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Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/3/2010 9:45 AM (GMT -6)   
 
Well got the latestest PSA and the number is 3.4 up from 2.4 in September not good.
Oncologist feels I should start HT intermittently.  He said I could start now or wait until my next PSA test in January.  Should I wait and get through the holidays then decide on what to do?  The doctor said he does not feel this would be a problem.  He just thinks the way my PSA is going it is going to be at about 10 within 6 months and that was my number.  Although I was hoping it would take years it looks like months.  I just wish somewhere I could find information that actually says HT therapy sooner than later actually is better.  All I find is that you think it is because the PSA is 0 for a while and what you do not know will not hurt you.  However, the cancer is still growing and the survivial time is not different.  Not sure what to do but looks like I need to make a decision my life could depend on it.
 
Jerry1   
Age 71 DX 8/13/08, PSA 4.0 Biopsy 14 samples , 1 positive, Gleason 4+4 - Da Vinci 10/17/08 organ confined, no positive margins or lymph nodes, both nerve bundles taken. Gleason 4+4, PT2A
Cath out 10/29/08 dry 11/19/08
First PSA 3/6/09 >0.1- 3/6/09 0.0, 6/3/09 0.1, 10/15/09 0.3, 12/14/09 0.5. IMRT 1/18/10 First PSA 1.5, 7/8/10 1.9, (not good IMRT a failure)
9/3/10 2.4 next PSA end of Oct

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3996
   Posted 11/3/2010 10:17 AM (GMT -6)   

Jerry -- i am so sorry to hear that.  i'm wishing the very best for you.

ed


age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 11/3/2010 10:18 AM (GMT -6)   
JERRY -whatever you choose to do - have HT now or after the holidays ( which is often stressful enough regardless of PCa) - you have our support.
hugs,
BRONSON & STEVE

p.s. here is a link for those learning about hormone treatment and the various forms - I am still learning about this confusing disease - and the more information we have the better we can battle it ...

www.prostatecancer.ca/PCCN/Prostate-Cancer/Treatment/Hormone-Therapy.aspx

Post Edited (tatt2man) : 11/3/2010 9:23:30 AM (GMT-6)


Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 288
   Posted 11/3/2010 10:38 AM (GMT -6)   
Jerry, sorry about the news. I'm trying to put myself at your decision (which I might be in a while) and wondering what I would do. I've read many reports and opinions, I haven't seen a definitive study yet. This close to the holidays I would opt to wait until after the holidays unless I was being physically pained and the HT would ease it. Your medical oncologist thought it would be fine too.

Our best,
Jake
Dx 8/08 Pre-op psa 4.2, Age 60, 7 of 12 biopsies positive 3+3
DaVinci LRP 11/08, clear margins, - EPE, 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
01/05/10 psa .3, SRT 01/19/10 start 39 sessions 70.2gy, psa @ 6 weeks into IMRT .4
Post SRT psa @ 10 weeks (5/31/2010) .2, @20 weeks (8/20/10) .1 (getting close)

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 11/3/2010 10:42 AM (GMT -6)   

Jerry:

 

I've been following your saga. It seems that you just can't catch a break with this crap. I wish I knew the answer to your question as I've seen arguments both ways.

 

I'd be tempted to wait the 2 months.

Can you get a second opinion via a consultation with some expert? Where are you located?

 

Mel


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/3/2010 12:09 PM (GMT -6)   
Jerry,  Dr. Strum has an informative (and lengthy) article about intermittent HT on the PCRI site.   This link should take you there: http://www.prostate-cancer.org/pcricms/node/199.  The article is about 10 yrs. old but has some good info in it.  His conclusion:

Conclusions

Our IAD2 study concluded that hormone-naïve patients who achieve and maintain a UD-PSA for at least one year during ADT may initiate IAD and anticipate a prolonged off-phase duration. Patients with PSAR and/or who require >= 4 months to reach a testosterone level >=150 ng/dl after ADT is stopped may not require a second cycle of IAD for years. Those with low volume disease requiring ADT in the future appear to have androgen-dependent PC (ADPC) and respond well to subsequent IAD cycles.

I hope this helps.

Carlos


Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, LFPF at 6 wks.,nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/3/2010 12:36 PM (GMT -6)   
 
Thank you all for your support and web site information.  Yes, I have consulted with two other oncologist and both feel HT is the next step, but neither could tell me when to start.
I have no pain, feel good, nothing shows on scans and I am being watched very carefully by my oncologist.  I am a little different because I am a Gleason 8 but also I am 71. I have decided to wait until January then have a serious discussion about HT treatment.  I feel I rushed into SRT knowing with my stats that the cancer was not local but advice from the experts said do it your last chance for a cure.  Well we all know how that turned out.  In the meantime, I am researching everything on can get my hands on regarding when to start HT.   Thank you all again for your thoughts and support.
 
Jerry1
Age 71 DX 8/13/08, PSA 4.0 Biopsy 14 samples , 1 positive, Gleason 4+4 - Da Vinci 10/17/08 organ confined, no positive margins or lymph nodes, both nerve bundles taken. Gleason 4+4, PT2A
Cath out 10/29/08 dry 11/19/08
First PSA 3/6/09 >0.1- 3/6/09 0.0, 6/3/09 0.1, 10/15/09 0.3, 12/14/09 0.5. IMRT 1/18/10 First PSA 1.5, 7/8/10 1.9, (not good IMRT a failure)
9/3/10 2.4 next PSA end of Oct

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 11/3/2010 2:13 PM (GMT -6)   
Jerry sorry to hear that you even have to think about HT right now. Just got my 6 1/2 month PSA today and it is still moving downward, although very slowly. .27 today so we will look at it again in six months and then look at options. Still think you did right by doing the SRT but wish the outcome had been more positive. Enjoy the holidays and keep us posted on any new developments or good books about HT.
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

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/3/2010 2:42 PM (GMT -6)   
Jerry,
 
More power to you.  I don't think 2 months will make any difference in the big scheme of things.
 
Beyond that, it is my logic that waiting too long enables the PC to take root in a bone or organ, and then it has found a food source, and can live without testosterone.  So the sooner I starve it, the better it will be.  That is my long term strategy after IMRT when the day comes.
 
BUT, I still hold strongly to quality of life issues and can change any of my formulated plans if I think I can maintain QOL for a longer period by not doing something.
 
Best of luck, and have a great holiday.  Maybe you could hook up with mel and go on a cruise.
 
Goodlife

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3072
   Posted 11/3/2010 3:04 PM (GMT -6)   
Jerry (which is a great name by the way),

I too am sorry for the latest report.

52 days to Christmas. Always listen to your doctor, but I vote for a good holiday season. Learn all you can and strike back afterwards.

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 11/3/2010 4:17 PM (GMT -6)   
Jerry, sorry about you elevated PSA news. Being a Gleason 8 myself, I've been following your journey. You are faced with a tough decision, if this wasn't the holiday season it would have been a no brainer to start HT but, if I was in your place, I would do the same thing that you chose to do. Good luck.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18 months) undetectable
Latest PSA test (21 months) .005

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/3/2010 4:36 PM (GMT -6)   
jerry, my dear friend, i am so, very sorry to hear about your latest news. really tough break, but all of us, myself included, are here to support you all the way, now and in the future.

david
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 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 11/3/2010 6:28 PM (GMT -6)   
Jerry, Darn I hate this news for you. I think if I were in your shoes I would do the same thing enjoy the hollidays then start the battle again. We all all supporting you in your decision.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/4/2010 9:58 AM (GMT -6)   
Thanks again for the support.  MJ and I had a serious talk last night and I believe we have decided to give HT a try come January, unless by some miracle my PSA goes down.
Like that is going to happen.  I know the way my PSA is moving that if I wait much longer I could be in trouble so I will give it a try.  If I cannot live with the side affects I can always stop but I do not want to give up the battle so soon.
 
My wife spoke with the oncologist yesterday and asked him to be honest regarding what he thinks my future holds.  He was very frank and said no one knows for sure because cancer is different in every person but from his experience he feels since I am very active and strong and did so well with radiation without any side affects, he feels I will respond to intermittent HT very well and that I should be around for many years.  MJ felt much better whether it will turn out that way who knows but for now I will do my best to enjoy ever day.  MJ and I are taking that cruise in April for my birthday and our 10th anniversary it is booked and payed for so hell with PC I am going to have fun.
 
Jerry1  

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 11/4/2010 10:06 AM (GMT -6)   
Missed this thread yesterday Jerry (time zone factors I expect)

Sorry about your news.
Looking at your PSA numbers and the failure or RT I'd say you look like whatever is making the PSA was not in the prostate bed and that suggest that HT could actually be quite effective if you opt for it.

Having fun sounds like the right way to go. (I get badly sea sick mind you so a cruise is not my idea of fun!)

Alf

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 11/4/2010 4:17 PM (GMT -6)   
Jerry,
That's a tough break you've copped. Although you say you feel you rushed into SRT given your stats I certainly wouldn't see it that way. The SRT may have failed but I would have take the same course if I were in your shoes. Organ confined, PT2A with the surgeon being extra cautious in taking both nerve bundles just in case. The only downer was the Gleason 8 pathology. To me SRT on relapse as a final attempt at cure was a no-brainer. On the HRT front, I would not think that delaying starting till next year would make much difference at all -------- may as well have a treatment free holiday break. Most recognise "Snuffy Myers" (he has had the disease for many years) as a major authority on HRT plus other treatments and his book "Beating Prostate Cancer----- Hormonal Therapy and Diet" may be well worth a read.
Have a good break,
Bill
Biopsy

4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007

Post-op

Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct '07 <0.1 undetectable
PSA Jan '08 <0.1 undetectable
PSA April '08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August '08 <0.001 undetectable (disregarded due to lab "misreporting"-----it is not possible for any lab to get a reading of less than .003)

Post-op pathology rechecked by new lab:

Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September '08 <0.01 (new lab)
PSA February 09 <0.01
PSA May '10 <0.01

www.yananow.net/Mentors/BillM2.htm

Never underestimate old people ............ you don't get to be old by being stupid.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/4/2010 5:44 PM (GMT -6)   
Jerry,

Where ae you crusing ? My wife and I are looking at one as well for our 39th.
Goodlife
 
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

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/5/2010 8:33 AM (GMT -6)   
 
Thanks Alf I am an old sailor and love the water luckily my wife also does not get seasick.  However, the ships are so big now you hardly feel any movement, not like when we go fishing here in Fl and get tossed around even on my friends 58 FT boat.
 
Bill thanks for the information think I will get the book and read as much as I can.
 
Goodlife,
 
Going on the brand new ship the Norwegian Epic to the Eastern Carribean booked a Penthouse Suite and this time going in style!
 
Jerry1 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/5/2010 8:52 AM (GMT -6)   
sounds wonderful, jerry. i love ships. crossed the atlantic 3x back in the good old days of real ocean liners. my wife is too afraid of the water part to ever want to be on a cruise.

this will be a good break for you, away from psa and PC, whatever happens there, can simply wait till another time. penthouse suite? how sweet that will be!!! enjoy, enjoy, enjoy.

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 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

teallen
Regular Member


Date Joined Sep 2010
Total Posts : 38
   Posted 11/5/2010 8:55 AM (GMT -6)   
Sorry for your news, stay strong keep yoour head up. Will keep you in our thoughts! That cruise sounds like a great idea! 

Age 42 PSA 7.4 4+4 G8
Davinci Sept.8 2010
No incontinence issues but ED issues
1st post surgery PSA <.008

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 11/5/2010 8:56 AM (GMT -6)   
Jerry,
Since starting my PCa journey 2 years ago I have not been abe to take a vacation. So it is okay when you mention a cruise, a ship and even the Carribean, but when you say Penthouse Suite it feels like someone is rubbing salt in the wound. Have a blast my friend, and hope that you post some pictures of the trip as well.
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

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 11/5/2010 9:37 AM (GMT -6)   
When are you doing the cruise.
 
We are currently in the midst of doing some kitchen renovations but we will be investigating cruises within a week.
 
We have a break in December
 
Mel

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 11/5/2010 11:48 AM (GMT -6)   
Jerry, very sorry about your failed SRT and rising PSA. I hope your enjoy your holiday. Also, I agree you should read Myers book. It gives you some comfort that HT may well be effective against your PCa for a very long time. Our stats are so close it is a little scary. Main differences are age and the fact that I opted for HT with SRT. I have got to tell you that I was concerned about not knowing if SRT was effective or not for over a year because I would be on HT that long, but now I find it a relief. Perhaps I just have my head in the sand, but it is a relief having a long period of time where I can think of myself as possibily being cured. Not having to think about PCa every minute of very day. That was the mode I was in up until I started HT/SRT.
 
HT undoubtably has it's downside, but it may well be managable for you. It is for me. Hopefully it will reduce your daily worry as it did for me. Again, best of luck. Enjoy your trip. BB
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 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.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/5/2010 2:53 PM (GMT -6)   
 
 
Thanks guys for all your support and advice, MJ and I planned this cruise last year for our 10th Anniversary not knowing what was in store for us.  Somehow, I am glad we did since now we have something fun to look forward to instead of just PSA results.  Goods friends are also going so we all should have a great time.  We both love the water and sun (good since we live in Fl) and enjoy cruising.  We are going in April which is also my birthday so we are going to concentrate on celebrating each other and all the good things in life.  My son and his wife and our grandkids are all coming for Thanksgiving so soon we will have some good family time.
 
Thanks again.
 
Jerry1

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/5/2010 3:39 PM (GMT -6)   
Jerry,

It is refreshing to see guys with their head on straight and priorities in order.

God Bless you my friend.

Goodlife
Goodlife
 
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
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