Not Seeing Posts With High Post-Op PSA

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wolfen
New Member


Date Joined Feb 2011
Total Posts : 5
   Posted 2/10/2011 5:04 PM (GMT -6)   
Probably because there is not too much good to say, but who has experience with a 7 PSA six years after removal?  No symptoms, but not too happy.  Any thoughts?

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/10/2011 6:21 PM (GMT -6)   
How often was your PSA being checked since your surgery? What were your readings up until it reached 7? You may not have any symptons, but were you under a doctor's care during this high rise to your current PSA reading? Feel like I am missing some key point of your story. Perhaps you can fill in the blanks.

Welcome aboard, please keep us posted.

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

Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 2/10/2011 6:26 PM (GMT -6)   
Wolfen,

I am only 16+ months out from surgery. At present my PSA is 3.9 as of January 7th. My PSA was never undetectable after surgery. I had SRT four months after surgery and METS radiation at 12 months following surgery.

My PSA test history is in my signature. At present my Onco and I are waiting until May 2011 to do another complete scan to see if there any other METS. This will be one year since my last set of scans.

Sonny
60 years old - PSA 11/07 3.0 PSA 5/09 6.4
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5% positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy
2/23/10 Post IMRT PSA 1.0
3/22/10 PSA 1.5
4/19/10 PSA 1.2
5/22/10 PSA 1.3
8/9/10 Completed Radiation for MET
9/7/10 PSA 2.2
1/5/11 PSA 3.9

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3072
   Posted 2/10/2011 7:02 PM (GMT -6)   
Wolfen,

Welcome to the site. One PSA by itself doesn't really give anyone enough information. What was your PSA after surgery, what other treatments have you had, what is your gleason, etc...
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Robotic Surgery
Jan. 2010 T3b, Gleason 9
Feb. 2010 Adjuvant Radiation

PSA History:
-----------------
Nov. 2009 4.30
Feb. 2010 <.05
May 2010 <.05
Aug. 2010 <.05
Nov. 2010 <.05

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3895
   Posted 2/10/2011 7:37 PM (GMT -6)   
A PSA of 7 six years post surgery means further treatment is necessary...Many of the people who post on this board are in the exact same situation...

Have you been getting regular PSA tests?
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

wolfen
New Member


Date Joined Feb 2011
Total Posts : 5
   Posted 2/11/2011 6:03 AM (GMT -6)   
Gentlemen: I am surprised by the number of responses, and I appreciate them all. One theme I see here is that folks keep very close tabs on their PSA. The other is that they do that in order to determine the point at which further treatment is necessary.

I am 64. My post op PSA was never zero. I was doubling about every 3 months. Approximately 10 months after nerve-sparing surgery, I had chemo. After chemo, the pattern slowed, but then returned. The oncologist said "metastatic in 5 and dead in 10".

I have been getting regular PSA tests, but have not kept a rigid PSA schedule. My post here has been prompted by the move from low numbers to the 4 of November 2009 and the 7 of 2010. The reason for not diligently monitoring every 6 months is what may be important to the thinking here; I do not see myself trying to buy 1 or 2 more years through Lupron. For me, it's a quality of life rather than a quantity issue.

So, you all have helped me formulate the question I really wanted to ask. That is, given my initial post, can anyone point me at data, or offer any insight that tells me how long I have (with no further treatment), and what to expect in the latter stages?

Again, thank you all for the responses.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 2/11/2011 9:12 AM (GMT -6)   
Wolfen, welcome

Did you ever consider or get offerred RT at any point?
Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 496
   Posted 2/11/2011 11:18 AM (GMT -6)   
Wolfen:
I hope I am not treading on sensitive toes in this post. I must say that the oncologist you refer to who predicted "mets in 5, dead in 10 years" Is an unfeeling, incompetent, medically ignorant oaf. I could go on.

wolfen
New Member


Date Joined Feb 2011
Total Posts : 5
   Posted 2/11/2011 11:38 AM (GMT -6)   
Thanks, Guys. I am not sensitive about hearing what the data says, and that was the case here. Granted, pretty blunt, but all my research backs up the data. In fairness, I asked what I should expect once the chemo failed.

As for RT, I have not considered that. The reason I have not is that I have not come to the point at which quantity of life outweighs quality. Again, based on my research, RT can have significant side effects, and it is unclear how much time it buys. In any event, I can't find anything, however, gruesome the side effects, that buys more than 24 to 36 months.

I guess all our points of view are colored by our specific situations. In my case, knowing what I know now, I would not do chemo again. I say that because I lost about 6 months of quality life and a signifcant amount of money to chemo without a significant return.

I am otherwise healthy and active. So, I am just looking for the signal that my active time is done so I can make the appropriate arrangements.

Again, I thank you all for your comments and your insights.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3998
   Posted 2/11/2011 1:24 PM (GMT -6)   
>>I am otherwise healthy and active. So, I am just looking for the signal that my active time is done so I can make the appropriate arrangements<<
 
if your research backs your findings what are you really asking?  good luck to you.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

wolfen
New Member


Date Joined Feb 2011
Total Posts : 5
   Posted 2/11/2011 2:33 PM (GMT -6)   
FB:

It seems that I have put you off without meaning to do so, and that I have been summarily dismissed as a result. My view is not a condemnation of others, nor is it intended to be defeatist or represent a lack of commitment to life. Rather, it is in keeping with my pragmatic view of life.

As to your question, I asked if anyone could tell me, from their experience or that of others they have met here, what the specific sign or signs are that I am nearing the end of my active time. I asked that of this forum because this is the place where I thought I might get some insight. As I said, such insight would be of great help to me in planning for my family.

Wolfen

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3072
   Posted 2/11/2011 3:42 PM (GMT -6)   
Wolfen,

I think you may be the first person I've heard of to go to chemo after RP without trying other therapies. Most do RT, which normally is not that bad...HT...then chemo...and even that's not it....new drugs/vaccines exist that can be used - Provenge, Arbierterone, etc...

I would not buy the fact that HT will only give you a year or 2. Men use HT intermittently all the time with great success.
Nov. 2009 Dx at Age 44
Dec. 2009 DaVinci Robotic Surgery
Jan. 2010 T3b, Gleason 9
Feb. 2010 Adjuvant Radiation

PSA History:
-----------------
Nov. 2009 4.30
Feb. 2010 <.05
May 2010 <.05
Aug. 2010 <.05
Nov. 2010 <.05

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3998
   Posted 2/11/2011 3:57 PM (GMT -6)   
Wolfen -- sorry if i have misinterpreted what you were saying.  my goal is to live as long as i can.  i've been through HT, BT and RT.  it hasn't been pleasant but it's been much better than the alternative.  sorry i can't help you and i'm not going to make any guesses.
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

wolfen
New Member


Date Joined Feb 2011
Total Posts : 5
   Posted 2/11/2011 4:29 PM (GMT -6)   
Jerry L.

I did the chemo because the PC models very closely follows the breast cancer model. There are studies going on that show the same drug impacts PC. Granted, I knew that was not a well-established protocol, but I made an informed decision.

You are the first person I have heard say that HT can be used intermittently with great success, so I would be interested in hearing more about that. All that I can find indicates that PC becomes hormone refractory after 2 to 3 years. That was a part of my decision to go to straight to chemo, i.e., the same place I would have wound up when it became hormone refractory. Again, based on discussion with my urologist and my oncologist, I made an informed decision.

I am certainly not opposed to living longer, gentlemen; I am simply opposed to trying to stretch my life out for a couple of years if I have to live those years miserably. Maybe my ineptitude in this forum environment is keeping me from learning anything. In any event, I continue to appreciate all those who respond.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/11/2011 4:50 PM (GMT -6)   
Wolfen,
I have been here over 4 years and while rare there are some guys who have elevated PSA's after therapy. One such man had a PSA of 8 when he had surgery, and his first post op PSA was 18. His wife posts every now and then here screen name is Myman. But there are others here as well that had detectable PSA's immediately after RP.

Earlier you stated:
"The oncologist said "metastatic in 5 and dead in 10"."

Wolf, you may need a new oncologist if he actually said that. As a moderator here and as a live prostate cancer support group president I cringe every time I hear a doctor put his foot in his mouth. I can name countless cases where a man wearing your shoes, or has even worse indicators has done very well and is still thriving well past that timeframe. In fact we have many such members here. I believe it was almost two years ago when the British government granted compassionate parole to the Lockerbie bomber because they said he would live another 3 months at most with his prostate cancer. Well again that was almost two years ago and he is still alive and living free in Libya. These things are not predictable and this oncologist if he made such a statement is not someone I would want on my team when fighting cancer.

Jerry's comment is correct in saying that chemo should not come before homonal therapies it should come after hormone therapies stop working. There is an exception. There are a few studies being conducted to determine if early or adjuvant chemotherapy is beneficial. But if you are not in such a study and you have not started hormone therapy, then I probably would count the recommendation for chemo when you did it as strike two for this oncologist.

That stated, welcome to the group. We have some very wonderful people here sharing and caring. Peace to you...

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/11/2011 4:53 PM (GMT -6)   
Wolf,
I didn't see your last post until after I hit the post button on my last post.

Intermittent hormone therapy is very common. In fact I am on a HT vacation right now. I am in remission four years out and for much of that 4 years I was on HT. Still doing well and not doing any therapies at this time.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 2/11/2011 7:04 PM (GMT -6)   
Wolfen, get another Oncologist, anyone with an attitude like that, I would not want treating me, the Urologist an Oncologist that are monitoring me, always reassure me that there are lots of ways to treat me if things go suddenly wrong , I would not want someone like that on my side.

There are others here still going after years of PSA rise.

Regards 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 from 30th April 08, until now range- 0.5 to 0.6, I am now 70
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