chaos and less controllable by drugs and protocols= teteraploid.

This is why ploidy analysis is of interest to some onco-docs in treating PCa. I cannot say I can explain this clearly and not qualified to elaborate on it, maybe my point is showing you how random and chaotic cancers can become. One of the worst cases of PCa, called small cell PCa can have very lousy prognosis and might not even give off much psa in some cases. One could literally die within one year of being diagnosed with this, have seen such happen. Luckily that one is a rarity among the 24 variants of PCa that have been identified recently. Number one rule in PCa....There are No Rules...said by somebody else, there might be rules but nothing to write in stone and plenty of exceptions and exclusions. My term is it is like the twilight zone, as it seems almost fictional to us all.

Read about ploidy analysis: www.prweb.com/releases/2007/10/prweb564967.htm
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Post Edited (zufus) : 9/29/2010 11:21:53 AM (GMT-6)

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