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pk5
Regular Member


Date Joined Jun 2010
Total Posts : 20
   Posted 3/20/2011 8:57 AM (GMT -6)   
I just had another PSA test and this time it's 2.6 up from 0.54 almost four month ago which means an increase of almost 400%.
I had it double checked and it's not a mistake :-(
I understand that PSA can go up and down but 400% in such a short time???????
 
By the way, had a colonoscopy which showed "Radiation proctitis". My thyroid reading is up from 1.09 to 7.01 as well. Don't think there is a connection but thought I would mention it anyway.
 
I have an appointment with the radiation oncologist in a couple of weeks, is there anything I should be asking him?
 
Cheers, and thanks for any help/explanation you can give.
 

Age 61
PSA 6/15/09 4.9
PSA 8/10/09 6.3
Da Vinci 8. Dec 09
Gleason 9, Stage T3b
Evidence of capsular penetration.
Tumor infiltration into the base of Lt. SV.
Negativ margins.
8 lymph nodes submitted showing only reactive changes.
PSA 6 weeks after surgery 0.16
PSA 10 weeks after surgery 0.21
Start Radiation.
PSA 6/11/10 1 month after RT 0.21
PSA 11/23/10 6 month after RT 0.54
PSA 3/16/11 10 month after RT 2.6

Post Edited (pk5) : 3/20/2011 9:14:10 AM (GMT-6)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 3/20/2011 10:28 AM (GMT -6)   
I'm so sorry to read this.
 
It sounds like RT just did not work.
 
Let us know what the oncologist says.
 
I will start my SRT soon.
 
We have similar stats.
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 3/20/2011 10:40 AM (GMT -6)   

Hello friend,

Sorry to hear about your rising PSA.  It is, I believe, time for you to gather some more info on the next steps.  It’s my hope that with Gleason 9 and seminal vesicle invasion (SVI), your doctors have previously indicated that you are at higher risk of progressing and needing additional treatment.  This is what it looks like to me, from my non-MD degreed perspective.

I have a free online link to a document which will help you get “grounded” in what most doctors will be thinking your “next steps” should be.  The National Comprehensive Cancer Network (NCCN) publishes GUIDELINES for treatment of most cancer types and THIS link takes you to the Patient Guide for Prostate Cancer. 

Lots of words in the front of the document, most of which you will already be familiar with, but then jump to the flowchart/”Treatment Pathways” starting on page 44.  From what you described in this thread, your pathway starts on pg44, then jumps to pg47, then to pg49, then to pg51.  You should map out your own pathway, and see if it follows the same steps that I just traced for you (you might have other information not included here that might lead elsewhere).

From pg51 (and pg52), we are talking about systemic treatment and controlling your testosterone in order to further control advancement of your cancer.  Please do read the descriptions on pages 58-59.

 

Depending on how much you’ve already learned over the last several years of your PC journey, this could be repetitive, but I find that it is sometimes helpful to go back to “square one” when embarking down a new pathway.  This GUIDELINE is the “patient version” of the same document that your doctors should also be following.  You will need to find a medical oncologist next, so I would advise searching for one who specialized in the complexities of prostate cancer and don’t settle for a generalist.

 

I hope this helps you, and best wishes…



Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/20/2011 1:07 PM (GMT -6)   
pk5,

i had the same shock recently, after taking a 6 month break from psa testing post salvage radiation, mine increased by
2,000 %. 5x your increase, so yes, its scary. in my case, the doctors decleared that my radiation has failed.

good luck to you

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,

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 3/20/2011 3:07 PM (GMT -6)   
PK
John Hopkins and Partin's findings are that patients with a G8 or greater, detectable psa after surgery, negative margins and positive SVI are much less likely to be cured by salvage radiation because these are indicative of distant mets.
Your best next step is to see an oncologist that specializes in PC, as there is nothing else a radiologist or surgeon can do for you.
Good luck.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

pk5
Regular Member


Date Joined Jun 2010
Total Posts : 20
   Posted 3/22/2011 8:50 AM (GMT -6)   
Thanks guys
Will let you know how I go.
Cheers

Age 61
PSA 6/15/09 4.9
PSA 8/10/09 6.3
Da Vinci 8. Dec 09
Gleason 9, Stage T3b
Evidence of capsular penetration.
Tumor infiltration into the base of Lt. SV.
Negativ margins.
8 lymph nodes submitted showing only reactive changes.
PSA 6 weeks after surgery 0.16
PSA 10 weeks after surgery 0.21
Start Radiation.
PSA 6/11/10 1 month after RT 0.21
PSA 11/23/10 6 month after RT 0.54
PSA 3/16/11 10 month after RT 2.6

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 3/22/2011 9:29 PM (GMT -6)   
PK5, just want you to know that we are all in your corner for you buddy. Do keep us posted.

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

gibson00
Regular Member


Date Joined Nov 2009
Total Posts : 212
   Posted 3/23/2011 5:31 AM (GMT -6)   
Based on your signature, it looks like you have not yet used hormone therapy? I'm guessing that would be your next step. And hormone therapy may hold things back for a -long- time, so don't give up!
Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.
Ended IMRT and Chemo (Taxotere) late May
Mid-July - pain finally better controlled with Fentanyl patch
Late July - Superpubic Cath. removed, peeing normal again
July 21 - PSA .21
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