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don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 3:11 PM (GMT -6)   
Greetings All:
 
Just got back from my follow up visit with the oncologist. News was not good as my PSA is up to 2.38 from 1.0 six months ago. Will retest in three months but I am not optimistic. We discussed future treatments. Return to HT, chemo, and so on. Don't know if I want to do any of it right now as I feel fine and do not exhibit any symptoms.
 
Any insights or friendly advice?
 
Don

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 3/16/2011 3:45 PM (GMT -6)   
Would you mind posting your stats? That would be helpful.
 
So sorry to read this
 
Mel

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 3:56 PM (GMT -6)   
Mel, I was sorry to hear it too but not unexpected given my original prognosis. Just have to see where it leads. Here is the history and thanks for the commiseration.
 
 
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/16/2011 4:37 PM (GMT -6)   
Sorry to hear that, Don, that's a pretty hefty increase. I am in a similar boat, as my salvage radiation has just recently failed, hope to be talking to a good medical oncologist soon. Wishing you the best no matter what.

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,

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 5:55 PM (GMT -6)   
Thanks, David. I keep up with your postings and know you have had a far rougher journey than I. Just feeling a bit off balance right now. Best to you as well.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/16/2011 5:59 PM (GMT -6)   
Don, I am of the persuaison that there's no such thing as an easy PC ride, some of ours are more complicated and/or troublesone than others. Can I assume additional or different HT is in your near future?
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,

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 6:17 PM (GMT -6)   
David, the options included another round of HT as before. I was not refractory yet. Probably more lupron or similar. The doc also mentioned some "second line" hormones though no more specific than that. I asked about some that I have researched like emcyt and DES. He also discussed, briefly, chemotherapy though my research says this is iffy for PCa. We talked a bit about Provenge but I think that it will ultimately be determined to be snake oil with no benefit not even the marginal benefit claimed. I could go in to a rant about this one but will spare you. (and others)

Right now I am not inclined to restart the HT. Research papers I read on the survival benefit are contradictory, as usual. One says "right thing to do" next one says "no discernable benefit". So, as long as I am feeling OK I may just wait a bit. I talked to a Dr. in Hilton Head (your area of the world) when researching the primary treatment and he does cryo. Said that it could be used as salvage after radiation but things I have read about that are pretty disconcerting also.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3055
   Posted 3/16/2011 6:21 PM (GMT -6)   
Don,

I was recently thrown out of the zero club boat and into a similar boat to you and many others on this board. As you might imagine, I don't like this new boat but it has nothing to do with the company, just need to paddle twice as much to travel half as far.

As a guy, we all just want to fix this thing, but I have yet to find the proper hammer or wrench.

I don't want to, but I'm sure I'll be doing the HT thing. There are other drugs that are coming down the pike that may play a role for us in controlling our PC. (Abiraterone, Provenge, for example...)

Hang in there,
Jerry L.
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
March, 2011 .09

lennybob
Regular Member


Date Joined Dec 2010
Total Posts : 99
   Posted 3/16/2011 6:32 PM (GMT -6)   

Don,

I am sorry for your news. I do not understand this disease. I also do not understand why people react differently to different treatments. None of it makes sense to me. I pray for many people on this forum and I will do the same for you.

God Bless,

Lynn


Age 53...51 when diagnosed.
February/09 PSA 11...GP discoverd during yearly physical...referred to Urologist
Biopsy found cancer, Gleason score of 6.
July 2009...Nerve-Sparing open radical prostatectomy.
Doing very well...only issue is ED and that is getting better.

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 6:47 PM (GMT -6)   
Jerry, I agree with you on the boat. Seems mine just developed a couple of more leaks.
 
Lynn, thank you for the prayers. Very much appreciated.
 
Don

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 3/16/2011 7:44 PM (GMT -6)   
Thanks for the update Don and I know those numbers are not the ones you wanted. Many of us will face the same dilemna and hopefully the outcome will keep us around for a very long time. Glad that you are feeling well as that is helpful.
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
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
Started IMRT Jan. 2010 72gys
7month post SRT PSA .2

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 3/16/2011 7:55 PM (GMT -6)   
Dan I just want you to know to say except hang in there buddy. We are with you and stand by your side.

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
2 year PSA <0.1
Only issue at this time is ED but getting better

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/16/2011 8:27 PM (GMT -6)   
Lennybob- your comment : Don,

I am sorry for your news. I do not understand this disease. I also do not understand why people react differently to different treatments. None of it makes sense to me. I pray for many people on this forum and I will do the same for you.
----------------------------------------------------------------------
The issues are so complex and vast that the current technologies cannot fully define PCa as to which receptors are the problem, some genes can be tested or effected(some still unknown), has 24 variant types of PCa now identified, the DNA of PCa biopsy samples could have different 3 ploidy analysis(chromosomal patterns-best to be found with diploid cell structures). I have posted the evidence of valuable pathology (link herein again), do look at what is in this to get the concept of some of it. Plus, PCa androgen receptors for HT control can change and thus become refractive on the  use of HT therapies, but another drug can enter through a different pathway or type of receptor....freakin complex.  There are a couple of different pathways to effect the PCa, is the good news, Provenge utilizes one of these genes that Bonkhoff is mentioning (is what I ascertain).
I have had very great success on alternative drug that has been working for 6-7 years, when ADT3 showed signs of failing back in 2004-5, it is apparently working on a different pathway and might even match up well with my genetic disorder for the disease. It has astounded me that it has worked this long and still is. This is why the artistry of Dr. Myers and those other celebrity docs as being worthy, they are doing so even without the known pathology that Bonkhoff could help identify. Probably way better if they knew this predictive pathology up front. Dr.Fred Lee has had super success on his uncureable PCa and now still living and around 28-29 yrs. since his diagnosis, used emcyt too. He is off the drug I have heard from insiders too.

Bonkhoff on pathology: http://www.prostapath.org/download/prognostic-predictive-markers.pdf
(this is a huge clue, and is under utilized, but he is the best in the world on this thus far)

Hope this helps you comprehend the how difficult it is to treat it once one has BCR.

Post Edited (zufus) : 3/16/2011 8:38:52 PM (GMT-6)


woodysgirl
Regular Member


Date Joined Jul 2010
Total Posts : 32
   Posted 3/17/2011 7:11 AM (GMT -6)   
Don, sorry to hear of your latest results. Woody's stats are similar to yours and though my interest in your progress is self serving I truly do wish you well. Hormone therapy is a bugger but if that is to be your course, I hope you have many successful years on it. peace to you - susan

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/17/2011 6:55 PM (GMT -6)   
Woodysgirl,

Thanks for the note. I really do not want to do the HT again but will if it works. Best to you and Woody. I will post again after next visit and path ahead is clearer.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10
09/10 1.00
03/11 2.38
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