First Post SRT result just in. Comments?

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BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 9:25 AM (GMT -6)   
Hi Folks.. good thoughts to each of you.
 
Had RRP May 2010. Post Gleason = 4+-3 w/titiary 5.
 
PSA
8/10 = <0.1
9/10 = 0.13
12/10 = 0.14
Jan-Feb SRT.
 
Just received 1st post SRT results:  <0.1
I'll find out more on Wed at my appt.
 
*I guess I have to assume that ANY psa drop will always be good news?
 
*Would I be correct in assuming that such a drop after SRT is an indication that at least some (and perhaps all) of the remaining pca cells were still in the prostate bed, and that SRT was indeed the move for me to make, in spite of it's side effects?
 
I'd appreciate the thoughts on this...
 
 
Hoping today brings something better to each of you. Bob on Cape.
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/7/2011 9:42 AM (GMT -6)   
That is an excellent first post-SRT reading, and a substantial drop. That's a good early sign. Congrats.

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 2/11 1.24
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 9/10,

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 9:51 AM (GMT -6)   
Thanks Dave.

I'm wondering, this test had to be sent out as my Rad Onc and I decided we'd do ultra psa test - post SRT.

Yet his nurse says she read it right from the result, "LESS THAN ZERO POINT 1".

Shouldn't I expect more specificity from an ultra.. another decimal... like 0.05 or something?

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/7/2011 10:35 AM (GMT -6)   
Sounds like they did the wrong test. My doctor insists that all post-SRT tests be the x.xx variety, not the x.x.

For now, it still gives you a good reading, but if you started creeping up in the future, the x.xx would be more useful.
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 2/11 1.24
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 9/10,

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 3/7/2011 10:47 AM (GMT -6)   
Sounds like good news.
perhaps if we wait till after your appointlent you'll have a few more details to help us comment on the bigger picture.

I too just got classified as <0.1 after SRT, but my hsopital only tests to X.X not X.XX, so I'm surprised that with you they have switched between one and two decimals.

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

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 11:19 AM (GMT -6)   
Well this confusion simply shouldnt be allowed to take place. We are talking people's lives here, that's the WHY you (all of us) are reading this at this very moment our life!

Rad Onc and I agreee we do ultra post srt.
The lab at the hospital, I have to remind them it's an "ULTRA".
I know from last time it had to be sent out for the ultra.
Almost as if they dont fully get the distinction. AND ITS A PRESCIPTION.

When I call today the rad unit nurse says "well you'll be meeting with him Wed".. As if 'whats the hurry with getting the result.. you'll see him in a few days".

She WAS and IS nice, dont get me wrong..

But it just sems to me that if I were a woman calling about my Breast Cancer test results, these medical staff members would appreciate the gravity of that information to the patient, whereas i'm not feeling it in my case.

They seem kind of casual with things that are basically the scorecard of my life. That psa result, that EXACT psa result matters to me! A LOT!

One year ago this month I was told I had cancer, out of nowhere, just living my life, 51 years old. Last May i've got a robot removing or permenantly effecting much of my sexual and plumbing devices, during a very inconvenient operation.

Then i'm told the pca was aggressive and has escaped the prostate. Failed surgery. For naught. Then the psa starts to rise again.

Off to a radiation chamber where they drill you with poSion that is geiong to mess even more with everything below the belt - AND above the shoulders.

So now it's results time, PSA time, the "WHY" in why someone willinginly swallows 66 gys of radioactivty.

So I call to get the results because me and my wife cant stand it any more, and they mention how i'd be seeing the dr in a few days anyway. I remind her that it's a rather important result to me, and she says "that's ok, I don't mind". I just don't think they understand. BUT they should be trained to!

THIS IS NOT A FRIGGEN GAME.

How do I have confidence in a result where we had to remind ALL THE PLAYERS along the change that it was an "Ultra" sensitive psa test. And thay come back with a result that says "LESS THAN 0.1".

Somthings got to change.

Post Edited (BobCape) : 3/7/2011 9:22:40 AM (GMT-7)


tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 3/7/2011 11:20 AM (GMT -6)   
Bob:
This is indeed good news. It is actually the VERY BEST POSSIBLE news.Less than the lowest possible range for the assay. How does that feel? Pretty darn good, eh?

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/7/2011 11:28 AM (GMT -6)   
Hi Tar..

It IS good news as best I can tell.. but as I mention above, when I can't have confidence in the people, or the test, it's hard to trust the test results.

I had two tests a week apart prior to srt.

.20 using standard at Boston med Center.
.14 using ultra out of Cape Cod.

They explained to me it was the .20 rounding off.

I'm concerned that many of the people on this site are more in tune with the importants and relevance of the "details" than many of the support staff at some of these medical facilities.

I dont suggest they are "bad" or "wrong".. Only that there may be a need to train some of them better with the nuances of pca, and that psa test. I dunno.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3996
   Posted 3/7/2011 11:38 AM (GMT -6)   
Bob -- post RP and SRT i just don't see the benefit of the ultrasensitive test.  but i know that's not the issue here.  try to relax until you see your doctor.  your result sounds excellent to me.
 
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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 3/7/2011 12:47 PM (GMT -6)   
My R-Doc was not interested in doing a post-treatment PSA test for 6 months. "It takes time for radiation to work" he said...I replied "I would like to do a PSA and "T" test now just to see where I stand right now, to get a baseline..Yes, that's a good idea he said, and wrote the script for the tests, which came back 0.0 and 6.. "See you in 6 months and call me if you have any problems"...So far, life is good...
Age 68.
PSA age 55: 3.5, DRE normal.
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 3rd 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. 2-15-'11 PSA 0.0

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/7/2011 3:16 PM (GMT -6)   
ed,

if a person didnt have to worry about bcr after surgery and/or srt, one wouldn't need x.xx testing. but since it can and does happen, it can make a big difference seeing a pattern that is truly rising.

now for those guys, that worry to death because their .005 rose to .006 in 3 months, i see your point, or if a .01 in six months becomes a .02, that's a lot of needless worry.

but for those that will have surgical or srt failure, those ultrasenstive number can be a big deal, as it can show an earlier arrival of bcr, so that you can be making plans sooner rather than later.

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 2/11 1.24
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 9/10,

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3996
   Posted 3/7/2011 3:44 PM (GMT -6)   
>>but for those that will have surgical or srt failure, those ultrasenstive number can be a big deal, as it can show an earlier arrival of bcr, so that you can be making plans sooner rather than later.<<
 
what plans?  when to start HT? 
 
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

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/7/2011 6:12 PM (GMT -6)   
Good job, Bob,
You can't do any better than undetectable. i personally am not the biggest fan of ultra sensitive tests. Still it is a preference of the doctors of patients and if it is desired then get it done...

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 ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 3/8/2011 5:37 AM (GMT -6)   
Congratulations Bob,

At the minimum your PSA has dropped by a third from .14 to just under 0.1 (and it might have dropped much more than that). That is GREAT news when considering its such a short time!

Congratulations!

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03|Feb10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01|Feb10 – 0.01

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/8/2011 11:13 AM (GMT -6)   
Bob, really good rant. I understand how you feel about others not having the same urgency or appreciation that we do for psa results. I like it when people let their thoughts out, it helps a great deal emotionally, I think. Congrats for the low psa results, by the way... wink
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 12/10-.09, 02/11-.08
ED-total-Bimix 30cc

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 3/8/2011 11:47 AM (GMT -6)   
Thanks to all, it is felt and appreciated.

p.s. Sorry for the spelling, more a case of getting older quickly and ALSO having my eye sight start to go north.
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